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Background: The impact of coronavirus disease 2019 extends far beyond the immediate burden on healthcare systems caused by hospitalisation of patients with the disease itself. Objective: To investigate the impact of the coronavirus disease 2019 pandemic on the referral rate of patients to the suspected head and neck cancer two-week-wait clinic. Methods: A multicentre retrospective study was performed investigating data collected for all patients attending the suspected head and neck cancer two-week-wait clinic in ENT departments in the West Midlands. Results: A total of 509 fast-track referrals were received from February to April in 2019, compared to 399 referrals in 2020. April 2020 saw a 62.4 per cent reduction in referral rate compared to April 2019. Conclusion: The coronavirus disease 2019 pandemic has resulted in changes to health-seeking behaviours, and healthcare provision and delivery. Urgent policy interventions may be required to compensate for the hidden impact that the coronavirus disease 2019 pandemic has had on those with cancer. [ABSTRACT FROM AUTHOR]

Background: The role of nutrition in the treatment of attention-deficit hyperactivity disorder (ADHD) is gaining international attention; however, treatments have generally focused only on diet restriction or supplementing with one nutrient at a time., Aims: To investigate the efficacy and safety of a broad-based micronutrient formula consisting mainly of vitamins and minerals, without omega fatty acids, in the treatment of ADHD in adults., Method: This double-blind randomised controlled trial assigned 80 adults with ADHD in a 1:1 ratio to either micronutrients (n = 42) or placebo (n = 38) for 8 weeks (trial registered with the Australian New Zealand Clinical Trials Registry: ACTRN12609000308291)., Results: Intent-to-treat analyses showed significant between-group differences favouring active treatment on self- and observer- but not clinician-ADHD rating scales. However, clinicians rated those receiving micronutrients as more improved than those on placebo both globally and on ADHD symptoms. Post hoc analyses showed that for those with moderate/severe depression at baseline, there was a greater change in mood favouring active treatment over placebo. There were no group differences in adverse events., Conclusions: This study provides preliminary evidence of efficacy for micronutrients in the treatment of ADHD symptoms in adults, with a reassuring safety profile.

Background: Individuals with serious mental illness have a markedly shorter life expectancy. A major contributor to premature death is cardiovascular disease (CVD). We investigated associations of (genetic liability for) depressive disorder, bipolar disorder and schizophrenia with a range of CVD traits and examined to what degree these were driven by important confounders. Methods: We included participants of the Dutch Lifelines cohort (N = 147 337) with information on self-reported lifetime diagnosis of depressive disorder, bipolar disorder, or schizophrenia and CVD traits. Employing linear mixed-effects models, we examined associations between mental illness diagnoses and CVD, correcting for psychotropic medication, demographic and lifestyle factors. In a subsample (N = 73 965), we repeated these analyses using polygenic scores (PGSs) for the three mental illnesses. Results: There was strong evidence that depressive disorder diagnosis is associated with increased arrhythmia and atherosclerosis risk and lower heart rate variability, even after confounder adjustment. Positive associations were also found for the depression PGSs with arrhythmia and atherosclerosis. Bipolar disorder was associated with a higher risk of nearly all CVD traits, though most diminished after adjustment. The bipolar disorder PGSs did not show any associations. While the schizophrenia PGSs was associated with increased arrhythmia risk and lower heart rate variability, schizophrenia diagnosis was not. All mental illness diagnoses were associated with lower blood pressure and a lower risk of hypertension. Conclusions: Our study shows widespread associations of (genetic liability to) mental illness (primarily depressive disorder) with CVD, even after confounder adjustment. Future research should focus on clarifying potential causal pathways between mental illness and CVD. [ABSTRACT FROM AUTHOR]

Background: Hospital-based biobanks are being increasingly considered as a resource for translating polygenic risk scores (PRS) into clinical practice. However, since these biobanks originate from patient populations, there is a possibility of bias in polygenic risk estimation due to overrepresentation of patients with higher frequency of healthcare interactions. Methods: PRS for schizophrenia, bipolar disorder, and depression were calculated using summary statistics from the largest available genomic studies for a sample of 24 153 European ancestry participants in the Mass General Brigham (MGB) Biobank. To correct for selection bias, we fitted logistic regression models with inverse probability (IP) weights, which were estimated using 1839 sociodemographic, clinical, and healthcare utilization features extracted from electronic health records of 1 546 440 non-Hispanic White patients eligible to participate in the Biobank study at their first visit to the MGB-affiliated hospitals. Results: Case prevalence of bipolar disorder among participants in the top decile of bipolar disorder PRS was 10.0% (95% CI 8.8–11.2%) in the unweighted analysis but only 6.2% (5.0–7.5%) when selection bias was accounted for using IP weights. Similarly, case prevalence of depression among those in the top decile of depression PRS was reduced from 33.5% (31.7–35.4%) to 28.9% (25.8–31.9%) after IP weighting. Conclusions: Non-random selection of participants into volunteer biobanks may induce clinically relevant selection bias that could impact implementation of PRS in research and clinical settings. As efforts to integrate PRS in medical practice expand, recognition and mitigation of these biases should be considered and may need to be optimized in a context-specific manner. [ABSTRACT FROM AUTHOR]

