Psychiatry-Interpersonal and Biological Processes最新文献

Objective: We assessed the impact of the COVID-19 pandemic on the implementation of a peer-integrated enhancement of integrated clinical care intervention to address the mental health needs of 450 patients undergoing treatment for a physical injury.

Methods: Qualitative data were collected by 7 clinician investigators of a randomized controlled trial acting as participant observers in a trauma care setting of a major U.S. metropolitan hospital and analyzed in collaboration with an external mixed methods specialist.

Results: The pandemic created or exacerbated several implementation barriers, including increased risk of infection, homelessness, hospitalizations and comorbid conditions such as fentanyl overdoses that increased demand on emergency department and Trauma Center services, imposition of safety measures to reduce risk of infection in clinical settings, transition from face-to-face to virtual interactions with study patients, shortages of specialty mental health providers, suspension of recruitment of patients into the study, scheduling calls with patients, and an increased workload for the study clinical interventionists. Peer specialists perceived the transition to virtual interactions with patients reduced their effectiveness; however, this was not reflected in assessments of patient satisfaction with services received and may have inadvertently increased adoption by Trauma Center staff. Reduction in reach of the intervention to target population was temporary.

Conclusions: The COVID-19 pandemic exacerbated existing barriers and created new barriers to successfully implementing evidence-based practices in trauma care settings, resulting in an attenuation of their effectiveness. However, the shift from face-to-face to virtual services delivery may have actually led to improved implementation outcomes.

Trial registration: ClinicalTrials.gov identifier: NCT03569878. Registered June 15, 2018.

Objective: Digital social technologies, such as social media and online multiplayer video games (MVGs), have ushered in an era of peer relationships that evolve online, in addition to in person. This report reviews existing research about the dual role of social media and MVGs in shaping youth social connectedness, recognizing both their potential benefits and their associated risks on youth mental health. By providing evidence-based insights, it aims to inform strategies that optimize these technologies' advantages while safeguarding youth mental health and well-being.

Method: This report reviews peer-reviewed literature, clinical recommendations, reports, and surveys that assess youth usage of social media and MVGs and their associated psychological and physical health outcomes.

Results: Social media provides many opportunities for peer connection, including self-expression and social support, fostering positive social development and well-being. MVGs combine entertainment with collaboration, further strengthening social bonds. However, the use of these technologies has also been linked to negative outcomes, including social isolation, depression, anxiety, and sleep disorders. Publically-available, evidence-based resources can provide caregivers and professionals with guidance and clinical recommendations regarding youth social media and MVG use.

Conclusions: Digital social technologies have become increasingly user-specific and immersive as the internet evolves and social media algorithms become more powerful. Additional research is required to understand how current youth usage of these technologies impacts physical and psychological outcomes. Future research should also investigate the differences in usage, outcomes, and the efficacy of treatments across youth sex and age.

Objective Resistance to unwanted sexual advances decreases likelihood of completed sexual victimization (SV), with psychological barriers to resistance (PBRs; i.e. fear of injury, concern for preserving the relationship, and self-consciousness) reducing likelihood of resisting. Prior SV is associated with distress, which could increase revictimization risk.Method: A cross-sectional survey was utilized to examine associations among history of SV, psychological distress (defined as symptoms of depression, anxiety, symptoms of post-traumatic stress disorder [PTSD], and alcohol use problems), and PBRs in a sample of college women (N = 374). It was hypothesized: 1) severity of SV would be associated with PBRs, 2) psychological distress would be associated with severity of SV, 3) psychological distress would be associated with each type of PBR, and 4) psychological distress would mediate associations between severity of SV and PBRs. Results: Severity of SV was associated with fear of injury exacerbation and concerns for relationship preservation as well as higher levels of psychological distress. Concerns for relationship preservation and self-consciousness were associated with more alcohol problems. Depression mediated severity of SV and PBR due to concern for relationship preservation.Conclusion: Risk reduction programs should address how the intersection of psychological distress and PBR influences resistance behavior, especially among women with a history of SV.

Background: Military personnel and active combatants are known to be at risk for perpetrating or witnessing acts that violate their moral code. These events, termed potentially morally injurious events (PMIEs), were found to be associated in cross-sectional studies with an increased risk of mental and behavioral health problems, such as depression and anxiety symptoms. However, the longitudinal contribution of deployment-related PMIEs and moral injury (MI) outcomes to depression and anxiety symptoms among veterans remain unclear, particularly during their initial years following discharge.

Method: Participants were 169 Israeli combat veterans who participated in a six-year longitudinal study with four measurement points (T1: 12 months before enlistment, T2: Six months following enlistment - pre-deployment, T3: 18 months following enlistment - post-deployment, and T4: 28 months following discharge). Participants' characteristics were assessed between 2019-2024 via semi-structured interviews (T1) and validated self-report measures (T2-T4).

