Search

Experiencing erotic feelings towards a patient is a fairly common occurrence, not pathological per se, during phases of psychotherapy. This study aims to analyze associations between, on the one hand, the presence in therapists of romantic attraction (RA), sexual attraction (SA), or flirting behavior (FB) toward patients and, on the other hand, a series of characteristics of therapist, patient, and treatment. Between April and June 2022, 547 psychotherapists completed an online survey investigating their affective and behavioral responses toward their most recently treated patient. Compared to female therapists, males showed significantly higher prevalence of SA alone (p <.001) or in combination with RA (p <.01), FB (p <.01), or both (p <.05). Multivariate adjusted regression models showed that RA was associated with patient age ≤40 years (OR:39.49 for age 18–29; OR:28.44 for age 30–39), male sex (OR:10.40), and diagnosis of mood disorder (OR:14.08). Furthermore, RA was associated with intense countertransference feelings of tenderness towards the patient (OR:79.77) and hostility towards significant figures in their life (OR: 77.93). SA was associated with the therapist's male sex/gender (OR: 16.14), psychoanalytic orientation (OR:13.34), post-license experience ≤20 years (OR:6.12 for 1–9 years; OR:6.08 for 10–19 years). Lastly, FB was associated with the therapist's male sex/gender (OR:16.94). [ABSTRACT FROM AUTHOR]

Background: Women with gynecologic disorders requiring a hysterectomy often have co-existing psychiatric diagnoses. A change in the dispensing pattern of antidepressant (AD) and antianxiety (AA) medications around the time of hysterectomy may be due to improvement in gynecologic symptoms, such as pelvic pain and abnormal bleeding, or the emotional impact of the hysterectomy. Unfortunately, these dispensing patterns before and after hysterectomy are currently undescribed. Objectives: To model the dispensing patterns of AD and AA medications over time among women with psychiatric disorders before and after benign hysterectomy for endometriosis and uterine fibroids; and to characterize clusters of patients with various dispensing behaviors based on these patterns. Design: Retrospective cohort study. Methods: This is a study of women who underwent a benign hysterectomy using data from the Merative MarkertScan® Research Databases (Ann Arbor, MI, USA). Inclusion criteria were reproductive-aged women (18–50 years), diagnosis of at least one mood or anxiety disorder, and at least one dispensing of AD or AA medications. We measured monthly adherence and persistence of AD/AA medication use over 12 months after hysterectomy. Group-based-trajectory modeling (GBTM) was used to identify trajectory groups of monthly AD/AA medication dispensing over the study period. Multinomial logistic regression was used to identify factors independently associated with individual dispensing trajectory patterns. Results: For a total of 11,607 patients, 6 dispensing trajectory groups were identified during the study period: continuously high (27.0%), continuously moderate (21.9%), continuously low (17.9%), low-to-high (10.0%), moderate-to-low (9.8%), and low-to-moderate (13.4%). Compared with the continuously high group, younger age, no history of a mood disorder, and uterine fibroids were clinical predictors of low dispensing. The discontinuation rate at 3 months after hysterectomy was higher at 88.6% in the continuously low group and at 66.5% in the continuously low-to-moderate group. Conclusions: This study demonstrates that GBTM identified six distinct trajectories of AD/AA medication dispensing in the perioperative period. Trajectory models could be used to identify specific dispensing patterns for targeting interventions. Plain language summary: Dispensing patterns of antidepressant and antianxiety medications for psychiatric disorders after benign hysterectomy in reproductive-aged women: Results from the group-based trajectory modeling Women with gynecologic disorders often have coexisting psychiatric diagnoses. A change in the dispensing pattern of antidepressant and antianxiety medications may be due to improvement in gynecologic symptoms or the emotional impact of the hysterectomy. However, static measures, such as the proportion of days covered or medication possession ratio, may not adequately predict meaningful dispensing patterns. Using the group-based trajectory modeling, 6 distinct patterns of medication dispensing over the perioperative periods of women with benign hysterectomy are identified and therefore used to assess how certain clinical characteristics influence these dispensing patterns. This study concludes that trajectory modeling may be a more appropriate approach to investigating dispensing patterns among women with preexisting psychiatric conditions. [ABSTRACT FROM AUTHOR]

Background: Patients with an ultra-high risk of psychosis (UHR) are more likely to transition to psychosis. Attachment style has also been associated with psychosis and other symptoms. Aims: To review attachment styles in UHR patients and to analyze related psychosocial factors. Ours is the first systematic review of attachment in this population. Method: We performed a systematic review of attachment and related psychosocial factors in UHR patients following the PRISMA methodology. Results: We identified five studies. The results revealed high rates of insecure attachment in this population (more than 80%). The UHR sample presented high levels of depression, anxiety, social anxiety, emotional reactivity, trauma, and poor mentalization. Premorbid social adjustment was a predictor of improvement in disorganization and negative symptoms. The rate of transition to psychosis was 10%. Attachment patterns accounted for 16.8% of the variance. This vulnerability for psychosis was also associated with poor mentalization. Conclusion: Early detection of patients with UHR and insecure attachment is crucial, since early intervention to address symptoms, mentalization, and attachment is feasible and may lead to an improvement in the remaining associated psychosocial related factors (secure style: better global functioning and less affective and anxious symptoms). PROSPERO ID440957 [ABSTRACT FROM AUTHOR]

Before adopting a scale for a new culture, researchers should conduct systematic translation procedures and evaluations to ensure its psychometric quality. The Pediatric Symptom Checklist–17 (PSC-17) is a brief and valid scale developed by U.S. researchers to evaluate children's emotional, attentional, and behavioral problems. This study aimed to adapt the PSC-17 to a Chinese version for use in elementary school settings. In this process, 74 teachers rated 666 students using the PSC-17. These students were also assessed using the Strengths and Difficulties Questionnaire (SDQ) and additional questions (e.g., teachers' referral status and demographic information). The scale was successfully translated into simplified Chinese using a standard procedure. Factor analysis supported a general factor model for the PSC-17. Furthermore, decent criterion validity and internal consistency were verified. Finally, a cut-off score of 17 was established, slightly higher than the original cut-off score of 15. We concluded that the PSC-17 is a high-quality screening tool in Chinese elementary schools. The findings are particularly relevant to researchers investigating children's emotional, attentional, and behavioral development within the Chinese cultural context. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relation between teachers' reports of classroom adversity, a measure of classroom hardship, and student problem behavior in a sample of students with or at risk of emotional/behavioral disorders. We also examined the extent to which this relation varied as a function of multiple domains of classroom quality. A series of multiple regression models, adjusting for the nesting of students within classrooms, were conducted. Models revealed a significant effect of the interaction between classroom adversity and classroom emotional support on teachers' reports of student problem behaviors. This effect indicated that in low-adversity classrooms, teachers differed in their reports of students' problem behaviors depending on their level of emotional support. In high-adversity classrooms, however, teachers' reports of students' problem behaviors were relatively similar regardless of their level of emotional support. Findings suggest classroom adversity is likely an important contextual factor to consider when examining student outcomes and that teacher emotional support may mitigate the influence of classroom adversity. We conclude with a discussion of the implications of this work for research and practice. [ABSTRACT FROM AUTHOR]

