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Egan SJ, Munro C, Pauley-Gadd SB, O'Brien A, Callaghan T, Payne N, Raghav S, Myers B, Hall C, Wilson H, Eisma MC, Boelen PA, Smith KV, Wild J, Duffy M, Trickey D, Bills E, Breen LJ. A protocol for a pilot randomised controlled trial of unguided internet cognitive behaviour therapy for grief in adolescents. Internet Interv 2024; 38:100771. [PMID: 39291171 PMCID: PMC11405812 DOI: 10.1016/j.invent.2024.100771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 08/05/2024] [Accepted: 09/03/2024] [Indexed: 09/19/2024] Open
Abstract
Grief is highly prevalent in adolescents, however, there have been no studies investigating internet delivered cognitive behaviour therapy for grief in adolescents (ICBT-G-A). In this paper, the co-design of an unguided ICBT-G-A intervention is described, and a protocol outlined for a pilot randomised controlled trial of the intervention. Participants will be randomised to the intervention (delivered via eight modules over a four-week period) or a four-week waitlist control. Intervention participants will complete a follow-up assessment at one-month post-intervention (eight weeks from the pre-intervention assessment). The intervention outcomes assessed at pre-intervention, post-intervention and follow-up include wellbeing and symptoms of anxiety, depression, post-traumatic stress, and prolonged grief. User feedback on experiences and acceptability of the intervention will be sought and feasibility assessed via programmatic data on recruitment and attrition.
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Affiliation(s)
- Sarah J Egan
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Caitlin Munro
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Sian B Pauley-Gadd
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Amy O'Brien
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Thomas Callaghan
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Nicholas Payne
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | | | - Bronwyn Myers
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research council, Tygerberg, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape town, South Africa
| | | | - Hayden Wilson
- Child and Adolescent Mental Health Service, Western Australia Country Health Service, Perth, Australia
| | - Maarten C Eisma
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, the Netherlands
| | - Paul A Boelen
- Department of Clinical Psychology, Utrecht University, the Netherlands
- ARQ National Psychotrauma Centre, Amsterdam, the Netherlands
| | - Kirsten V Smith
- Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Jennifer Wild
- Department of Experimental Psychology, University of Oxford, United Kingdom
- Phoenix Australia, Department of Psychiatry, University of Melbourne, Australia
| | | | | | - Elizabeth Bills
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
| | - Lauren J Breen
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
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Lau-Zhu A, Chan C, Gibson D, Stark E, Wang J, Happé F, Stacey J, Cooper M. Specificity of Episodic Future Thinking in Adolescents: Comparing Childhood Maltreatment, Autism Spectrum, and Typical Development. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01232-7. [PMID: 39167319 DOI: 10.1007/s10802-024-01232-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 08/23/2024]
Abstract
Maltreatment and autism can be associated with overlapping difficulties across functional domains (e.g., social, emotional, and sensory) and high rates of mental health problems. A cognitive approach focussing on affect-laden cognition, here on episodic future thinking (FT), could help inform cognitive assessments and adapt psychological interventions. Three groups of adolescents (N = 85), (i) maltreatment (n = 28), (ii) autism (n = 29), and (iii) typical development without maltreatment/autism (TD; n = 28), matched in age (10-16 years old), sex (assigned at birth), and socioeconomic status, completed a newly adapted online Autobiographical Future Thinking Test. As predicted, the maltreatment group generated significantly fewer specific future events relative to the TD group, however, the number of specific future events did not significantly differ between the autism and the other groups. Exploratory analyses showed that lower FT specificity was significantly associated with more depressive (but not anxiety) symptoms across the three groups. These findings shed light on the cognitive profiles of both maltreatment and autism during adolescence and signal FT as a potential therapeutic target for adolescents with these developmental differences. Our study lays the foundation for additional comparisons of maltreatment-related presentations versus autism with improved designs and a broader set of cognitive and clinical domains.
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Affiliation(s)
- A Lau-Zhu
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford, UK.
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London, UK.
