Search results for: mental health symptoms

Authors: Vartan Agopian

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Millions of Syrian families have been displaced since the beginning of the Syrian war, and the negative effects of post-war trauma have shown detrimental effects on the mental health of refugee children. While educational strategies have focused on vocational training and academic achievement, little has been done to include music in the school curriculum to help these children improve their mental health. The literature of music education and psychology, on the other hand, shows the positive effects of music on traumatized children, especially when it comes to dealing with stress. This paper presents a brief literature review of trauma, music therapy, and music in the classroom, after having introduced the Syrian war and refugee situation. Furthermore, the paper highlights the benefits of using music with traumatized children from the literature and offers strategies for teachers (such as singing, playing an instrument, songwriting, and others) to include music in their classrooms to help Syrian refugee children deal with post-war trauma.

Keywords: children, music, refugees, Syria, war

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Authors: Catherine Bradshaw

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Educators often report difficulty managing behavior problems and other mental health concerns that students display at school. These concerns also interfere with the learning process and can create distraction for teachers and other students. As such, schools play an important role in both preventing and intervening with students who experience these types of challenges. A number of models have been proposed to serve as a framework for delivering prevention and early intervention services in schools. One such model is called Positive Behavioral Interventions and Supports (PBIS), which has been scaled-up to over 26,000 schools in the U.S. and many other countries worldwide. PBIS aims to improve a range of student outcomes through early detection of and intervention related to behavioral and mental health symptoms. PBIS blends and applies social learning, behavioral, and organizational theories to prevent disruptive behavior and enhance the school’s organizational health. PBIS focuses on creating and sustaining tier 1 (universal), tier 2 (selective), and tier 3 (individual) systems of support. Most schools using PBIS have focused on the core elements of the tier 1 supports, which includes the following critical features. The formation of a PBIS team within the school to lead implementation. Identification and training of a behavioral support ‘coach’, who serves as a on-site technical assistance provider. Many of the individuals identified to serve as a PBIS coach are also trained as a school psychologist or guidance counselor; coaches typically have prior PBIS experience and are trained to conduct functional behavioral assessments. The PBIS team also identifies a set of three to five positive behavioral expectations that are implemented for all students and by all staff school-wide (e.g., ‘be respectful, responsible, and ready to learn’); these expectations are posted in all settings across the school, including in the classroom, cafeteria, playground etc. All school staff define and teach the school-wide behavioral expectations to all students and review them regularly. Finally, PBIS schools develop or adopt a school-wide system to reward or reinforce students who demonstrate those 3-5 positive behavioral expectations. Staff and administrators create an agreed upon system for responding to behavioral violations that include definitions about what constitutes a classroom-managed vs. an office-managed discipline problem. Finally, a formal system is developed to collect, analyze, and use disciplinary data (e.g., office discipline referrals) to inform decision-making. This presentation provides a brief overview of PBIS and reports findings from a series of four U.S. based longitudinal randomized controlled trials (RCTs) documenting the impacts of PBIS on school climate, discipline problems, bullying, and academic achievement. The four RCTs include 80 elementary, 40 middle, and 58 high schools and results indicate a broad range of impacts on multiple student and school-wide outcomes. The session will highlight lessons learned regarding PBIS implementation and scale-up. We also review the ways in which PBIS can help educators and school leaders engage in data-based decision-making and share data with other decision-makers and stakeholders (e.g., students, parents, community members), with the overarching goal of increasing use of evidence-based programs in schools.

Keywords: positive behavioral interventions and supports, mental health, randomized trials, school-based prevention

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Authors: A. Gazdzinska, P. Jagielski, E. Kaniewska, S. P. Gazdzinski, M. Wylezol

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Background: In the multi-factor etiology of obesity, an increasing degree of importance is attributed to behavioral factors. Lifestyle and health-oriented behaviors heavily influence the treatment of multiple diseases, including obesity. However, only a few studies evaluated health-related behaviors exhibited by patients qualified for bariatric surgery. None of them was performed in Polish population. Aim: Assessment of health behaviors of obese patients according to the degree of mood disorders. Method: The study involved 93 patients (66 females) who were qualified for bariatric surgery in the Department of Surgery of the Military Institute of Aviation Medicine in Warsaw. Diagnostic instrument was the Juczynski’s Inventory of Health Behavior (HBI), which evaluates health behavior in four categories, i.e. proper nutrition habits (PNH), preventive behavior (PH), health practices (HP) and positive mental attitude (PMA). The average HBI falls in the range between 24 and 120 points, for each category of health behaviors fall between 1 and 5 (higher score means higher severity declared healthy behaviors). The depressive symptoms in patients were assessed with Beck Depression Inventory (BDI). All analyses were conducted using STATISTICA 12. Results: The average age was 44.2 ± 11.5 years, mean BMI was 44.3 ± 10.5 kg/m2 and 46.8 ± 7.6 kg/m2, in females and males respectively. According to BDI, 32% patients had mild level of depression, 10% moderate and 14% severe depression. BDI scores were not different between females and males. Low results with regard to the health behaviors declared were obtained by 35.5 % of patients, medium by 44.0%, while high ones by only 20.5%. On average, patients gained 3.28 points in PNH, 3.37 points in PH, 3.29 points in HP, while 3.42 in the PMA category, showing average intensity of these behaviors. These health behaviors were practiced significantly more often by women (p = 0.04). The average HBI was 80.2; with average score of 81.5 for females and 76.6 for males, respectively (p = 0.03). Women were better in the PNH category (p = 0.02). A positive correlation was found between age and all categories of health behaviors, in particular PNH (R = 0.38; p = 0.001), PH (R = 0.26; p = 0.01), HP (R = 0.27; p = 0.01) and PMA (R = 0.24; p = 0.02), independent of gender. The severity of depression had a significant impact only on the behaviors associated with proper eating habits, which saw a negative correlation between BDI scores and the PNH (R = -0.21; p = 0.04). Conclusions: Majority of morbidly obese patients qualified for bariatric surgery obtained low to average scores in health behavior questionnaire. However, these results are similar in comparison with the Polish adult population. In accordance to these results, it seems that healthy behaviors, among them eating behaviors, do not appear to be a cause of obesity epidemic or they might be acquired when the disease is already underway. Female gender and age had a positive effect, and depression had a negative effect on the level of health behaviors among patients qualified for bariatric surgery.

