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Post-traumatic stress disorder (PTSD) is a mental health condition that can occur following exposure to a traumatic experience. An estimated 12 million U.S. adults are presently affected by this disorder. Current treatments include psychological therapies (e.g., exposure-based interventions) and pharmacological treatments (e.g., selective serotonin reuptake inhibitors (SSRIs)). However, a significant proportion of patients receiving standard-of-care therapies for PTSD remain symptomatic, and new approaches for this and other trauma-related mental health conditions are greatly needed. Psychedelic compounds that alter cognition, perception, and mood are currently being examined for their efficacy in treating PTSD despite their current status as Drug Enforcement Administration (DEA)- scheduled substances. Initial clinical trials have demonstrated the potential value of psychedelicassisted therapy to treat PTSD and other psychiatric disorders. In this comprehensive review, we summarize the state of the science of PTSD clinical care, including current treatments and their shortcomings. We review clinical studies of psychedelic interventions to treat PTSD, trauma-related disorders, and common comorbidities. The classic psychedelics psilocybin, lysergic acid diethylamide (LSD), and N,N-dimethyltryptamine (DMT) and DMT-containing ayahuasca, as well as the entactogen 3,4-methylenedioxymethamphetamine (MDMA) and the dissociative anesthetic ketamine, are reviewed. For each drug, we present the history of use, psychological and somatic effects, pharmacology, and safety profile. The rationale and proposed mechanisms for use in treating PTSD and traumarelated disorders are discussed. This review concludes with an in-depth consideration of future directions for the psychiatric applications of psychedelics to maximize therapeutic benefit and minimize risk in individuals and communities impacted by trauma-related conditions., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Occupational therapists have a long history of assessing functional cognition, defined as the ability to use and integrate thinking and performance skills to accomplish complex everyday activities. In response to passage of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 (Pub. L. 113-185), the American Occupational Therapy Association has been advocating that the Centers for Medicare and Medicaid Services consider functional cognition for inclusion in routine patient assessment in postacute care settings, with important implications for occupational therapy. These efforts have the potential to increase referrals to occupational therapy, emphasize the importance of addressing functional cognition in occupational therapy practice, and support the value of occupational therapy in achieving optimal postacute care outcomes., (Copyright © 2017 by the American Occupational Therapy Association, Inc.)

Objective: The study aim was to determine natural variability in somatosensation across age groups using brief measures. We validated measures in a community-dwelling population as part of the National Institutes of Health (NIH) Toolbox for Assessment of Neurological and Behavioral Function (NIH Toolbox; http://www.nihtoolbox.org)., Method: Participants included community-dwelling children and adults (N=367, ages 3-85 yr) across seven sites. We tested haptic recognition, touch detection-discrimination, and proprioception using brief affordable measures as required by the NIH Toolbox., Results: Accuracy improved from young children to young adults; from young to older adults, the pattern reversed slightly. We found significant differences between adults and older adults. One proprioception test (kinesthesia; p=.003) showed gender differences (females more accurate). We provide expected score ranges for age groups as a basis for understanding age-related expectations for somatosensory perception., Conclusion: The age-related patterns of somatosensory perception from this study refine decision making about performance., (Copyright © 2015 by the American Occupational Therapy Association, Inc.)

Age at first stroke is decreasing, and most strokes are mild to moderate in severity. Executive function (EF) deficits are increasingly recognized in the stroke population, but occupational therapists have not altered their evaluation methods to fully accommodate changing patient needs. We present a hierarchical performance-based testing (PBT) pathway using data to illustrate how PBT could identify patients with mild stroke-related EF deficits in need of occupational therapy intervention. Data suggest that a substantial number of patients with EF deficits after mild stroke could benefit from occupational therapy services., (Copyright © 2015 by the American Occupational Therapy Association, Inc.)

OBJECTIVE. This article describes a performance-based measure of executive function, the Multiple Errands Test-Revised (MET-R), and examines its ability to discriminate between people with mild cerebrovascular accident (mCVA) and control participants. METHOD. We compared the MET-R scores and measures of CVA outcome of 25 participants 6 mo post-mCVA and 21 matched control participants. RESULTS. Participants with mCVA showed no to minimal impairment on measures of executive function at hospital discharge but reported difficulty with community integration at 6 mo. The MET-R discriminated between participants with and without mCVA (p ≤ .002). CONCLUSION. The MET-R is a valid and reliable measure of executive functions appropriate for the evaluation of clients with mild executive function deficits who need occupational therapy to fully participate in community living., (Copyright © 2013 by the American Occupational Therapy Association, Inc.)

Objective: Pain is an important component of health and function, and chronic pain can be a problem in its own right. The purpose of this report is to review the considerations surrounding pain measurement in the NIH Toolbox, as well as to describe the measurement tools that were adopted for inclusion in the NIH Toolbox assessment battery., Methods: Instruments to measure pain in the NIH Toolbox were selected on the basis of scholarly input from a diverse group of experts, as well as review of existing instruments, which include verbal rating scales, numerical rating scales, and graphical scales., Results: Brief self-report measures of pain intensity and pain interference were selected for inclusion in the core NIH Toolbox for use with adults. A 0 to 10 numerical rating scale was recommended for measuring pain intensity, and a 6-item Patient Reported Outcome Measurement Information System (PROMIS) short form for measuring pain interference. The 8-item PROMIS Pediatric Pain Interference measure was recommended as a supplemental measure. No specific measure was recommended for measuring pain intensity in children., Conclusions: Core and supplemental measures were recommended for the NIH Toolbox. Additional measures were reviewed for investigators who seek tools for measuring pain intensity in pediatric samples.

Touch sensation is one element of sensory function. As such, somatosensation is one of the sensory domains included in the NIH Toolbox, which is an assessment battery for measuring a range of human functions including emotional health, sensation, cognition, and motor function. We evaluated a variety of methods for inclusion in the NIH Toolbox main battery. In a convenience sample of 409 participants, we evaluated aspects of kinesthesia, pain, and tactile discrimination. We present results on these measures across the lifespan and discuss implications for future studies that use the NIH Toolbox and these measures.

Objective: We investigated participation levels and relationships among cognition, depression, and participation for people with severe congestive heart failure (CHF)., Method: People with severe CHF (New York Heart Association Class III or IV) awaiting heart transplantation (N = 27) completed standardized tests of cognition and self-report measures of executive dysfunction, depressive symptoms, and participation., Results: Possible depression (64%) and cognitive impairment (15%-59%) were prevalent. Participants reported significant reductions in participation across all activity domains since CHF diagnosis (ps < .001). Worse executive dysfunction and depressive symptoms were associated with reduced participation and together accounted for 35%-46% of the variance in participation (ps < .01)., Conclusion: Participation restrictions associated with CHF are not limited to physically demanding activities and are significantly associated with executive dysfunction and depression. Cardiac rehabilitation should address cognitive and psychological functioning in the context of all life situations instead of focusing solely on physical function and disability.