Examining Bicultural Stress & Well-being Processes among Adolescents

Research Paper Title

Disentangling relationships between bicultural stress and mental well-being among Latinx immigrant adolescents.

Background

The Acculturative Process and Context Framework (Ward & Geeraert, 2016) proposes that acculturative stressors influence psychological well-being over time.

In fact, extant literature has linked bicultural stress with psychological functioning; yet, no studies have explored the causal dominance of bicultural stress.

The purpose of the present study was to evaluate the directionality of prospective relations among bicultural stress and psychosocial functioning (i.e., depressive symptoms, hopefulness, and self-esteem) in Latinx immigrant adolescents across 5 waves.

Methods

There were 303 Latinx adolescents who were recruited for this study from Los Angeles and Miami and were assessed across 5 waves at 6-month intervals.

Adolescents were 14.50 years old on average (SD = .88) and 53.16% were male.

Adolescents reported living in the United States for 2.07 years on average (SD = 1.87). A Random-Intercept Cross-Lagged Panel Model (RI-CLPM) was used to examine the between- and within-person relations among bicultural stress, depressive symptoms, hopefulness, and self-esteem in a comprehensive model.

Results

The comprehensive RI-CLPM including bicultural stress, depressive symptoms, hopefulness, and self-esteem exhibited excellent model fit.

Between-person, trait-like relations among constructs ranged from small to large, as expected.

Within-person, cross-lagged estimates among constructs were overall inconsistent, with some evidence that, within individuals, self-esteem influences later hopefulness.

Conclusions

Findings from this study indicate that the RI-CLPM is an effective strategy to examine bicultural stress and well-being processes among adolescents.

There is a need for further research examining bicultural stress among Latinx immigrant youth, particularly within prevention and intervention studies.

Reference

Romero, A., Piña-Watson, B., Stevens, A.K., Schwartz, S.J., Unger, J.B., Zamboanga, B.L., Szapocznik, J., Lorenzo-Blanco, E., Cano, M,Á., Meca, A., Baezconde-Garbanati, L., Córdova, D., Villamar, J.A., Soto, D.W., Lizzi, K.M., Des Rosiers, S.E., Pattarroyo, M. & Oshri, A. (2020) Disentangling relationships between bicultural stress and mental well-being among Latinx immigrant adolescents. Journal of Consulting and Clinical Psychology. 88(2), pp.149-159. doi: 10.1037/ccp0000466.

Need a Mental Health Buddy?

A former gunner has set up an initiative to help veterans with mental health issues in his hometown of Barrow-in-Furness.

Tony McNally has introduced a buddy system whereby ex-Service personnel give up their time to talk to others.

Working closely with local authorities and healthcare professionals, the volunteers are on standby to provide extra support to those who find themselves in a dark place.

McNally also contacted the town’s sports teams for free tickets for veterans, with rugby league outfit Barrow Raiders the first to get on board.

“I have found that when I attend a sporting event, I forget all about my own PTSD and other worries,” he said.

McNally has set up a Facebook page – Furness and South Lakes Buddy Buddy Mental Health Group.

For more info email: fslmhg@yahoo.com.

New Plank Record

A 62-Year-old former US Marine has set a world record for maintaining the plank.

On 15 February 2020, George Hood kept static for an incredible 8 hours 15 minutes and 15 seconds.

Hood, a former US Marine and retired Drug Enforcement Administration supervisory special agent, has broken the record for longest plank before, in 2011 when he held it for 1 hour and 20 minutes. But when he tried to set it again in 2016, he lost to Mao Weidong from China, who held a plank for 8 hours, 1 minute and 1 second.

A Guinness World Record official adjudicated at the event in Chicago, which raised money for an Illinois-based mental health counselling facility.

With his experience in the military and law enforcement, Hood said he knew mental illness is often stigmatized. So he completed the challenge at 515 Fitness, a gym that helps address mental illness through exercise and professional help.” (Lee, 2020).

The ultra-endurance athlete trained for seven hours a day for 18 months, completing around 2,100 hours of plank time, 270,000 push-ups and nearly 674,000 sit-ups.

“”It’s 4-5 hours a day in the plank pose,” Hood told CNN. “Then I do 700 pushups a day, 2,000 situps a day in sets of a hundred, 500 leg squats a day. For upper body and the arms, I do approximately 300 arm curls a day.”” (Lee, 2020).

