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Explore trial participants’ and research team members’ perceptions of the impact of the videoconference-based, supportive care program (SPIN-CHAT Program) during early COVID-19 for individuals with systemic sclerosis (SSc). Data were collected cross-sectionally. A social constructivist paradigm was adopted, and one-on-one videoconference-based, semi-structured interviews were conducted with SPIN-CHAT Trial participants and research team members. A hybrid inductive-deductive approach and reflexive thematic analysis were used. Of the 40 SPIN-CHAT Trial participants and 28 research team members approached, 30 trial participants (Mean age = 54.9; SD = 13.0 years) and 22 research team members agreed to participate. Those who took part in interviews had similar characteristics to those who declined. Five themes were identified: (1) The SPIN-CHAT Program conferred a range of positive psychological health outcomes, (2) People who don’t have SSc don’t get it: The importance of SSc-specific programming, (3) The group-based format of the SPIN-CHAT Program created a safe space to connect and meet similar others, (4) The structure and schedule of the SPIN-CHAT Program reduced feelings of boredom and contributed to enhanced psychological health, (5) The necessity of knowledge, skills, and tools to self-manage SSc and navigate COVID-19. Participants’ and research team members’ perspectives elucidated SPIN-CHAT Program benefits and how these benefits may have been realized. Results underscore the importance of social support from similar others, structure, and self-management to enhance psychological health during COVID-19. clinicaltrials.gov (NCT04335279)IMPLICATIONS FOR REHABILITATIONThe videoconference-based, supportive care SPIN-CHAT Program enhanced psychological health amongst individuals affected by systemic sclerosis.SPIN-CHAT Program participants and research team members shared that being around similar others, program structure, and self-management support were important and may have contributed to enhanced psychological health.Further efforts are required to explore experiences within supportive care programs to better understand if and how psychological health is impacted. The videoconference-based, supportive care SPIN-CHAT Program enhanced psychological health amongst individuals affected by systemic sclerosis. SPIN-CHAT Program participants and research team members shared that being around similar others, program structure, and self-management support were important and may have contributed to enhanced psychological health. Further efforts are required to explore experiences within supportive care programs to better understand if and how psychological health is impacted.

Background Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. We completed an initial feasibility trial of an online self-administered version of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program using the cohort multiple randomized controlled trial (RCT) design. Due to low intervention offer uptake, we will conduct a new feasibility trial with progression to full-scale trial, using a two-arm parallel, partially nested RCT design. The SPIN-SELF Program has also been revised to include facilitator-led videoconference group sessions in addition to online material. We will test the group-based intervention delivery format, then evaluate the effect of the SPIN-SELF Program on disease management self-efficacy (primary) and patient activation, social appearance anxiety, and functional health outcomes (secondary). Methods This study is a feasibility trial with progression to full-scale RCT, pending meeting pre-defined criteria, of the SPIN-SELF Program. Participants will be recruited from the ongoing SPIN Cohort (http://www.spinsclero.com/en/cohort) and via social media and partner patient organizations. Eligible participants must have SSc and low to moderate disease management self-efficacy (Self-Efficacy for Managing Chronic Disease (SEMCD) Scale score ≤ 7.0). Participants will be randomized (1:1 allocation) to the group-based SPIN-SELF Program or usual care for 3 months. The primary outcome in the full-scale trial will be disease management self-efficacy based on SEMCD Scale scores at 3 months post-randomization. Secondary outcomes include SEMCD scores 6 months post-randomization plus patient activation, social appearance anxiety, and functional health outcomes at 3 and 6 months post-randomization. We will include 40 participants to assess feasibility. At the end of the feasibility portion, stoppage criteria will be used to determine if the trial procedures or SPIN-SELF Program need important modifications, thereby requiring a re-set for the full-scale trial. Otherwise, the full-scale RCT will proceed, and outcome data from the feasibility portion will be utilized in the full-scale trial. In the full-scale RCT, 524 participants will be recruited. Discussion The SPIN-SELF Program may improve disease management self-efficacy, patient activation, social appearance anxiety, and functional health outcomes in people with SSc. SPIN works with partner patient organizations around the world to disseminate its programs free-of-charge. Trial registration ClinicalTrials.govNCT04246528. Registered on 27 January 2020