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, UK.
| | - C Chan
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, UK
| | - D Gibson
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, UK
| | - E Stark
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford, UK
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
| | - J Wang
- Child and Adolescent Mental Health Services, Berkshire Healthcare NHS Foundation Trust, Reading, UK
| | - F Happé
- Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Stacey
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, UK
| | - M Cooper
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford, UK
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Radez J, Johns L, Waite F. Understanding unusual sensory experiences: a randomised experimental study of a school-based intervention for adolescents. Child Adolesc Ment Health 2024; 29:14-21. [PMID: 36959519 PMCID: PMC10877969 DOI: 10.1111/camh.12651] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND One in ten young people experience unusual sensory experiences (USE), such as hallucinations. From a cognitive perspective, the appraisal of USE determines the impact of these experiences. Negative appraisal, as well as other psychological processes (e.g. thinking flexibility, maladaptive schemas, anxiety/depression), is associated with more distress. Our aim was to (a) develop a universal single-session school-based intervention on USE for adolescents and (b) evaluate the effect of the intervention on appraisals of and help seeking intentions for USE. METHODS A randomised controlled experimental design with a one-month follow-up was used to test the effectiveness of the intervention in one school. Students (n = 223) aged 12-13 were randomised by class to a single-session intervention on USE or a control intervention (generic mental wellbeing). Participants completed measures of appraisals of and help-seeking intentions for USE at pre- and postintervention and at one-month follow-up. They also completed measures of schemas, thinking flexibility and anxiety/depression at preintervention. RESULTS Overall, 190 adolescents completed the main outcome measures at all three points. The intervention on USE led to a significant (p < .05) increase of positive appraisals of USE compared with the control, with effects sustained at one-month follow-up. The intervention on USE did not lead to significantly greater help-seeking intentions for USE (p = .26). Adolescents' schemas were associated with appraisals and slow thinking and anxiety/depressive symptoms with help-seeking behaviour for USE. CONCLUSIONS A single-session universal school-based intervention shows promise by improving appraisals of USE. Further research is required across different school populations.
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Affiliation(s)
- Jerica Radez
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences DivisionUniversity of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
| | - Louise Johns
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences DivisionUniversity of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Felicity Waite
- Oxford Health NHS Foundation TrustOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
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Hayes D, Fancourt D, Burton A. The experiences and impact of the COVID-19 pandemic on young carers: practice implications and planning for future health emergencies. Child Adolesc Psychiatry Ment Health 2024; 18:2. [PMID: 38172971 PMCID: PMC10765662 DOI: 10.1186/s13034-023-00697-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Young carers are children or young people aged up to 25 years old who undertake unpaid caring responsibilities for a friend or family member. Young carers faced significant challenges brought on by the COVID-19 pandemic. We explored the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the United Kingdom (UK) to understand how to improve services, as well as support this population in future health emergencies. METHOD We conducted 22 qualitative semi-structured interviews from May to November 2021 with 14 young carers and eight staff working in organisations that supported them. Interviews took place remotely over video or telephone call and explored participant experiences of the pandemic and its impact on their health, wellbeing and caring responsibilities. We used reflexive thematic analysis to analyse interview transcripts. RESULTS We identified four overarching themes pertaining to the impact of the pandemic and associated restrictions on mental health, wellbeing and access to support in young carers in the UK: (1) challenges in protecting loved ones from the virus, (2) changes to and loss of routine, (3) reduced access to pre-pandemic informal and formal support structures and (4) better understanding of inner resilience and goals. Many participants struggled with their mental health and wellbeing as a result of pandemic related restrictions which impacted on support structures for themselves and the individual they cared for. However, positive impacts pertained to additional support provided by local authority and third sector organisations. CONCLUSIONS Our findings highlight some of the changes that affected young carers during the COVID-19 pandemic. The impact of changes to routine and a reduction in pre-pandemic support were the greatest concerns reported by participants in this study. The additional support provided by local authority and third sector organisations during social restrictions suggests such organisations could play a greater role in supporting this population going forward and that schools and Governments may wish to put in additional strategies and provisions to protect young carers in the future.