Increased reactivity to daily stressors is associated with mental health difficulties, which are common in autistic individuals. We investigated affective reactivity to daily-life stress, cognitive emotion regulation, and their link with co-occurring mental health symptoms in adolescents and young adults with autism. A 6-day ecological momentary assessment protocol was used to assess perceived daily-life stress (event-related, activity-related, and social stress) as well as negative affects in autistic (n = 39, age = 18.4) and non-autistic (n = 55, age = 18.1) participants. Co-occurring mental health difficulties, social functioning, and cognitive emotion regulation were assessed with questionnaires and clinical evaluations. Youth with autism showed higher levels of perceived stress related to their daily social context and activities, as well as an increased affective reactivity to activity-related stressors compared with non-autistic youth. Moreover, they reported using less adaptive and more non-adaptive emotion regulation, the latter increasing their affective response to daily stressors and possibly contributing to the severity of co-occurring mental health symptoms. Our findings demonstrate high perceived daily-life stress in autistic adolescents and young adults. To minimize the negative effects of stress and the development of mental health symptoms, interventions could focus on effective stress management and strategies that autistic young people use to manage their emotions. Previous research has shown that autistic individuals report high levels of perceived stress and have an increased likelihood of developing mental health difficulties. Increase in individuals' negative emotions in relation to perceived stress (i.e. affective reactivity to stress) is a known risk factor for mental health difficulties. In this study, we investigated perceived daily stress and affective reactivity to stress in autistic (n = 39, age = 18.4) and non-autistic (n = 55, age = 18.1) adolescents and young adults. We used the ecological momentary assessment, a technique that allows to assess individuals repeatedly in their daily life using their smartphone. Moreover, participants filled a questionnaire to evaluate the strategies they use to regulate emotions when faced with difficulties. Finally, a clinical interview and a parent-report questionnaire were used to assess mental health symptoms. Autistic youth reported higher levels of perceived daily stress compared with non-autistic peers. Moreover, they showed increased affective reactivity to stress related to their daily activities. Autistic participants reported more emotion regulation difficulties (e.g. more repetitive thinking of difficulties) compared with non-autistic participants. Difficulties in emotion regulation increased negative emotions in relation to stress and might contribute to the severity of mental health symptoms. We conclude that adolescents and young adults with autism report high perceived stress in their daily lives. To minimize the negative impact of stress and the development of mental health symptoms, people supporting autistic young people could focus on stress management skills and the strategies that the youth use to manage emotions. [ABSTRACT FROM AUTHOR]

Objective: Medications are critical for treating major depressive disorder (MDD) and bipolar disorder (BD). Unfortunately, 30% to 40% of individuals do not respond well to current pharmacotherapy. Given the compelling growing body of research on the gut-brain axis, this study aims to assess patient perspectives regarding microbiome-based therapies (MBT) such as probiotics, prebiotics, dietary changes, or fecal microbiota transplantation (FMT) in the management of MDD and BD. Methods: This single-centred observational study used quantitative and qualitative assessments to examine patient perceptions of MBT. Participants diagnosed with MDD or BD completed an anonymous questionnaire obtaining demographics, prior medication history, and symptom burden. Self-assessment questionnaires specific to each diagnosis were also used: Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR), Altman Self-Rating Mania Scale (ASRM), and General Anxiety Disorder Questionnaire (GAD-7). A logistic regression model analysed the association of MBT acceptance with disorder type, QIDS-SR, and GAD-7 scores. A bootstrap method assessed the proportion of MBT acceptance. The qualitative assessment consisted of 30-minute interviews to elicit perceptions and attitudes towards MBT. Results: The qualitative assessment achieved information power with n = 20. Results from the 63-item MBT questionnaire (n = 43) showed probiotics (37.2%) as the top choice, followed by FMT (32.6%), dietary change (25.6%), and prebiotics (4.6%). A majority of participants (72.1%) expressed willingness to try MBT for their mood disorder, however, logistic regression analysis did not identify statistically significant predictors for MBT acceptance among disorder type, QIDS-SR, and GAD-7. Conclusion: There is an increased focus on the gut microbiota's role in mood disorders' etiology and treatment. Promising research and patient interest underscore the necessity for exploring and educating on patient perspectives and the factors influencing attitudes towards MBT. [ABSTRACT FROM AUTHOR]

As humanity has been utilizing psychedelic substances for millennia, much knowledge has already been accumulated about the exploratory potential and therapeutic power of the psychedelic-induced nonordinary states of consciousness (NSC). However, we still have only a limited understanding of the process that unfolds in mind and the brain. Only recently have systematic investigations become possible, as the myths about psychedelics are abating and the legal strictures gradually loosening. With the availability of brain imaging techniques, exciting findings have been made about the associated dynamic brain processes. Our prospective observations of spontaneously generated NSC, major mood disorders, have been elucidating another dynamic aspect, the oscillatory brain processes. The findings indicate that the NSC's propensity is markedly increased at the peaks of the oscillatory brain activity and that the NSC entirely unfolds when the oscillations exceed their normal range. The observation that neurobiological correlates of experientially opposite NSC, melancholy and mania, appear qualitatively the same is compatible with the concept that the experiential content is emerging from nonlocal consciousness. Psychedelic experiences are triggered by the administration of the psychedelic drug. However, they are influenced by nondrug factors and molded, in particular, by the individual's mental set and the setting of the session. The transformative process can be utilized psychotherapeutically for healing and profound inner restructuring. [ABSTRACT FROM AUTHOR]

In Tourette syndrome (TS), apart from multiple motor and vocal tics, there are often myriads of associated conditions apparently similar to attention-deficit-hyperactivity-disorder (ADHD), obsessive-compulsive-disorder (OCD), mood-and-conduct disorder, learning difficulties, etc. On the other hand, tic disorders often occur as co-morbidity with many neurodevelopmental disorders such as ADHD, OCD and mood disorders, and pharmacotherapy of these behavioral conditions may worsen the tics. So, the confusion lies whether to separately code and manage the different neurodevelopmental disorders or assume an umbrella construct of "TS-plus," as suggested by some researchers. In this background, we share three cases of children and adolescents having multiple tics with mixed behavioral presentations of ADHD/OCD/mood disorders that created a lot of diagnostic dilemma and treatment-related complications in prior psychiatric consultations. They were finally diagnosed as "TS-plus" and managed with low-dose-risperidone-mono-pharmaco-therapy and psychological interventions. In conclusion, psychiatrists should be vigilant for Tourette-syndrome while handling children with repetitive motor behaviors along with hyperactivity, obsession-compulsion, mood-conduct, etc. Assumption of an umbrella-construct approach of "TS-plus" may be beneficial in limiting the number of diagnosis and their separate pharmacotherapy, which may worsen the clinical scenario. [ABSTRACT FROM AUTHOR]

About 16 million adults present with chronic back pain, the sixth most costly condition in the United States (US). Estimates suggest that about 60% of initial back surgeries have a successful outcome; however, many don't, leaving over 80,000 failed back surgeries per year. Failed Back Surgery Syndrome (FBSS) is defined by the International Association for the Study of Pain as back pain, with or without radiating pain, located in the lower limbs, of unknown origin, which persists or begins after surgical procedures are performed to treat lumbar disc herniations. Psychiatric comorbidities and psychosocial factors have been associated with patients presenting with this syndrome. A retrospective cross-sectional study was performed to identify the prevalence of FBSS in a population of patients during the period of January 2019-December 2020 across Hospital Corporation of America (HCA) Healthcare in the US. With a sample of 28,426 patients who underwent back surgery only 8% had FBSS. Those with FBSS (N = 2434) were mainly females (54.27%) with a mood disorder (61.18%), P -value <.0001. Among those with FBSS, there was a statistically significant relationship between mood disorder and smoking (57.37%) and obesity (54.61%) compared to non-smokers and non-obese. Lifestyle interventions may ameliorate disabling symptoms and improve the well-being of this population. [ABSTRACT FROM AUTHOR]