Objective: Posttraumatic stress disorder (PTSD) has been shown to significantly impair quality of life (QOL), although no meta-analysis has evaluated the effect of psychotherapies for PTSD on QOL in the civilian population. The current meta-analysis aimed to assess these effects in the adult civilian population. Method: An exhaustive search of 13 databases revealed 9 studies of moderate to strong methodological quality evaluating mainly cognitive-behavioral therapy (8 of 9 studies). A total of 421 participants were allocated to a psychotherapy condition, 174 to a waitlist control group, and 203 were allocated to an active control group. Waitlist and active-controlled random effects of psychotherapies on QOL were computed. Risk of bias was assessed using multiple indices. Results: Pre-post treatment pooled effect sizes were small to moderate for QOL (active-controlled: Hedges' g = 0.37, 95% confidence interval [CI;0.14, 0.59]; waitlist-controlled: g = 0.63, CI [0.44, 0.83]) and were both large (waitlist-controlled: g = -1.36, CI [-1.85, -0.88]) and small (active-controlled: g = -0.40, CI [-0.57, -0.23]) for PTSD. Risk of bias analyses support robust and conservative results. Conclusions: The results, mainly with respect to cognitive-behavioral therapy, suggest that psychotherapies for PTSD improve QOL. More research is required to determine whether improvements are adequate in restoring QOL to a clinically acceptable level. Future studies should evaluate the effects of psychotherapies on the different dimensions of QOL as well as the specific effects of additional QOL-focused interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Summary Background No trials have tested multifaceted mental health interventions recommended by public health organisations during COVID-19. The objective of this trial was to evaluate the effect of the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Program on anxiety symptoms and other mental health outcomes among people vulnerable during COVID-19 owing to a pre-existing medical condition. Methods The SPIN-CHAT Trial was a pragmatic, two-arm, parallel, partially nested, randomised, controlled trial (1:1 allocation to intervention or waitlist). Eligible participants with systemic sclerosis were recruited from the international SPIN COVID-19 Cohort. SPIN COVID-19 Cohort participants were eligible for the trial if they completed baseline measures and had at least mild anxiety symptoms, had not tested positive for COVID-19, and were not currently receiving mental health counselling. SPIN-CHAT is a 4-week (3 sessions per week) videoconference-based group intervention that provided education and practice with mental health coping strategies, and provided social support to reduce isolation. Groups included 6–10 participants. The primary outcome analysed in the intention-to-treat population was anxiety symptoms (PROMIS Anxiety 4a version 1.0) immediately post-intervention. This trial is registered with ClinicalTrials.gov, NCT04335279 and is complete. Findings Of participants who completed baseline measures between April 9, 2020, and April 27, 2020, 560 participants were eligible and 172 participants were randomly assigned to intervention (n=86) or waitlist (n=86). Mean age was 55·0 years (SD 11·4 years), 162 (94%) were women, and 136 (79%) identified as White. In intention-to-treat analyses, the intervention did not significantly reduce anxiety symptoms post-intervention (−1·57 points, 95% CI −3·59 to 0·45; standardised mean difference [SMD] −0·22 points) but reduced symptoms 6 weeks later (−2·36 points, 95% CI −4·56 to −0·16; SMD −0·31). Depression symptoms were significantly lower 6 weeks post-intervention (−1·64 points, 95% CI −2·91 to −0·37; SMD −0·31); no other secondary outcomes were significant. No adverse events were reported. Interpretation The intervention did not significantly improve anxiety symptoms or other mental health outcomes post-intervention. However, anxiety and depression symptoms were significantly lower 6 weeks later, potentially capturing the time it took for new skills and social support between intervention participants to affect mental health. Multi-faceted interventions such as SPIN-CHAT have potential to address mental health needs in vulnerable groups during COVID-19, yet uncertainty remains about effectiveness. Funding Canadian Institutes of Health Research (CIHR; VR4-172745, MS1-173066); McGill Interdisciplinary Initiative in Infection and Immunity Emergency COVID-19 Research Fund; Scleroderma Canada, made possible by an educational grant for patient support programming from Boehringer Ingelheim; the Scleroderma Society of Ontario; Scleroderma Manitoba; Scleroderma Atlantic; Scleroderma Australia; Scleroderma New South Wales; Scleroderma Victoria; Scleroderma Queensland; Scleroderma SASK; the Scleroderma Association of BC; and Sclerodermie Quebec.

We aimed to investigate (1) bivariate associations between alcohol use, time perspective, temporal competency, and personality traits; (2) the extent to which different temporal scales predicted alcohol use in order to select constructs most related to alcohol use; and (3) the most related temporalities as mediators between personality traits and alcohol use. French (n = 389) and Canadian (n = 478) college students responded to questionnaires online. Analyses included (1) correlations between measures; (2) three multiple regressions in which different sets of temporalities (ZTPI, TCT-5D, a combination of scales) predicted alcohol use; (2) five multiple parallel mediator models, in which one big-5 trait was entered as a distal factor leading to alchol use through the parallel mediators of temporalities. Most temporal dimensions were correlated with alcohol use and a unique set of personality traits. The combination of temporal scales (past negative, present hedonist, anticipation, temporal rupture) predicted alcohol use better than any other instrument. All personality traits explained alcohol use through different sets of temporalities. Cases of indirect only and competitive mediation were observed. Personality traits explained alcohol consumption through the multiple parallel mediators of temporalities. In some cases (neuroticism, openness and agreeableness) temporalities had to be taken into account in order to observe an effect of personality on alcohol use which helps explain inconsistencies in the literature. Future work may benefit from taking into account combinations of temporal dimensions in order to best explain (drinking) behaviors, including but not limited to the Zimbardo Time Perspective Inventory.

OBJECTIVE The PTSD Checklist for DSM (PCL) is the most widely used screener to assess posttraumatic stress disorder (PTSD) in those with psychotic disorders (psychosis), though previous research has questioned its validity in psychosis. Considerable symptom overlap between the 2 disorders (e.g., concentration difficulties, avoidance, etc.) along with the general underdiagnosing of PTSD in psychosis speaks to the need for consensus regarding brief screeners. This hypothesis-generating study is the first to explore the PCL-5 (its most recent iteration) factor structure in psychosis to assess if a more valid underlying structure may exist. METHOD Sixty-5 individuals who met the DSM-5 PTSD criterion A traumatic event following an interview subsequently completed the PCL-5. Exploratory factor analysis was conducted to explore the latent structure of the PCL-5 in psychotic disorders. RESULTS A 4-factor solution differing from the DSM-5 4-factor model emerged as the best fitting model. Resulting PCL-5 dimensions in psychosis were identified as (1) Reexperiencing/Negative Affect; (2) Depressive; (3) Externalizing Anxious Behaviors; and (4) Avoidance/Physiological Reactivity. CONCLUSIONS Results guide the hypothesis that the latent structure of the PCL-5 may be unique in psychosis, which will have important clinical implications. Research is now needed to confirm the proposed model in larger samples of individuals with psychosis. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Peer-facilitated support groups are an important source for receiving disease-related information and support for people with systemic sclerosis (or scleroderma). A recent survey explored reasons for attending systemic sclerosis support groups in Europe and Australia and used exploratory factor analysis to group reasons for attendance into three main themes: (1) interpersonal and social support, (2) disease treatment and symptom management strategies, and (3) other aspects of living with systemic sclerosis. The objective of the present study was to replicate this study in a sample of patients from North America using confirmatory factor analysis. A 30-item survey was used to assess reasons for attendance and organizational preferences among systemic sclerosis patients in Canada and the United States. In total, 171 members completed the survey. In the confirmatory factor analysis, the three-factor model showed good fit to the data (χ2(399) = 646.0, p

