Search results for: antisite disorder

Authors: Nina Kaufmans

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Traditional therapies, utilizing spoken narratives as a primary source of intervention, are proven to be limited in effectively treating post traumatic stress disorder. Following the effects of the global pandemic of COVID-19, an increasing number of mental health consumers are beginning to experience somatically-based distress in addition to existing mental health symptoms. Moreover, the aftermath of the rapid increase in demand for mental health services has caused significant burnout in mental health professionals. This paper explores the ramifications of recent changes and challenges in the mental health demands and subsequent response and its consequences for mental health workers. We will begin by investigating the neurobiological mechanisms involved in traumatic experiences, then discuss the premises for "bottom-up" or somatically oriented psychotherapy approaches, and finally offer clinical skills and interventions for clients diagnosed with post traumatic stress disorder. In addition, we will discuss how somatically-based psychotherapy interventions implemented in sessions may decrease burnout and improve the well-being of clinicians. We will discuss how the integration of somatically-based interventions into counseling would increase the effectiveness of mental health recovery and sustain remission while simultaneously providing opportunities for self-care for mental health professionals.

Keywords: somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment

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Authors: In Hee Shim, Dong Sik Bae

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Introduction: Obesity and unfavorable lipid profile may be linked to depressive disorders. This study compared the levels of obesity, lipid profiles and depression severity of patients with depressive disorders. Methods: This study included 156 patients diagnosed with a depressive disorder who were hospitalized between March 2012 and February 2016. The patients were categorized into mild to moderate and severe depressive groups, based on Hamilton Depression Rating Scale scores (Mild to moderate depression 8-23 vs. severe depression ≥ 24). The charts of the patients were reviewed to evaluate body mass index and lipid profiles, including total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides (TG), confounding factors, such as other general medical disorders (hypertension, diabetes mellitus, and dyslipidemia), except smoking status (insufficient data). Demographic and clinical characteristics, such as age, sex, comorbidities, family history of mood disorders, psychotic features, and prescription patterns were also assessed. Results: Compared to the mild to the moderate depressive group, patients with severe depression had significantly lower rate of male and comorbidity. The patients with severe depression had a significantly lower TG than patients in the mild to moderate depressive group. After adjustment for the sex and comorbidity, there were no significant differences between the two groups in terms of the obesity and lipid profiles, including TG. Conclusion: These results did not show a significant difference in the association between obesity, lipid profiles and the depression severity. The role of obesity and lipid profiles in the pathophysiology of depression remains to be clarified.

Keywords: depression, HAM-D, lipid profiles, obesity

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Authors: Neringa Bagdonaite

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Study Aims: The current study aimed to systematically analyse various research done in the area of female post-traumatic stress disorder (PTSD) and alcohol abuse, and to critically review these results on the basis of theoretical models as well as answer following questions: (I) What is the reciprocal relationship between PTSD and problem alcohol use among females; (II) What are the moderating/mediating factors of this relationship? Methods: The computer bibliographic databases Ebsco, Scopus, Springer, Web of Science, Medline, Science Direct were used to search for scientific articles. Systematic analyses sample consisted of peer-reviewed, English written articles addressing mixed gender and female PTSD and alcohol abuse issues from Jan 2012 to May 2017. Results: Total of 1011 articles were found in scientific databases related to searched keywords of which 29 met the selection criteria and were analysed. The results of longitudinal studies indicate that (I) various trauma, especially interpersonal trauma exposure in childhood is linked with increased risk of revictimization in later life and problem alcohol use; (II) revictimization in adolescence or adulthood, rather than victimization in childhood has a greater impact on the onset and progression of problematic alcohol use in adulthood. Cross-sectional and epidemiological studies also support significant relationships between female PTSD and problem alcohol use. Regards to the negative impact of alcohol use on PTSD symptoms results are yet controversial; some evidence suggests that alcohol does not exacerbate symptoms of PTSD over time, while others argue that problem alcohol use worsens PTSD symptoms and is linked to chronicity of both disorders, especially among women with previous alcohol use problems. Analysis of moderating/mediating factors of PTSD and problem alcohol use revealed, that higher motives/expectancies, specifically distress coping motives for alcohol use significantly moderates the relationship between PTSD and problematic alcohol use. Whereas negative affective states mediate relationship between symptoms of PTSD and alcohol use, but only among woman with alcohol use problems already developed. Conclusions: Interpersonal trauma experience, especially in childhood and its reappearance in lifetime is linked with PTSD symptoms and problem drinking among women. Moreover, problem alcohol use can be both a cause and a consequence of trauma and PTSD, and if used for coping it, increases the likelihood of chronicity of both disorders. In order to effectively treat both disorders, it’s worthwhile taking into account this dynamic interplay of women's PTSD symptoms and problem drinking.

Keywords: female, trauma, post-traumatic stress disorder, problem alcohol use, systemic analysis

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Authors: Kathleen Seers, Rachel Hogg

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Diagnosis of Autism Spectrum Disorder (ASD) in women is increasing, prompting research into the presentation of female ASD and exploring why females are failing to meet the diagnostic threshold. One explanation is the use of masking behaviors, where traits of ASD are suppressed and gender-appropriate behaviors are mimicked to reduce the visibility and victimization of ASD girls. Current research explores ASD presentation and the lived experiences of ASD girls and adolescents; however, there is a paucity of literature in relation to the intra- and inter- psychic experiences of ASD women. Through a social constructionist framework, this qualitative study sought to understand how the construction of gender and the medicalisation of ASD influences women’s experiences of ASD. This study also explored the use and consequence of masking strategies and the impact this has on well-being. Eight women were interviewed, and three major themes were identified. The themes outline the influence of gender expectations and social norms on the women’s experiences, the significance of diagnosis to their identity, and the influence of the medicalization of ASD. Participants shared experiences of feeling different and internalizing blame for this difference. The feeling of difference was a major contributor to the women’s positive or negative mental well-being. The process of diagnosis allowed participants to create and confirm their identity. Diagnosis also led to improvements in well-being, however, the findings also explore the complexity of labeling individuals with a disorder and the difficulties that arise from the construct of ‘functionality’ for those with Autism. The study also explores the temporal nature of ASD and the changing experiences of women as they mature. It is hoped this study promotes discussion and provides clinicians and those connected to ASD women with insights into the support ASD women require to live authentic lives.

Keywords: female autism, gender, masking, social constructionism

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Authors: Tsirekidze M., Aprasidze T.