Background: Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB). Methods: Using prospective cohorts from the Leuven College Surveys (n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments. Results: Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10–20% at the highest predicted risk could effectively reach 34.9–56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8–93.4, AUC = 0.88–0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts. Conclusions: Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes. [ABSTRACT FROM AUTHOR]

Background: Social scientists generally agree that health disparities are produced, at least in part, by adverse social experiences, especially during childhood and adolescence. Building on this research, we use an innovative method to measure early adversity while drawing upon a biopsychosocial perspective on health to formulate a model that specifies indirect pathways whereby childhood and adolescent adversity become biologically embedded and influence adult health. Method: Using nearly 20 years of longitudinal data from 382 Black Americans, we use repeated-measures latent class analysis (RMLCA) to construct measures of childhood/adolescent adversities and their trajectories. Then, we employ structural equation modeling to examine the direct and indirect effects of childhood/adolescent adversity on health outcomes in adulthood through psychosocial maladjustment. Results: RMLCA identified two classes for each component of childhood/adolescent adversity across the ages of 10 to 18, suggesting that childhood/adolescent social adversities exhibit a prolonged heterogeneous developmental trajectory. The models controlled for early and adult mental health, sociodemographic and health-related covariates. Psychosocial maladjustment, measured by low self-esteem, depressive and anxiety symptoms, and lack of self-control, mediated the relationship between childhood/adolescent adversity, especially parental hostility, racial discrimination, and socioeconomic class, and both self-reported illness and blood-based accelerated biological aging (with proportion mediation ranging from 8.22% to 79.03%). Conclusion: The results support a biopsychosocial model of health and provide further evidence that, among Black Americans, early life social environmental experiences, especially parenting, financial stress, and racial discrimination, are associated with adult health profiles, and furthermore, psychosocial mechanisms mediate this association. [ABSTRACT FROM AUTHOR]

Background: People with post-traumatic stress disorder (PTSD) exhibit negative cognitions, predictive of PTSD severity. The Post-Traumatic Cognitions Inventory (PTCI) is a widely used instrument measuring trauma-related cognitions and beliefs with three subscales: negative thoughts of self (SELF), negative cognitions about the world (WORLD), and self-blame (BLAME). Aims: The current study attempted to validate the use of the PTCI in people with serious mental illness (SMI), who have greater exposure to trauma and elevated rates of PTSD, using confirmatory factor analysis (CFA) and examining convergent and divergent correlations with relevant constructs. Method: Participants were 432 individuals with SMI and co-occurring PTSD diagnosis based on the Clinician Administered PTSD Scale, who completed PTCI and other clinical ratings. Results: CFAs provided adequate support for Foa's three-factor model (SELF, WORLD, BLAME), and adequate support for Sexton's four-factor model that also included a COPE subscale. Both models achieved measurement invariance at configural, metric and scalar levels for three diagnostic groups: schizophrenia, bipolar and major depression, as well as for ethnicity (White vs Black), and gender (male vs female). Validity of both models was supported by significant correlations between PTCI subscales, and self-reported and clinician assessed PTSD symptoms and associated symptoms. Conclusions: Findings provide support for the psychometric properties of the PTCI and the conceptualization of Sexton's four-factor and Foa's three-factor models of PTCI among individuals diagnosed with SMI (Foa et al., 1999). [ABSTRACT FROM AUTHOR]

Background. Accumulating evidence indicates that a variety of distal and proximal factors might impact a risk of suicide. However, the association between both groups of factors remains unknown. Therefore, in the present study, we aimed to investigate the interplay between distal and proximal correlates of the current suicidal ideation. Methods. A total of 3,000 individuals (aged 18–35 years, 41.7% males), who had reported a negative history of psychiatric treatment, were enrolled through an online computer-assisted web interview. Self-reports were administered to measure: (a) distal factors: a history of childhood trauma (CT), reading disabilities (RDs), symptoms of attention-deficit/hyperactivity disorder (ADHD), lifetime history of non-suicidal self-injury (NSSI), lifetime problematic substance use as well as family history of schizophrenia and mood disorders; (b) proximal factors: depressive symptoms, psychotic-like experiences (PLEs), and insomnia; and (c) sociodemographic characteristics. Results. Suicidal ideation was directly associated with unemployment, being single, higher level of RD, lifetime history of NSSI as well as higher severity of PLEs, depression, and insomnia. The association of distal factors with suicidal ideation was fully (a history of CT and symptoms of ADHD) or partially (a history of NSSI and RD) mediated by proximal factors (PLEs, depression, and insomnia). Conclusions. Main findings from this study posit the role of distal factors related to neurodevelopmental disorders, CT and NSSI in shaping suicide risk. Their effects might be partially or fully mediated by depression, PLEs, and insomnia. [ABSTRACT FROM AUTHOR]

Background: Health services utilization, as one of the mechanisms of the health system, guarantees a healthy life and improves well-being for everyone. Aims: The aim of this study was to identify factors affecting the use of outpatient health services among women. Methods/designs: This scoping review examined the studies related to outpatient health services utilization (OHSU) and its determinants among women. This review was conducted on English language studies published between 2010 and 2023 (All searches were conducted on 20 January 2023). Studies available in databases such as Web of Science, MEDLINE (PubMed), Scopus, Wiley library, Proquest, and Google Scholar were searched manually. Selected keywords and their equivalents were used to search for related articles in each database. Results: A total of 18 795 articles were identified, of which 37 met the inclusion criteria. Findings showed that age, marital status, level of education, employment status, income level, socioeconomic status, rape experience, health insurance, health status, ethnicity, living in rural areas, quality of services, area of residence, having a purpose in life and access to health services affect OHSU among women. Conclusions: The results of the present review showed that in order to achieve the universal goals of health services coverage and health service utilization, it is necessary for countries to provide insurance coverage to the maximum number of people. Also, policies should change in favor of the elderly, poor and low-income, low-educated, rural, ethnic minority, and chronically ill women and provide them with free preventive health services. [ABSTRACT FROM AUTHOR]