Keywords: depression, habits, health behaviours, obesity

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Authors: Gizem Akcan, Erdinc Ozturk

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When it is examined as historically, it has caught attention that homosexual people try to behave as heterosexual or come out to have a place in community. Homosexual people have identity confusion during identity development, they have high levels of need for absolute truth and their psychological well being is affected negatively because of high levels of need for absolute truth and they have problems about self concept clarity. People who have problems about self concept clarity have problems on problem solving and show lots of symptoms of stress. People who have clear self concept use healthier coping strategies to solve problems. The purpose of this study is to show whether need for absolute truth predicts problem solving and symptoms of stress via mediator effect of self concept clarity or not on homosexual men. The participants of this study were 200 homosexual men. The ages of participants were 20-50. In addition, Demographic Information Form, Self Concept Clarity Scale, Need for Absolute Truth Scale, Stres Self-Assessment Checklist and Problem Solving Inventory were applied to the participants. The assessment of the data was made with confirmatory factor analysis and structural equation modeling analysis. According to the results of this study, need for absolute truth predicts problem solving and symptoms of stress via mediator effect of self concept clarity on homosexual men.

Keywords: need for absolute truth, self concept clarity, symptoms of stress, problem solving

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Authors: Nikk Leavitt, Peter Kellett, Cheryl Currie, Richard Larouche

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Background: Masculinity has been associated with poor mental health outcomes in adult men and is colloquially referred to as toxic. Masculinity is traditionally measured using the Male Role Norms Inventory, which examines behaviors that may be common in men but that are themselves associated with poor mental health regardless of gender (e.g., aggressiveness). The purpose of this study was to examine if masculinity is associated with generalized anxiety among men using this inventory vs. a man’s personal definition of it. Method: An online survey collected data from 1,200 men aged 18-65 across Canada in July 2022. Masculinity was measured using: 1) the Male Role Norms Inventory Short Form and 2) by asking men to self-define what being masculine means. Men were then asked to rate the extent they perceived themselves to be masculine on a scale of 1 to 10 based on their definition of the construct. Generalized anxiety disorder was measured using the GAD-7. Multiple linear regression was used to examine associations between each masculinity score and anxiety score, adjusting for confounders. Results: The masculinity score measured using the inventory was positively associated with increased anxiety scores among men (β = 0.02, p < 0.01). Masculinity subscales most strongly correlated with higher anxiety were restrictive emotionality (β = 0.29, p < 0.01) and dominance (β = 0.30, p < 0.01). When traditional masculinity was replaced by a man’s self-rated masculinity score in the model, the reverse association was found, with increasing masculinity resulting in a significantly reduced anxiety score (β = -0.13, p = 0.04). Discussion: These findings highlight the need to revisit the ways in which masculinity is defined and operationalized in research to better understand its impacts on men’s mental health. The findings also highlight the importance of allowing participants to self-define gender-based constructs, given they are fluid and socially constructed.

Keywords: masculinity, generalized anxiety disorder, race, intersectionality

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Authors: Hillary Jo Muyalde

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Introduction: Elite athletes train regularly to enhance their physical endurance, but sometimes, training sessions are not enough. When competition comes, these athletes struggle to find focus. Mental imagery is a psychological technique that helps condition the mind to focus and eventually help improve performance. This study aims to help elite competitive swimmers of the University of the East improve their performance with Mental Imagery as an auxiliary tool. Methodology: The study design used was quasi-experimental with a purposive sampling technique and a within-subject design. It was conducted with a total of 41 participants. The participants were given a Sport Imagery Ability Questionnaire (SIAQ) to measure imagery ability and the Mental Imagery Program. The study utilized a Paired T-test for data analysis where the participants underwent six weeks of no mental imagery training and were compared to six weeks with the Mental Imagery Program (MIP). The researcher recorded the personal best time of participants in their respective specialty stroke. Results: The results of the study showed a t-value of 17.804 for Butterfly stroke events, 9.922 for Backstroke events, 7.787 for Breaststroke events, and 17.440 in Freestyle. This indicated that MIP had a positive effect on participants’ performance. The SIAQ result also showed a big difference where -10.443 for Butterfly events, -5.363 for Backstroke, -7.244 for Breaststroke events, and -10.727 for Freestyle events, which meant the participants were able to image better than before MIP. Conclusion: In conclusion, the findings of this study showed that there is indeed an improvement in the performance of the participants after the application of the Mental Imagery Program. It is recommended from this study that the participants continue to use mental imagery as an auxiliary tool to their training regimen for continuous positive results.