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Introduction: The problem of dissocial behavior is at the heart of the social sciences and psychiatry; however, it should be noted that its psychiatric aspect is little studied, and some issues of the problem are still controversial. This is complicated by the diversity of terminological concepts in defining “dissocial behavior”, “behavioral disorder”, “abnormal behavior”, “deviant behavior”, “delinquent behavior”, etc. In literature, there is no comprehensive definition of the essence of dissociative behavior. Numerous attempts to systematize dissociative disorders should also be considered unsatisfactory, which is primarily related to the lack of solid criteria for defining this group of disorders. According to the clinical classification, dissocial behavior is divided into psychotic and non-psychotic forms. Such differentiation is conditional in nature since it is not always possible to draw precise, clear distinctions between these forms, and in addition, there is a transition of a behavior disorder or so-called intermediate forms. One group of authors distinguishes two main forms of deviant behavior in terms of both theoretical and practical significance - non-pathological and pathological. In recent years, especially, the non-pathological form of behavior disorder has become topical. It refers to a large group of forms of deviant behavior, the emergence of which is associated with psychologically full-fledged reactions of children and adolescents to stressful situations and extreme conditions. According to the authors, its concept is understandable-it is difficult to draw a line between psychologically understandable reactions and psychogenically induced reactive states. In addition, the concept of "normal" child and adolescent is, to some extent, a vague concept, as in medicine, any definition of the norm. From a practical (more precisely, pragmatic) point of view, the term "abnormal behavioral disorder" undoubtedly makes sense, especially for the purpose of forensic psychiatric examination. Non-pathological deviation mainly includes transient situational reactions, microsocial-pedagogical backwardness, and character accentuation.Deviant behavior was predominantly manifested in a non-pathological form, which, in our opinion, is due to the difficult socio-economic situation of the country, moral-ethical deprivation, and expressed frustration. By itself, society is an indicator of deviation. Add to this situation complicated factors such as micro-social-pedagogical leave, unfavorable family environment, and parenting defects. Consideration is also given to the connection of acceptable deviation with the personal structural features of the adolescent. Aim: The topic of our discussion is the dissocial behavior of the non-psychotic register. Methods: We surveyed 120 adolescents with deviant behaviors. 61% of them were diagnosed with various neuropsychiatric disorders. Results: Abnormal forms of deviant behavior were observed in 13%, and non-pathological forms in -69%. A combination of non-pathological and pathological forms was present in 10% of cases. In the case of non-pathological deviation, microsocial-pedagogical acceptance was revealed in 62%, character accentuation in 22%; during the pathological forms, pathological reactions were observed in 21%, and abnormal formation of the person -21%. Conclusion: It should be emphasized that in case of any of the above defects, if the so-called family psychosis, and medical and pedagogical habilitation measures for the adolescent, it is quite possible to prevent the abnormal development of the child's personality, correct his character, regulate behavior and develop positive labor-social relations.

Keywords: dissocial personality, deviant behavior, dissocial, delinquent behavior

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Authors: Danielle Page

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Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This research aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases. The contribution of this work to the field of forensic psychology will be significant, as it will analyze preexisting case studies and experimental data in an effort to improve the ways in which veteran cases are handled in the criminal justice system. Military personnel involved in the criminal justice system are a vulnerable population in need of healthcare and legislative attention, and this work will bring us one step closer to providing them with just that.

Keywords: forensic psychology, psychotraumatology, PTSD, veterans

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Authors: Louise Penzenstadler, Tiphaine Robet, Radu Iuga, Daniele Zullino

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Context: The outpatient clinic of the psychiatric addiction service of Geneva University Hospital has been providing support to individuals affected by various narcotics for 30 years. However, the increasing consumption of crack cocaine in Geneva has presented a new challenge for the healthcare system. Research Aim: The aim of this research is to evaluate the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder. Methodology: The research utilizes a combination of quantitative and qualitative retrospective data analysis to evaluate the effectiveness of the outreach intervention. Findings: The data collected from October 2023 to December 2023 show that the outreach program successfully made 1,071 contacts with drug users and led to 15 new requests for care and enrollment in treatment. Patients expressed high satisfaction with the intervention, citing easy and rapid access to treatment and social support. Theoretical Importance: This research contributes to the understanding of the challenges and specific needs of a complex group of drug users who face severe health problems. It highlights the importance of outreach interventions in establishing trust, connecting users with care, and facilitating medication-assisted treatment for opioid addiction. Data Collection: Data was collected through the outreach program's interactions with drug users, including street outreach interventions and presence at locations frequented by users. Patient satisfaction surveys were also utilized. Analysis Procedures: The collected data was analyzed using both quantitative and qualitative methods. The quantitative analysis involved examining the number of contacts made, new requests for care, and treatment enrollment. The qualitative analysis focused on patient satisfaction and their perceptions of the intervention. Questions Addressed: The research addresses the following questions: What is the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder? How effective is the outreach program in connecting drug users with care and initiating medication-assisted treatment? Conclusion: The outreach program has proven to be an effective intervention in establishing trust with crack users, connecting them with care, and initiating medication-assisted treatment for opioid addiction. It has also highlighted the importance of addressing the specific challenges faced by this group of drug users.

Keywords: crack addiction, outreach treatment, peer intervention, polydrug use

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Authors: Navah Z. Ratzon, Shlomit Cohen, Sigal Portnoy

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This work focuses on posture and risk factors for the musculoskeletal disorder in guitarists, which constitutes the largest group of musicians today. The source of the problems experienced by these musicians is linked to physical, psychosocial and personal risk factors. These muscular problems are referred to as Playing Related Musculoskeletal Disorder (PRMD). There is not enough research that specifically studies guitar players, and to the extent of our knowledge, there is almost no reference to the characteristics of their movement patterns while they play. This is in spite of the high prevalence of PRMD in this population. Kinematic research may provide a basis for the development of a prevention plan for this population and their unique characteristics of playing patterns. The aim of the study was to investigate the correlation between risk factors for PRMD among guitar players and self-reporting of pain in the skeletal muscles, and specifically to test whether there are differences in the kinematics of the upper body while playing in a sitting or standing posture. Twenty-five guitarists, aged 18-35, participated in the study. The methods included a motion analysis using a motion capture system, anthropometric measurements and questionnaires relating to risk factors. The questionnaires used were the Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms and the Demand Control Support Questionnaire, as well as a questionnaire of personal details. All of the study participants complained of musculoskeletal pain in the past year; the most frequent complaints being in the left wrist. Statistically significant correlations were found between biodemographic indices and reports of pain in the past year and the previous week. No significant correlations were found between the physical posture while playing and reports of pain among professional guitarists. However, a difference was found in several kinematic parameters between seated and standing playing postures. In a majority of the joints, the joint angles while playing in a seated position were more extreme than those during standing. This finding may suggest a higher risk for musculoskeletal disorder while playing in a seated position. In conclusion, the results of the present research highlight the prevalence of musculoskeletal problems in guitar players and its correlation with various risk factors. The finding supports the need for intervention in the form of prevention through identifying the risk factors and addressing them. Relating to the person, to their occupation and environment, which are the basis of proper occupational therapy, can help meet this need.