To celebrate the reclaiming of his world record title, Hood finished off the event with a quick 75 push-ups/press-ups.

Hood has set the plank record a total of six times over the past eight years.

Hood said this will likely be his last time breaking the world record for planking, but his next goal is to set the Guinness World Record for most pushups completed in one hour, which currently stands at 2,806.

The female record is currently held by Dana Glowacka from Canada, who held a plank for 4 hours, 19 minutes and 55 seconds last year, according to Guinness World Records.

References

Lee, A. (2020) 62-year-old former Marine sets Guinness World Record by holding plank for over 8 hours. Available from World Wide Web: https://edition.cnn.com/2020/02/23/us/new-planking-world-record-trnd/index.html. [Accessed: 06 April, 2020].

Soldier. (2020) On His Toes. Soldier: Magazine of the British Army. April 2020, pp.16.

Can Questionnaires Guide Decisions to Refer Adults in Mental Health Services to Autism Diagnostic Services?

Research Paper Title

Testing adults by questionnaire for social and communication disorders, including autism spectrum disorders, in an adult mental health service population.

Background

Autism is difficult to identify in adults due to lack of validated self-report questionnaires.

The researchers compared the effectiveness of the autism-spectrum quotient (AQ) and the Ritvo autism-Asperger’s diagnostic scale-revised (RAADS-R) questionnaires in adult mental health services in two English counties.

Methods

A subsample of adults who completed the AQ and RAADS-R were invited to take part in an autism diagnostic observation schedule (ADOS Module 4) assessment with probability of selection weighted by scores on the questionnaires.

Results

There were 364 men and 374 women who consented to take part.

Recorded diagnoses were most commonly mood disorders (44%) and mental and behavioural disorders due to alcohol/substance misuse (19%), and 4.8% (95% CI [2.9, 7.5]) were identified with autism (ADOS Module 4 10+).

One had a pre-existing diagnosis of autism; five (26%) had borderline personality disorders (all female) and three (17%) had mood disorders.

The AQ and RAADS-R had fair test accuracy (area under receiver operating characteristic [ROC] curve 0.77 and 0.79, respectively).

AQ sensitivity was 0.79 (95% CI [0.54, 0.94]) and specificity was 0.77 (95% CI [0.65, 0.86]); RAADS-R sensitivity was 0.75 (95% CI [0.48, 0.93]) and specificity was 0.71 (95% CI [0.60, 0.81]).

Conclusions

The AQ and RAADS-R can guide decisions to refer adults in mental health services to autism diagnostic services.

Reference

Brugha, T., Tyrer, F., Leaver, A., Lewis, S., Seaton, S., Morgan, Z., Tromans, S. & van Rensburg, K. (2020) Testing adults by questionnaire for social and communication disorders, including autism spectrum disorders, in an adult mental health service population. International Journal of Methods in Psychiatric Research. 29(1):e1814. doi: 10.1002/mpr.1814. Epub 2020 Jan 10.

Can Testing by Questionnaire Guide Decisions to Refer Adults in Mental Health Services to Autism Diagnostic Services?

Research Paper Title

Testing adults by questionnaire for social and communication disorders, including autism spectrum disorders, in an adult mental health service population.

Background

Autism is difficult to identify in adults due to lack of validated self-report questionnaires.

The researchers compared the effectiveness of the autism-spectrum quotient (AQ) and the Ritvo autism-Asperger’s diagnostic scale-revised (RAADS-R) questionnaires in adult mental health services in two English counties.

Methods

A sub-sample of adults who completed the AQ and RAADS-R were invited to take part in an autism diagnostic observation schedule (ADOS Module 4) assessment with probability of selection weighted by scores on the questionnaires.

Results

There were 364 men and 374 women who consented to take part. Recorded diagnoses were most commonly mood disorders (44%) and mental and behavioural disorders due to alcohol/substance misuse (19%), and 4.8% (95% CI [2.9, 7.5]) were identified with autism (ADOS Module 4 10+).

One had a pre-existing diagnosis of autism; five (26%) had borderline personality disorders (all female) and three (17%) had mood disorders.

The AQ and RAADS-R had fair test accuracy (area under receiver operating characteristic [ROC] curve 0.77 and 0.79, respectively).