The Screen for Child Anxiety Related Emotional Disorders: Parent Version (SCARED-P) was originally developed for use in middle childhood and adolescence. The present study examined the psychometric properties and validity of the SCARED-P in an early childhood sample (predominantly aged 4–7 years). The 41-item version of the SCARED-P was administered to the parents of 233 children (mean age = 6.31 years, SD = 1.08; females = 34.3%). Confirmatory factor analysis provided mixed support for the original five-factor model of the SCARED-P. The SCARED-P demonstrated good to excellent internal consistency (total α =.94, subscale α =.68–.89), and good construct validity with the Child Behavior Checklist, Strengths and Difficulties Questionnaire, and the Developmental and Well-being Assessment. These findings indicate overall initial support for the SCARED-P's utility as a measure of anxiety in early childhood, but further psychometric and validation studies are needed in larger community-based samples of young children. [ABSTRACT FROM AUTHOR]

The mental health and wellbeing of children and young people who have been in care, primarily foster care, kinship care or residential care, remains a public health priority. The Care-experienced cHildren and young people's Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) synthesized evidence for the effectiveness of interventions targeting: subjective wellbeing; mental, behavioral and neurodevelopmental disorders; and suicide-related outcomes. Searches were conducted in 16 bibliographic databases and 22 websites between 1990 and 2022. This was supplemented by citation tracking, screening of relevant systematic reviews, and expert recommendation. We identified 35 interventions, with 44 evaluations via randomized controlled trials. Through meta-analyses, we found that interventions have a small beneficial impact on a variety of mental health outcomes in the short term (0–6 months). Interventions improved total social, emotional, and behavioral problems (d = −0.15, 95% CI [−0.28, −0.02]), social-emotional functioning difficulties (d = −0.18, 95% CI [−0.31, −0.05]), externalizing problem behaviors (d = −0.30, 95% CI [−0.53, −0.08]), internalizing problem behaviors (d = −0.35, 95% CI [−0.61, −0.08]); and depression and anxiety (d = −0.26, 95% CI [−0.40, −0.13]). Interventions did not demonstrate any effectiveness for outcomes assessed in the longer term (>6 months). Certainty of effectiveness was limited by risk of bias and imprecision. There was limited available evidence for interventions targeting subjective wellbeing and suicide-related outcomes. Future intervention design and delivery must ensure that programs are sufficient to activate causal mechanisms and facilitate change. Evaluation research should use a robust methodology. PROSPERO Registration: CRD42020177478 [ABSTRACT FROM AUTHOR]

Research has shown links between emotion regulation strategies and child mental health. However, it is not well known how the characteristics of children may moderate these links. The aim of this study was to explore whether environmental sensitivity—the ability to perceive and process information about the environment—moderates links between emotion regulation strategies (cognitive reappraisal and expressive suppression) and children's emotional and behavioral problems. The study included 1381 children (M age = 10.53, 51% girls) who gave information about their emotion regulation and environmental sensitivity, and whose teachers reported on their emotional and behavioral problems. The results showed that suppression predicted a higher amount of problems for girls regardless of their sensitivity level. For boys, environmental sensitivity moderated this link. Among more environmentally sensitive boys, the association between suppression usage and emotional and behavioral problems was stronger than among less sensitive boys. These results show that the effects of suppression may be exacerbated depending on the child's gender and environmental sensitivity. [ABSTRACT FROM AUTHOR]

Objective: Diagnostic assessment of ADHD is challenging due to comorbid psychopathologies and symptoms overlapping with other psychiatric disorders. In this study, we investigate if a distinct pattern of neuromuscular dysregulation previously reported in ADHD, can help identifying ADHD in psychiatric patients with diverse and complex symptoms. Method: We explored the impact of neuromuscular dysregulation, as measured by The Motor Function Neurologic Assessment (MFNU), on the likelihood of being diagnosed with ADHD, affective disorder, anxiety disorder, or personality disorder among adults (n = 115) referred to a psychiatric outpatient clinic. Results: Logistic regression revealed that neuromuscular dysregulation was significantly associated with ADHD diagnosis only (OR 1.15, p <.01), and not with affective-, anxiety-, or personality disorders. Sensitivity and specificity for ADHD at different MFNU scores is provided. Conclusions: A test of neuromuscular dysregulation may promote diagnostic accuracy in differentiating ADHD from other psychiatric disorders in patients with an overlapping symptom picture. This may have important implications for clinical practice. More studies are needed. [ABSTRACT FROM AUTHOR]

Prompted by Signal et al.'s study, this research examines UK "Pet Insurance" policies to see if and how experiencing domestic violence and abuse (DVA) in interspecies households is excluded under insurance policies terms. Situating our findings within the existing literature on human and companion animal victims of DVA, we discuss the implications for improving cross-reporting and multi-agency action to protect and prevent harm to humans and companion animal victims of DVA. In turn we identify a series of recommendations to combat discrimination in insurance, set out in our conclusion. [ABSTRACT FROM AUTHOR]

Children with disruptive mood dysregulation disorder have difficulties with emotion regulation and recognition which impacts their social functioning. Due to its recent definition, there is limited information on the neural mechanisms of this disorder. This exploratory study examined the role of autonomic heart regulation in children with disruptive mood dysregulation disorder, motivated by suggestions of reduced autonomic regulation (measured by heart rate variability) associated with psychiatric disorders in adults and children. The cross-sectional design sampled two groups of children, one with disruptive mood dysregulation disorder (n = 15; 14 male) and the other with typical development (n = 15; 14 male). Heart rate variability, facial emotion recognition accuracy and speed, and prosody were measured. There were no significant differences in heart rate variability between the two groups before, or during, the tasks. However, children with disruptive mood dysregulation disorder experienced significantly greater difficulty recognising fear in faces compared to controls and confused other negatively valenced emotions. There was also a significant negative correlation between heart rate variability and prosody modulation (verbal expression of emotion) in the control group, a relationship that was absent in the disruptive mood dysregulation disorder group. These results suggest that atypical autonomic regulation during emotionally evocative situations and difficulty with facial emotion recognition may contribute to the challenges experienced by children with disruptive mood dysregulation disorder. This is valuable knowledge for psychologists, which can contribute to individualised, effective, and comprehensive care that addresses the child's emotional, social, and relational well-being. [ABSTRACT FROM AUTHOR]

The role of a special educator is one of many different hats, including teacher, interventionist, comforter, parent, counselor, therapist, and administrator. These varying roles, particularly when working with students with emotional behavioral disorders, create one of the most emotionally taxing and challenging jobs in public education, which in turn leads to increased educator burnout and attrition. However, this does not need to be the fate of special educators. The purpose of this article is to (a) review one current support system widely implemented in the field for teachers of children with emotional behavioral disorders, (b) discuss the benefits of mentorship in the teaching workforce, (c) identify some of the barriers to mentorship, and (d) identify areas of reform for more effective mentorship practices. [ABSTRACT FROM AUTHOR]