Keywords: body posture, motion tracking, PRMD, guitarists

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Authors: Boshra Mozaffar, Iskandar Idris

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Taste change is a common complication after Bariatric surgery (BS). However, the cause of this is still not clear. Since zinc is important fortaste perception, zinc deficiency, which is common after BS, may play an important role for taste change after BS. In this review, we aimto collate evidence relating to taste change and zinc deficiencyin relation to BS; effects of zinc replacement on taste perception in general and thereafter discuss the possible role of zinc deficiency to induce taste change after BS. A literature search was conducted, using four electronic bibliographical databases—EMBASE, PubMed, AMED and MEDLINE. We identified all available and relevant articles published before 30th February 2021.In total, 33 studies were included. The total number of participants analysed was N= 3264. We showed that taste change is a frequent complication after BS, especially after Roux-en-Y gastric bypass RYGBP comparing to other types of procedures. Patients' taste sensitivity differs among studies, but the most important decline in taste preference was observed for sweet food. Twelve studies investigating zinc deficiency following BS showed a significant decrease in zinc levels at six months after surgery. Supplementation with 45–50 mg of zinc sulphate was effective in improving taste, except in cancer patients, who showed no improvement in taste following zinc supplementation. Zinc deficiency appears to be associated with taste change after BS. Supplementation with much higher levels of zinc, at 45–50 mg, was effective in taste change treatment for many cases of taste disorder. The currently recommended levels of zinc replacements currently prescribed to patients following BS were not effective for avoiding zinc deficiency after BS—and thus not effective for averting taste change. It is therefore suggested that taste change following BS is closely related to zinc deficiency induced by the surgery.

Keywords: taste change, taste disorder, bariatric surgery, zinc, zinc sulphate or Zn, deficiency, supplementation, and micro-nutrient deficiencies

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Authors: Fahad Almehmadi, Abdullah Alrajhi, Bader K. Alaslab, Abdullah A. Al Qurashi, Hattan A. Hassani

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Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an uncommon, inheritable cardiac disorder characterized by the progressive substitution of cardiac myocytes by fibro-fatty tissues. This pathologic substitution predisposes patients to ventricular arrhythmias and right ventricular failure. The underlying genetic defect predominantly involves genes encoding for desmosome proteins, particularly plakophilin-2 (PKP2). These aberrations lead to impaired cell adhesion, heightening the susceptibility to fibrofatty scarring under conditions of mechanical stress. Primarily, ARVD/C affects the right ventricle, but it can also compromise the left ventricle, potentially leading to biventricular heart failure. Clinical presentations can vary, spanning from asymptomatic individuals to those experiencing palpitations, syncopal episodes, and, in severe instances, sudden cardiac death. The establishment of a diagnostic criterion specifically tailored for ARVD/C significantly aids in its accurate diagnosis. Nevertheless, the task of early diagnosis is complicated by the disease's frequently asymptomatic initial stages, and the overall rarity of ARVD/C cases reported globally. In some cases, as exemplified by the adult female patient in this report, the disease may advance to terminal stages, rendering therapies like Ventricular Tachycardia (VT) ablation ineffective. This case underlines the necessity for increased awareness and understanding of ARVD/C to aid in its early detection and management. Through such efforts, we aim to decrease morbidity and mortality associated with this challenging cardiac disorder.

Keywords: ARVD/C, cardiology, interventional cardiology, cardiac electrophysiology

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Authors: J. Jessa

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Background: Autism is a pervasive developmental disorder, the incidence of which has significantly increased in recent years. Children with autism have impairments in social skills, communication, and imagination. Children with autism has more common than healthy children feeding problems: food selectivity, problems with gastrointestinal tract: diarrhea, constipations, abdominal pain, reflux and others. Many parents of autistic children report that after implementation of gluten-, casein- and sugar free diet those symptoms disappear and even cognitive functions become better. Some children begin to understand speech and to communicate with parents, regain eye contact, become more calm, sleep better and has better concentration. Probably at the root of this phenomenon lies elimination from the diet peptides construction of which is similar to opiates. Enhanced permeability of gut causes absorption of not fully digested opioid-like peptides from food, like gluten and casein and probably others (proteins from soy and corn) which impact on brain of autistic children. Aim of the study: The aim of the study is to assess the safety of gluten-free diet in children with autism, aged 2,5-7. Methods: Participants of the study (n=70) – children aged 2,5-7 with autism are divided into 3 groups. The first group (research group) are patients whose parents want to implement a gluten-free diet. The second group are patients who have been recommended to eliminate from the diet artificial substances, such as preservatives, artificial colors and flavors, and others (control group 1). The third group (control group 2) are children whose parents did not agree for implementation of the diet. Caregivers of children on the diet are educated about the specifics of the diet and how to avoid malnutrition. At the start of the study we exclude celiac disease. Before the implementation of the diet we performe a blood test for patients (morphology, ferritin, total cholesterol, dry peripheral blood drops to detect some genetic metabolic diseases), plasma aminogram) and urine tests (excretion of ions: Mg, Na, Ca, the profile of organic acids in urine), which assess nutritional status as well as the psychological test assessing the degree of the child's psychological functioning (PEP-R). All of these tests will be repeated after one year from the implementation of the diet. Results: To the present moment we examined 42 children with autism. 12 of children are on gluten- free diet. Our preliminary results are promising. Parents of 9 of them report that, there is a big improvement in child behavior, concentration, less aggression incidents, better eye contact and better verbal skills. Conclusion: Our preliminary results suggest that dietary intervention may positively affect developmental outcome for some children diagnosed with ASD.