AQ sensitivity was 0.79 (95% CI [0.54, 0.94]) and specificity was 0.77 (95% CI [0.65, 0.86]); RAADS-R sensitivity was 0.75 (95% CI [0.48, 0.93]) and specificity was 0.71 (95% CI [0.60, 0.81]).

Conclusions

The AQ and RAADS-R can guide decisions to refer adults in mental health services to autism diagnostic services.

Reference

Brugha, T., Tyrer, F., Leaver, A., Lewis, S., Seaton, S., Morgan, Z., Tromans, S. & van Rensburg, K. (2020) Testing adults by questionnaire for social and communication disorders, including autism spectrum disorders, in an adult mental health service population. International Journal of Methods in Psychiatric Research. 29(1):e1814. doi: 10.1002/mpr.1814. Epub 2020 Jan 10.

What is the Impact of Onset of Psychiatric Disorders & Psychiatric Treatment on Mortality Among Patients with Cancer?

Research Paper Title

Impact of Onset of Psychiatric Disorders and Psychiatric Treatment on Mortality Among Patients with Cancer.

Background

Psychiatric disorders are common in patients with cancer.

The impact of both psychiatric disorders and psychiatric treatment on mortality in patients with cancer needs to be established.

Methods

Nationwide claims data were analysed.

To investigate the association between psychiatric disorders and mortality, 6,292 male and 4,455 female patients with cancer who did not have a record of psychiatric disorders before cancer onset were included.

To examine the association between psychiatric treatment and mortality, 1,467 male and 1,364 female patients with cancer were included.

Incident psychiatric disorder and receipt of psychiatric treatment within 30 days from the onset of a psychiatric disorder were the main independent variables.

Dependent variables were all-cause and cancer-related mortality. Cox proportional hazards regression with time-dependent covariates was used.

Results

The onset of psychiatric disorders was associated with a significantly increased risk of mortality in both male (all-cause hazard ratio [HR]: 1.55; cancer-related HR: 1.47) and female patients with cancer (all-cause HR: 1.50; cancer-related HR: 1.44) compared with patients with cancer without psychiatric disorders.

Both male and female patients who received psychiatric treatment within 30 days of diagnosis of a psychiatric disorder had a lower risk of cancer-related mortality (males, HR: 0.73; females, HR: 0.71) compared with patients with cancer with psychiatric disorders who did not receive psychiatric treatment.

Conclusions

Patients with cancer with newly diagnosed psychiatric disorders had a higher mortality rate.

Among these, those who received psychiatric treatment showed lower rates of mortality.

Thus, early detection and early treatment of psychiatric disorders in patients with cancer is needed.

Implications for Practice

The current study supplements the body of evidence supporting the association of psychiatric disorders onset and treatment with cancer outcomes.

Patients with cancer showed an increased risk of both all-cause and cancer-related mortality upon psychiatric disorder onset.

Among patients with newly diagnosed psychiatric disorders, those who received psychiatric treatment showed lower cancer-related mortality.

Thus, raising awareness of both the risk of psychiatric disorders and the positive effects of psychiatric treatment on cancer outcomes is necessary among patients with cancer, caregivers, and oncologists.

Furthermore, it is necessary to adopt a multidisciplinary approach, encouraging patients with cancer to undergo a neuropsychological assessment of their mental health status and receive appropriate and timely psychological interventions.

Reference

Lee, S.A., Nam, C.M., Kim, Y.H., Kim, T.H., Jang, S.I., Park, E.C. (2020) Impact of Onset of Psychiatric Disorders and Psychiatric Treatment on Mortality Among Patients with Cancer. The Oncologist. doi: 10.1634/theoncologist.2019-0396. [Epub ahead of print].

Linking Opioid Use Disorder & High Levels of Out-patient Care Prior to Diagnosis

Research Paper Title

The cascade of care for opioid use disorder: a retrospective study in British Columbia, Canada.

Background

The ‘cascade of care’ framework, measuring attrition at various stages of care engagement, has been proposed to guide the public health response to the opioid overdose public health emergency in British Columbia, Canada.

The researchers estimated the cascade of care for opioid use disorder and identified factors associated with care engagement for people with opioid use disorder (PWOUD) provincially.

Methods

Retrospective study using a provincial-level linkage of four health administrative databases.

All PWOUD in BC from 01 January 1996 to 30 November 2017.

The eight-stage cascade of care included diagnosed PWOUD, ever on opioid agonist treatment (OAT), recently on OAT, currently on OAT and retained on OAT: ≥ 1, ≥ 3, ≥ 12 and ≥ 24 months).