Aims and method To re-evaluate vitamin D testing and supplementation among in-patients with intellectual and developmental disability (IDD) and examine any correlates with physical health conditions, including COVID-19. Records of all in-patients between January 2019 and July 2020 (n = 78) were examined for 25-hydroxyvitamin D (25(OH)D) level, ward area, supplementation status, test seasonality, medication and health status. Results The mean 25(OH)D level for supplemented (800 IU/day) patients was 75 nmol/L (s.d. = 20), compared with 40 nmol/L (s.d. = 19) in the non-supplemented group (P < 0.001). Thirty-eight percent of those who were in-patients during the first wave of the COVID-19 pandemic developed symptoms, but the small sample size could not establish vitamin D levels as a predictor of outcome. Clinical implications Vitamin D (800 IU/day) supplementation is effective but the adequacy of the nationally recommended dose of 400 IU/day is unclear. Links to COVID-19 merit further research. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a neurodevelopmental condition that can affect a person's ability to manage the complexities of varied social and environmental situations. This is particularly evident in the dynamic context of a school classroom. To assist students with ASD to navigate the complexities of Australian primary and secondary mainstream classrooms, educators are required to provide 'reasonable adjustments' to support learning; that is, to make changes that are practicable and achievable in order for students to access learning on the same basis as their peers. We present an argument that the 'reasonable adjustments' made by schools to ensure that students with ASD have equitable learning opportunities should meet a criterion of acceptability where the adjustment is evidence based. The paper also offers a summary of evidence-based pedagogical strategies that have been effective for students with ASD and concludes with a discussion offering evidence-based practices as a solution to meeting legislative requirements for students with disability. [ABSTRACT FROM AUTHOR]

Background: No evidence-based therapy for borderline personality disorder (BPD) exhibits a clear superiority. However, BPD is highly heterogeneous, and different patients may specifically benefit from the interventions of a particular treatment. Methods: From a randomized trial comparing a year of dialectical behavior therapy (DBT) to general psychiatric management (GPM) for BPD, long-term (2-year-post) outcome data and patient baseline variables (n = 156) were used to examine individual and combined patient-level moderators of differential treatment response. A two-step bootstrapped and partially cross-validated moderator identification process was employed for 20 baseline variables. For identified moderators, 10-fold bootstrapped cross-validated models estimated response to each therapy, and long-term outcomes were compared for patients randomized to their model-predicted optimal v. non-optimal treatment. Results: Significant moderators surviving the two-step process included psychiatric symptom severity, BPD impulsivity symptoms (both GPM > DBT), dependent personality traits, childhood emotional abuse, and social adjustment (all DBT > GPM). Patients randomized to their model-predicted optimal treatment had significantly better long-term outcomes (d = 0.36, p = 0.028), especially if the model had a relatively stronger (top 60%) prediction for that patient (d = 0.61, p = 0.004). Among patients with a stronger prediction, this advantage held even when applying a conservative statistical check (d = 0.46, p = 0.043). Conclusions: Patient characteristics influence the degree to which they respond to two treatments for BPD. Combining information from multiple moderators may help inform providers and patients as to which treatment is the most likely to lead to long-term symptom relief. Further research on personalized medicine in BPD is needed. [ABSTRACT FROM AUTHOR]

Background: Trait boredom is associated with several internalizing and externalizing problems. Addressing existing research gaps in the field, the present study investigated the map of cognitive processes for boredom, based on the rational emotive behaviour therapy model (REBT). Aims: The general aim of the study was to investigate the organization of irrational and rational evaluative cognitions related to boredom, and the association between boredom and depression symptoms and state/trait anxiety. Methods: The 233 participants (84% women) completed online scales of evaluative cognitions, trait boredom, trait/state anxiety and depression. Multiple mediation models via the SPSS extension PROCESS were employed. Results: The REBT psychopathology and psychological health models were partially confirmed, as the evaluative primary cognitions predicted positively and significantly the secondary ones in both cases. Low frustration tolerance (LFT) and global evaluations (GE), and frustration tolerance (FT), respectively, had significant effects. We found a positive significant association between boredom proneness and the negative dysfunctional emotions investigated. Conclusions: Both results offer further support for the hierarchy of cognitions and the distinction between the level of irrationality and rationality in REBT. This is the first attempt to assess a cognitive map of boredom, underlining the importance of (L)FT in relation to boredom. The significance of GE in boredom suggests that people might see themselves responsible, or even blame themselves, others or life itself while bored. The associations of boredom with anxiety and depression are relevant, as its role in those contexts is not yet fully understood. [ABSTRACT FROM AUTHOR]