Keywords: gluten free diet, autism spectrum disorder, autism, blood test

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Authors: Francisca Alves, Diana Figueiredo, Paula Vagos, Luiza Lima, Maria do Céu Salvador, Daniel Rijo

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In recent years, Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of numerous anxiety disorders, including social anxiety disorder (SAD). However, limited evidence exists on its therapeutic gains for adolescents with SAD. The current work presents a weekly 10-session manualized online ACT approach to adolescent SAD, being the first study to do so in a clinical sample of adolescents. The intervention ACT@TeenSAD addresses the six proposed processes of psychological inflexibility (i.e., experiential avoidance, cognitive fusion, lack of values clarity, unworkable action, dominance of the conceptualized past and future, attachment to the conceptualized self) in social situations relevant to adolescents (e.g., doing a presentation). It is organized into four modules. The first module explores the role of psychological (in)flexibility in SAD (session 1 and 2), addressing psychoeducation (i.e., functioning of the mind) according to ACT, the development of an individualized model, and creative hopelessness. The second module focuses on the foundation of psychological flexibility (session 3, 4, and 5), specifically on the development and practice of strategies to promote clarification of values, contact with the present moment, the observing self, defusion, and acceptance. The third module encompasses psychological flexibility in action (sessions 6, 7, 8, and 9), encouraging committed action based on values in social situations relevant to the adolescents. The fourth modules’ focus is the revision of gains and relapse prevention (session 10). This intervention further includes two booster sessions after therapy has ended (3 and 6-month follow-up) that aim to review the continued practice of learned abilities and to plan for their future application to potentially anxious social events. As part of an ongoing clinical trial, the intervention will be assessed on its feasibility with adolescents diagnosed with SAD and on its therapeutic efficacy based on a longitudinal design including pretreatment, posttreatment, 3 and 6-month follow-up. If promising, findings may support the online delivery of ACT interventions for SAD, contributing to increased treatment availability to adolescents. This availability of an effective therapeutic approach will be helpful not only in relation to adolescents who face obstacles (e.g., distance) when attending to face-to-face sessions but also particularly to adolescents with SAD, who are usually more reluctant to look for specialized treatment in public or private health facilities.

Keywords: acceptance and commitment therapy, social anxiety disorder, adolescence, manualized online approach

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Authors: Meral Huri, Sedef Şahin

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Post-traumatic stress disorder (PTSD) is characterized by psychiatric symptoms and triggered by a terrifying experience which may immediately effect cognitive, affective, behavioral and social skills of the individual. One of the most common noncutaneous cancer among men is prostate cancer. The incidence of psychological stress is quite common in men with prostate cancer. The aim of the study was to explore the PTSD frequency among prostate cancer and define the relationship between occupational participation, coping skills and level of perceived social support among patients with prostate cancer. Forty patients diagnosed with prostate cancer were included in the study. After dividing the patients into two groups ( study/ control) according to type of tumor, we recorded their characteristics and evaluations differences. We evaluated the demographic information form, Structured Clinical Interview for DSM-IV (SCID- I)- Clinical Version for PTSD, Multidimensional Scale of Perceived Social Support, Styles of Coping Inventory and Canadian Occupational Performance Measure (COPM) before and after 1 month from surgery. The mean age of the study group (n:18) was 65.85.6 years (range: 61-79 years). The mean age of the control group (n: 22) was a little bit higher than the study group with mean age 71.3±6.9 years (range: 60-85 years). There was no statistically significant difference between the groups for age and the other characteristics. According to the results of the study, statistically significant difference was found between the level of PTSD of study and the control group. 22% of study group showed PTSD while 13% of the control group showed PTSD (r: 0.02, p<0.001). The scores of study group and control group showed statistically significant difference in five sub-categories of Styles of Coping Inventory. Patients with prostate cancer showed decreased scores in optimistic, seeking social supports and self-confident approach, while increased scores in helpless and submissive sub-categories than the control group (p<0.001). The scores of Multidimensional Scale of Perceived Social Supports of study group and control group showed statistically significant difference. The total perceived social supports score of the study group was 71.34 ± 0.75 while it was 75.34 ± 0.64 for the control group. Total and the sub-category scores of study group were statistically significant lower than the control group. According to COPM, mean scores of occupational participation of study group for occupational performance were 4.32±2.24 and 7.01±1.52 for the control group, respectively). Mean Satisfaction scores were 3,22±2.31 and 7.45±1.74 for the study and control group, respectively. The patients with prostate cancer and benign prostate hyperplasia (BPH) did not show any statistically difference in activity performance (r:0.87) while patients with prostate cancer showed statistically lower scores than the patients with BPH in activity satisfaction (r:0.02, p<0.001).Psycho-social occupational therapy interventions might help to decrease the prevalence of PTSD by increasing associated factors such as the social support perception, using coping skills and activity participation of patients with prostate cancer.

Keywords: activity performance, occupational therapy, posttraumatic stress disorder, prostate cancer

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Authors: M. Isabel Santos, Ana Breda, Ana Margarida Almeida

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Research on academic abilities of individuals with autism spectrum disorder (ASD) underlines the importance of mathematics interventions. Yet the proposal of digital applications for children and youth with ASD continues to attract little attention, namely, regarding the development of mathematical reasoning, being the use of the digital technologies an area of great interest for individuals with this disorder and its use is certainly a facilitative strategy in the development of their mathematical abilities. The use of digital technologies can be an effective way to create innovative learning opportunities to these students and to develop creative, personalized and constructive environments, where they can develop differentiated abilities. The children with ASD often respond well to learning activities involving information presented visually. In this context, we present the digital Learning Environment on Mathematics for Autistic children (LEMA) that was a research project conducive to a PhD in Multimedia in Education and was developed by the Thematic Line Geometrix, located in the Department of Mathematics, in a collaboration effort with DigiMedia Research Center, of the Department of Communication and Art (University of Aveiro, Portugal). LEMA is a digital mathematical learning environment which activities are dynamically adapted to the user’s profile, towards the development of mathematical abilities of children aged 6–12 years diagnosed with ASD. LEMA has already been evaluated with end-users (both students and teacher’s experts) and based on the analysis of the collected data readjustments were made, enabling the continuous improvement of the prototype, namely considering the integration of universal design for learning (UDL) approaches, which are of most importance in ASD, due to its heterogeneity. The learning strategies incorporated in LEMA are: (i) provide options to custom choice of math activities, according to user’s profile; (ii) integrates simple interfaces with few elements, presenting only the features and content needed for the ongoing task; (iii) uses a simple visual and textual language; (iv) uses of different types of feedbacks (auditory, visual, positive/negative reinforcement, hints with helpful instructions including math concept definitions, solved math activities using split and easier tasks and, finally, the use of videos/animations that show a solution to the proposed activity); (v) provides information in multiple representation, such as text, video, audio and image for better content and vocabulary understanding in order to stimulate, motivate and engage users to mathematical learning, also helping users to focus on content; (vi) avoids using elements that distract or interfere with focus and attention; (vii) provides clear instructions and orientation about tasks to ease the user understanding of the content and the content language, in order to stimulate, motivate and engage the user; and (viii) uses buttons, familiarly icons and contrast between font and background. Since these children may experience little sensory tolerance and may have an impaired motor skill, besides the user to have the possibility to interact with LEMA through the mouse (point and click with a single button), the user has the possibility to interact with LEMA through Kinect device (using simple gesture moves).