Keywords: mental Imagery, personal best time, SIAQ, specialty stroke

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Authors: Layla Haidar, Shari Esquenazi-Karonika

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Introduction: Mental health includes one’s emotional, psychological, and interpersonal well-being; it ranges from “good” to “poor” on a continuum. At the individual-level, it affects how a person thinks, feels, and acts. Moreover, it determines how they cope with stress, relate to others, and interface with their surroundings. Research has yielded that mental health is directly related with short- and long-term physical health (including chronic disease), health risk behaviors, education-level, employment, and social relationships. As is the case with physical conditions like diabetes, heart disease, and cancer, mitigating the behavioral and genetic risks of debilitating mental health conditions like anxiety and depression can nurture a healthier quality of mental health throughout one’s life. In order to maximize the benefits of prevention, it is important to identify modifiable risks and develop protective habits earlier in life. Methods: The Adolescent Behaviors and Experiences Survey (ABES) dataset was used for this study. The ABES survey was administered to high school students (9th-12th grade) during January 2021- June 2021 by the Centers for Disease Control and Prevention (CDC). The data was analyzed to identify any associations between feelings of sadness, hopelessness, or increased suicidality among high school students with relation to their participation on one or more sports teams and their average daily consumed screen time. Data was analyzed using descriptive and multivariable analytic techniques. A multinomial logistic regression of each variable was conducted to examine if there was an association, while controlling for grade-level, sex, and race. Results: The findings from this study are insightful for administrators and policymakers who wish to address mounting concerns related to student mental health. The study revealed that compared to a student who participated on zero sports teams, students who participated in 1 or more sports teams showed a significantly increased risk of depression (p<0.05). Conversely, the rate of depression in students was significantly less in those who consumed 5 or more hours of screen time per day, compared to those who consumed less than 1 hour per day of screen time (p<0.05). Conclusion: These findings are informative and highlight the importance of understanding the nuances of student participation on sports teams (e.g., physical exertion, social dynamics of team, and the level of competitiveness within the sport). Likewise, the context of an individual’s screen time (e.g., social media, engaging in team-based video games, or watching television) can inform parental or school-based policies about screen time activity. Although physical activity has been proven to be important for emotional and physical well-being of youth, playing on multiple teams could have negative consequences on the emotional state of high school students potentially due to fatigue, overtraining, and injuries. Existing literature has highlighted the negative effects of screen time; however, further research needs to consider the type of screen-based consumption to better understand its effects on mental health.

Keywords: behavioral science, mental health, adolescents, prevention

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Authors: Elizabeth O'Brien, Raegan Murphy

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Research suggests that high levels of empathy in individuals with partners with mental health difficulties can lead to improved outcomes for their partner while compromising their own mental health. Specifically, it is proposed that the affective dimension of empathy diminishes resilience to the distress of a partner, whereas cognitive empathy (CE) enhances it. The relationship between different empathy dimensions and psychological resilience measures has not been investigated in partners of people with depression. Psychological inflexibility (PI) is a construct that can be understood as distress intolerance and is suggested to be an important feature of psychological resilience. The current study, therefore, aimed to investigate the differential role of dispositional empathy dimensions in PI for people living with a partner with depression. A cross-sectional design was employed in which 148 participants living with a partner with depression and 45 participants for a comparison sample were recruited using online platforms. Participants completed online surveys with measures relating to demographics, empathy, and PI. Scores were compared between the study and comparison samples. The study sample scored significantly lower for CE and affective empathy (AE) and significantly higher for PI than the comparison sample. Exploratory and regression analyses were run to examine associations between variables within the study sample. Analyses revealed that CE predicted the resilience outcome whilst AE did not. These results suggest that interventions for partners of people with depression that bolster the CE dimension alone may improve mental health outcomes for both members of the couple relationship.