Adolescent anhedonia is a multidimensional construct defined as the loss of enjoyment or pleasure across multiple domains of life. Anhedonia is concurrently associated with substantial impairment and distress, and it prospectively predicts the onset, severity, and treatment of depression. Despite its demonstrated importance, a limited number of anhedonia measures are validated for adolescents. The current study assessed the psychometric properties of the Dimensional Anhedonia Rating Scale (DARS) in 400 English-speaking, 12- to 19-year-old adolescents. Overall, the DARS demonstrated good convergent and discriminant validity, but sub-optimal concurrent validity. The strengths and limitations of the DARS and its utility as a measure of adolescent anhedonia are discussed. Furthermore, future directions for the construction of measures of adolescent anhedonia are outlined. [ABSTRACT FROM AUTHOR]

Intolerance of uncertainty (IU) is a risk factor for poor mental health. Acquired brain injury (ABI; for example, stroke, traumatic brain injury) often brings considerable uncertainty and increased mood disorder vulnerability. The Intolerance of Uncertainty Scale–Short Form (IUS-12) is a brief, well-validated IU measure in non-ABI samples, comprising two subscales, namely, Prospective Anxiety and Inhibitory Anxiety. Here, for the first time, we investigated its reliability and validity (N = 118), and factor structure (N = 176), in ABI. Both subscales had high test–retest reliability (intraclass correlation coefficients [ICCs] of.75 and.86) and were significantly associated with mood disorder symptoms. The two-factor model was superior to a one-factor IU model fit. Some fit statistics were less than optimal (standardized root mean square residual [SRMR] = 0.06, root mean square error of approximation [RMSEA] = 0.09); hence, exploration of other factor structures in other ABI samples may be warranted. Nonetheless, the IUS-12 appears suitable in ABI. [ABSTRACT FROM AUTHOR]

In recent years, some models for binary and graded format responses have been proposed to assess unipolar variables or "quasi-traits." These studies have mainly focused on clinical variables that have traditionally been treated as bipolar traits. In the present study, we have made a proposal for unipolar traits measured with continuous response items. The proposed log-logistic continuous unipolar model (LL-C) is remarkably simple and is more similar to the original binary formulation than the graded extensions, which is an advantage. Furthermore, considering that irrational, extreme, or polarizing beliefs could be another domain of unipolar variables, we have applied this proposal to an empirical example of superstitious beliefs. The results suggest that, in certain cases, the standard linear model can be a good approximation to the LL-C model in terms of parameter estimation and goodness of fit, but not trait estimates and their accuracy. The results also show the importance of considering the unipolar nature of this kind of trait when predicting criterion variables, since the validity results were clearly different. [ABSTRACT FROM AUTHOR]

Objective: Post-stroke mental health impairments are common, but under-assessed and under-treated. We aim to describe trends in the provision of mood management to patients with stroke, and describe factors associated with adoption of national mood management recommendations for stroke within Australian hospitals. Design: Secondary analysis of cross-sectional data from the biennial Stroke Foundation Audit Program. Setting: Participating acute (2011–2021) and rehabilitation hospitals (2012–2020) in Australia. Participants: In the acute audit, 22,937 stroke cases were included from 133 hospitals. In the rehabilitation audit, 15,891 stroke cases were included from 127 hospitals. Main measures: Hospital- and patient-level mood management processes. Results: Among 133 acute hospitals (22,937 stroke episodes), improvements were made between 2011 and 2021 in utilization of mood screening (17% [2011], 33% [2021]; p < 0.001) and access to psychologists during hospital stay (18% [2011], 45% [2021]; p < 0.001). There was no change in access to a psychologist among those with a mood impairment (p = 0.34). Among 127 rehabilitation hospitals (15,891 stroke episodes) improvements were observed for mood screening (35% [2012], 61% [2020]; p < 0.001), and access to a psychologist during hospital stay (38% [2012], 68% [2020]; p < 0.001) and among those with a mood-impairment (30% [2012], 50% [2020]; p < 0.001). Factors associated with receiving mood management processes included: younger age, not requiring an interpreter and longer length of stay. Conclusions: Adherence to mood management recommendations has improved over 10 years within Australian hospitals. Those aged over 65, requiring an interpreter, or with shorter hospital stays are at risk of missing out on appropriate mood management. [ABSTRACT FROM AUTHOR]

In the current study we sought to identify sexual behavior profiles and examine the levels of childhood abuse history and trauma measures in each profile. The study was conducted among a large non-clinical sample of men and women (n = 806). Latent profile analysis was employed to identify distinct profiles of sexual behaviors and then childhood abuse, posttraumatic stress disorder (PTSD), depression, and anxiety, and motives for engaging in sex were assessed in each profile. Four distinct profiles of sexual behavior were identified: hyposexual individuals, hypersexual porn users, porn users, and within usual ranges (WURs). Hypersexual porn users had significantly more childhood trauma (emotional, physical, and sexual) than WURs, significantly greater PTSD symptom than WURs and hyposexual individuals, and significantly greater anxiety and depression as compared with all other groups. The hyposexual individuals had significantly lower scores on all motives for engaging in sex than did porn users or hypersexual porn users. Hypersexual porn users and porn users reported coping and peer-pressure as motives for engaging in sex more than did WURs or hyposexual individuals. Clinicians working with survivors of childhood abuse should consider directly targeting these different maladaptive sexual behaviors by addressing PTSD symptoms, affective disorders, and motives for engaging in sex. [ABSTRACT FROM AUTHOR]

Background: A variety of psychiatric illnesses can develop in children of parents who suffer from bipolar affective disorder. Aims: The purpose of the research was to investigate, among the offsprings of patients diagnosed with schizophrenia and bipolar disorder type I, the prevalence of a variety of psychiatric diseases as well as a range of behavioral abnormalities. Method: This was a cross-sectional observational comparative study. The outpatient psychiatric clinics at Shebin Elkom Mental Health Hospital, Menofia Governorate, Egypt 500 offspring (there were 250 offspring of parents both diagnosed with schizophrenia and 250 offsprings born to parents with bipolar affective disorder). Results: Statistically significant association of male gender with somatic complaints, social problems, and attention problems in the bipolar offspring group. In addition, there was a statistically significant association between female gender and anxiety or depression in the bipolar offspring group. Moreover, there was a statistically significant association between male gender and thought problems and aggressive behavior in the schizophrenia group. Assessment of psychiatric symptoms using K-SADS in relation to gender revealed a statistically significant association of male gender with affective disorder, behavioral disorder, and substance use disorder in the bipolar offspring group. Moreover, there was a statistically significant association between female gender and psychotic disorder in the schizophrenia group. Conclusion: We concluded that offspring with bipolar illness had a significant association with somatic symptoms, anxiety/depressive disorder, social issues, attention problems, and aggressive behavior. Schizophrenia offspring were strongly related to thought issues. [ABSTRACT FROM AUTHOR]