Results: Exposure to PMIE-Self (i.e. self-perpetrated potentially morally injurious events) at T3 predicted severity of depressive symptoms (T4), and MI-outcomes of shame and trust-violation (T4) predicted both severity of depressive and anxiety symptoms (T4), above and beyond the pre-enlistment personal characteristics (T1), depressive and anxiety symptoms (T2 and T3), personality risk factors (T2) and combat exposure (T3).

Conclusions: Deployment-related PMIE experiences, especially PMIE-Self experiences, and MI outcomes, were found to be valid predictors of higher severity of depression and anxiety symptoms following discharge. Routine screening and targeted interventions should be available to combatants upon their discharge from the military, a transition identified as vulnerable to the consequences of moral injury.

Objective: Posttraumatic stress disorder (PTSD) has four symptom clusters: intrusion, avoidance, negative cognitions/mood, and hyperarousal. Little is known about the extent to which the intensity of the symptom clusters vary from moment-to-moment. Using an ecological momentary assessment methodology, this study examined within day variation in the four PTSD symptom clusters.

Methods: Participants with PTSD (N = 78) completed self-report assessments of 18 posttraumatic stress symptoms (PTSS) four times daily for 15 days. Linear mixed models and linear spline models examined how PTSS and each of the four PTSD symptom clusters varied across six daily time-blocks (0700, 1000, 1300, 1600, 1900, 2200).

Results: PTSS and each symptom cluster differed across the six time-blocks: PTSS, F(5, 345) = 10.06, p < .001; intrusion: 3.02, p < .05; avoidance: 11.31, p < .001; negative cognitions/mood: 7.42, p < .001; and hyperarousal: 9.34, p < .001. All symptom clusters were lowest at the first time-block with an overall increasing pattern across the six time-blocks. Knot analyses indicated maximum symptoms of intrusion at 1000, while maximum symptoms of avoidance, negative cognitions/mood, and hyperarousal occurred at 1300.

Conclusions: All four PTSD symptom clusters vary within a day, are lowest in the morning and peak at different times. Further study of the causes of this within day variation, including the neurobiological, psychological, behavioral, and lifestyle factors is important for understanding the mechanisms of and interventions for PTSD.

Aim: This study examines anxiety as a mediator between early warm and secure memories and healthy eating among college students, and the moderating role of physical activity in the early warm and secure memories-anxiety relationship.

Methods: In December, 2024, 2,984 Chinese undergraduates (42% male, 58% female; mean age 19.03)completed surveys assessing early warm and secure memories, anxiety, healthy eating, and physical activity. SPSS 29.0 analyzed correlations, PROCESS Macro testedthe mediation model, and moderated mediation model.

Results: Early warm and secure memories negatively correlated with anxiety (r = ‒0.359)and positively with physical activity (r = 0.098) and healthy eating (r = 0.245). Anxiety negatively correlated with physical activity (r = ‒0.089)and healthy eating (r = ‒0.209). Mediation analysis showed early warm and secure memories directly predicted healthy eating (β = 0.243, p < .001),with anxiety partially mediating this link (indirect effect β = ‒0.144, p < .001). Physical activity moderated the early warm and secure memories-anxiety pathway (interaction β = ‒0.044, p < .05), buffering anxiety's impact.

Conclusion: Early warm and secure memories promote healthy eating both directly and indirectly by reducing anxiety, with physical activity weakening the early warm and secure memories-anxiety association. Findings highlight the importance of fostering secure childhood memories for mental health and healthy eating. Interventions should leverage early warm and secure memories as a psychological resource and incorporate physical activity to enhance student well-being.

Objective:Chronic pain can result in psychological distress. In addition, sleep disturbance is associated with both chronic pain and psychological distress. However, no study has comprehensively investigated the roles of sleep disturbance in the associations between pain and psychological distress in the general population. Our study aims to explore the mediating as well as the moderating effects of sleep disturbance between chronic pain and psychological distress in a national Canadian sample. Methods: Data were analyzed from the Canadian Community Health Survey-Mental Health (CCHS-MH), a national cross-sectional study comprised of adult respondents who provided information on chronic pain, sleep and psychological distress (N = 25,113). The 10-item Kessler Psychological Distress Scale (K-10) was used to assess psychological distress. Structural equation modeling (SEM) was used to measure the mediating and moderating effects of sleep disturbance on the relationships between chronic pain and psychological distress. Results: Our findings indicated that sleep disturbance had both direct and indirect effects on psychological distress. Sleep disturbance partially mediated the relationships between chronic pain and psychological distress (β = 0.10, p < .05). The model accounts for 30.3% of the variance in psychological distress. Sleep disturbance also played a moderating role in the relationships between chronic pain and psychological distress. The pronounced moderation effect was found in the "no sleep disturbance group" (β = 0.20, p < .05). Conclusions: These results revealed that addressing sleep problems should be one of the targets of intervention and prevention for psychological distress among those individuals suffering from chronic pain.