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Affiliation(s)
- D Hayes
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - D Fancourt
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK
| | - A Burton
- The Social Biobehavioural Research Group, Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London (UCL), 1-19 Torrington Place, London, WC1E 7HB, UK
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, Weich S. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-107. [PMID: 38314750 DOI: 10.3310/vkty5822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and adolescents is consistently challenged. A review is needed to explore how best to undertake risk assessment and the appropriate role for tools/checklists within the assessment pathway. Aims To map research relating to risk assessment for child and adolescent mental health and to identify features that relate to a successful risk assessment. Objectives To review factors within the clinical encounter that impact upon risk assessments for self-harm and suicide in children and adolescents: i. to conduct a realist synthesis to understand mechanisms for risk assessment, why they occur and how they vary by context ii. to conduct a mapping review of primary studies/reviews to describe available tools of applicability to the UK. Data sources Databases, including MEDLINE, PsycINFO®, EMBASE, CINAHL, HMIC, Science and Social Sciences Citation Index and the Cochrane Library, were searched (September 2021). Searches were also conducted for reports from websites. Review methods A resource-constrained realist synthesis was conducted exploring factors that impact upon risk assessments for self-harm and suicide. This was accompanied by a mapping review of primary studies/reviews describing risk-assessment tools and approaches used in UK child and adolescent mental health. Following piloting, four reviewers screened retrieved records. Items were coded for the mapping and/or for inclusion in the realist synthesis. The review team examined the validity and limitations of risk-screening tools. In addition, the team identified structured approaches to risk assessment. Reporting of the realist synthesis followed RAMESES guidelines. Results From 4084 unique citations, 249 papers were reviewed and 41 studies (49 tools) were included in the mapping review. Eight reviews were identified following full-text screening. Fifty-seven papers were identified for the realist review. Findings highlight 14 explanations (programme theories) for a successful risk assessment for self-harm and suicide. Forty-nine individual assessment tools/approaches were identified. Few tools were developed in the UK, specifically for children and adolescents. These lacked formal independent evaluation. No risk-screening tool is suitable for risk prediction; optimal approaches incorporate a relationship of trust, involvement of the family, where appropriate, and a patient-centred holistic approach. The objective of risk assessment should be elicitation of information to direct a risk formulation and care plan. Limitations Many identified tools are well-established but lack scientific validity, particularly predictive validity, or clinical utility. Programme theories were generated rapidly from a survey of risk assessment. Conclusions No single checklist/approach meets the needs of risk assessment for self-harm and suicide. A whole-system approach is required, informed by structured clinical judgement. Useful components include a holistic assessment within a climate of trust, facilitated by family involvement. Study registration This study is registered as PROSPERO CRD42021276671. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135079) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Cantrell
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Katie Sworn
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Duncan Chambers
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Andrew Booth
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | | | - Scott Weich
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
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Grothus S, Sommer A, Claus BB, Stahlschmidt L, Chorpita BF, Wager J. The German version of the Revised Children's Anxiety and Depression Scale-Psychometric properties and normative data for German 8- to 17-year-olds. Int J Methods Psychiatr Res 2023; 32:e1965. [PMID: 36920869 DOI: 10.1002/mpr.1965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/17/2023] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVES Anxiety and depression are internalizing mental disorders often commencing in childhood and manifesting in adolescence. The Revised Anxiety and Depression Scale (RCADS) is an internationally widely used standardized diagnostic tool, but the German version has only been validated in a pediatric chronic pain sample; normative data are not available. The aim of this study is to test its reliability (internal consistency) and validity (factorial, convergent, known-groups) in a representative German school sample and to provide norm data. METHODS Data were collected from N = 1562 German schoolchildren (Mage = 12.2; SDage = 2.33; range 8-17 years; 52.4% girls). RESULTS Cronbach's α ranged from 0.73 to 0.96 for the total and the six subscales (five anxiety and one depression). Confirmatory factor analysis showed the 6-factor model had acceptable to good model fit with CFI = 0.93, TLI = 0.93, RMSEA = 0.05, SRMR = 0.05, which was better than 1- and 2-factor models. The (sub)scales correlated moderate to high negatively with health-related quality of life (-0.31 ≤ τ ≤ -0.51; p < 0.001) and positively with functional impairment (0.31 ≤ τ ≤ 0.48; p < 0.001). Mean scores of anxiety and depression scales were significantly higher in girls and partly in adolescents. CONCLUSION Findings provide support for the good psychometric properties of the German RCADS in a community sample.