Keywords: autism spectrum disorder, digital technologies, inclusion, mathematical abilities, mathematical learning activities

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Authors: Julianne Macmullen

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Due to advances in technology and early detection and treatment of cancer, many cancer patients are surviving longer than five years post-diagnosis. Most cancer patients suffer from depression, anxiety, and post-traumatic stress disorder (PTSD) at some point during diagnosis, treatment, and survivorship. A subgroup of patients will continue to suffer from depression and PTSD and require early intervention. Support groups provide patients with the emotional and informational support they require while also giving survivors a sense of community, friendship, and purpose. This type of support is recognized by researchers to improve the quality of life while also decreasing depression and PTSD symptoms. The gaps in the literature include cultural diversity, minorities, and support groups involving cancer types other than breast cancer. Another gap in the literature includes the perceptions of cancer patients as well as longitudinal studies to determine the relationships between support groups and decreased depression and PTSD rates over time. Future research is required to fill the gaps in the literature mentioned previously. Future research is also needed to analyze the difference in age groups and different types of support groups such as professionally-led, peer-led, and online. Implications for practice involve providers assessing for the symptoms of depression and PTSD in order to offer prompt treatment and support services to those patients. In conclusion, social support by way of support groups improves the quality of life, gives survivors a sense of purpose to help others while also gaining the support they need, and reduces the rate of depressive episodes related to PTSD.

Keywords: cancer survivor, survivorship, post-traumatic stress disorder (PTSD), depression, support groups

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Authors: Cecile Garry, Katia Rovira, Julie Brisson

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Autism Spectrum Disorder (ASD) is defined by a qualitative and quantitative impairment of social interaction. Indeed early intervention programs, such as the Early Start Denver Model (ESDM), aimed at encouraging the development of social skills. In classroom, the children need to be socially engaged to learn. Early intervention programs can thus be implemented in kindergarten schools. In these schools, ASD children have more opportunities to interact with their peers or adults than in elementary schools. However, the preschool children with ASD are less socially engaged than their typically developing peers in the classroom. They initiate, respond and maintain less the social interactions. In addition, they produce more responses than initiations. When they interact, the non verbal communication is more used than verbal or symbolic communication forms and they are more engaged with adults than with peers. Nevertheless, communicative patterns may vary according to the clinical profiles of ASD children. Indeed, the ASD children with better cognitive skills interact more with their peers and use more symbolic communication than the ASD children with a low cognitive level. ASD children with the less severe symptoms use more the verbal communication than ASD children with the more severe symptoms. Small groups and structured activities encourage coordinated joint engagement episodes in ASD children. Our goal is to evaluate ASD children’s social engagement development in class, with their peers or adults, during dyadic or group activities. Participants were 19 preschool children with ASD aged from 3 to 6 years old that benefited of an early intervention in special kindergarten schools. Severity of ASD symptoms was measured with the CARS at the beginning of the follow-up. Classroom situations of interaction were recorded during 10 minutes (5 minutes of dyadic interaction and 5 minutes of a group activity), every 2 months, during 10 months. Social engagement behaviors of children, including initiations, responses and imitation, directed to a peer or an adult, were then coded. The Observer software (Noldus) that allows to annotate behaviors was the coding system used. A double coding was conducted and revealed a good inter judges fidelity. Results show that ASD children were more often and longer socially engaged in dyadic than in groups situations. They were also more engaged with adults than with peers. Children with the less severe symptoms of ASD were more socially engaged in groups situations than children with the more severe symptoms of ASD. Then, ASD children with the less severe symptoms of ASD were more engaged with their peers than ASD children with the more severe symptoms of ASD. However, the engagement frequency increased during the 10 month of follow-up but only for ASD children with the more severe symptoms at the beginning. To conclude, these results highlighted the necessity of individualizing early intervention programs according to the clinical profile of the child.

Keywords: autism spectrum disorder, preschool children, developmental psychology, early interventions, social interactions

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Authors: Surekha Rathod

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Sickle cell disease is a vascular disorder characterized by chronic, ongoing organ damage that is punctuated by episodes of acutely painful vascular complications.1 It is the most common genetic blood disorder in the United States, with about 2000 infants being identified through routine blood screenings annually, and an estimated 104,000-138,000 affected individuals living in the United States. Approximately 0.3%-1.3% of African American are affected by Sickle Cell Diseases (SCD).3 The aim of this paper is to present oral health status of patients with SCD. A total of 200 subjects of both sexes in the age group 18- 40 years were included in this study. The subjects were examined and the following indices were recorded • Oral hygiene index – Simplified (OHI-S). • Probing depths (PD). • Clinical Attachment Levels (CAL). • Gingival Index - Loe and Sillness. • Turesky Gillmore Glickman Modification of the Quigley Hein Plaque Index. (1970) • DMFT index. • Sickle Cell Disease Severity Index. A total of 1478 patients were screened of which 200 subjects were found to be diagnosed with SCD by electrophoresis. The study thus, included 200 subjects (111 females & 89 males) diagnosed with Sickle Cell Disease in the age group of 18-40 years. The probing pocket depths (PPD) were measured in millimeters. 36% had PPD in the range of 2-4mm, 48% had PPD in the range of 4-6mm while 16% had PPD of more than 6mm. Similar results were obtained for the Clinical Attachment Levels (CAL). 29.5 % subjects had CAL 2-4mm, 44.5% had 4-6mm & 26% had CAL 6mm & above. We can thus conclude that although oral health is not a priority for patients with SCD, it is supported by increased plaque accumulation. Because of the chronic anemic state of the patients with SCD, they should be encouraged to pay strict attention to oral hygiene instructions and practice.