Introduction Although cognitive-behavioral therapy (CBT) is effective in treating post-traumatic stress disorder (PTSD), some clients remain symptomatic after treatment. Some individuals with PTSD may present more severe dysfunctional cognitive schemas and use dysfunctional coping strategies. Objectives The review aims to answer the following questions: 1) Is there a relation between pre-treatment core beliefs or coping strategies and PTSD outcomes following CBT? 2) Are core beliefs or coping strategies modified following CBT for PTSD? Method PsycNet, PubMed, Cinahl, Embase, Web of Science, Scopus, Cochrane, ProQuest and EBSCO were systematically searched for the literature published between 1975 and May 2015, for papers including adults with PTSD, CBT for PTSD, and quantitative measures of cognitive schemas or coping strategies. Results, study characteristics and risks of bias were examined for the included studies. Results The search led to the inclusion of 10 studies. Regarding schemas, the only study included shows that they change positively with psychotherapy and that some of these changes predict changes in symptoms after treatment. Regarding coping, four studies report either positive or negative links between dysfunctional coping strategies and post-treatment symptoms, six studies report a positive change in coping strategies, and one study does not report any change. Conclusion Although more studies are needed to unequivocally answer the research questions, this systematic review demonstrates the relevance of considering coping strategies, and possibly schemas, in CBT studies in the context of PTSD.

Background Evidence from clinical trials suggests psychological interventions should be considered as an adjunct to medications. Objective The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of clinical hypnosis on pain, anxiety and medication needs during wound care in adults suffering from a burn injury. Data sources Medline, PsychINFO, CINAHL, Embase, ISI, SCOPUS, Cochrane, and Proquest databases were searched for randomized controlled trials comparing hypnosis to other interventions during dressing change in adult patients. Data synthesis Two independent reviewers extracted relevant articles and assessed their methodological quality. Only six studies met the inclusion criteria and were described in detail. Available data was pooled with Revman 5.3. Results For the primary outcome, we found a statistically significant difference in pain intensity ratings favoring hypnosis (MD = −8.90, 95% CI −16.28, −1.52). For the secondary outcomes, there was a statistically significant difference in anxiety ratings favoring hypnosis (MD = −21.78, 95% CI −35.64, −7.93) and no difference in medication usage (MD = −0.07, 95% CI −0.32, 0.17). Conclusion These results suggest that hypnosis reduces pain intensity and anxiety ratings in adults undergoing burn wound care. However, because of the limitations discussed, clinical recommendations are still premature.

To the Editor: Lemay, Hoolahan, and Buchanan published the results of a pilot study in a 2019 issue of the American Journal of Pharmaceutical Education .[1][1] They developed a promising six-week dual intervention involving yoga and meditation for college students (one session per week). One group

Contains fulltext : 219490.pdf (Publisher’s version ) (Open Access) Purpose: Many people with scleroderma rely on peer-led support groups as a coping resource. Reasons for not attending support groups in scleroderma have been investigated only in North American participants. This study assesses reasons for nonattendance in European countries and compares results with previously published North American findings. Materials and Methods: The same 21-item survey as used in the North American sample assessed possible reasons for not attending scleroderma support groups. Proportions of items rated Important or Very Important were compared between samples. Results: Consistent with the North American survey findings (N = 242), the two items most commonly rated as (Very) Important reasons for nonattendance among 228 European participants were (1) already having enough support (57%), and (2) not knowing of any local scleroderma support groups (58%). Compared to North American non-attenders, European patients were significantly more likely to rate not knowing enough about what happens at support groups (46% vs 19%), not having reliable ways to get to meetings (35% vs 17%), and being uncomfortable sharing experiences with a group (22% vs 11%) as (Very) Important reasons for nonattendance. Conclusions: Improving access to European support groups, providing education about support groups and group leader training may encourage participation. 8 p.

Summary Background Pain is an important and detrimental feature of systemic sclerosis but is often overlooked or deprioritised in research and clinical care. Raynaud's phenomenon, arthritis, and cutaneous ulcers are among the commonly reported disease manifestations of systemic sclerosis that could be associated with pain. We aimed to assess levels of pain intensity and interference and to evaluate disease factors associated with pain intensity and interference. Methods In this multicentre cross-sectional study, participants from the Scleroderma Patient-centered Intervention Network cohort who completed pain intensity and interference measures (Patient Reported Outcomes Information System-29 profile, version 2·0) as part of baseline assessments were included. Patients were recruited from 46 centres in Australia, Canada, France, Mexico, Spain, the UK, and the USA between April 15, 2014, and Jan 7, 2020. Eligible patients included those aged 18 years or older who met the criteria for systemic sclerosis devised by the American College of Rheumatology and the European League Against Rheumatism. Associations of pain intensity and pain interference with systemic sclerosis-related variables and overlap syndromes, controlling for sociodemographic variables, were assessed with multiple linear regression. Continuous independent variables were standardised. Findings Among 2157 participants with systemic sclerosis (268 [12%] males and 1889 [88%] females), 1870 (87%) reported mild, moderate, or severe pain (defined as ≥1 on a 0 to 10 scale), and 815 (38%) reported moderate or severe pain (defined as ≥5). Moreover, 757 (35%) participants reported moderate or severe pain interference. Greater pain intensity was independently associated with female sex (0·58 points [95% CI 0·26–0·90]), non-White race or ethnicity (0·50 points [0·21–0·79]), fewer years in formal education (0·30 points per SD [0·19–0·41]), country (reference: USA; Canada: 0·29 points [0·01–0·57] and UK: 0·58 points [0·21–0·95]), greater body-mass index (0·35 points per SD [0·24–0·45]); joint contractures (0·67 points [0·39–0·94]), digital ulcers (0·33 points [0·10–0·55]), gastrointestinal involvement (0·66 points [0·33–0·98]), skin involvement (measured using modified Rodnan skin score; 0·22 points per SD [0·10–0·35]), rheumatoid arthritis (0·96 points [0·50–1·43]), and Sjogren's syndrome (0·42 points [0·01–0·83]). Pain interference results were similar. Interpretation Pain is common among people with systemic sclerosis. Controlling for sociodemographic variables, greater pain was associated with multiple systemic sclerosis-related manifestations, including joint contractures, digital ulcers, gastrointestinal involvement, skin involvement, and the presence of overlap syndromes. Health-care providers should work with patients to address pain, including identifying and addressing systemic sclerosis manifestations associated with their pain, and supporting behavioural approaches to minimise impact on function and quality of life. Funding Canadian Institutes of Health Research, Arthritis Society, The Lady Davis Institute for Medical Research of the Jewish General Hospital, Jewish General Hospital Foundation, McGill University, Scleroderma Society of Ontario, Scleroderma Canada, Sclerodermie Quebec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, and Scleroderma Queensland.