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Affiliation(s)
- Susanne Grothus
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Ariane Sommer
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Benedikt B Claus
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
| | - Lorin Stahlschmidt
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Bruce F Chorpita
- Department of Psychology, University of California, Oakland, California, USA
| | - Julia Wager
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- PedScience Research Institute, Datteln, Germany
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Murray A, Speyer L, Thye M, Stewart T, Obsuth I, Kane J, Whyte K, Devaney J, Rohde LA, Ushakova A, Rhodes S. Illuminating the daily life experiences of adolescents with and without ADHD: protocol for an ecological momentary assessment study. BMJ Open 2023; 13:e077222. [PMID: 37775284 PMCID: PMC10546102 DOI: 10.1136/bmjopen-2023-077222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk of a range of difficulties, among which emotion regulation, peer and co-occurring mental health problems are prominent challenges. To better support adolescents with ADHD, ecologically valid interventions that can be embedded in daily life to target the most proximal antecedents of these challenges are needed. Ecological momentary assessment (EMA) designs are ideally suited to meeting this need. METHODS AND ANALYSES In the mental health in the moment ADHD study, we will use an EMA design to capture the daily life experiences of approximately 120 adolescents aged 11-14 years with a clinical diagnosis of ADHD and the same number of age-matched and gender-matched peers without a diagnosis of ADHD. We will combine this with comprehensive information gathered from online surveys. Analysing the data using techniques such as dynamic structural equation modelling, we will examine, among other research questions, the role of emotion regulation and peer problems in mediating the links between characteristics of ADHD and commonly co-occurring outcomes such as anxiety, depression and conduct problems. The results can help inform interventions to support improved peer functioning and emotion regulation for adolescents with ADHD. ETHICS AND DISSEMINATION This study received a favourable ethical opinion through the National Health Service ethical review board and the University of Edinburgh PPLS Research Ethics panel. The results will be disseminated through journal publications, conferences and seminar presentations and to relevant stakeholders, such as those with ADHD, their families and clinicians.
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Affiliation(s)
- Aja Murray
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Lydia Speyer
- Department of Psychology, Lancaster University, Edinburgh, UK
| | - Melissa Thye
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Tracy Stewart
- Moray House of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Ingrid Obsuth
- Clinical and Health Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Jennifer Kane
- Clinical and Health Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Katie Whyte
- Department of Psychology, St Andrew's University, St Andrews, UK
| | - John Devaney
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Luis Augusto Rohde
- ADHD Outpatient Program and Developmental Psychiatry Program, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry & National Center for Research and Innovation in Mental Health, Sao Paolo, Brazil
- UniEduk, Brazil, Brazil
| | - Anastasia Ushakova
- Centre for Computing, Health Informatics and Statistics, Lancaster University, Lancaster, UK
| | - Sinead Rhodes
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Fancourt D, Burton A, Bu F, Deighton J, Turner R, Wright J, Bradbury A, Tibber M, Talwar S, Hayes D. Wellbeing while waiting evaluating social prescribing in CAMHS: study protocol for a hybrid type II implementation-effectiveness study. BMC Psychiatry 2023; 23:328. [PMID: 37165351 PMCID: PMC10170442 DOI: 10.1186/s12888-023-04758-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/06/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Social prescribing is a mechanism of connecting patients with non-medical forms of support within the community and has been shown to improve mental health and wellbeing in adult populations. In the last few years, it has been used in child and youth settings with promising results. Currently, pathways are being developed for social prescribing in Child and Adolescent Mental Health Services (CAMHS) to support children and young people on treatment waiting lists. The Wellbeing While Waiting study will evaluate whether social prescribing benefits the mental health and wellbeing of children and young people. METHODS This study utilises an observational, hybrid type II implementation-effectiveness design. Up to ten CAMHS who are developing social prescribing pathways as part of a programme run across England with support from the Social Prescribing Youth Network will participate. Outcomes for children and young people receiving social prescribing whilst on CAMHS waiting lists will be compared