Keywords: affective empathy, cognitive empathy, depression, partners, psychological inflexibility

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Margareth Guimaraes Lima, Marilisa Berti A. Barros, Deborah Carvalho Malta

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The relationship between physical activity (PA) and depression has been investigated, in both, observational and clinical studies: PA can integrate the treatments for depression; the physical inactivity (PI) may contribute to increase depression symptoms; and on the other hand, emotional problems can decrease PA. The main of this study was analyze the association among leisure and transportation PI and time watching television (TV) according to depression (minor and major), evaluated with the Patient Health Questionnaire (PHQ-9). The association was also analyzed by gender. This is a cross-sectional study. Data were obtained from the National Health Survey 2013 (PNS), performed with representative sample of the Brazilian adult population, in 2013. The PNS collected information from 60,202 individuals, aged 18 years or more. The independent variable were: leisure time physical inactivity (LTPI), considering inactive or insufficiently actives (categories were linked for analyzes), those who do not performed a minimum of 150 or 74 minutes of moderate or vigorous LTPA, respectively, by week; transportation physical inactivity (TPI), individuals who did not reached 150 minutes, by week, travelling by bicycle or on foot to work or other activities; daily time watching TV > 5 hours. The principal independent variable was depression, identified by PHQ-9. Individuals were classified with major depression, with > 5 symptoms, more than seven days, but one of the symptoms was “depressive mood” or “lack of interest or pleasure”. The others had minor depression. The variables used to adjustment were gender, age, schooling and chronic disease. The prevalence of LTPI, TPI and TV time were estimated according to depression, and differences were tested with Chi-Square test. Adjusted prevalence ratios were estimated using multiple Poisson regression models. The analyzes also had stratification by gender. Mean age of the studied population was 42.9 years old (CI95%:42.6-43.2) and 52.9% were women. 77.5% and 68.1% were inactive or insufficiently active in leisure and transportation, respectively and 13.3% spent time watching TV 5 > hours. 6% and 4.1% of the Brazilian population were diagnosed with minor or major depression. LTPI prevalence was 5% and 9% higher among individuals with minor and major depression, respectively, comparing with no depression. The prevalence of TPI was 7% higher in those with major depression. Considering larger time watching TV, the prevalence was 45% and 74% higher among those with minor and major depression, respectively. Analyzing by gender, the associations were greater in men than women and TPI was note be associated, in women. The study detected the higher prevalence of leisure time physical inactivity and, especially, time spent watching TV, among individuals with major and minor depression, after to adjust for a number of potential confounding factors. TPI was only associated with major disorders and among men. Considering the cross-sectional design of the research, these associations can point out the importance of the mental problems control of the population to increase PA and decrease the sedentary lifestyle; on the other hand, the study highlight the need of interventions by encouraging people with depression, to practice PA, even to transportation.

Keywords: depression, physical activity, PHQ-9, sedentary lifestyle

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Authors: Minhae Shim Roth

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The “Deinstitutionalization movement” refers to the spatial transition in the United States during the mid-20th century when the treatment of mental illness purportedly moved from long-term psychiatric institutions to community integrated care. Contrary to the accepted narrative of mental health care in the U.S., asylums did not close or empty. Some remained psychiatric hospitals, which came to be called forensic hospitals or state hospitals; others were converted into prisons or carceral institutions. During Deinstitutionalization, the asylum system became an appendage of the carceral system, with state hospitals becoming little more than holding centers for prisoners who were civilly committed, those incompetent to stand trial, offenders with mental health issues, and those found not guilty by reason of insanity. Psychiatric patients who became prisoners and prisoners who became patients became entangled in the phenomenon called transinstitutionalization. This paper investigates the relationship between psychiatric and criminal incarceration in 20th century California and focuses particularly on the case of Korean-American Chol Soo Lee, who fought detention in the psychiatric-prison system through the writ of habeas corpus. This study uses methodologies like critical theory, close reading, and archival research. This paper argues that during his psychiatric hospitalization at Napa State Hospital and incarceration in the California Department of Corrections, Lee underwent what sociologist Erving Goffman coined in his 1960 text Asylums as the process of “mortification.” After a burst of Asian American solidarity and legal aid that resulted in Lee’s triumphant release from Death Row in 1983 through a writ of habeas corpus, Lee struggled in the free world due to the long-lasting consequences of institutionalization, which led to alienation, recidivism, and an early death at the age of 62. This paper examines the trajectory of Lee’s trial and the legal activism behind it within the context of Goffman’s theory of total institutions and offer a nuanced reading of Lee’s case both during and after his incarceration.

Keywords: criminal justice, criminal law, law and mental capacity, habeas corpus, deinstitutionalization, mental health

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Authors: Nyla Anjum, Humaira Bano

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Disability, regardless of its type and nature limits one or two significant life activities. These limitations constitute risk factors for suicide. Rate and intensity of problem upsurges in critical age of adolescence. Researches in the field of mental health over look problem of suicide among persons with disability. Aim of the study was to investigate prevalence and risk factors for suicide among adolescents with disability. The study constitutes purposive sample of 106 elements of both gender with four major categories of disability: hearing impairment, physical impairment, visual impairment and intellectual disabilities. Face to face interview technique was opted for data collection. Other variable are: socio-economic status, social and family support, provision of services for persons with disability, education and employment opportunities. For data analysis independent sample t-test was applied to find out significant differences in gender and One Way Analysis of variance was run to find out differences among four types of disability. Major predictors of suicide were identified with multiple regression analysis. It is concluded that ideation, plans and attempts of suicide among adolescents with disability is a multifaceted and imperative concern in the area of mental health. Urgent research recommendations contains valid measurement of suicide rate and identification of more risk factors for suicide among persons with disability. Study will also guide towards prevention of this pressing problem and will bring message of happy and healthy life not only for persons with disability but also for their families. It will also help to reduce suicide rate in society.