Introduction No studies have examined factors associated with fear in any group of people vulnerable during COVID-19 due to pre-existing medical conditions. Objective To investigate factors associated with fear of consequences of COVID-19 among people living with a pre-existing medical condition, the autoimmune disease systemic sclerosis (SSc; scleroderma), including country. Methods Pre-COVID-19 data from the Scleroderma Patient-centered Intervention Network (SPIN) Cohort were linked to COVID-19 data collected in April 2020. Multivariable linear regression was used to assess factors associated with continuous scores of the 10-item COVID-19 Fears Questionnaire for Chronic Medical Conditions, controlling for pre-COVID-19 anxiety symptoms. Results Compared to France (N = 156), COVID-19 Fear scores among participants from the United Kingdom (N = 50) were 0.12 SD (95% CI 0.03 to 0.21) higher; scores for Canada (N = 97) and the United States (N = 128) were higher, but not statistically significant. Greater interference of breathing problems was associated with higher fears due to COVID-19 (Standardized regression coefficient = 0.12, 95% CI 0.01 to 0.23). Participants with higher financial resources adequacy scores had lower COVID-19 Fear scores (Standardized coefficient = −0.18, 95% CI −0.28 to −0.09). Conclusions Fears due to COVID-19 were associated with clinical and functional vulnerabilities in this chronically ill population. This suggests that interventions may benefit from addressing specific clinical issues that apply to specific populations. Financial resources, health policies and political influences may also be important. The needs of people living with chronic illness during a pandemic may differ depending on the social and political context in which they live., Highlights • People with chronic diseases may experience high levels of fear due to COVID-19. • We examined factors associated with fears due to COVID-19 in an at-risk population. • We used the validated COVID-19 Fears Questionnaire for Chronic Medical Conditions. • Fears due to COVID-19 among people with SSc differed substantially by country. • Interference of breathing problems and financial adequacy were related to fears.

Individuals with psychosis and comorbid posttraumatic stress disorder typically present with more severe forms of illness. Subthreshold posttraumatic stress symptoms (PTSS) are also likely to cause significant distress. The spontaneous disclosure of abuse history is unlikely, which is problematic given that PTSS often go unnoticed due to psychotic symptom overlap, yet when asked, most individuals desire treatment even for subthreshold PTSS. if associations are found between PTSS severity, clinical symptomology, and patient-centered variables, it will further justify the need to enhance PTSS screening during routine care to encourage appropriate referral to specialized services. One hundred and two individuals with psychosis participated in an intake evaluation following referral for psychological services at a clinic specializing in psychological interventions for psychosis, which included the PTSD Checklist for DSM-5. Prevalence of trauma exposure was explored in conjunction with PTSS severity and referral-type. Clinical variables were entered in a multivariate analysis of variance with low, moderate, and high PTSS severity. Of the 102 participants, 21.6% did not report trauma and 14.7% reported events not meeting DSM-5 PTSD criterion A. Data from 65 participants were included; 6.2% of which were referred for trauma. Main effects emerged for all variables except wellbeing and delusional severity. Depression, anxiety, and stress were all significantly higher in the severe compared to low PTSS categories. Quality of life was significantly lower in the severe versus low PTSS category. Severe PTSS were associated with depression, anxiety, and stress, and lower QoL. A severe PTSS category captures a broader range of people likely requiring services and speaks to an important need to improve referral rate for trauma intervention.

Objective Contagious disease outbreaks and related restrictions can lead to negative psychological outcomes, particularly in vulnerable populations at risk due to pre-existing medical conditions. No randomised controlled trials (RCTs) have tested interventions to reduce mental health consequences of contagious disease outbreaks. The primary objective of the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Trial is to evaluate the effect of a videoconference-based program on symptoms of anxiety. Secondary objectives include evaluating effects on symptoms of depression, stress, loneliness, boredom, physical activity, and social interaction. Methods The SPIN-CHAT Trial is a pragmatic RCT that will be conducted using the SPIN-COVID-19 Cohort, a sub-cohort of the SPIN Cohort. Eligible participants will be SPIN-COVID-19 Cohort participants without a positive COVID-19 test, with at least mild anxiety (PROMIS Anxiety 4a v1.0 T-score ≥ 55), not working from home, and not receiving current counselling or psychotherapy. We will randomly assign 162 participants to intervention groups of 7 to 10 participants each or waitlist control. We will use a partially nested RCT design to reflect dependence between individuals in training groups but not in the waitlist control. The SPIN-CHAT Program includes activity engagement, education on strategies to support mental health, and mutual participant support. Intervention participants will receive the 4-week (3 sessions per week) SPIN-CHAT Program via videoconference. The primary outcome is PROMIS Anxiety 4a score immediately post-intervention. Ethics and dissemination The SPIN-CHAT Trial will test whether a brief videoconference-based intervention will improve mental health outcomes among at-risk individuals during contagious disease outbreak., Highlights • No RCTs have tested mental health interventions in contagious disease outbreaks. • People with scleroderma face fear and isolation during COVID-19. • SPIN-CHAT is designed to improve mental health in SSc patients during COVID-19. • SPIN-CHAT provides 12 group sessions over 4 weeks. • The SPIN-CHAT trial will randomize 162 participants to intervention or waitlist.