to a control group recruited prior to the pathway roll-out. Questionnaire data will be collected at baseline, 3 months and 6 months. Primary outcomes for children and young people are mental health symptoms (including anxiety, depression, stress, emotional and behavioural difficulties). Secondary outcomes include: loneliness, resilience, happiness, whether life is worthwhile, life satisfaction, and service use. An implementation strand using questionnaires and interviews will explore the acceptability, feasibility, and suitability of the pathway, potential mechanisms of action and their moderating effects on the outcomes of interest, as well as the perceived impact of social prescribing. Questionnaire data will be analysed mainly using difference-in-differences or controlled interrupted time series analysis. Interview data will be analysed using reflexive thematic analysis. DISCUSSION The Wellbeing While Waiting study will provide the first rigorous evidence of the impact of social prescribing for children and young people on waiting lists for mental health treatment. Findings will help inform the prioritisation, commissioning, and running of social prescribing in other CAMHS. To maximise impact, findings will be available on the study website ( https://sbbresearch.org ) and disseminated via national and international networks. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Daisy Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, Social Biobehavioural Research Group, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Alexandra Burton
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, Social Biobehavioural Research Group, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Feifei Bu
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, Social Biobehavioural Research Group, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Jessica Deighton
- Evidence Based Practice Unit, University College London and the Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
| | - Richard Turner
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, Social Biobehavioural Research Group, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Joely Wright
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, Social Biobehavioural Research Group, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Alexandra Bradbury
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, Social Biobehavioural Research Group, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Marc Tibber
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Shivangi Talwar
- Division of Psychiatry, University College London, Maple House, Gower Street, London, WC1E 6BT, UK
| | - Daniel Hayes
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, Social Biobehavioural Research Group, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- Evidence Based Practice Unit, University College London and the Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK.
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Radez J, Waite F, Izon E, Johns L. Identifying individuals at risk of developing psychosis: A systematic review of the literature in primary care services. Early Interv Psychiatry 2023; 17:429-446. [PMID: 36632681 PMCID: PMC10946574 DOI: 10.1111/eip.13365] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/12/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
AIM Psychosis and related disorders are a major public health issue. Early identification and prevention for those at high risk (at-risk-mental-state, ARMS) is important. General practitioners (GPs) are often the first point of contact for health services. In this review we aim to identify (1) the most common methods for identifying individuals with an ARMS in primary care, (2) the methods for improving identification of individuals with an ARMS in primary care, and (3) the most common barriers that prevent GPs from screening for individuals with an ARMS. METHODS We conducted a systematic review (PROSPERO 42021245095) of quantitative and qualitative studies with no date restriction. Searches were performed in September 2021. Studies' quality was appraised using Mixed Methods Appraisal tool (MMAT). RESULTS We identified 16 eligible studies, and all but one provided quantitative data. Nearly two-thirds of studies were classified as 'medium' quality. Employing narrative synthesis, we identified three themes relating to (1) improving GP knowledge and confidence in identifying individuals with an ARMS, (2) balancing the over- and under-identification of individuals with an ARMS in primary care, and (3) supporting GPs as significant stakeholders in early diagnosis and treatment of individuals with an ARMS. CONCLUSIONS Improved identification of individuals with an ARMS is needed. We identified various strategies, including development and implementation of identification methods (e.g., screening measures), educational interventions for GPs (e.g., workshops), and systemic interventions (e.g., simplifying referrals to secondary care, developing integrated services). When implemented successfully, these interventions may help facilitate the access to appropriate care for individuals with an ARMS.