Health-care use, homelessness and other demographics were obtained from physician billing records, hospitalisations, and drug dispensation records. Receipt of income assistance was indicated by enrolment in Pharmacare Plan C.

Results

A total of 55 470 diagnosed PWOUD were alive at end of follow-up. As of 2017, a majority of the population (n = 39 456; 71%) received OAT during follow-up; however, only 33% (n = 18 519) were currently engaged in treatment and 16% (n = 8960) had been retained for at least 1 year.

Compared with those never on OAT, those currently engaged in OAT were more likely to be aged under 45 years [adjusted odds ratio (aOR) = 1.75, 95% confidence interval (CI) = 1.64, 1.89], male (aOR = 1.72, 95% CI = 1.64, 1.82), with concurrent substance use disorders (aOR = 2.56, 95% CI = 2.44, 2.70), hepatitis C virus (HCV) (aOR = 1.22, 95% CI = 1.14, 1.33) and either homeless or receiving income-assistance (aOR = 4.35, 95% CI = 4.17, 4.55).

Regular contact with the health-care system-either in out-patient or acute care settings-was common among PWOUD not engaged in OAT, regardless of time since diagnosis or treatment discontinuation.

Conclusions

People with opioid use disorder in British Columbia, Canada show high levels of out-patient care prior to diagnosis.

Younger age, male sex, urban residence, lower income level and homelessness appear to be independently associated with increased opioid agonist treatment engagement.

Reference

Piske, M., Zhou, H., Min, J.E., Hongdilokkul, N., Pearce, L.A., Homayra, F., Socias, M.E., McGowan, G. & Nosyk, B. (2020) The cascade of care for opioid use disorder: a retrospective study in British Columbia, Canada. Addiction (Abingdon, England). doi: 10.1111/add.14947. [Epub ahead of print].

Completed my Level 2 Certificate in Information, Advice or Guidance

Introduction

The Level 2 Information, Advice or Guidance (IAG) qualification has been developed for learners working in this field to share good practice and build confidence in their ability to effectively fulfil their role as providers of advice and guidance.

What is the Level 2 Certificate in Information Advice or Guidance?

UK employers are often interested in candidates who can demonstrate an understanding of the importance of interacting appropriately with customers, clients and colleagues.

By studying the level 2 Information, Advice or Guidance (IAG) course, individuals will gain an in-depth understanding of the key areas associated with providing effective IAG, including signposting, referrals, record keeping, confidentiality and communication/listening techniques.

Curriculum

The IAG qualification will help learners to develop an understanding of the requirements of the IAG practice and aid them in guiding those that they are supporting to make informed choices.

  • Unit 1: IAG in Practice:
    • In this unit, individuals will learn about the various differences between IAG and the requirements of different clients and how these are best met.
    • It will also help individuals to gain in-depth knowledge of the boundaries and responsibilities present when offering IAG, including signposting, referrals and record keeping.
  • Unit 2: Developing Interaction Skills for IAG:
    • Within this unit, individuals will discover how to interact with clients, executing appropriate and effective questioning techniques, listening skills and non-verbal communication.
    • They will also gain knowledge of the impact of values, beliefs and attitudes on any interactions individuals may encounter, as well as the importance of confidentiality and impartiality.
  • Unit 3: Signposting and Referral in IAG:
    • In this unit, individuals will gain an understanding of the difference between signposting and referrals – when it is appropriate to refer or signpost an individual organisation’s procedures.
    • Employees will also gain knowledge of good practice when signposting and referring, including recording, monitoring and evaluating.
  • Unit 4: IAG in Context:
    • Within this unit, individuals will gain an understanding of IAG in the context of their own practice and a specific group of clients – exploring different ways of assisting clients to explore and make choices.
    • Knowledge on discriminatory practices and behaviours affecting specific client groups, as well as potential barriers and how to overcome them, are explored within this unit.
  • Unit 5: Skills for Advice Providers:
    • This unit provides individuals with an understanding of the purpose and process of an advice interview, examining the relationship between client and advisor, the advisor’s role, stages of the advice interview and how to ensure client confidentiality.
    • A key part of this section is gaining knowledge of social policy in advice work, negotiating effectively on a client’s behalf and support and action planning.

Learning Methods

This course will take approximately twenty (20) weeks to complete and consists of five (5) written assessments.