Panic disorder with or without agoraphobia (PD/A) and obsessive-compulsive disorder (OCD) are characterized by major behavioral dysruptions that may affect patients’ social and marital functioning. The disorders’ impact on interpersonal relationships may also affect the quality of support patients receive from their social network. The main goal of this systematic review is to determine the association between social or marital support and symptom severity among adults with PD/A or OCD. A systematic search of databases was executed and provided 35 eligible articles. Results from OCD studies indicated a negative association between marital adjustment and symptom severity, and a positive association between accommodation from relatives and symptom severity. However, results were inconclusive for negative forms of social support (e.g. criticism, hostility). Results from PD/A studies indicated a negative association between perceived social support and symptom severity. Also, results from studies using an observational measure of marital adjustment indicated a negative association between quality of support from the spouse and PD/A severity. However, results were inconclusive for perceived marital adjustment and symptom severity. In conclusion, this systematic review generally suggests a major role of social and marital support in PD/A and OCD symptomatology. However, given diversity of results and methods used in studies, more are needed to clarify the links between support and symptom severity among patients with PD/A and OCD.

Background and aimsPersonality traits are considered distal determinants of various behaviors including alcohol consumption meaning that the association between traits and behaviors is mediated by ...

The objectives were to identify reasons why patients attend scleroderma support groups and to ascertain preferences for how meetings are best organized.The survey included 30-items on reasons for attending and nine items on organizational preferences. Patients were recruited through European patient organizations. Exploratory factor analysis was used to group reasons for attendance thematically.About 213 scleroderma patients (192 women) completed the survey. A three-factor model best described reasons for attending [χPeople with scleroderma attend support groups to give and obtain social support and for education about managing their disease and other aspects of living with scleroderma. Support groups should be structured to facilitate both educational and informational aspects and to provide opportunities for sharing and support between members. Implications for rehabilitation Local peer-led support groups are an important support and informational resource for patients living with scleroderma. People with scleroderma attend support groups in order to: (1) obtain interpersonal and social support, (2) learn about disease treatment and symptom management strategies, and (3) discuss other aspects of living with scleroderma outside of symptom management. Most support group members prefer groups with a trained facilitator, that include family members or loved ones in the groups, that include between 11and 20 members, that last between 1 and 2 h, and that meet once every 1-3 months. Rehabilitation professionals can support the formation and management of local support groups or can refer patients to national scleroderma patient organizations for information on support groups that they may be able to access.

Introduction Studies have shown that, following psychotherapy for posttraumatic stress disorder (PTSD), symptoms and quality of life (QoL) may improve in many patients, but not always to the same extent. Dysfunctional core beliefs, such as personality beliefs (PB), are associated to psychopathology, including PTSD, and could be associated with the types of coping strategies deployed by an individual. Beliefs and coping strategies were also linked to psychotherapeutic outcomes. Objectives (1) To examine the associations between baseline PB as well as pre- and post-treatment coping strategies; (2) To investigate the mediation effects between PB and the changes in QoL, through changes in coping strategies in a cognitive-behavioral psychotherapy (CBT). Method Seventy-one adults with PTSD participating in a correlational/observational CBT study were assessed for PB before a CBT, as well as for coping strategies and QoL, before and after a CBT. Results PB were generally associated with post-treatment distancing coping. Moreover, changes in distancing coping mediated the relationships between avoidant or dependent PB and psychological QoL improvements. Conclusion This is the first study to show the relationships between PB and coping strategies in PTSD patients, and that higher avoidant or dependent PB predicts a lower reduction in the use of distancing coping through psychotherapy, which is associated with less improvement in psychological QoL. Future studies are needed to further define the role of these variables and target more precisely factors that may hamper the treatment effects of CBT for PTSD.

Contains fulltext : 197998.pdf (Publisher’s version ) (Closed access) Purpose: Systemic sclerosis or scleroderma is a chronic, rare connective tissue disease with negative physical and psychological implications. Coping strategies used by scleroderma patients have not been studied in-depth. The objective of the present study was to gain a greater understanding of the coping strategies employed by people living with scleroderma. Method: Three semi-structured focus group discussions were conducted with a total of 22 people with scleroderma. Interviews were recorded, transcribed, and analyzed using content analysis. Coping strategies discussed were analyzed through Lazarus and Folkman's theoretical model of coping, including: (1) problem-focused, (2) emotion-focused, and (3) meaning-focused coping. Results: Participants reported using a combination of problem-focused (e.g., professional help; seeking disease-related information), emotion-focused (e.g., social support; adaptive distraction techniques), and meaning-focused coping strategies (e.g., benefit finding; goal reappraisal) to help them to cope with and manage their disease. However, many patients reported having difficulty in accessing support services. Conclusions: Scleroderma patients use similar coping strategies as patients with more common diseases, but they may not have access to the same level of support services. Accessible interventions, including self-management programs, aimed at improving problem- and emotion-focused coping are needed. Further, increased access to support groups may provide patients with opportunities to obtain social support and enhance coping. 10 p.