Keywords: chronic, genetic, oral, sickle cell disease, vascular

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Authors: Shweta Verma

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Background: Epilepsy is a chronic non-communicable central nervous system (CNS) disorder which affects a large population of all ages. Different classes of drugs are used for the treatment of this neurological disorder, but due to augmented drug resistance and side effects, these drugs become incompetent. Therefore, we design the synthesis of ten new derivatives of Phenytoin. The moiety of Phenytoin was hybridized with different phenols by using three step approach. The synthesized molecules were then investigated for different physicochemical parameters, such as Log P values using diverse software programs and to predict the potential to cross the blood-brain barrier. Objective: The Phenytoin derivatives were designed, synthesized, and characterized to meet the structural necessities indispensable for antiepileptic activity. Method: Firstly, the chloroacetylation of the 5,5-diphenyl hydantoin was carried out, and then various substituted phenols were added to it. The synthesized compounds were characterized and evaluated for antianxiety activity by elevated plus maze method and antiepileptic activity by using subcutaneous pentylenetetrazole (scPTZ) and maximal electroshock (MES) models and neurotoxicity. Result: The number of derivatives of 5,5-diphenyl hydantoin was developed and optimized. The number of parameters was optimized which reveal that the compound containing chloro group such as C3 and C6 showed imperative potential when compared with the standard drug Diazepam. Other compounds containing nitro and methyl group were also found to possess activity. Conclusion: It was summarized that the new compounds of 5,5-diphenyl hydantoin derivatives were synthesized. The results of the data show that the compound containing chloro group is more potent for CNS activity. The new compounds have the probability of being optimized further to engender new scaffolds to treat various CNS disorders.

Keywords: phenytoin, parameters, CNS activity, blood-brain barrier, Log P, CNS active

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

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Authors: Anne Giles

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Humans naturally wish they could forget traumatic experiences. To help prevent future harm, however, the human brain has evolved to retain data about experiences of threat, alarm, or violation. When given compassionate support and assistance with thinking helpfully and realistically about traumatic events, most people can adjust to experiencing hardships, albeit with residual sad, unfortunate memories. Persistent, recurrent, intrusive memories, difficulty sleeping, emotion dysregulation, and avoidance of reminders, however, may be symptoms of Post-traumatic Stress Disorder (PTSD). Brain scans show that PTSD affects brain functioning. We currently have no physical means of restoring the system of brain structures and functions involved with PTSD. Medications may ease some symptoms but not others. However, forms of "talk therapy" with cognitive components have been found by researchers to reduce, even resolve, a broad spectrum of trauma symptoms. Many cultures have taboos against talking about hardships. Individuals may present themselves to mental health care professionals with severe, disabling trauma symptoms but, because of cultural norms, be unable to speak about them. In China, for example, relationship expectations may include the belief, "Bad things happening in the family should stay in the family (jiāchǒu bùkě wàiyán 家丑不可外扬)." The concept of "family (jiā 家)" may include partnerships, close and extended families, communities, companies, and the nation itself. In contrast to many trauma therapies, Cognitive Processing Therapy (CPT) for Post-traumatic Stress Disorder asks its participants to focus not on "what" happened but on "why" they think the trauma(s) occurred. The question "why" activates and exercises cognitive functioning. Brain scans of individuals with PTSD reveal executive functioning portions of the brain inadequately active, with emotion centers overly active. CPT conceptualizes PTSD as a network of cognitive distortions that keep an individual "stuck" in this under-functioning and over-functioning dynamic. Through asking participants forms of the question "why," plus offering a protocol for examining answers and relinquishing unhelpful beliefs, CPT assists individuals in consciously reactivating the cognitive, executive functions of their brains, thus restoring normal functioning and reducing distressing trauma symptoms. The culturally sensitive components of CPT that allow people to "talk about it without talking about it" may offer the possibility for worldwide relief from symptoms of trauma.

Keywords: cognitive processing therapy (CPT), cultural norms, post-traumatic stress disorder (PTSD), trauma recovery

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Authors: Antarip Bhattacharya, Dhritiman Maitra

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Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.

Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH

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Authors: Ange Weinrabe, James Tran, Ian B. Hickie

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Risk-taking behaviour is common during youth. In the time between adolescence and early adulthood, young people (aged 15-25 years) are more vulnerable to mood disorders, such as anxiety and depression. What impact does an emerging mood disorder have on decision-making in youth at critical decision points in their lives? In this article, we explore the impact of risk and ambiguity on youth decision-making in a clinical setting using a well-known economic experiment. At two time points, separated by six to eight weeks, we measured risky and ambiguous choices concurrently with findings from three psychological questionnaires, the 10-item Kessler Psychological Distress Scale (K10), the 17-item Quick Inventory of Depressive Symptomatology Adolescent Version (QIDS-A17), and the 12-item Somatic and Psychological Health Report (SPHERE-12), for young help seekers aged 16-25 (n=30, mean age 19.22 years, 19 males). When first arriving for care, we found that 50% (n=15) of participants experienced severe anxiety (K10 ≥ 30) and were severely depressed (QIDS-A17 ≥ 16). In Session 2, taking attrition rates into account (n=5), we found that 44% (n=11) remained severe across the full battery of questionnaires. When applying multiple regression analyses of the pooled sample of observations (N=55), across both sessions, we found that participants who rated severely anxious avoided making risky decisions. We suggest there is some statistically significant (although weak) (p=0.09) relation between risk and severe anxiety scores as measured by K10. Our findings may support working with novel tools with which to evaluate youth experiencing an emerging mood disorder and their cognitive capacities influencing decision-making.

Keywords: anxiety, decision-making, risk, adolescence

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Authors: José Nogueira

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This research aims to analyze the impact of autism spectrum disorders (ASD) in families with children and youth (0-25 years) with ASD in Portugal. The impact will be evaluated on a multidimensional perspective, following the work on the concept of quality life from WHOQOL Group (UN). The study includes quantitative and qualitative methodology. It correlates statistical sources and other information with the data obtained through a survey of a sample of about 100 families with children/youth with ASD (October and November 2013). The results indicate a strong impact of autism on the quality of life for families in all study dimensions. The research shows a negative impact on quality of life for families in material and financial conditions, physical and emotional well-being, career progression, feelings of injustice, social participation and self-perception of happiness. The quality of life remained in the relationship with the family and the spouse, interpersonal relationships and beliefs about himself. The ASD improved the quality of life aspects such as interest, knowledge and exercise of rights on disability, autonomy to make decisions and be able to deal with stress. Other dimensions are contemplated: a detailed characterization of the child/young with ASD and all family members (household composition, relationship status, academic qualifications, occupation, income, and leisure) the impact of diagnosis in the family wellbeing, medical and therapeutic processes, school inclusion, public support, social participation, and the adequacy and implementation of legislation. The study evaluates also the strengths and weaknesses of the Portuguese public rehabilitation system and demonstrates how a good law-in-theory may not solve the problems of families in practice due to the allocation of insufficient public resources, both financial and human resources.