Each individual is required to give written responses to an assessment booklet. This can be either handwritten in the booklet itself or completed using an electronic template of the booklet.

Individuals will be required to submit five (5) assessments each taking approximately four (4) weeks to complete.

What is the Potential Utility of EEG as a Treatment Planning Tool for Escitalopram Therapy?

Research Paper Title

Use of Machine Learning for Predicting Escitalopram Treatment Outcome From Electroencephalography Recordings in Adult Patients With Depression.

Background

Social and economic costs of depression are exacerbated by prolonged periods spent identifying treatments that would be effective for a particular patient. Thus, a tool that reliably predicts an individual patient’s response to treatment could significantly reduce the burden of depression.

To estimate how accurately an outcome of escitalopram treatment can be predicted from electroencephalographic (EEG) data on patients with depression.

Methods

This prognostic study used a support vector machine classifier to predict treatment outcome using data from the first Canadian Biomarker Integration Network in Depression (CAN-BIND-1) study.

The CAN-BIND-1 study comprised 180 patients (aged 18-60 years) diagnosed with major depressive disorder who had completed 8 weeks of treatment. Of this group, 122 patients had EEG data recorded before the treatment; 115 also had EEG data recorded after the first 2 weeks of treatment.

All participants completed 8 weeks of open-label escitalopram (10-20 mg) treatment.

The ability of EEG data to predict treatment outcome, measured as accuracy, specificity, and sensitivity of the classifier at baseline and after the first 2 weeks of treatment.

The treatment outcome was defined in terms of change in symptom severity, measured by the Montgomery-Åsberg Depression Rating Scale, before and after 8 weeks of treatment.

A patient was designated as a responder if the Montgomery-Åsberg Depression Rating Scale score decreased by at least 50% during the 8 weeks and as a nonresponder if the score decrease was less than 50%.

Results

Of the 122 participants who completed a baseline EEG recording (mean [SD] age, 36.3 [12.7] years; 76 [62.3%] female), the classifier was able to identify responders with an estimated accuracy of 79.2% (sensitivity, 67.3%; specificity, 91.0%) when using only the baseline EEG data.

For a subset of 115 participants who had additional EEG data recorded after the first 2 weeks of treatment, use of these data increased the accuracy to 82.4% (sensitivity, 79.2%; specificity, 85.5%).

Conclusions

These findings demonstrate the potential utility of EEG as a treatment planning tool for escitalopram therapy.

Further development of the classification tools presented in this study holds the promise of expediting the search for optimal treatment for each patient.

Reference

Zhdanov, A., Atluri, S., Wong, W., Vaghei, Y., Daskalakis, Z.J., Blumberger, D.M., Frey, B.N., Giacobbe, P., Lam, R.W., Milev, R., Mueller, D.J., Turecki, G., Parikh, S.V., Rotzinger, S., Soares, C.N., Brenner, C.A., Vila-Rodriguez, F., McAndrews, M.P., Kleffner, K., Alonso-Prieto, E., Arnott, S.R., Foster, J.A., Strother, S.C., Uher, R., Kennedy, S.H. & Farzan, F. (2020) Use of Machine Learning for Predicting Escitalopram Treatment Outcome From Electroencephalography Recordings in Adult Patients With Depression. JAMA Network Open. 3(1):e1918377. doi: 10.1001/jamanetworkopen.2019.18377.

Dosed (2019)

Introduction

An award-winning documentary film about treating anxiety, depression and addiction with psychedelic medicine.

Outline

After years of prescription medications failed her a suicidal woman, Adrianne, turns to underground healers to try and overcome her depression, anxiety, and opioid addiction with illegal psychedelic medicine like magic mushrooms and iboga.

Production & Filming Details

  • Director(s): Tyler Chandler.
  • Producer(s): Robert J. Barnhart, Tyler Chandler, Jason Hodges, Kelley Hodges, Chris Mayerson, Nicholas Meyers, and Nick Soares.
  • Writer(s): Tyler Chandler, Nicholas Meyers, and Jessie Deeter (Story consultant).
  • Music: Jayme McDonald.
  • Cinematography: Nicholas Meyers.
  • Editor(s): Tyler Chandler and Nicholas Meyers.
  • Production: Golden Teacher Films.
  • Release Date: 20 March 2019 (US).
  • Running Time: 82 minutes.