This project examines the effects of self- and partner-rated personality and their reciprocal interaction between two partners. Personality in 113 young dating couples was measured with the Five-Factor Model and maladaptive personality trait model of the DSM-5. Partners completed self- and partner-reports of the NEO-FFI-3 and the Personality Inventory for DSM-5 (PID-5) as well as the self-report Dyadic Adjustment Scale (DAS). Three sets of Actor-Partner Interdependence Models (APIMs) were run to estimate actor and partner effects of self-rated personality, partner-rated personality, and of both sets of effects simultaneously in an integrated model. When self- and partner-rating models were examined separately, several significant actor and partner effects were observed. However, the strongest effects were observed in the partner-rating models. When self- and partner-rated personality were examined at the same time, most effects from the self-rating models disappeared. Furthermore, most of the effects as well as the strongest one observed were associated with an individual&rsquo, s perception of their partner&rsquo, s personality, particularly men&rsquo, s perception of women&rsquo, s personality. This study demonstrates the incremental predictive utility of individuals&rsquo, perception of their partner&rsquo, s personality for explaining their own dyadic adjustment.

We developed and validated a new version of our test of temporal competency. In three studies we (1) defined dimensions, created items and studied face and content validity; (2) examined dimensionality and reliability; and (3) confirmed factor structure and studied convergent validity. Focus groups were held in which we drew up temporal concepts that articulated well with clinical observations. We derived a questionnaire that was administered to French young people and this data was used to reduce the questionnaire to 15 items. Reliability and validity of the 15-item version was studied among samples: French college, French high school, and Québec college. Five dimensions were defined and retained: anticipation, full present, temporal rupture, past, future. 15 items explained 68% of variance. The model provided adequate fit in confirmatory analyses across samples. Scales converged with hypothesized dimensions of the ZTPI and scales mostly maintained acceptable reliability. Conceptual issues with ZTPI were addressed, possibly rectified and discussed in light of clinical practice. The past was defined by how much one grows from experience independently of how ‘happy’ or ‘sad’ events were. Full present and temporal rupture relate to living in the now, the first by means of flow and engagement, the second by means of addictive behaviors. Future entailed a projection unto uncertainty, whereas anticipation defined adapting behavior in order to achieve short-term goals. We found that the questionnaire had adequate psychometric proprieties among Francophone youth in Canada and in France.

Objective Fear associated with medical vulnerability should be considered when assessing mental health among individuals with chronic medical conditions during the COVID-19 pandemic. The objective was to develop and validate the COVID-19 Fears Questionnaire for Chronic Medical Conditions. Methods Fifteen initial items were generated based on suggestions from 121 people with the chronic autoimmune disease systemic sclerosis (SSc; scleroderma). Patients in a COVID-19 SSc cohort completed items between April 9 and 27, 2020. Exploratory factor analysis (EFA) and item analysis were used to select items for inclusion. Cronbach's alpha and Pearson correlations were used to evaluate internal consistency reliability and convergent validity. Factor structure was confirmed with confirmatory factor analysis (CFA) in follow-up data collection two weeks later. Results 787 participants completed baseline measures; 563 of them completed the follow-up assessment. Ten of 15 initial items were included in the final questionnaire. EFA suggested that a single dimension explained the data reasonably well. There were no indications of floor or ceiling effects. Cronbach's alpha was 0.91. Correlations between the COVID-19 Fears Questionnaire and measures of anxiety (r = 0.53), depressive symptoms (r = 0.44), and perceived stress (r = 0.50) supported construct validity. CFA supported the single-factor structure (χ2(35) = 311.2, p, Highlights • People with chronic diseases are at risk if infected with the COVID-19 virus. • The COVID-19 Fears Questionnaire assesses fear among people with medical conditions. • 121 people with scleroderma from 10 countries provided item suggestions. • Validity was supported in a sample of 787 scleroderma patients. • The questionnaire is available for use in studies during the COVID-19 crisis.

In recent years, many authors have written on the importance of analyzing social support when it comes to understanding PTSD patients. However, the effects of important aspects of the social support construct itself, such as the source of support and its underlying psychosocial processes, remain relatively unexamined. Using a qualitative design, this study sought to explore social support processes between PTSD patients and their relatives. More specifically, thematic and conversational analysis were performed on filmed interactions between 48 PTSD patients and an accompanying person (AP) of their choice. Results indicated that female PTSD patients generally presented a higher frequency of negative interactions than male diagnosed with PTSD. Moreover, couples generally experienced more negative social support compared to non-couples. Finally, it was found that the length of the relationship as well as the onset of the PTSD (before or after the beginning of the relationship) influenced the quality of the interactions for couples in this sample. To our knowledge, this study is one of the few qualitative research that has been made on interactions between PTSD patients and their relatives. This study also offers an innovative point of view on the social processes underlying marital and social support, such as the impact of the length and moment of apparition of romantic relationships on the quality of support offered.