Keywords: autism, families, quality of life, autism spectrum disorder

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Authors: Olga Santesteban, Glorisa Canino, Hector R. Bird, Cristiane S. Duarte

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Objective: To address whether harsh discipline is associated with disruptive behavior disorders (DBD) in Puerto Rican children over time. Background: Both cross-sectional and longitudinal studies report that rates of DBD vary by gender, age and other demographics, being more frequent among boys, later in life and among those who live in urban areas. Also, the literature supports the direct, positive association between harsh discipline and externalizing behaviors. Nevertheless, scholars have underscored the important role of race and ethnicity in understanding discipline effects on children. The impact of harsh discipline in a Puerto Rican population remains to be studied. Methods: Sample: This is a secondary analysis of the Boricua Youth Study which assessed yearly (3 times) Puerto Rican children aged 5-15 in two different sites: San Juan (Puerto Rico) and the South Bronx (NY), N=2951. Participants that did not have scores of harsh discipline in the 3 waves were excluded for this analysis (N=2091). Main Measures: a) Harsh Discipline (Parent report) was measured using 6 items from the “Parental Discipline Scale” that measures various forms of punishment, including physical and verbal abuse, and withholding affection; b) Disruptive Behavior Disorder (Parent report): Parent version of the Diagnostic Interview Schedule for Children-IV (DISC-IV) was used to asses children’s conduct disorders; c) Demographic factors: Child gender, child age, family income, marital status; d) Parental factors: parental psychopathology, parental monitoring, familism, parent support; e) Children characteristics: Controlling for any diagnostic at wave 1 (internalizing or externalizing). Data Analysis: Logistic regression was carried out relating the likelihood of DBD to harsh discipline along waves controlling for potential confounders as demographics, child and parent characteristics. Results: There were no significant differences in harsh discipline by site in wave 1 and wave 2 but there was a significant difference in wave 3. Also, there were no significant differences in DBD by site in wave 1 and wave 2 but there was a significant difference in wave 3. There was a significant difference of discipline by gender and age in all the waves. We calculated unadjusted (OR) and adjusted (AOD) and 95% confidence intervals (95%CI) showing the relation between harsh discipline at wave 1 and the presence of child disruptive behavior disorder at wave 3 for both South Bronx and Puerto Rico. There was an association between harsh discipline and the likelihood of having DBD in The Bronx (AOR=1.76; 95%CI=1.13-2.74, p.013) and in Puerto Rico (AOR=2.17; 95%CI=1.28-3.67, p.004) having controlled for demographic, parental and individual factors. Conclusions: Context may be an important differential factor shaping the potential risk of harsh discipline toward DBD for Puerto Rican children.

Keywords: disruptive behavior disorders, harsh discipline, puerto rican, psychological education

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Authors: Sakinah Idris, Femke Ten Hoeve, Kirstin Greaves-Lord

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Background: Social skills interventions are considered to be efficacious if social skills are improved as a result of an intervention. Nevertheless, the objective assessment of social skills is hindered by a lack of sensitive and validated measures. To measure the change in social skills after an intervention, questionnaires reported by parents, clinicians and/or teachers are commonly used. Observations are the most ecologically valid method of assessing improvements in social skills after an intervention. For this purpose, The Program for the Educational and Enrichment of Relational Skills (PEERS) was developed for adolescents, in order to teach them the age-appropriate skills needed to participate in society. It is an evidence-based intervention for adolescents with ASD that taught ecologically valid social skills techniques. Objectives: The current study aims to describe the development and psychometric evaluation of the Dutch Contextual Assessment of Social Skills (CASS), an observational outcome measure of social skills for adolescents with Autism Spectrum Disorder (ASD). Methods: 64 adolescents (M = 14.68, SD = 1.41, 71% boys) with ASD performed the CASS before and after a social skills intervention (i.e. PEERS or the active control condition). Each adolescent completed a 3-minute conversation with a confederate. The conversation was prompt as a natural introduction between two-unfamiliar, similar ages, opposite-sex peers who meet for the first time. The adolescent and the confederate completed a brief questionnaire about the conversation (Conversation Rating Scale). Results: Results indicated sufficient psychometric properties. The Dutch CASS has a high level of internal consistency (Cronbach's α coefficients = 0.84). Data supported the convergent validity (i.e., significant correlated with the Social Skills Improvement System (SSiS). The Dutch CASS did not significantly correlate with the autistic mannerism subscale from Social Responsiveness Scale (SRS), thus proved the divergent validity. Based on scorings made by raters who were kept blind to the time points, reliable change index was computed to assess the change in social skills. With regard to the content validity, only the learning objectives of the first two meetings of PEERS about conversational skills relatively matched with rating domains of the CASS. Due to this underrepresentation, we found an existing observational measure (TOPICC) that covers some of the other learning objectives of PEERS. TOPICC covers 22% of the learning objectives of PEERS about conversational skills, meanwhile, CASS is 45%. Unfortunately, 33% of the learning objectives of PEERS was not covered by CASS or TOPICC. Conclusion: Recommendations are made to improve the psychometric properties and content validity of the Dutch CASS.

Keywords: autism spectrum disorder, observational, PEERS, social skills

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Authors: John E. Muñoz, Jose F. Lopez, David S. Lopez

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Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that affects 1 out of 5 Colombian children, converting into a real public health problem in the country. Conventional treatments such as medication and neuropsychological therapy have been proved to be insufficient in order to decrease high incidence levels of ADHD in the principal Colombian cities. This work demonstrates a design and development of a videogame that uses a brain computer interface not only to serve as an input device but also as a tool to monitor neurophysiologic signal. The video game named “The Harvest Challenge” puts a cultural scene of a Colombian coffee grower in its context, where a player can use his/her avatar in three mini games created in order to reinforce four fundamental aspects: i) waiting ability, ii) planning ability, iii) ability to follow instructions and iv) ability to achieve objectives. The details of this collaborative designing process of the multimedia tool according to the exact clinic necessities and the description of interaction proposals are presented through the mental stages of attention and relaxation. The final videogame is presented as a tool for sustained attention training in children with ADHD using as an action mechanism the neuromodulation of Beta and Theta waves through an electrode located in the central part of the front lobe of the brain. The processing of an electroencephalographic signal is produced automatically inside the videogame allowing to generate a report of the theta/beta ratio evolution - a biological marker, which has been demonstrated to be a sufficient measure to discriminate of children with deficit and without.