The way that people internalize adverse experiences plays an important role in the development of psychopathology. The Pathogenic Belief Scale (PBS) is intended to operationalize a transtheoretical understanding of repetitive patterns of emotion-laden beliefs that develop in childhood and continue to influence people's current experience. Using a cross-sectional survey design, we recruited a large heterogeneous sample of 246 clinic outpatients and 732 adults in the community. Besides the PBS, measures of adverse parenting experiences and common psychopathology were administered. An exploratory factor analysis of the total sample of 978 participants was conducted followed by a convergent validity analysis for the 246 clinic outpatients. The three-factor solution included "cannot rely on others," "undeserving," and "interpersonal guilt," and it showed good psychometric properties, including convergent validity with the measures of adverse parenting experiences and psychopathology. The 34-item PBS offers a promising self-report measure that could help delineate and understand the pathogenic beliefs that heterogeneous samples of patients may hold. Pathogenic beliefs may be relevant to the psychotherapy process, regardless of model or theoretical context. [ABSTRACT FROM AUTHOR]

Background. Personality traits have been associated with long-term suicide risk but their relationship with short-term risk is still unknown. Therefore, to address this gap, we explored the moderating effect of personality traits on the relationship between the Suicide Crisis Syndrome (SCS) and short-term suicidal behaviors (SB). Sampling and Methods. Adult participants (N = 459) were administered the Suicide Crisis Inventory (SCI), a validated self-report questionnaire designed to measure the intensity of the Suicidal Crisis Syndrome, the Big Five Inventory for personality traits, and the Columbia Suicide Severity Rating Scale for SB at intake and at a 1-month follow-up. The PROCESS macro in SPSS was used to test the moderation model. Covariates hypothesized to influence the results were added: age, gender, ethnicity, years of education, and depressive symptomatology on the Beck Depression Inventory. This study was a secondary analysis drawn from a larger study on the SCS. Results. SCI total score had a significant positive relationship with SB at the 1-month follow-up for patients with lower levels of extraversion, agreeableness, conscientiousness, and openness, respectively. Hence, these four traits were protective against SB. There was an association between SCI and SB for patients with high levels of neuroticism at the 1-month follow-up. Conclusions. High levels of neuroticism served as a risk factor, whereas high levels of the other Big Five traits were protective factors against short-term SB in the context of elevated SCS symptoms. Thus, personality traits play a role in moderating the relationship between the SCS and imminent SB. [ABSTRACT FROM AUTHOR]

Background: Accurate psychometrics benefit from assessing given constructs within specifically defined contexts. The assessment of context-specific irrational beliefs as put forth in rational emotive behaviour therapy (REBT), under the three basic psychological needs described in self-determination theory (SDT), represents a new path for research. Under the umbrella of 'positive psychology', a new scale for adolescents combining REBT and SDT is the first step towards conceptualizing irrational beliefs within the three basic psychological needs. The integration of REBT and SDT would provide a more fully integrated view of adolescent mental health, and as such could provide a more cost-effective approach for preventing cognitive, emotive and behavioural disturbances in young people. Aims: The main aim of this paper is to outline the development and validation of the Rational Emotive Self Determination Scale for Adolescents (RESD-A), which measures irrational beliefs about the three basic psychological needs (autonomy, competence and relatedness). Method: To achieve this main study aim, we report the results of four studies that test the factor structure, internal consistency, construct, predictive validity, and test–re-test reliability of the 51-item RESD-A, within samples of Turkish adolescents. Results: Data analyses confirmed the theoretical expectations and yielded promising results for the validity and reliability of the RESD-A. Conclusions: The results suggest that assessment of irrational beliefs in the context of autonomy, competence and relatedness is possible and valuable for the treatment of adolescents. [ABSTRACT FROM AUTHOR]

This article offers a synthesis of understandings of wasta, seen as a form of social network prevalent in the Arab Middle East. Whilst there has been increasing interest in this practice, research remains fragmented and has been criticised for its limited theoretical rigor. To address this issue, a systematic review of peer-reviewed journal articles exploring wasta published between 1993 and 2019 was conducted. We analysed the identified papers according to the theoretical lens from which wasta was viewed, creating a bridge between a theoretical focus on the macro aspect of wasta and an alternative focus on its micro aspects, leading to the development of a holistic model of wasta. The model also helps us to understand the complexity of wasta, both as the network itself and as the social ties that exist among its members, and sheds light on the complex nature of the role and interactions of the wasta. The findings respond to calls for more holistic and inclusive research to inform social networks research and bridge the micro–macro divide. This article offers recommendations to future researchers to build on the holistic and emic approach to wasta research adopted here. [ABSTRACT FROM AUTHOR]

Whoever has travelled in the New England States will remember, in some cool village, the large farmhouse, with its clean-swept grassy yard ... In the family "keeping-room," as it is termed, he will remember the staid, respectable old bookcase, with its glass doors, where Rollin's History, Milton's Paradise Lost, Bunyan's Pilgrim's Progress, and Scott's Family Bible, stand side by side in decorous order, with multitudes of other books, equally solemn and respectable. Harriet Beecher Stowe, Uncle Tom's Cabin (Boston, MA, 1852), 226 [ABSTRACT FROM AUTHOR]