Background Individuals with psychosis and comorbid posttraumatic stress disorder (PTSD) typically present with more severe forms of illness. Subthreshold posttraumatic stress symptoms (PTSS) are also likely to cause significant distress. There is a need to enhance screening processes for distressing PTSS to encourage appropriate referral to specialized services. The PTSD checklist for DSM-5 (PCL-5) is a widely used self-report to assess PTSS, though there is concern regarding its validity for use in psychosis. If people scoring in the severe PTSS range on the PCL-5 also present with clinical profiles similar to those typically meeting diagnosis for PTSD, it will justify considering a broader range of PTSS and support the use of the PCL-5 as a brief screener. A severe range will arguably capture a wider array of individuals, including those with subthreshold PTSS who also likely require trauma-focused intervention. Methods One hundred and two individuals with psychosis completed the PCL-5 and a battery of clinical scales as part of an intake evaluation following referral for psychological follow-up at a clinic specializing in psychosocial interventions for psychosis. Prevalence and type of DSM-5 criterion A event were explored in conjunction with PTSS severity and referral-type. Pearson correlations identified clinical variables associated with PCL-5 total scores and were subsequently entered into a multivariate analysis of variance (MANOVA) with dichotomized PTSS severity categories (low, moderate, severe). Post hoc analyses explored significant interactions. Results Of the 102 participants, 21.6% reported no prior trauma and 14.7% reported non-valid events. Sixty-five participants were included in the analysis; 6.2% of which were referred for trauma. 81.5% reported criterion A events, 10.8% reported psychosis-related events, and 7.7% did not disclose an event. PCL-5 scores were dichotomized using the 33rd and 66th percentiles, translating into low (≤ 24), moderate (25–47), and severe (≥48) groups. Delusion severity and subjective stress, anxiety, depression, social anxiety, quality of life (QoL), and wellbeing were entered into a one-way MANOVA with PTSS severity groups. Significant main effects surviving Bonferroni correction emerged for all variables except delusion severity (F(2,40) = 3.06, p = .058) and wellbeing (F(2,56) = 1.50, p =.233). Stress (F(2,62) = 7.37, p = .001) was higher in the severe (M = 13.13, SD = 5.18) versus low group (M = 7.05, SD = 4.40, p = .001). Anxiety (F(2,62) = 8.02, p = .001) was also higher in the severe (M = 12.30, SD = 5.07) compared to low group (M = 5.85, SD = 5.06, p = .000), and depression (F(2,62) = 5.37, p = .007) was additionally higher in the severe (M = 12.61, SD = 5.73) compared to low group (M = 7.20, SD = 4.97, p = .005). Finally, social anxiety (F(2,58) = 4.25, p = .026.) was higher in the severe (M = 7.76, SD = 3.58) versus low group (M = 4.68, SD = 3.68, p = .029), while QoL (F(2,58) = 3.47, p = .038) was lower in the severe (M = 49.95, SD = 10.99) compared to low group (M = 58.95, SD = 13.76, p = .037). Discussion Due to a relatively high number of invalid questionnaires (14.7%), service users should likely complete the PCL-5 in the presence of a health-care practitioner. Findings suggest inadequate referral rates for specialized services when they may indeed benefit the service-user. Severe PTSS was associated with increased symptoms of subjective anxiety, depression, stress, social anxiety, and decreased QoL, regardless of whether diagnostic criteria for PTSD was met. A severe PTSS category likely captures a broader range of individuals requiring specialized intervention and speaks to an important need to both facilitate and increase referral rate for trauma-focused therapy.

Introduction Relationships between personality traits and alcohol consumption behaviors have been inconsistently found. Research suggests that taking into account more proximal factors, such as drinking motives, would aid in explaining these inconsistent findings. Method Participants (N = 690) were administered measures of alcohol use, drinking motives and personality traits. Five multiple parallel mediator models were elaborated wherein drinking motives mediated the relationship between each trait and AUDIT scores once having controlled for age, school group and sex. Results Enhancement, social and conformity motives mediated the relationship between extraversion and alcohol use. The indirect effect between agreeableness or conscientiousness and alcohol use was mediated by decreased coping-depression, enhancement and social motives. Interestingly, neuroticism alone did not predict alcohol consumption, but a case of competitive mediation was observed. Neuroticism led to heightened coping-depression motives, which led to increased alcohol use, but also to increased conformity motives, which led to depleted alcohol consumption. Discussion Our study suggests that most Big 5 personality traits have a relationship with alcohol consumption in part because they develop into drinking motives. Inconsistent findings observed in the extent literature were explained in part by conditional processes.

Contains fulltext : 182460.pdf (Publisher’s version ) (Closed access) Objective: Peer-led support groups are an important resource for many people with scleroderma (systemic sclerosis; SSc). Little is known, however, about barriers to participation. The objective of this study was to identify reasons why some people with SSc do not participate in SSc support groups. Methods: A 21-item survey was used to assess reasons for non-attendance among SSc patients in Canada and the United States. Exploratory factor analysis (EFA) was conducted using the software MPlus 7 to group reasons for non-attendance into themes. Results: A total of 242 (202 women) people with SSc completed the survey. EFA results indicated that a three-factor model best described the data (X2(150)=302.7, p

Introduction: Individuals with visible differences due to medical conditions, such as systemic sclerosis (SSc; scleroderma), have reported difficulty navigating social situations because of issues such as staring, invasive questions, and rude comments. Fears or anxiety linked to situations in which a person interacts with others is known as social interaction anxiety. However, there exists no validated measurement tool to examine social interaction anxiety in rheumatologic conditions. Methods: The present study examines the reliability (internal consistency) and validity (structural and convergent) of the Social Interaction Anxiety Scale-6 (SIAS-6) in a sample of 802 individuals with SSc, and compares these psychometric properties across limited and diffuse subtypes of the disease. Multi-group confirmatory factor analysis was used to examine the factor structure of the SIAS-6 in patients with both limited and diffuse SSc. Results: A one-factor structure was found to fit well for individuals with SSc with both limited and diffuse disease. The measure demonstrated strong internal consistency reliability and convergent validity with relevant measures in expected magnitudes and directions. Conclusions: The SIAS-6 is a psychometrically robust measure that can confidently be used in SSc populations to examine social interaction anxiety. Moreover, scores can meaningfully be compared between patients with limited and diffuse disease., MD Anderson Cancer Center - University of Texas MD Anderson Cancer Center(undefined), Financial support: The Scleroderma Patient-centered Intervention Network (SPIN) is funded by a Canadian Institutes of Health Research (CIHR) Emerging Team Grant for Rare Diseases (PI, Thombs; TR3-119192). In addition to CIHR funding, SPIN has received institutional contributions from the Lady Davis Institute for Medical Research of the Jewish General Hospital, Montréal, Canada and from McGill University, Montréal, Canada. SPIN has also received support from the Scleroderma Society of Ontario, Scleroderma Canada, and Sclérodermie Québec. Ms. Gholizadeh’s work on this project was supported by a Rheumatology Research Foundation: Health Professional Research Preceptorship. Dr. Kwakkenbos was supported by a CIHR Banting Postdoctoral Fellowship. Ms. Jewett was supported by a CIHR Doctoral Research Award. Dr. Thombs was supported by an Investigator Salary Award from the Arthritis Society