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Affiliation(s)
- Jerica Radez
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
| | - Felicity Waite
- Oxford Health NHS Foundation TrustOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Emma Izon
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
| | - Louise Johns
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of OxfordOxfordUK
- Oxford Health NHS Foundation TrustOxfordUK
- Department of PsychiatryUniversity of OxfordOxfordUK
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Carvajal-Velez L, Ahs JW, Lundin A, van den Broek M, Simmons J, Wade P, Chorpita B, Requejo JH, Kohrt BA. Validation of the Kriol and Belizean English Adaptation of the Revised Children's Anxiety and Depression Scale for Use With Adolescents in Belize. J Adolesc Health 2023; 72:S40-S51. [PMID: 36400635 DOI: 10.1016/j.jadohealth.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 09/28/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE To validate a culturally-adapted Kriol and Belizean English version of the Revised Children's Anxiety and Depression Scale (RCADS) through comparison with clinical diagnoses made using the Kiddie Schedule of Affective Disorders and Schizophrenia. METHODS Participants comprised of 256 adolescents aged 10-14 years and 15-19 years, who completed the adapted RCADS (10 depression items, 12 anxiety items) in one-on-one interviews, followed by a diagnostic assessment using Kiddie Schedule of Affective Disorders and Schizophrenia administered by trained clinicians. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratios, area under the curve (AUC), and Youden's Index were calculated for RCADS cutoffs and scores on the total scale and anxiety and depression subscales. RESULTS For adolescents aged 10-14 years (n = 161), the AUC was 0.72 for the full scale, 0.67 for anxiety subscale, and 0.76 for depression subscale. For adolescents aged 15-19 years (n = 95), the AUCs were 0.82, 0.77, and 0.83. Most depression items performed well in discriminating those with and without diagnoses. Separation anxiety items performed poorly. "Thoughts of death" were common even among adolescents not meeting diagnostic criteria. The RCADS depression subscale presented the strongest psychometric properties with adolescents aged 15-19 years (at cutoff of 13, sensitivity = 0.83, specificity = 0.77, positive predictive value = 0.47, negative predictive value = 0.95, odds ratio = 15.96). CONCLUSION The adapted RCADS-22 had acceptable categorization for adolescents aged 10-14 years and excellent categorization for adolescents aged 15-19 years; therefore, the tool is recommended for use among the latter age group. Based on sensitivity and specificity values at different cutoffs, guidance is provided to select different thresholds to suit clinical, public health, or other uses to detect and quantify adolescent depression and anxiety in Belize.
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Affiliation(s)
- Liliana Carvajal-Velez
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Jill W Ahs
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Health Sciences, Swedish Red Cross University, Stockholm, Sweden
| | - Andreas Lundin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Myrthe van den Broek
- War Child Holland and Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, Netherlands
| | - Juliet Simmons
- Department of Mental Health, Ministry of Health and Wellness, Belize City, Belize
| | | | - Bruce Chorpita
- Department of Psychology, University of California, Los Angeles, California
| | - Jennifer Harris Requejo
- Division of Data, Analytics, Planning and Monitoring, Data and Analytics Section, UNICEF, New York
| | - Brandon A Kohrt
- Department of Psychiatry, George Washington University, Washington, District of Columbia
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MALAKCIOGLU C. Validity and Reliability of the Anxiety Assessment Scale: A New Three-dimensional Perspective. Medeni Med J 2022; 37:165-172. [PMID: 35735160 PMCID: PMC9234362 DOI: 10.4274/mmj.galenos.2022.75318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Anxiety is inseparable from life due to its survival value. Up-to-date and multidimensional assessment of anxiety is necessary to develop effective interventions to cope with high anxiety levels. This study was conducted to examine the psychometrics of the Anxiety Assessment Scale (AAS). Methods: Data were collected between January and April 2021 from 756 students (42.9% males and 57.1% females) studying medicine at Istanbul Medeniyet University. Seven experts evaluated the items to detect content validity in the final application form. Both exploratory and confirmatory factor analyses (EFA and CFA) were used for construct validity. The Beck Anxiety Inventory was also applied for concurrent validity. Test-retest reliabilities were calculated within four weeks. IBM SPSS 25 and AMOS 24 were used for statistical analyses. Results: Data were suitable for factor analyses (Kaiser-Meyer-Olkin=0.800, chi-square=3018.854, df=45). The EFA showed the three-factor structure with 10 items, and 70.1% of the variance was explained. Factor loads of the items varied between 0.61 and 0.87; data-model fit was suitable (CFI=0.92, TLI=0.93, RMSEA=0.059, SRMR=0.046, chi-square/df=1.556) according to CFA. Concurrent scale validity was also confirmed by the Pearson correlation (r=0.167, p<0.01). The test-retest reliabilities (r) were all >0.5 (p<0.001). The Cronbach a coefficients were 0.845 (AAS), 0.770 (Physiological Tension=PT), 0.822 (Worrying=W), and 0.838 (Feeling Unsafe=FU). Conclusions: AAS is a reliable and valid measurement instrument to assess anxiety levels in three dimensions. AAS can be applied for research, psychological assessment, and other appropriate application purposes.