Objective: The present review aimed to examine the association between different styles of attachment and proneness to shame.

Method: A systematic literature search was conducted across databases including PubMed, Scopus, Web of Science, and Google Scholar which led to the inclusion of 18 studies in the analysis. The meta-analysis incorporated studies involving diverse populations, ensuring a comprehensive understanding of the attachment-shame relationship across various demographic contexts. Four correlational meta-analyses were conducted to investigate the relationship between secure, insecure styles- dismissive, preoccupied, and fearful attachment styles and proneness to shame. Random-effect models in R were employed and the quality of the studies was assessed using the Newcastle-Ottawa Scale.

Results: Study findings revealed a significant small to moderate negative association between secure attachment and shame (Effect Size [ES] = -0.29); moderate positive associations were found between fearful (ES = 0.39) and preoccupied attachment styles (ES = 0.33) with shame; small but significant positive association was found between dismissing attachment and shame (ES = 0.13). Subgroup analysis revealed that the association between all three insecure attachment styles and shame was more pronounced among LGBTQ+ individuals. Meta-regression analysis showed that gender significantly influenced the associations for preoccupied and dismissing attachment styles.

Conclusion: These results demonstrate that the strength of association with shame varies by type of attachment style. The results also point to the moderating influence of gender and sexual orientation. These insights have important clinical implications and suggest directions for future research on tailoring interventions based on attachment styles.

Objective: Emergencies in child and adolescent psychiatry are prevalent, and pediatric psychiatric emergency departments play a crucial role in acute intervention during mental health-related crises. This retrospective cross-sectional study aimed to analyze the characteristics of children and adolescents who were admitted to a pediatric psychiatric emergency department.

Method: The data were collected from the records of 8803 patients (females 56.6%, Mage = 15.07 ± 2.6) admitted to our pediatric psychiatry emergency department between 2014 and 2021. Diagnoses were made using the International Statistical Classification of Diseases, 10th Revision. We used descriptive statistics to determine patient characteristics and conducted a regression analysis to compare the changes in the admissions numbers by the year.

Results: It was found that depressive disorder was the highest psychiatric diagnosis, with a percentage of 21.4%. Depressive disorder, autism spectrum disorder, and obsessive-compulsive disorder have shown an increase over the years. In 2020, with the onset of the COVID-19 pandemic, psychiatric admissions reached their lowest level. The percentage of hospitalizations was 21.1% for the total of all years. No significant change was found in the total number of admissions, sex, and age.

Conclusions: The number of admissions for female adolescents who were diagnosed with depressive disorder to our pediatric psychiatry emergency department is shown to be high. The fact that these patients seek help more frequently should be taken into consideration during the planning of mental health services for outpatient and inpatient clinics as well as pediatric psychiatry emergency services.

Objective: The armed conflict in Ukraine and its impact on Europe's economy have led to an war and economic crisis, potentially affecting the mental health of women during the perinatal period. This study aimed to assess the severity of depressive symptoms and labor anxiety among Polish women in perinatal period during this crisis. Methods: From June 2, 2022, to April 11, 2023, 152 women completed three sets of online surveys-two during pregnancy (before 33 weeks and/or between 33 and 37 weeks) and one postpartum (4 weeks after childbirth). The questionnaires used to evaluate the anxiety and depressive symptoms included Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI-2), Labor Anxiety Questionnaire (LAQ), and team-developed questionnaires evaluating war-related anxiety (WAQ) and global situation anxiety (GSAQ) Statistical analyses included U-Mann Whitney, Kruskal-Wallis, Wilcoxon signed-rank, Friedman tests and Spearman's correlations, with a significance level set at p < .05. Results: Among Polish pregnant women aged 23-43, 31.6% of participants experienced depressive symptoms, while 70.4% reported increased labor-related anxiety. Additionally, 24.3% experienced significant anxiety due to the war, and 25% suffered from severe anxiety related to the global situation. Positive correlations were noted between EPDS and GSAQ scores (R = 0.34, p < .001) and LAQ and WAQ scores (R = 0.21, p = .008). Conclusions: The prevalence of perinatal depression is high during war and economic crisis, underscoring the urgent need to improve screening for perinatal depression in Poland. Further, the manuscript did not discuss symptom patterns across the three time points.