Background: Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients' and therapists' estimations of TA among clients with severe disturbances, while focusing on two potential moderators: client diagnosis and alliance instrument. Method: Weconducted a systematic literature search of studies examining both client perspective and therapist perspective on TA in psychotherapy among people with schizophrenia spectrum disorders, personality disorders, and substancemisuse disorders. Wethen analyzed the data using a random-effects meta-analytic model with Cohen's d standardized mean effect size. Results: Heterogeneity analyses (k = 22, Cohen's d =-.46, 95% confidence interval = .31-1.1) produced a significant Q-statistic (Q = 94.96) and indicated high heterogeneity, suggesting that moderator analyses were appropriate. Conclusions: Our findings show that the type of TA instrument moderates the agreement on TA between client and therapist, but there was no indication of the client's diagnosis moderating the effect. The agreement between client and therapist estimations seems to be dependent on the instrument that is used to assess TA. Specific setting-related instruments seem to result in higher agreement between clients' and therapists' estimations than do more general instruments that are applied to assess TA. [ABSTRACT FROM AUTHOR]

Despite the importance of understanding the narrative abilities of bilingual children, minimal research has focused on Spanish–English bilingual preschoolers. Therefore, this study examined the cross-language macrostructure and within-language microstructure relations in the English and Spanish narratives of bilingual preschoolers and examined whether language dominance impacted these relations. Narratives were elicited from 200 preschool-aged children of Latino heritage. Microstructure measures included the number of different words, the mean length of utterance in words, and the subordination index. The narrative scoring scheme measured macrostructure (Heilmann, Miller, Nockerts, & Dunaway, 2010). Using standardized language testing of expressive vocabulary and sentence comprehension, the children were classified into two groups: balanced dominance and Spanish dominant. Results revealed that English macrostructure and Spanish macrostructure were not related after controlling for microstructure measures within languages. Children's microstructure abilities in each language were strongly related to their macrostructure abilities within that language. Dominance did not moderate these relations. Consistent with previous research on school-age children, vocabulary was a unique predictor of macrostructure production. This study highlights the additional importance of utterance length within both languages to macrostructure during the preschool years. The absence of unique cross-language macrostructure relations and the absence of dominance group moderation may have been due to the immaturity of the children's narratives. [ABSTRACT FROM AUTHOR]

Background: The cognitive restructuring of maladaptive beliefs within many cognitive behavioural psychotherapies typically encourages the client to undertake self-reflection. However, whilst self-consciousness can aid self-regulation, it is also implicated in a broad Grange of psychopathologies. The extent to which self-consciousness is associated with psychological distress is yet to be fully determined, but recent literature suggests that irrational beliefs, as proposed within rational emotive behaviour theory (REBT) may play an important role. Aims: The aim of the study was to test the mediational effects of self-consciousness, specifically reflection and rumination, on the relationship between irrational beliefs and psychological distress. Based on past research, it was hypothesized that reflection and rumination would mediate the positive relationship between irrational beliefs and psychological distress. We expected irrational beliefs to interact with rumination to positively predict psychological distress, and irrational beliefs to interact with reflection to negatively predict psychological distress. Method: The present research tested a structural equation model (SEM) in which rumination and reflection mediated the relationship between irrational beliefs and psychological distress. Results: Results indicated that rumination mediates the positive relationship between irrational beliefs and psychological distress. However, in contrast to our hypotheses, significant mediation did not emerge for reflection. Conclusions: This study is the first to show how irrational beliefs and rumination interact to predict psychopathology using advanced statistical techniques. However, future research is needed to determine whether similar mediational effects are evident with rational beliefs as opposed to irrational beliefs. [ABSTRACT FROM AUTHOR]

Background: Past reviews of cognitive behavioural therapy (CBT) for anger have focused on outcome in specific subpopulations, with few questions posed about research design and methodology. Since the turn of the century, there has been a surge of methodologically varied studies awaiting systematic review. Aims: The basic aim was to review this recent literature in terms of trends and patterns in research design, operationalization of anger, and covariates such as social desirability bias (SDB). Also of interest was clinical outcome. Method: After successive culling, 42 relevant studies were retained. These were subjected to a rapid evidence assessment (REA) with special attention to design (ranked on the Scientific Methods Scale) measurement methodology (self-monitored behaviour, anger questionnaires, and others’ ratings), SDB assessment, and statistical versus clinical significance. Results: The randomized controlled trial characterized 60% of the studies, and the State Trait Anger Expression Inventory was the dominant measure of anger. All but one of the studies reported statistically significant outcome, and all but one of the 21 studies evaluating clinical significance laid claim to it. The one study with neither statistical nor clinical significance was the only one that had assessed and corrected for SDB. Conclusions: Measures remain relatively narrow in scope, but study designs have improved, and the outcomes suggest efficacy and clinical effectiveness. In conjunction with previous findings of an inverse relationship between anger and SDB, the results raise the possibility that the favourable picture of CBT for anger may need closer scrutiny with SDB and other methodological details in mind. [ABSTRACT FROM AUTHOR]

This study compared NRT-performance in monolingual Dutch and bilingual Turkish–Dutch third-graders using a Dutch Nonword Repetition Task (NRT). Several novel response analyses at the phoneme level were applied to further understand the earlier reported overall accuracy differences in NRT-performance between bilinguals and monolinguals. Analyses in which the retention of phonemes and the retention of their serial order were disentangled revealed that monolinguals outperform bilinguals with respect to the retention of the phonemes themselves. However, both groups did not differ in their retention of the serial order of correctly recalled phonemes. Furthermore, this study confirms that expressive vocabulary skills do affect overall NRT-performance. The results are discussed in light of current short-term memory (STM) models and the role of long-term phonological knowledge in NRT tasks. [ABSTRACT FROM AUTHOR]