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Spence SH, Rapee RM. The development and preliminary validation of a brief scale of emotional distress in young people using combined classical test theory and item response theory approaches: The Brief Emotional Distress Scale for Youth (BEDSY). J Anxiety Disord 2022; 85:102495. [PMID: 34826643 DOI: 10.1016/j.janxdis.2021.102495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
Reliable, valid, and brief measures are important for identifying young people in community contexts who experience mental health problems. This paper reports the development and preliminary validation of the Brief Emotional Distress Scale for Youth (BEDSY), a measure based on anxiety and depression symptoms that load strongly upon the general construct of emotional distress. Participants, aged 11-17 years, included 2663 from a community population and 281 referred anxious youth. From a pool of 20 items, eight were selected for the final scale using methods from classical test theory, followed by item response theory (IRT). The final eight items met the pre-specified criteria for skewness and kurtosis, item-total correlations, IRT characteristics, and discrimination between referred vs. community samples. Exploratory structural equation modeling for a bi-factor model indicated that 81% of total variance was explained by the general emotional distress factor. The 8-item BEDSY showed strong internal consistency, good construct validity, and acceptable sensitivity and specificity in discriminating between a community sample vs anxious youth, and between youth with and without high levels of depressive symptoms. As such the scale has strong potential as a brief screen for identifying emotionally distressed young people in community contexts.
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Affiliation(s)
- Susan H Spence
- Australian Institute of Suicide Research and Prevention and School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
| | - Ronald M Rapee
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia.
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Pine R, Mbinta J, Te Morenga L, Fleming T. A Casual Video Game With Psychological Well-being Concepts for Young Adolescents: Protocol for an Acceptability and Feasibility Study. JMIR Res Protoc 2021; 10:e31588. [PMID: 34387558 PMCID: PMC8391754 DOI: 10.2196/31588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022] Open
Abstract
Background Many face-to-face and digital therapeutic supports are designed for adolescents experiencing high levels of psychological distress. However, promoting psychological well-being among adolescents is often neglected despite significant short-term and long-term benefits. Objective This research has 3 main objectives: (1) to assess the acceptability of Match Emoji, a casual video game with psychological well-being concepts among 13-15-year-old students in a New Zealand secondary school; (2) to identify the feasibility of the research process; and (3) to explore the preliminary well-being and therapeutic potential of Match Emoji. Methods Approximately 40 participants aged 13-15 years from a local secondary college in Wellington, New Zealand, will be invited to download and play Match Emoji 3-4 times a week for 5-15 minutes over a 2-week period. Participants will complete 4 assessments at baseline, postintervention, and 3 weeks later to assess psychological well-being and therapeutic changes. Statistical analysis will be used to synthesize data from interviews and triangulated with assessment changes and game analytics. This synthesis will help to assess the acceptability and feasibility of the Match Emoji. Results The key outputs from the project will include the acceptability, feasibility, and therapeutic potential of Match Emoji. It is anticipated that participants will have finished playing the recommended game play regimen by August 2021 with analysis of results completed by October 2021. Conclusions Data from the study are expected to inform future research on Match Emoji including a randomized controlled trial and further adjustments to the design and development of the game. International Registered Report Identifier (IRRID) PRR1-10.2196/31588
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Affiliation(s)
- Russell Pine
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - James Mbinta
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Lisa Te Morenga
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Theresa Fleming
- School of Health, Victoria University of Wellington, Wellington, New Zealand
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