Keywords: suicide, risk factors, adolescent, disability, mental health

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Authors: Jaylo Abalos, Sophia Zamora

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BACKGROUND: Various gastrointestinal (GI) symptoms, including diarrhea, nausea/vomiting and abdominal pain, have been reported in patients with Coronavirus disease 2019 (COVID-19). In this context, the presence of GI symptoms is variably associated with poor clinical outcomes in COVID-19. We aim to determine the outcomes of hospitalized COVID-19 patients with gastrointestinal symptoms. METHODOLOGY: This is a retrospective cohort study that used medical records of admitted COVID-19 patients from March 2020- March 2021 in a tertiary hospital in Pangasinan. Data records were evaluated for the presence of gastrointestinal manifestations, including diarrhea, nausea, vomiting and abdominal pain at the time of admission. Comparison between cases or COVID-19 patients presenting with GI manifestations to controls or COVID-19 patients without GI manifestation was made. RESULTS: Four hundred three patients were included in the study. Of these, 22.3% presented with gastrointestinal symptoms, while 77.7% comprised the study controls. Diarrhea was the most common GI symptom (10.4%). No statistically significant difference was observed in comorbidities and laboratory findings. Mortality was the primary outcome of the study that did not reach statistical significance between cases and controls (13.33% vs. 16.30%, p =0.621). There were also no significant differences observed in the secondary outcomes, mean length of stay, (14 [12-18 days] in cases vs 14 [12- 17.5 days] in controls, p = 0.716) and need for mechanical ventilation (12.22% vs 16.93%, p = 0.329). CONCLUSION: The results of the study revealed no association of the GI symptoms to poor outcomes, including a high rate of mortality, prolonged length of stay and increased need for mechanical ventilation.

Keywords: gastrointestinal symptoms, COVID-19, outcomes, mortality, length of stay

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Authors: Abigaile Rose Mary R. Capay, Janne Ly Castillon-Gilpo, Sheila A. Javier

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The transition to online learning has been a challenging feat on the mental health of tertiary students. This study investigated whether learning mindfulness strategies online would help in improving students’ imagination, conscientiousness, extraversion, agreeableness and emotional stability, as measured by the International Personality Item Pool (IPIP) Big Five Factor Markers, as well as their dispositional mindfulness as measured by the Mindfulness Attention Awareness Scale (MAAS). Fifty-two college students participated in the experiment. The 23 participants assigned to the treatment condition received 6-weekly experiential sessions of online mindfulness training and were advised to follow a daily mindfulness practice, while the 29 participants from the control group only received a 1-hour lecture. Scores were collected at pretest and posttest. Findings show that there was a significant difference in the pretest and posttest scores of students assigned in the treatment group, likewise medium effect sizes in the variables: dispositional mindfulness (t (22) = 2.64, p = 0.015, d = .550), extraversion (t (22) = 2.76, p = 0.011, d = 0.575), emotional stability (t (22) = 2.99, p = 0.007, d = .624), conscientiousness (t (22) = 2.74, p = 0.012, d = .572) and imagination (t (22) = 4.08, p < .001), but not for agreeableness (t (22) = 2.01, p = 0.057, d = .419). No significant differences were observed on the scores of the control group. Educational institutions are recommended to consider teaching basic mindfulness strategies to tertiary students, as a valuable resource in improving their mental health as they navigate through adjustments in online learning.

Keywords: mindfulness, school-based interventions, MAAS, IPIP Big Five Markers, experiment

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Authors: Yushen Dai, Tao Deng, Miaoying Chen, Baoqin Huang, Yan Ji, Yongshen Feng, Shaofei Liu, Dongmei Zhong, Tao Zhang, Lifeng Zhang

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Background: Detection and diagnosis are prerequisites for early interventions in the care of children with Autism Spectrum Disorder (ASD). However, few studies have focused on this topic. Aim: This study aims to characterize the timing from symptom detection to intervention in children with ASD and to identify the potential predictors of early detection, diagnosis, and intervention. Methods and procedures: A cross-sectional survey was conducted with 314 parents of children with ASD in Guangzhou, China. Outcomes and Results: This study found that most children (76.24%) were diagnosed within one year after detection, and 25.8% of them did not receive the intervention after diagnosis. Predictors to ASD diagnosis included ASD-related symptoms identified at a younger age, more serious symptoms, and initial symptoms with abnormal development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with the social deficit, sensory anomalies, and without language impairment, parents as the primary caregivers, family with lower income and less social support utilization increased the odds of the time lag between detection and diagnosis. Children whose fathers had a lower level of education were less likely to receive the intervention. Conclusions and Implications: The study described the time for detection, diagnosis, and interventions of children with ASD. Findings suggest that the ASD-related symptoms, the timing at which symptoms first become a concern, primary caregivers’ roles, father’s educational level, and the family economic status should be considered when offering support to improve early detection, diagnosis, and intervention. Helping children and their families take full advantage of support is also important.