To acquire a new word, learners need to create its representation in phonological short-term memory (STM) and then encode it in their long-term memory. Two strategies can enable word representation in STM: universal segmentation and phonological mapping. Universal segmentation is language universal and thus should predict word learning in any language, while phonological mapping is language specific. This study investigates the mechanisms of vocabulary learning through a comparison of vocabulary learning task results in multiple languages.We tested 44 Polish third graders learning English on phonological STM, phonological awareness in Polish and in English, and on three tasks, which involved learning novel word forms in Polish (first language), in English (second language), and in a language that did not resemble any language known to participants (an unknown language). Participants' English proficiency was controlled through a vocabulary task. The results suggest that word learning engages different mechanisms for familiar and unfamiliar languages. Phonological awareness in English predicted learning second language and unknown language words, and phonological STM predicted learning words of the unknown language.We propose that universal segmentation facilitates word learning only in an unfamiliar language, while in familiar languages speakers use phonological mapping in order to learn new words. [ABSTRACT FROM AUTHOR]

Our study examines the contribution of genetic and environmental factors (both shared and unique) to frailty, measured using the Rockwood Frailty Index (FI) in a sample of twins from the St Thomas’ UK Adult Twin Registry. The FI was based on 39 items of potential health deficit. Study participants were 3,375 volunteer adult twins (840 monozygotic and 802 dizygotic twin-pairs) 40.0–84.5 years old. First, we used structural equation modeling to estimate the relative contribution of genetics and of the shared and unique environment to variance in FI adjusted for age. In a second analysis, multiple linear regression was used to examine variance in FI as a function of father's occupational class (a component of shared environment and a measure of childhood socioeconomic status [SES]), adjusting for age, birth weight, marital status, and health behaviors (smoking, alcohol consumption, and physical activity). Statistical analyses were conducted using IBM SPSS® Version 22 software and Mx open source software. Findings showed that 45% (95% confidence intervals [CIs] 30–53%) of the inter-individual variation in FI was heritable and 52% (95% CIs 47–57%) was due to the individual's unique environment. Multiple linear regression also showed a small but statistically significant inverse association between father's occupational class and FI, mediated by one's own educational attainment and birth weight. Our results indicate that frailty is both genetically and environmentally determined. Thus, its prevention and management call for a multifaceted approach that includes addressing deleterious environmental factors, some of which, like childhood SES, may act across the life course. [ABSTRACT FROM PUBLISHER]

This study’s objectives were, first, to examine the association between social engagement and the odds of taking hypertensive medications and treatment among adults in China; and second, to explore the lifestyle and psychological mechanisms underlying this association. Data were from the WHO Study on Global AGEing and Adult Health (WHO-SAGE), a national survey of 11,046 participants aged 18 to 69 conducted in China in 2010. The key outcome was a dichotomous indicator of whether the respondent was taking hypertensive medication or other treatment. A series of logistic regression models were fitted to examine the research questions. Higher levels of social engagement were found to be associated with a lower odds of taking hypertensive medication or treatment, and the association was stronger for women than for men. Lifestyle factors (i.e. smoking and BMI) and perceived overall life satisfaction were significant covariates. Life satisfaction helped explain some of the social engagement benefit for both men and women and BMI only appeared to be a mediator for men. Being married was not significantly associated with lower odds of taking hypertensive medication or treatment in either men or women. Social engagement seems to be protective against hypertension for adult men and women in China, although causation could not be determined in this cross-sectional study. Psychosocial mechanisms are probably at work, but these vary by gender. [ABSTRACT FROM PUBLISHER]

An editorial is presented on highlighting major change in patient illness related behaviour forming part of the hidden cost of the pandemic. Topics include cholesteatoma diagnosis by special sequences of magnetic resonance imaging (MRI) allowing many patients avoiding costly and inconvenient second- or third-look tympanoplasty operations; and primarily sexually-transmitted disease strengthening the push for HPV vaccination prior to the age of sexual activity.

An editorial is presented on the plethora of advantages, such as ambidextrous hand mobility and stereopsis. It outlines improved visualization of the surgical field provided by the endoscope enables less bony auditory canal drilling and less post-operative pain, as well as limited manipulation of the chorda tympani, leading to better rates regarding post-operative dysgeusia. An overview of the studies endoscopic stapes surgery is presented.

A letter to the editor is presented in response to the article about the vital role of micronutrients in treating attention-deficit hyperactivity disorder (ADHD).