Autistic people appear to be at increased risk of post-traumatic stress disorder, and experiences involving violence or sexual abuse appear to be common in this population. However, knowledge concerning trauma in autistic people with co-occurring intellectual disabilities is limited. In this cross-sectional study, we explored the prevalence of post-traumatic stress disorder, as well as the prevalence and clinical correlates of reported experiences of violence and sexual abuse, in a clinical sample of 88 autistic adults with intellectual disabilities referred for mental health assessment. Only three participants (3.4%) were diagnosed with post-traumatic stress disorder, even if experiences involving violence (34.1%) or sexual abuse (17.0%) were common. Anxiety and affective disorders were common diagnoses among participants with these experiences. Controlling for autism characteristics, level of intellectual disability and communication skills, experiences of violence/sexual abuse were found to be associated with a measure of 'challenging' behaviours (Aberrant Behaviour Checklist). These results indicate that potentially traumatic experiences are common in autistic adults with intellectual disabilities referred for mental health assessment and that post-traumatic stress disorder may be under-recognised. The findings highlight the importance of trauma screening and post-traumatic stress disorder assessment, as well as the importance of trauma-informed care, in this population. Post-traumatic stress disorder is a mental health disorder that may be triggered by the experience of events perceived as terrifying or overwhelming. Examples of such events include being the victim of violence or sexual abuse. Compared with other people, autistic people have increased risk of being exposed to violence or sexual abuse. In addition, autistic people may be more vulnerable to developing post-traumatic stress disorder following such exposure. However, knowledge is limited concerning the prevalence of experiences involving violence and sexual abuse, and post-traumatic stress disorder, in autistic people with co-occurring intellectual disabilities. Detection of these experiences, and identification of post-traumatic stress disorder, may be challenging in these individuals, and previous research indicates that post-traumatic stress disorder symptoms may be overlooked or misinterpreted. In this study, we examined prevalence of post-traumatic stress disorder, violence and sexual abuse in a clinical sample of 88 autistic adults with intellectual disabilities referred for mental health assessment. Only 3.4% were diagnosed with post-traumatic stress disorder, even if experiences involving violence (34.1%) or sexual abuse (17.0%) were common. Anxiety and affective disorders were common diagnoses among participants with these experiences. Controlling for autism characteristics, level of intellectual disability and communication skills, experiences of violence/sexual abuse were found to be associated with a measure of 'challenging' behaviours. These results indicate that potentially traumatic experiences are common in autistic adults with intellectual disabilities referred for mental health assessment, and that post-traumatic stress disorder may be under-recognised. The findings highlight the importance of trauma screening and post-traumatic stress disorder assessment, as well as the importance of trauma-informed care, in this population. [ABSTRACT FROM AUTHOR]

Objective: This analysis estimated 2013 annual healthcare costs associated with the common mental disorders of mood and anxiety disorders and psychological symptoms within a representative sample of Australian women. Methods: Data from the 15-year follow-up of women in the Geelong Osteoporosis Study were linked to 12-month Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data. A Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Non-patient edition identified common mental disorders and the General Health Questionnaire 12 assessed psychological symptoms. Participants were categorised into mutually exclusive groups: (1) common mental disorder (past 12 months), (2) subthreshold (no common mental disorder and General Health Questionnaire 12 score ⩾4) or (3) no common mental disorder and General Health Questionnaire 12 score <4. Two-part and hurdle models estimated differences in service use, and adjusted generalised linear models estimated mean differences in costs between groups. Results: Compared to no common mental disorder, women with common mental disorders utilised more Medicare Benefits Schedule services (mean 26.9 vs 20.0, p < 0.001), had higher total Medicare Benefits Schedule cost ($1889 vs $1305, p < 0.01), received more Pharmaceutical Benefits Scheme prescriptions (35.8 vs 20.6, p < 0.001), had higher total Pharmaceutical Benefits Scheme cost ($1226 vs $740, p < 0.05) and had significantly higher annual out-of-pocket costs for Pharmaceutical Benefits Scheme prescriptions ($249 vs $162, p < 0.001). Compared to no common mental disorder, subthreshold women were less likely to use any Medicare Benefits Schedule service (89.6% vs 97.0%, p < 0.01), but more likely to use mental health services (11.4% vs 2.9%, p < 0.01). The subthreshold group received more Pharmaceutical Benefits Scheme prescriptions (mean 43.3 vs 20.6, p < 0.001) and incurred higher total Pharmaceutical Benefits Scheme cost ($1268 vs $740, p <.05) compared to no common mental disorder. Conclusions: Common mental disorders and subthreshold psychological symptoms place a substantial economic burden on Australian healthcare services and consumers. [ABSTRACT FROM AUTHOR]

A major challenge for juvenile correctional facilities (JCF) is providing literacy instruction to a transitory student population with a wide range of literacy abilities. The purpose of this study was to identify unique literacy profiles of students in long-term JCF taking into consideration their reading abilities, language abilities, intelligence quotient (IQ), disability classification, age, and grade level. Using latent profile analyses with a sample of 370 in the southeastern United States, we identified three distinct classes. Three ability groups of students (average literacy abilities, below-average literacy abilities, substantially below-average literacy abilities) were identified. Thirty-six percent performed at the average level, 55% performed below grade level; and 8% had substantial literacy deficits with an overrepresentation of students with emotional disturbance (ED) and specific learning disability (SLD). Findings provide the foundation for an evidence-based multi-tiered system of supports literacy framework within JCF. Instructional implications concerning the provision of English Language Arts in JCF are provided. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the relationship between physical intimate partner violence (IPV) victimization and four related aspects of emotional well-being: threat sensitivity, intolerance of uncertainty, impulse control, and access to resources for emotional regulation. We draw on a transactional model of IPV and emotional regulation to theorize how invalidation and partner threats in relationships can generate harmful emotional outcomes. We used representative data collected for residents living in five U.S. states: Colorado, Minnesota, Mississippi, New Jersey, and Texas. Our analytic sample included individuals who reported having been in a romantic relationship in the past year (N = 2,501). Data were collected using a probability-based web panel, between April 29 and May 15, 2022. Following the presentation of descriptive statistics and bivariate correlations, we developed a series of four multivariate models (ordinary least squares [OLS], negative binomial) to analyze the association between IPV victimization and each emotional outcome. All models adjusted for pertinent demographic and geographic control measures. Physical IPV victimization was associated with increased intolerance of uncertainty and heightened threat sensitivity. IPV victimization also corresponded with poorer impulse control and fewer resources for emotional regulation. Overall, our results demonstrate that experiences of physical IPV victimization are linked to poorer emotional outcomes. These outcomes can be harmful to broader mental health and potentially impact long-term well-being. The findings underscore the importance of mental health screenings that extend beyond assessments of diagnostic-level functions and allocating resources toward alleviating other clinically relevant factors that might arise from or even prompt additional exposure to physical IPV. [ABSTRACT FROM AUTHOR]

Objectives: To characterize health related quality of life (HRQOL) for Canadians aged 16 to 25 (adolescents and young adults, AYAs) seeking care for mood and anxiety concerns at the First Episode Mood and Anxiety Program, in London, Ontario and to identify factors associated with HRQOL in this population. Methods: AYAs completed demographic, psychometric, and HRQOL questionnaires. We calculated 36-Item Short-Form Health Survey (SF-36) scores standardized to Canadian and US population norms. We computed Short Form 6 Dimension (SF-6D) utilities conducting multivariable linear regression analysis, adjusting for age, sex, ethnoracial minority status, parental marital/cohabitation status, parental education, the Anxiety Sensitivity Index (ASI-R), Montgomery-Åsberg Depression Rating Scale Self-Report (MADRS-S), Sheehan Disability Scale (SDS), and a modified Inventory of College Students' Recent Life Experiences (ICSRLE-M). Results: Amongst 182 AYAs who completed questionnaires, mean physical component summary (PCS), mental component summary (MCS) and SF-6D utility scores were low, 43.8 (SD = 16.6), 19.0 (SD = 11.9) and.576 (SD =.074), respectively. Maternal post-secondary education, depression (MADRS-S) and functional impairment (SDS) were significantly associated with SF-6D utility. Conclusion: This cohort of mental healthcare-seeking AYAs had significantly impaired psychometric and utility-based measures of quality of life, underscoring the importance of timely access to healthcare services for this population. [ABSTRACT FROM AUTHOR]