Keywords: autism spectrum disorder, child, detection, diagnosis, intervention, social support

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Authors: Xin Qi Dong, Melissa Simon

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Aims: Elder mistreatment and suicidal ideation are important public health concerns among aging populations. This study will examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the USA. Methods: Guided by a community-based participatory research approach, in this study we conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago area from 2011 to 2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results: Overall, 3,159 Chinese older adults participated in this study, and their mean age was 72.8 years. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with 2-week suicidal ideation (OR 2.46, 95% CI 1.52--4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62--3.73). With respect to gender differences, the study found that the association remained significant for older women but not for older men after adjusting for all confounding factors. Conclusion: As the largest epidemiology study conducted among Chinese older adults in the USA, this study suggests that elder mistreatment is significantly associated with 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation.

Keywords: suicidal ideation, elder abuse, family violence, Asian health equity

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Authors: Mohamad Reza Khodabakhsh

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The present study investigated the effectiveness of attachment-based family therapy on maladaptive schemas and depressive symptoms of adolescence. This study was a quasi-experimental study, and a pre-test and post-test design with a control group were used. In this study, the study population included all adolescence. The sample consisted of 30 adolescents who were selected by the available sampling method. Then they were randomly divided into experimental (n = 15) and control (n = 15) groups. Data were collected in this study using the Beck Depression Inventory (1974) and the short form of Young's early maladaptive schema questionnaire (1988). After taking the pre-test, group implementation of family therapy based on attachment style was presented for 11 sessions of two and a half hours for two months in the experimental group. At the end of the sessions, both groups were retested, and the data were analyzed using analysis of covariance in SPSS-22 software. The results showed that attachment-based family therapy led to a significant reduction in maladaptive schemas, including emotional deprivation, rejection/abandonment, mistrust/abuse, social isolation, disability/shame, dependence/inadequacy, vulnerability/trauma, and depressive symptoms were compared to the control group. It can be concluded that this treatment has an effect on maladaptive schemas and symptoms of depression.

Keywords: attachment-based family therapy, maladaptive schemas, depressive symptoms, adolescence

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Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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Authors: Umaiza Bashir, Ushna Farukh

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The present study examined the perspective of school students regarding teacher’s behavioral pattern during a teaching in classroom and its influence on the students’ socialization particularly forming peer relationships with the development of emotional, behavioral problems in school children. To study these dimension of teacher-student classroom relationship, 210 school children (105 girls and 105 boys) within the age range of 14 to 18 years were taken from the government, private schools. The cross-sectional research design was used in which stratified random sampling was done. Teacher-student interaction scale was used to assess the teacher-student relationship in the classroom, which had two factors such as positive and negative interaction. Peer relationship scale was administered to investigate the socialization of students, and School Children Problem Scale was also given to the participants to explore their emotional, behavioral issues. The analysis of Pearson correlation showed that there is a significant positive relationship between negative teacher-student interaction and student’s emotional-behavioral as well as social problems. Another analysis of t-test revealed that boys perceived more positive interaction with teachers than girls (p < 0.01). Girls showed more emotional behavioral problems than boys (p < 0.001) Linear regression explained that age, gender, negative teacher’s interaction with students and victimization in social gathering predicts mental health problems in school children. This study suggests and highlights the need for the school counselors for the better mental health of students and teachers.

Keywords: teacher-student interaction, school psychology, student’s emotional behavioral problems

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Authors: Susanne Manes, Anni Glaeser, Katharina Wick, Bernhard Strauss, Uwe Berger

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Introduction: Over the last decades growing rates of mental health concerns among children and adolescents have been observed. At the same time, physical well-being of children and adolescents becomes increasingly impaired as well. Schools play an important role in preventing mental and physical disorders and in promoting well-being. Self-esteem, as well as social integration, are vital influence factors for mental and physical well-being. The purpose of this study was to develop and evaluate the program 'VorteilJena' for secondary schools in Germany focusing on self-esteem and social integration to improve mental and physical well-being. Method: The school-based health promotion program was designed for students in 5th grade and higher. It consists of several short pedagogical exercises instructed by a teacher and were integrated into the regular class over the course of ten weeks. The exercises focused on fostering social integration using either tasks improving team spirit or exercises that increase tolerance and sense of belonging. Other exercises focused on strengthening the self-esteem of the students. Additionally, the program included a poster exhibition titled 'Belonging' which was put up in the school buildings. The exhibition comprised ten posters which addressed relevant risk factors and resources related to social integration and self-esteem. The study was a randomized controlled sequential study with a pre and post measurement conducted in ten German schools. A total of 1642 students (44% male) were recruited. Their age ranged from 9 to 21 years (M=12.93 years; SD= 2.11). The program was conducted in classes ranging from 5th to 12th grade. Results: The program improved wellbeing, self-esteem and social integration of the involved students compared to the control group. Differential effects depending on implementation rates or age of the students will be analyzed. Moreover, implications for future school-based health promotion programs targeting self-esteem and social integration will be discussed. Conclusion: Social integration considerably influences self-esteem and well-being of students and can be targeted by school-based programs including short and modest exercises. Since a sufficient implementation of health promotion programs is essential, the present program due to its practicability represents a good opportunity to install health promotion focusing on social integration in schools.