Nutrient deficiencies have been implicated in anti-social behaviour in schoolchildren; hence, correcting them may improve sociability. We therefore tested the effects of vitamin, mineral and n-3 supplementation on behaviour in a 12-week double-blind randomised placebocontrolled trial in typically developing UK adolescents aged 13–16 years (n 196). Changes in erythrocyte n-3 and 6 fatty acids and some mineral and vitamin levels were measured and compared with behavioural changes, using Conners’ teacher ratings and school disciplinary records. At baseline, the children’s PUFA (n-3 and n-6), vitamin and mineral levels were low, but they improved significantly in the group treated with n-3, vitamins and minerals (P=0·0005). On the Conners disruptive behaviour scale, the group given the active supplements improved, whereas the placebo group worsened (F =5·555, d=0·35; P =0·02). The general level of disciplinary infringements was low, thus making it difficult to obtain improvements. However, throughout the school term school disciplinary infringements increased significantly (by 25 %; Bayes factor =115) in both the treated and untreated groups. However, when the subjects were split into high and low baseline infringements, the low subset increased their offences, whereas the high-misbehaviour subset appeared to improve after treatment. But it was not possible to determine whether this was merely a statistical artifact. Thus, when assessed using the validated and standardised Conners teacher tests (but less clearly when using school discipline records in a school where misbehaviour was infrequent), supplementary nutrition might have a protective effect against worsening behaviour. [ABSTRACT FROM AUTHOR]

Past research demonstrates a phenotypic relationship between childhood maltreatment and adult health problems. Explanations of this association usually point to either: (a) a direct causal link, whereby exposure to early stress disrupts biological functioning during sensitive periods of development; or (b) an indirect effect operating through socioeconomic attainment, poor health behaviors, or some other pathway leading from childhood to adulthood. The current study examined whether the association between childhood maltreatment and adult health reflects genetic or environmental mediation. Using a large sample of adult American twins, we separately estimated univariate biometric models of child maltreatment and adult physical health, followed by a bivariate biometric model to estimate genetic and environmental correlations between the two variables. We found that a summary count of chronic health conditions shared non-trivial genetic overlap with childhood maltreatment. Our results have implications for understanding the relationship between maltreatment and health as one of active interplay rather than a simple cause and effect model that views maltreatment as an exogenous shock. [ABSTRACT FROM PUBLISHER]

It is known that mortality of Jews is different from the mortality of the populations that surround them. However, the existence of commonalities in mortality of different Jewish communities across the world has not received scholarly attention. This paper aims to identify common features of the evolution of Jewish mortality among Jews living in Israel and the Diaspora. In the paper the mortality of Jews in Israel is systematically compared with the mortality of the populations of developed countries, and the findings from the earlier studies of mortality of Jews in selected Diaspora communities are re-examined. The outcome is a re-formulation and extension of the notion of the ‘Jewish pattern of mortality’. The account of this pattern is based on the consistently low level of behaviourally induced mortality, the migration history of Jewish populations and the enduring influence of early-life conditions on mortality at older ages. [ABSTRACT FROM PUBLISHER]

Many Americans hold distorted views of elected officials and, as our study shows, the blame is due partly to our ideological biases and partly to mass media. Analyzing a nationally representative online survey, we corroborate recent research that found that one in five Americans still believe president Barack Obama is a Muslim and that almost seven in ten mistakenly think Sarah Palin, and not Saturday Night Live’s Tina Fey, was the first to say “I can see Russia from my house.” Although race, political ideology, and “born-again” or evangelical Christian status were the primary drivers of misperceptions about Obama’s faith, media use had a more crucial role in predicting the more widespread misperception about Palin. Misattribution of the Fey quote to Palin was greatest among heavy viewers of traditional news media and late-night TV comedy, which is suggestive of the “lamestream media” effect often espoused by prominent Republican figures. [ABSTRACT FROM AUTHOR]

Under the traditional system of peer-reviewed publication, the degree of prestige conferred to authors by successful publication is tied to the degree of the intellectual rigor of its peer review process: ambitious scientists do well professionally by doing well epistemically. As a result, we should expect journal editors, in their dual role as epistemic evaluators and prestige-allocators, to have the power to motivate improved author behavior through the tightening of publication requirements. Contrary to this expectation, I will argue that the publication bias literature in academic medicine demonstrates that editor interventions have had limited effectiveness in improving the health of the publication and trial registration record, suggesting that much stronger interventions are needed. [ABSTRACT FROM AUTHOR]

This study examined interdependent trajectories of sexual risk, substance use, and conduct problems among 12- to 18-year-old African American youths who were followed annually as part of the Mobile Youth Study. We used growth mixture modeling to model the development of these three outcomes in the 1,406 participants who met the inclusion criteria. Results indicate that there were four distinct classes: normative, low risk (74.3% of sample); increasing high-risk takers (11.9%); adolescent-limited conduct problems and drug risk with high risky sex (8.0%); and early experimenters (5.8%) The higher risk classes had higher rates of pregnancy and sexually transmitted infections diagnoses than the normative sample at each of the ages we examined. Differing somewhat from our hypothesis, all of the nonnormative classes exhibited high sexual risk behavior. Although prevention efforts should be focused on addressing all three risk behaviors, the high rate of risky sexual behavior in the 25% of the sample that fall into the three nonnormative classes underscores an urgent need for improved sex education, including teen pregnancy and HIV/sexually transmitted infections prevention, in this community. [ABSTRACT FROM PUBLISHER]