Keywords: BCI, neuromodulation, ADHD, videogame, neurofeedback, theta/beta ratio

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Authors: Santhani M. Selveindran

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Background: Natural disasters are traumatic global events that are becoming increasing more common, with significant psychosocial impact on survivors. This impact results not only in psychosocial distress but, for many, can lead to psychosocial disorders and chronic psychopathology. While there are currently available interventions that seek to prevent and treat these psychosocial sequelae, their effectiveness is uncertain. The evidence-base is emerging with more primary studies evaluating the effectiveness of various psychosocial interventions for survivors of natural disasters, which remains to be synthesized. Aim of Review: To identify, critically appraise and synthesize the current evidence-base on the effectiveness of psychosocial interventions in preventing or treating Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD) in adults and children who are survivors of natural disasters. Methods: A protocol was developed as a guide to carry out this review. A systematic search was conducted in eight international electronic databases, three grey literature databases, one dissertation and thesis repository, websites of six humanitarian and non-governmental organizations renowned for their work on natural disasters, as well as bibliographic and citation searching for eligible articles. Papers meeting the specific inclusion criteria underwent quality assessment using the Downs and Black checklist. Data were extracted from the included papers and analysed by way of narrative synthesis. Results: Database and website searching returned 3777 papers where 31 met the criteria for inclusion. Additional 2 papers were obtained through bibliographic and citation searching. Methodological quality of most papers was fair. Twenty-five studies evaluated psychological interventions, five, social interventions whereas three studies evaluated ‘mixed’ psychological and social interventions. All studies, irrespective of methodological quality, reported post-intervention reductions in symptom scores for PTSD, depression and/or anxiety and where assessed, reduced diagnosis of PTSD and MDD, and produced improvements in self-efficacy and quality of life. Statistically significant results were seen in 27 studies. However, three studies demonstrated that the evaluated interventions may not have been very beneficial. Conclusions: The overall positive results suggest that any psychosocial interventions are favourable and should be delivered to all natural disaster survivors, irrespective of age, country, and phase of disaster. Yet, heterogeneity and methodological shortcomings of the current evidence-base makes it difficult to draw definite conclusions needed to formulate categorical guidance or frameworks. Further, rigorously conducted research is needed in this area, although the feasibility of such, given the context and nature of the problem, is also recognized.

Keywords: psychosocial interventions, natural disasters, survivors, effectiveness

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Authors: Seyed Saeid Nabavi

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Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

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Authors: Lian Tong, Yan Ye, Qiong Yan

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Background: Children with attention-deficit/hyperactivity disorder (ADHD) often experience sleep problems, but the comorbidity mechanism has not been sufficiently studied. This study aimed to determine the comorbidity of ADHD and sleep problems as well as the moderating effects of bedtime activities and depression/anxiety symptoms on the relationship between ADHD and sleep problems. Methods: We recruited 934 primary students from third to fifth grade and their parents by stratified random sampling from three primary schools in Shanghai, China. This study used parent-reported versions of the ADHD Rating Scale-IV, Children’s Sleep Habits Questionnaire, and Achenbach Child Behavior Checklist. We used hierarchical linear regression analysis to clarify the moderating effects of bedtime activities and depression/anxiety symptoms. Results: We found that children with more ADHD symptoms had shorter sleep durations and more sleep problems on weekdays. Screen time before bedtime strengthened the relationship between ADHD and sleep-disordered breathing. Children with more screen time were more likely to have sleep onset delay, while those with less screen time had more sleep onset problems with increasing ADHD symptoms. The high bedtime eating group experienced more night waking with increasing ADHD symptoms compared with the low bedtime eating group. Anxiety/depression exacerbated total sleep problems and further interacted with ADHD symptoms to predict sleep length and sleep duration problems. Conclusions: Bedtime activities and emotional problems had important moderating effects on the relationship between ADHD and sleep problems. These findings indicate that appropriate bedtime management and emotional management may reduce sleep problems and improve sleep duration for children with ADHD symptoms.

Keywords: ADHD, sleep problems, anxiety/depression, bedtime activities, children

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Authors: Diana Vieira Figueiredo, Rita Ramos Miguel, Maria do Céu Salvador, Luiza Nobre-Lima, Daniel RIjo, Paula Vagos

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Social Anxiety Disorder (SAD) is characterized by a marked and persistent fear of social and/or performance situations in which one may be exposed to the scrutiny of others.  SAD has its usual onset and is highly prevalent during adolescence; if left untreated, it often has a chronic and unremitting course. So, it seems important to understand the psychological processes that might predict the development of SAD. One of these processes may be self-compassion, which has been found to be associated with social anxiety in both adults and adolescents. Self-compassion involves three main components, each with a positive (compassionate behavior) and negative (uncompassionate behavior) pole – self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus over-identification. The negative indicators of self-compassion (self-judgement, isolation, and over-identification) were found to be more strongly linked to mental health problems than the positive indicators (self-kindness, common humanity, and mindfulness). Additionally, negative associations were found between the positive indicators of self-compassion (self-kindness, common humanity, mindfulness) and psychopathology. The current study aimed to investigate the role of self-kindness, self-judgment, common humanity, isolation, mindfulness, and over-identification in the likelihood of an adolescent presenting SAD by comparing groups of normative and socially anxious adolescents. The sample consisted of 32 adolescents (Mage = 15.88, SD = .833) of which 23 were girls. Adolescents were assessed through a clinical structured interview that led 17 to be assigned to the clinical group (presenting a primary diagnosis of SAD) and 15 to be assigned to the non-clinical group (presenting no clinical diagnosis). Variables under study were measured through the Self-Compassion Scale for adolescents (SCS-A), which assesses the six indicators of self-compassion presented above. Six separate models were tested, each with one of the subscales of the SCS-A as the independent variable and with the group (clinical versus non-clinical) as the dependent variable. The models considering isolation, over-identification, self-judgement, and self-kindness fitted the data and accurately predicted group belonging for between 75% to 84.4% of cases. Results indicated that the log of the odds of an adolescent presenting SAD was positively related to isolation, over-identification, and self-judgement and negatively associated with self-kindness. Findings provide support for the idea that decreased self-compassion may place adolescents at increased risk for experiencing clinical levels of social anxiety: on the one hand, adolescents with higher levels of isolation, over-identification, and self-judgement seem to be more prone to the development of psychopathological levels of social anxiety; on the other hand, self-kindness may play a protective role in the development of SAD in this developmental phase. So, if focusing on social feared consequences and perceiving to be different from others may be distinctive features of SAD, developing self-kindness may be the antidote to promote diminished levels of social anxiety and more.

Keywords: adolescents, social anxiety disorder, self-compassion, diagnosis odds-ration

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