Keywords: social integration, well-being, health promotion in schools, self-esteem

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Authors: Kathleen Canul

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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

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Authors: Ildikó Balatoni, Nikolett Kosztin

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In this study the importance of maintaining the mental and physical health of employees was examined from the perspective of the employers. To this end companies in Hajdú-Bihar county of Hungary that are within in the TOP 100 based on their net revenue were interviewed. Economic sectors that were represented the most in this survey were processing, services, trade, agriculture, and construction. We examined whether or not companies provided any benefits to their employees concerning health awareness. Among respondents those who offered various services of medical specialists and/or discounted gym or swim passes in addition to compulsory medical examinations were hard to find, however more employers organize health and sports days. Nevertheless, a significant albeit very shallow positive correlation were found between the number of offered benefits vs. total gross income and vs. number of employees (r2=0.2555, p<0.001 and r2=0.1196 and p<0.05, respectively). In conclusion, while workplace health promotion is necessary it requires a change in employers’attitudes.

Keywords: corporate health promotion, employees, employers, health

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Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

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The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL) , its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know that any patient will need to take the time to know that his new physical limitations do not limit him as a person, as soul, no matter what other people are thinking as a positive hopeful attitude is essential for combating HCV.

Keywords: hepatitis C virus chronic infection - physical health component and mental health component of QoL– total quality of life

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Authors: Valentine Seymour

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Environmental volunteering organisations use questionnaires to explore the relationship between environmental volunteers and their health. To the author’s best knowledge, no one has explored volunteers’ health perception, which could be considered when designing a health impact measurement tool used to increase effective communication. This paper examines environmental volunteers' perceptions of health, knowledge which can be used to design a health impact measurement tool. This study uses focus group interviews, content analysis, and a general inductive approach to explore the health perceptions of volunteers who engage in environmental volunteering activities from the perspective of UK charity The Conservation Volunteers. Findings showed that volunteer groups presented were relatively similar in how they defined the term health, with their overall conceptual model closely resembling that of the World Health Organization 1948 definition. This suggests that future health impact measurement tools in the environmental volunteering sector could base their design around the World Health Organization’s definition.

Keywords: health perception, impact measurement, mental models, tool development

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Authors: Michele M. Mahr

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The purpose of this study is to educate, inform, and facilitate scholarly conversation and discussion regarding the implementation of mindfulness techniques when working with individuals with substance use disorder (SUD) or addictive behaviors in mental health. Mindfulness can be recognized as the present moment, non-judgmental awareness, initiated by concentrated attention that is non-reactive and as openheartedly as possible. Individuals with SUD or addiction typically are challenged with triggers, environmental situations, cravings, or social pressures which may deter them from remaining abstinent from their drug of choice or addictive behavior. Also, mindfulness is recognized as one of the cognitive and behavioral treatment approaches and is both a physical and mental practice that encompasses individuals to become aware of internal situations and experiences with undivided attention. That said, mindfulness may be an effective strategy for individuals to employ during these experiences. This study will reveal how mental health practitioners and addiction counselors may find mindfulness to be an essential component of increasing wellness when working with individuals seeking mental health treatment. To this end, mindfulness is simply the ability individuals have to know what is actually happening as it is occurring and what they are experiencing at the moment. In the context of substance abuse and addiction, individuals may employ breathing techniques, meditation, and cognitive restructuring of the mind to become aware of present moment experiences. Furthermore, the notion of mindfulness has been directly connected to the development of neuropathways. The creation of the neural pathways then leads to creating thoughts which leads to developing new coping strategies and adaptive behaviors. Mindfulness strategies can assist individuals in connecting the mind with the body, allowing the individual to remain centered and focused. All of these mentioned above are vital components to recovery during substance abuse and addiction treatment. There are a variety of therapeutic modalities applying the key components of mindfulness, such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy for depression (MBCT). This study will provide an overview of both MBSR and MBCT in relation to treating individuals with substance abuse and addiction. The author will also provide strategies for readers to employ when working with clients. Lastly, the author will create and foster a safe space for discussion and engaging conversation among participants to ask questions, share perspectives, and be educated on the numerous benefits of mindfulness within wellness.

Keywords: mindfulness, wellness, substance abuse, mental health

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Authors: Shachi Joshi

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Purpose: The primary aim of this study was to determine the prevalence of pelvic dysfunction symptoms following OASI. The secondary aim was to assess the scope of a dedicated perineal trauma clinic in identifying and investigating women that have experienced faecal incontinence after OASI and if a transitional clinic arrangement to colorectal surgeons would be useful. Methods: The clinical database was used to identify and obtain information about 118 women who sustained an OASI (3rd/ 4th degree tear) between August 2016 and July 2017. A questionnaire was designed to assess symptoms of pelvic dysfunction; this was sent via the post in November 2018. Results: The questionnaire was completed by 45 women (38%). Faecal incontinence was experienced by 42% (N=19), flatus incontinence by 47% (N=21), urinary incontinence by 76% (N=34), dyspareunia by 49% (N=22) and pelvic pain by 33% (N=15). Of the questionnaire respondents, only 62% (N=28) had attended a perineal trauma clinic appointment. 46% (N=13) of these women reported having experienced difficulty controlling flatus or faeces in the questionnaire, however, only 23% (N=3) of these reported ongoing symptoms at the time of clinic attendance and underwent an endoanal ultrasound scan. Conclusion: Pelvic dysfunction symptoms are highly prevalent following an OASI. Perineal trauma clinic attendance alone is not sufficient for identification and follow up of symptoms. Transitional care is needed between obstetric and colorectal teams, to recognize and treat women with ongoing faecal incontinence.