Background: Deliberate self-harm (DSH) and emotion dysregulation (ED) peaks in adolescence, and is associated with an increased risk of psychopathology, suicide and lower functioning in adulthood. DBT-A has been established as an effective treatment for reducing DSH, however less is known about changes in emotion dysregulation. This study aimed to identify baseline predictors of treatment response in outcome trajectories of DSH and emotion dysregulation. Methods: Response trajectories of DSH and ED were investigated using Latent Class Analysis on RCT data comparing DBT-A and EUC for 77 adolescents treated for deliberate self-harm and borderline traits. Logistic regression analysis was used to examine baseline predictors. Results: Two-class solutions were selected for both indicators, distinguishing between early and late responders in DSH, and responders and non-responders in ED. Higher levels of depression, shorter DSH histories and not receiving DBT-A predicted less favourable response in DSH, while DBT-A was the only predictor of treatment response in ED. Conclusions: DBT-A was associated with a significantly faster reduction of deliberate self-harm in the short-term and improved emotion regulation in the long-term. [ABSTRACT FROM AUTHOR]

Background: Disruptive Mood Dysregulation Disorder was included in DSM-5 to accommodate new research addressing aspects of emotional dysregulation in children suffering from disruptive behavior problems. Despite growing interest in Disruptive Mood Dysregulation Disorder, few studies have looked at prevalence rates in European clinical populations. The primary objective of this study was to examine the prevalence and characteristics associated with Disruptive Mood Dysregulation Disorder in a Norwegian clinical sample. Methods: The present study assessed children 6–12 years of age referred to a mental health clinic for evaluation and treatment (N = 218, M age = 9.6, 60.4% boys) and compared those who did and did not meet Disruptive Mood Dysregulation Disorder diagnostic criteria. Diagnoses were determined using K-SADS-PL 2013. Associated difficulties at home and in school were measured by Achenbach Systems of Empirically Based Assessment battery. Results: In this clinical sample, 24% met the diagnostic criteria for Disruptive Mood Dysregulation Disorder. Children with Disruptive Mood Dysregulation Disorder were more likely than those without Disruptive Mood Dysregulation Disorder to be male (77% vs. 55%, p =.008), be living in poverty, have multiple mental health diagnoses (79% vs. 53%, p =.001), and have lower global functioning levels as measured by Children's Global Assessment Scale (range 0–100, M = 47, SD = 8.5 vs. M = 57, SD = 11.4, p =<.001). Finally, parents and teachers of children with Disruptive Mood Dysregulation Disorder reported lower overall competence and adaptive functioning, and higher total symptom load than children with other diagnoses. Conclusion: Disruptive Mood Dysregulation Disorder is highly prevalent in a Norwegian clinical sample and displays a high symptom load. Our results are in accordance with similar studies. Consistent findings across the world may support Disruptive Mood Dysregulation Disorder as a valid diagnostic category. [ABSTRACT FROM AUTHOR]

There have been proposals to expand definitions for categorical disorders and dimensionally conceptualized syndromes (e.g., psychopathy) to include negative mood lability and dysregulation (NMD). Factor analytic results are often presented in support of these proposals, and we provide factor analytic demonstrations across clinically oriented samples showing that NMD indicators load strongly onto factors with a range of psychopathology. This is unsurprising from a transdiagnostic perspective but shows that factor analysis could potentially be used to justify expanding definitions for specific constructs even though NMD indicators show strong, nonspecific loadings on psychopathology factors ranging widely in nature. Expanding construct definitions and assessment approaches to emphasize NMD also may negatively impact discriminant validity. We agree that targeting NMD is essential for comprehensive assessment, but our demonstrative analyses highlight a need for using factor analysis and other statistical methods in a careful, theoretically driven manner when evaluating psychopathology structure and developing measures. [ABSTRACT FROM AUTHOR]

Background: Persistent cognitive impairment is frequent across bipolar disorder (BD) and major depressive disorder (MDD), highlighting an urgent need for pro-cognitive treatments. Aim: This study investigated effects of erythropoietin (EPO) on cognitive impairment and dorsal prefrontal cortex (dPFC) activity in affective disorders. Methods: In this randomized, double-blinded, placebo-controlled trial, cognitively impaired patients with remitted BD or MDD received 1 weekly recombinant human EPO (40,000 IU/mL) or saline infusion for a 12-week period. Assessments were conducted at baseline, after 2 weeks of treatment (week 3), immediately after treatment (week 13) and at 6-months follow-up. Participants underwent functional MRI during performance on a n-back working memory (WM) task at baseline and week 3, and for a subgroup 6 weeks post-treatment (week 18). The primary outcome was a cognitive composite score at week 13, whereas secondary outcomes comprised sustained attention and functioning. WM-related dPFC activity was a tertiary outcome. Results: Data were analysed for 101 of the 103 included patients (EPO, n = 58; saline, n = 43). There were no effects of EPO over saline on any cognitive or functional outcomes or on WM-related dPFC activity. Conclusions: The absence of treatment-related changes in cognition and neural activity was unexpected and contrasts with multiple previous preclinical and clinical studies. It is possible that the lack of effects resulted from a recent change in the manufacturing process for EPO. Nevertheless, the findings support the validity of dPFC target engagement as a biomarker model for pro-cognitive effects, according to which treatments that do not improve cognition should not modulate dPFC activity. Trial registrations: EudraCT no.: 2016–004023-24; ClinicalTrials.gov identifier: NCT03315897. [ABSTRACT FROM AUTHOR]

Students with emotional and behavioral disorders (EBD) characteristically experience academic difficulties. There is growing evidence that the continuum from academic competence to underachievement is partially explained by executive function (EF; neurocognitive attention-regulation processes) and stress. Yet, there is scarce research investigating these relationships among students with or at risk for EBD, especially during the elevated stress and risk period of middle school, and particularly among racially/ethnically under-represented groups. Therefore, with 118 U.S. middle schoolers with or at risk for EBD and typical peers (70% Hispanic/Latinx; 25% Black), we examined group differences and relationships among perceived family, peer, and school stress, EF, and academic outcomes. When compared with their typical peers, students with or at risk for EBD scored lower on EF and academic tasks. For all students, higher EF predicted better academic functioning. Perceived stress was directly and negatively related with EF and indirectly associated with academic outcomes via EF. [ABSTRACT FROM AUTHOR]

The Canadian Network for Mood and Anxiety Treatments (CANMAT) has updated their clinical guidelines for the treatment of major depressive disorder (MDD) in adults. The guidelines provide a comprehensive summary of the latest evidence for the assessment and treatment of MDD, including various treatment options such as psychological, pharmacological, and digital health interventions. The guidelines emphasize the importance of combining psychological approaches with pharmacotherapy and provide recommendations for treatment evaluation. However, there are variations in advice on treatment strategies among different guidelines, particularly regarding the use of lithium and ketamine as adjunct-treatments. In the future, there may be a shift towards personalized treatment approaches based on individual molecular features and the integration of artificial intelligence in the development of clinical guidelines. [Extracted from the article]