We read with interest a paper by Gao et al. (2015) lished in the International Journal of Nursing Studies. ever, we would like to comment on the conclusions wn by the authors. This study investigates the effects of interpersonal-psychotherapy (IPT)-oriented postnatal choeducation program on reducing postpartum depressymptoms, and enhancing social support and maternal competence with Chinese first-time mothers. Thus, the hors conducted a randomized clinical trial with two ups in order to verify this assumption (hypothesis). The erimental group received the usual routine postnatal e and a 1-h education session based on IPT with one telephone follow-up within 2 weeks after discharge (n = 90). The control group received only the usual routine postnatal care (n = 90). The outcome variables were measured using the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987), the Perceived Social Support Scale (PSSS; Zimet et al., 1988) and the Efficacy subscale of the Parenting Sense of Competence Scale (PSOC-E; Gibaud-Wallston and Wandersman, 1978) at baseline (2–3 days after delivery) and 6 weeks later at follow-up. Based on their results, the authors concluded that the program was effective in decreasing depressive symptoms and promoting social support and maternal role competence. First, we would like to caution against the conclusions made in Gao et al.’s study. In their discussion, the authors mention that the program is effective in increasing social support in the experimental group, while the results show a decrease in both the experimental group (MT1 = 66.01, SDT1 = 7.17; MT2 = 65.44, SDT2 = 8.43) and the control group (MT1 = 66.56, SDT1 = 8.35; MT2 = 61.82, SDT2 = 9.99). Even if the decrease in social support is greater in the control T I C L E I N F O

The main objective of this study is to investigate the relationship between self-esteem, specific coping strategies and marital adjustment. The sample consists of 216 subjects from 108 couples who completed the Dyadic Adjustment Scale, the Rosenberg Self-Esteem Scale and the Ways of Coping Checklist. The results confirm the presence of a relationship between self-esteem, specific coping strategies and marital adjustment in men and women. High self-esteem and marital adjustment are associated with the use of problem solving strategies and less avoidance as a way of coping. Moreover, cross analyses reveal that one’s feelings of self-worth are associated with his/her spouse's marital adjustment. The theoretical implications of these results are discussed.

ObjectivesThe Scleroderma Patient-centered Intervention Network—Scleroderma Support group Leader EDucation (SPIN-SSLED) Programme was designed to improve confidence and self-efficacy and to reduce burden for support group leaders. Objectives were to (1) evaluate feasibility of programme delivery, including required resources, management issues and scientific aspects (eg, performance of outcome measures) and (2) assess user satisfaction and identify any modifications needed to improve programme content or delivery based on participant feedback.DesignNon-randomised feasibility trial.SettingNorth American patient organisations.ParticipantsCurrent support group leaders or potential new leaders referred by patient organisations.InterventionThe programme included 13 modules delivered live via videoconference over 3 months (April to July 2018) in 60 to 90 min sessions.Outcome measures(1) Elements of feasibility, including enrolment and consent procedures, percentage of referred group leaders who consented to participate, session attendance and technical support requirements; (2) programme usability, understandability, organisation and clarity; (3) leader satisfaction with the programme and (4) planned trial outcome measures, including support group leader self-efficacy, burnout, emotional distress and physical function.ResultsAll 12 referred potential participants consented to enrol, and 10 were included in two training groups of five participants each. Participants attended 95% of sessions. Required technical support was minimal, and videoconferencing technology functioned well. Overall programme satisfaction rating was 9.4/10. Mean item rating on the eight items of the Client Satisfaction Questionnaire-8 was 3.83 (1=low satisfaction; 4=high satisfaction). Pre-post scores on the Scleroderma Support Group Leader Self-efficacy Scale increased by 1.7 SDs (large effect); scores on burnout, emotional distress and physical function improved by 0.44, 0.38 and 0.45 SDs (moderate effects).ConclusionThe SPIN-SSLED Programme was feasibly delivered, including management, resource and scientific aspects. Participant satisfaction was high. The programme is ready to be tested in a full-scale randomised controlled trial.Trial registration numberNCT03508661

Panic disorder and agoraphobia are both characterized by avoidance behaviors, which are known correlates of treatment discontinuation. The aim of this exploratory study is to distinguish the profile of participants suffering from panic disorder with agoraphobia that complete treatment from those who discontinue therapy by assessing four categories of predictor variables: the severity of the disorder, sociodemographic variables, participants’ expectations, and dyadic adjustment. The sample included 77 individuals diagnosed with panic disorder with agoraphobia who completed a series of questionnaires and participated in a cognitive-behavioral group therapy consisting of 14 weekly sessions. Hierarchical linear regression analyses revealed the importance of anxiety, prognosis, and role expectations as well as some individual variables as predictors of therapeutic dropout, either before or during treatment. Among the most common reasons given by the 29 participants who discontinued therapy were scheduling conflicts, dissatisfaction with treatment, and conflicts with their marital partner. These results suggest that expectations and dyadic relationships have an impact on therapeutic discontinuation. The clinical implications of these findings are discussed.

Item does not contain fulltext Body concealment is an important component of appearance distress for individuals with disfiguring conditions, including scleroderma. The objective was to replicate the validation study of the Body Concealment Scale for Scleroderma (BCSS) among 897 scleroderma patients. The factor structure of the BCSS was evaluated using confirmatory factor analysis and the Multiple-Indicator Multiple-Cause model examined differential item functioning of SWAP items for sex and age. Internal consistency reliability was assessed via Cronbach's alpha. Construct validity was assessed by comparing the BCSS with a measure of body image distress and measures of mental health and pain intensity. Results replicated the original validation study, where a bifactor model provided the best fit. The BCSS demonstrated strong internal consistency reliability and construct validity. Findings further support the BCSS as a valid measure of body concealment in scleroderma and provide new evidence that scores can be compared and combined across sexes and ages. 8 p.