Keywords: incontinence, obstetric anal sphincter, injury, repair

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Authors: Alexander Dao, Oscar Wambuguh

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Irritable Bowel Syndrome (IBS) is a heterogeneous functional bowel disease that is characterized by chronic visceral abdominal pain and abnormal bowel function and habits. Its multifactorial pathophysiology and mechanisms are still largely a mystery to the contemporary biomedical community, although there are many hypotheses to try to explain IBS’s presumed physiological, psychosocial, genetic, and environmental etiologies. IBS’s symptomatic presentation is varied and divided into four major subtypes: IBS-C, IBS-D, IBS-M, and IBS-U. Given its diverse presentation and unclear mechanisms, diagnosis is done through a combination of positive identification utilizing the “Rome IV Irritable Bowel Syndrome Criteria'' (Rome IV) diagnostic criteria while also excluding other potential conditions with similar symptoms. Treatment of IBS is focused on the management of symptoms using an assortment of pharmaceuticals, lifestyle changes, and dietary changes, with future potential in microbial treatment and psychotherapy as other therapy methods. Its chronic, heterogeneous nature and disruptive gastrointestinal (GI) symptoms are negatively impactful on patients’ daily lives, health systems, and society. However, with a better understanding of the gaps in knowledge and technological advances in IBS’s pathophysiology, management, and treatment options, there is optimism for the millions of people worldwide who are suffering from the debilitating effects of IBS.

Keywords: irritable bowel syndrome, lifestyle, diet, functional gastrointestinal disorder

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Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: Ghazala Yasmeen, Zahid Yousaf

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Frequent social media use has significantly changed people's life and communication styles during the last two decades. Social media use has multiple dimensions, and there are nuanced relationships between it and how it affects different societal subgroups. With the increased popularity and rapid growth of social networking sites, people are experiencing potential social media addiction, which causes severe mental health problems. How social media is dramatically influencing the lives and mental health of its users, and particularly of the students, creating psychological issues, e.g., isolation, depression, and anxiety, will be the primary objective of this study. This research will address the problems confronted by many students who are regular social media users and can undergo mental distress. This study aims to explore how social media use can lead to isolation, depression, and anxiety. This research will also investigate the effects of cyber-bullying on social, emotional, and psychological wellbeing. For this purpose, the researcher will use the survey technique as a method of inquiry. Ryff's theory of Psychological wellbeing will be used as a theoretical framework to explore the association between social media addiction and psychological effects among users. For data collection, the researcher will use the quantitative research method through a survey questionnaire from three universities in Pakistan from the public and private sectors. This study will imply a two-stage random sampling technique. At first, the researcher will select 20% of students from universities. In the second stage, 20% of students using different social networking sites will be chosen, and draw a representative sample from these will be. The intended study will use questionnaires comprising two portions. The first section will consist of social media engagement by the students, following impacts on their mental health and reported attitude towards psychological wellbeing. This study will spotlight the considerations of parents, educationists, and policymakers to take measures against the devastating effects of cyber-crimes on young adults.

Keywords: anxiety, depression, isolation, social media, wellbeing

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Authors: Ozgu Hafizoglu

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An analogy is an essential tool of human cognition that enables connecting diffuse and diverse systems with physical, behavioral, principal relations that are essential to learning, discovery, and innovation. The Cognitive Model of Analogy (CMA) leads and creates patterns of pathways to transfer information within and between domains in science, just as happens in the brain. The connectome of the brain shows how the brain operates with mental leaps between domains and mental hops within domains and the way how analogical reasoning mechanism operates. This paper demonstrates the CMA as an evolutionary approach to science, technology, and life. The model puts forward the challenges of deep uncertainty about the future, emphasizing the need for flexibility of the system in order to enable reasoning methodology to adapt to changing conditions in the new era, especially post-pandemic. In this paper, we will reveal how to draw an analogy to scientific research to discover new systems that reveal the fractal schema of analogical reasoning within and between the systems like within and between the brain regions. Distinct phases of the problem-solving processes are divided thusly: stimulus, encoding, mapping, inference, and response. Based on the brain research so far, the system is revealed to be relevant to brain activation considering each of these phases with an emphasis on achieving a better visualization of the brain’s mechanism in macro context; brain and spinal cord, and micro context: glia and neurons, relative to matching conditions of analogical reasoning and relational information, encoding, mapping, inference and response processes, and verification of perceptual responses in four-term analogical reasoning. Finally, we will relate all these terminologies with these mental leaps, mental maps, mental hops, and mental loops to make the mental model of CMA clear.

Keywords: analogy, analogical reasoning, brain connectome, cognitive model, neurons and glia, mental leaps, mental hops, mental loops

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