General labels tend to obscure objective realities upon which disability rights are based and can deny individuals with disabilities their educational and civil rights. Undoubtedly, stigma can come from labels unnecessarily categorizing people into separate groups. However, stigma does not reside primarily in disability categories/terms but in what people think of words' referents. The replacement of the old disability categories/terms with new ones is a case of what is called the "euphemism treadmill," showing how concepts and mentally represented realities, not words, are the key issue. However, in the case of disabilities, scientific names are unavoidable for the purposes of research, education, advocacy, and social welfare. Some people try to avoid naming special education and its derivatives just as they do in the case of disability categories. We argue that scientifically validated disability and special education labels are necessary and legitimate classifications required for progress in disability research and practice. They provide the most direct route to legally protecting and serving individuals with educational disabilities. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the efficacy of the Family Check-Up initiated during kindergarten on teacher-report of children's emotional and behavior concerns in fourth grade. Participants were 57 primary caregivers, along with their children and teachers. Participants were randomized to a Family Check-Up condition or school-as-usual control condition. Teachers reported on children's emotional and behavior concerns at kindergarten and fourth grade. Findings suggested children whose caregivers were randomized to the Family Check-Up condition outperformed children in the school-as-usual control condition on moderate and serious emotional and behavior concerns in fourth grade. Implications for aligning and integrating family-centered assessment and treatment in schools are discussed. [ABSTRACT FROM AUTHOR]

Disproportionality persists with regard to the labeling of students with emotional and behavioral disorders (EBD). A blending of critical race theory and disability studies, or DisCrit, provides a framework to examine disproportionality. In this article, a DisCrit mindset is applied to examine how racism and ableism intersect to disproportionately marginalize children of color. A critique of assessment practices, as well as the EBD definition, from a DisCrit perspective is offered to strengthen approaches for equity. We end with recommendations for educational practices and policies and suggest areas for future research. [ABSTRACT FROM AUTHOR]

Teachers should possess adequate knowledge of emotional and behavioral disorders (EBDs) to effectively meet the unique needs of students with EBDs. This study explored the implementation and outcomes of a professional development training program on EBDs. In addition, the study examined outcomes concerning the knowledge of in-service teachers about EBDs and their self-efficacy in working with students with EBDs. This study recruited 81 general education teachers from two Saudi Arabia elementary schools, assigned under the intervention or waitlist control groups. Measures of knowledge and self-efficacy in EBDs were obtained at baseline, immediately after training, and at 5 weeks follow-up. The results demonstrated that teacher knowledge and self-efficacy in working with students with EBDs significantly improved as a result of the training program. In addition, the study observed that teacher efficacy was significantly correlated with their knowledge of EBDs. Improving teacher knowledge and self-efficacy through professional development training will mainly increase their ability and willingness to teach students with EBDs successfully in an inclusive learning environment. [ABSTRACT FROM AUTHOR]

When people experience emotions in a group, their emotions tend to have stronger intensity and to last longer. Why is that? This question has occupied thinkers throughout history, and with the use of digital media it is even more pressing today. Historically, attention has mainly focused on processes driven by the way emotions are shared between people via emotional interactions. Although interactions are a major driver of group emotionality, I review empirical findings that suggest that understanding group emotionality requires a broader view that integrates two additional processes: how emotions unfold within the social infrastructure in which they are shared and how these processes are affected by people's cognition about emotions. I propose to summarize the literature using an infrastructure-cognition-interaction framework that contributes to a broader understanding of group emotionality, which should improve our ability to predict group emotionality and to change these emotions when they are undesired. [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) students report higher alcohol consumption, emotion regulation difficulties, and sexual assault victimization severity than cisgender, heterosexual individuals. A sample of 754 undergraduate students completed an online survey assessing alcohol use, emotion regulation, and sexual victimization. Regression analyses indicated that, among SGM students with higher emotion regulation difficulties, typical weekly drinking was positively associated with sexual assault victimization severity, but among cisgender, heterosexual students and SGM students with lower emotion regulation difficulties, there was no association between drinking and victimization severity. Thus, SGM students benefit from interventions targeting alcohol use and emotion regulation difficulties. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate social cognition and empathy properties in children among Disruptive Mood Dysregulation Disorder (DMDD) + Attention and Hyperactivity Disorder(ADHD); ADHD and healthy controls from Türkiye. Methods: Twenty-two children with DMDD were compared to matched 30 children with ADHD and 60 healthy controls. We administered Affective Reactivity Index (ARI), KaSi Empathy Scale, Kiddie-SADS, and Reading Mind in the Eyes Test (RMET) to evaluate Theory of Mind skills to all study participants. Results: DMDD + ADHD group had lower performance in ToM skills and empathy than in two groups. The ARI scores were found to be statistically significantly higher in the DMDD group than in two groups. It was also found that ARI, empathy, and ToM scores were significantly related in children with DMDD + ADHD. Conclusion: These results might be important to understand the difficulties in social functioning and interpersonal relationship in children with DMDD and ADHD. Children with DMDD may attend specific therapeutic programs which include specific techniques in social cognition, emotion regulation, and irritability. [ABSTRACT FROM AUTHOR]

The purpose of this study is to estimate the rate of emotional disturbance (ED) among children in foster care and assess the validity of the national foster care census data (AFCARS) measure of ED. This study used linked child protection and Medicaid records from 2014 and 2015, for the states of California and Wisconsin, as well as data from AFCARS, a federal population census of children in foster care which states are mandated to contribute to. ED is defined by AFCARS and includes an array of mental and behavioral health diagnoses. According to AFCARS, 13% of CA children in foster care and 15% of WI children in foster care had an ED, whereas Medicaid claims produce rates of 45% and 48%, respectively. Rates of ED among children in congregate care were underestimated by 43–46 percentage points, with substantial proportions having diagnoses of disruptive behavioral disorders. Despite the AFCARS ED measure being cited in congressional testimonies and its wide use in research, results from this study suggest that the AFCARS ED estimates are an unreliable metric for use in research, policy, or practice. [ABSTRACT FROM AUTHOR]

Introduction: Social determinants of health (SDH) influence and modify the risk for mental health disorders. To our knowledge, no study has explored SDH in the context of mental health in Saudi Arabia (SA) using population-based data. This study investigated the association between several SDH and anxiety and mood disorders in SA. Methods: We utilized data from the nationally-representative Saudi National Mental Health Survey (SNMHS) conducted in 2014 to 2016. This study examined associations between personal-level, socioeconomic, physical health, and family environment characteristics and anxiety and mood disorders. Participants were classified as having anxiety-only disorders, mood-only disorders, or comorbidity of both disorders. Multinomial logistic regression models were employed to examine the associations between SDH and anxiety and/or mood disorders, comparing them to participants who had not experienced these disorders. Results: A total of 4,004 participants were included in this analysis; the lifetime prevalence of disorders was: anxiety only (18%), mood only (3.8%), and comorbidity of both (5.3%). Regression models indicated that females, young adults (26–35 years), individuals with a higher level of education, and those who were separated or widowed had higher odds of experiencing anxiety and/or mood disorders. Furthermore, there was a significant and direct association between having physical chronic conditions and all three categories of anxiety and mood disorders. Experiencing Adverse Childhood Events (ACEs) was also associated with a significant risk of developing anxiety and/or mood disorders, with the highest risk associated with physical or sexual abuse, followed by violence and neglect. Conclusion: This study underscores the correlation between several personal-level, socioeconomic, and environmental SDH and anxiety and mood disorders in SA. These findings provide a foundation for future analyses examining the intricate interplay between upstream and downstream SDH in SA. Such research can enhance local scientific knowledge, aid in planning for social services, and inform policy decisions and treatment strategies. [ABSTRACT FROM AUTHOR]