Men's supportive stance is an essential component for making women's world better. There are growing debates among policymakers and researchers on the role of males in maternal health programmes, which is a big challenge in India where society is male driven. This study aims to look into the variations and determinants of maternal health care utilization in India and in three demographically and socioeconomically disparate states, namely Uttar Pradesh, West Bengal and Maharashtra, by husband's knowledge, attitude, behaviour towards maternal health care and gender violence, using data from the National Family Health Survey III 2005–06 (equivalent to the Demographic and Health Survey in India). Women's antenatal care visits, institutional delivery and freedom in health care decisions are looked into, by applying descriptive statistics and multivariate models. Men's knowledge about pregnancy-related care and a positive gender attitude enhances maternal health care utilization and women's decision-making about their health care, while their presence during antenatal care visits markedly increases the chances of women's delivery in institutions. From a policy perspective, proper dissemination of knowledge about maternal health care among husbands and making the husband's presence obligatory during antenatal care visits will help primary health care units secure better male involvement in maternal health care. [ABSTRACT FROM PUBLISHER]

Background: Panic disorder (PD) is a common, often unrecognized condition among patients presenting with chest pain to the emergency departments (ED). Nevertheless, psychological treatment is rarely initiated. We are unaware of studies that evaluated the efficacy of brief cognitive-behavioural therapy (CBT) for this population. Aim: Evaluate the efficacy of two brief CBT interventions in PD patients presenting to the ED with chest pain. Method: Fifty-eight PD patients were assigned to either a 1-session CBT-based panic management intervention (PMI) (n = 24), a 7-session CBT intervention (n = 19), or a usual-care control condition (n = 15). A structured diagnostic interview and self-reported questionnaires were administered at pre-test, post-test, 3- and 6-month follow-ups. Results: Statistical analysis showed significant reduction in PD severity following both interventions compared to usual care control condition, but with neither showing superiority compared to the other. Conclusions: CBT-based interventions as brief as a single session initiated within 2 weeks after an ED visit for chest pain appear to be effective for PD. Given the high prevalence of PD in emergency care settings, greater efforts should be made to implement these interventions in the ED and/or primary care setting. [ABSTRACT FROM PUBLISHER]

My response is organized into three sections. The first revisits the theme of the target article, the explanatory power of sexual selection versus social role theory. The second considers the range and scope of sexual selection, and its application to human sex differences. Two topics are examined in more detail: (1) the paternity uncertainty theory of partner violence; (2) evolution of inter-group aggression. Section 4 covers ultimate and proximal explanations and their integration within an ethological approach. I consider the development of sex differences in aggression, and their causal mechanisms, within this framework. [ABSTRACT FROM AUTHOR]

I argue that the magnitude and nature of sex differences in aggression, their development, causation, and variability, can be better explained by sexual selection than by the alternative biosocial version of social role theory. Thus, sex differences in physical aggression increase with the degree of risk, occur early in life, peak in young adulthood, and are likely to be mediated by greater male impulsiveness, and greater female fear of physical danger. Male variability in physical aggression is consistent with an alternative life history perspective, and context-dependent variability with responses to reproductive competition, although some variability follows the internal and external influences of social roles. Other sex differences, in variance in reproductive output, threat displays, size and strength, maturation rates, and mortality and conception rates, all indicate that male aggression is part of a sexually selected adaptive complex. Physical aggression between partners can be explained using different evolutionary principles, arising from the conflicts of interest between males and females entering a reproductive alliance, combined with variability following differences in societal gender roles. In this case, social roles are particularly important since they enable both the relatively equality in physical aggression between partners from Western nations, and the considerable cross-national variability, to be explained. [ABSTRACT FROM AUTHOR]

Background:Recent research into positive experiences in caregivers has begun to redress the traditional focus on negative aspects of caregiving experiences. Method:This exploratory study used a cognitive-behavioural approach ? namely, the transactional stress model (Lazarus and Folkman, 1984) ? to investigate associations between appraisals, coping, and gains over a 6-week period in a small sample (N= 4; case series) design involving stroke caregivers. Analysis involved visual inspection of graphs, supported by descriptive statistics, and co-variation analysis. Results:Participants reported high levels of positive experiences, and these increased over the study period, a previously unreported trend. The study also found individual differences in the interactions between appraisal, coping, and caregiving gain variables, findings explained by the transactional stress model. Conclusions:Implications for clinical practice and future research are addressed. [ABSTRACT FROM AUTHOR]

AbstractHistorically people with intellectual disabilities have not been offered or received cognitive behavioural interventions that have been shown to be effective for mental health and emotional problems experienced by those without such disabilities. This is despite many people with intellectual disabilities having life experiences that potentially result in them having an increased risk to such problems. This paper discusses whether such therapeutic disdain is justified based on the evidence that is available and emerging concerning the application of cognitive behavioural interventions for this population. Issues concerning access to services, the ability of people with intellectual disabilities to engage in and benefit from the cognitive components of CBT, and the effect of cognitive abilities and IQ level on treatment effectiveness are explored in relation to this question. [ABSTRACT FROM AUTHOR]

With the International Polar Year (IPY) having commenced in March 2007, key issues relating to the polar regions are again in focus. This article reviews one central legal issue re-emerging in the Arctic: global regulation of safety standards for international shipping. The ‘Guidelines for ships operating in Arctic ice-covered waters’ are examined, with a view to the probable expansion of shipping in the Arctic in near future. Following an introduction to navigational issues within the Arctic context, the article describes how the guidelines came into being, and then analyses key elements and structure of the regulations and shortfalls of today's arrangements. The possible relevance of the guidelines to the Antarctic is also discussed briefly. Finally, the article inquires into the key repercussions of introducing binding regulations. [ABSTRACT FROM PUBLISHER]