The Individuals with Disabilities Education Act allows states some autonomy in altering the disability category terminology and definitions, given that the changes do not exclude students eligible under the federal language. Several states have used this flexibility for the emotional disturbance category historically. This study provides a contemporary analysis of the interstate variation in the emotional disturbance category through a comprehensive evaluation of state department education policy documents for differences in terminology, definition, and disability-specific evaluation procedures and guidance. The work is contextualized by previous reviews of similar but different purposes relevant to the time periods in which they occurred. Data from the current study show continued convergence toward the language in the federal definition. Results present notable differences related to cultural considerations, the social maladjustment exclusionary clause, and the provision of mental health services. Implications for research and policy are discussed. [ABSTRACT FROM AUTHOR]

Students with emotional and behavioral challenges often struggle with writing. Curriculum-based measurement (CBM) is an assessment used for a variety of purposes including screening, progress monitoring, and data-based individualization. However, little research has examined technical properties of writing CBM data and supported inferences. This study examined criterion validity of two CBM tasks with the Test of Written Language-4 and whether writing fluency was affected by writing prompt type. Thirty-eight students in 7th–12th grades with emotional and behavioral challenges completed a descriptive writing task and a narrative writing task. Writing samples were scored for the number of words written, words spelled correctly, correct word sequences, and correct minus incorrect word sequences. Across all scoring procedures, associations between the descriptive prompt and the Test of Written Language-4 (number of words written, r =.27 [−.12,.58], words spelled correctly, r =.33 [−.05,.62]; correct word sequences, r =.38 [01,.65]; and correct minus incorrect word sequences, r =.44 [.08,.69] were stronger than associations between the narrative prompt and criterion measure. [ABSTRACT FROM AUTHOR]

Due to ongoing and severe teacher shortages, preparing and sustaining a skilled special education teacher (SET) workforce is a top policy priority. Understanding predictors of SETs' intent to leave is crucial for policy makers and school leaders alike, as they seek to develop interventions to support retention efforts. In this study, we examined attrition intentions among SETs serving students with emotional and behavioral disorders (EBDs), using longitudinal survey data from a U.S. nationally representative sample of teachers in the 2019–2020 school year (fall-winter-spring). We measured teachers' self-efficacy and burnout in fall, winter, and spring as well as teachers' intent to leave in spring. We found all three dimensions of fall burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) had an indirect effect on spring intent to leave. All three dimensions of burnout in the spring predicted intent to leave, as did winter scores on depersonalization. Cross-time relationships between of dimensions of self-efficacy and burnout were revealed; however, at no timepoint was self-efficacy a significant predictor of intent to leave in spring, whether directly or indirectly. We discuss implications for both practitioners and researchers. [ABSTRACT FROM AUTHOR]

The relationship between body dissatisfaction and negative affect is complex, with some research suggesting that this combination motivates individuals to engage in more health-related behaviors; while other studies find it increases unhealthy behavior. To bridge this gap, it may be the case that to the extent these individuals have continuity between their present and future selves, the more likely they are able to make positive health-related choices with this future self in mind. We examined individuals (n = 344; 51.74% men) aged between 18 and 72 years (M = 39.66, SD = 11.49) who endorsed high negative affect along with body dissatisfaction but either had high or low levels of future self-continuity. We found individuals experiencing body dissatisfaction and negative affect reported higher engagement in healthy behaviors only if they had a strong connection to their future self, index of moderated mediation = 0.07 (95% CI = 0.02, 0.13). These findings support targeting future-self continuity in therapeutic regimens to bolster engagement in healthy behaviors among individuals with body dissatisfaction and high negative affect. [ABSTRACT FROM AUTHOR]

Objectives: A systematic review and meta-analysis were conducted to determine if children born with cleft lip and/or palate are at increased risk of psychological and peer difficulties, and if so, which difficulties they develop. Methods: EMBASE, MEDLINE, and PsycINFO were searched for English language studies published between January 2005 and January 2022 which investigated the psychological outcomes and peer function of children with nonsyndromic cleft lip and palate. Outcomes included internalizing problems, such as anxiety and depression, externalizing problems, such as hyperactivity, conduct disorders, self-concept including self-image and self-esteem, peer problems, resilience, coping, and overall psychological function. A risk of bias assessment was performed using the Newcastle-Ottawa Scale. Random effects models were used in the meta-analysis to compare the outcomes for children born with a cleft and those without. Results: In total 41 studies met inclusion criteria, with 9 included in the meta-analysis. Children born with a cleft appear to have similar psychological outcomes compared to normative controls when using the strengths and difficulties questionnaire. There are some minor differences between self-report and parent report, with parents generally reporting that their child with a cleft has increased emotional, conduct, and hyperactivity problems. The small differences between the study cohort and control cohorts are unlikely to imply any differences on a clinical level. Conclusions: Overall psychological outcomes appear to be similar between children born with a cleft and the nonaffected population, however, some symptoms such as anxiety and depression appear higher in children with cleft lip and/or palate. [ABSTRACT FROM AUTHOR]

The assessment of oppositional defiant disorder, conduct disorder, antisocial personality disorder, and intermittent explosive disorder—the Disruptive, Impulse Control and Conduct Disorders—can be affected by biases in clinical judgment, including overestimating concerns about distinguishing symptoms from normative behavior and stigma associated with diagnosing antisocial behavior. Recent nosological changes call for special attention during assessment to symptom dimensions of limited prosocial emotions and chronic irritability. The present review summarizes best practices for evidence-based assessment of these disorders and discusses tools to identify their symptoms. Despite the focus on disruptive behavior disorders, their high degree of overlap with disruptive mood dysregulation disorder can complicate assessment. Thus, the latter disorder is also included for discussion here. Good practice in the assessment of disruptive behavior disorders involves using several means of information gathering (e.g., clinical interview, standardized rating scales or checklists), ideally via multiple informants (e.g., parent-, teacher-, and self-report). A commitment to providing a full and accurate diagnostic assessment, with careful and attentive reference to diagnostic guidelines, will mitigate concerns regarding biases. [ABSTRACT FROM AUTHOR]

Objective: Blood biomarkers of neuronal injury such as neurofilament light (NfL) show promise to improve diagnosis of neurodegenerative disorders and distinguish neurodegenerative from primary psychiatric disorders (PPD). This study investigated the diagnostic utility of plasma NfL to differentiate behavioural variant frontotemporal dementia (bvFTD, a neurodegenerative disorder commonly misdiagnosed initially as PPD), from PPD, and performance of large normative/reference data sets and models. Methods: Plasma NfL was analysed in major depressive disorder (MDD, n = 42), bipolar affective disorder (BPAD, n = 121), treatment-resistant schizophrenia (TRS, n = 82), bvFTD (n = 22), and compared to the reference cohort (Control Group 2, n = 1926, using GAMLSS modelling), and age-matched controls (Control Group 1, n = 96, using general linear models). Results: Large differences were seen between bvFTD (mean NfL 34.9 pg/mL) and all PPDs and controls (all < 11 pg/mL). NfL distinguished bvFTD from PPD with high accuracy, sensitivity (86%), and specificity (88%). GAMLSS models using reference Control Group 2 facilitated precision interpretation of individual levels, while performing equally to or outperforming models using local controls. Slightly higher NfL levels were found in BPAD, compared to controls and TRS. Conclusions: This study adds further evidence on the diagnostic utility of NfL to distinguish bvFTD from PPD of high clinical relevance to a bvFTD differential diagnosis, and includes the largest cohort of BPAD to date. Using large reference cohorts, GAMLSS modelling and the interactive Internet-based application we developed, may have important implications for future research and clinical translation. Studies are underway investigating utility of plasma NfL in diverse neurodegenerative and primary psychiatric conditions in real-world clinical settings. [ABSTRACT FROM AUTHOR]