COVID-19 and beyond: A systematic review of adaptations to psychosocial support in oncology.

AIMS: To understand the strategies used to continue providing psychosocial support to cancer patients during the pandemic, including outcomes and implications beyond the pandemic. DESIGN: A systematic review of original research. DATA SOURCES: ProQuest Health & Medicine, CINAHL Complete (via EBSCOhost), Scopus, and PubMed were searched for original work published between January 2020 and December 2022. METHODS: Abstract and title screening identified eligible articles for full-text review. Following a full-text review, data were extracted from eligible articles, and a risk of bias assessment was conducted. A synthesis without meta-analysis was performed. RESULTS: Thirty-four articles met the selection criteria. These articles provide evidence that systematic adaptations during the pandemic improved the assessment and screening of psychological needs and/or increased the number of clients accessing services. Additionally, while the pandemic was associated with decreased psychosocial well-being for cancer patients, five intervention studies reported improvements in psychosocial well-being. Barriers, strategies, and recommendations were described. CONCLUSION: Adapting psychosocial support during a pandemic can be successful, achieved relatively quickly, and can increase the uptake of support for people experiencing cancer. IMPLICATIONS FOR PATIENT CARE: It is imperative that these adaptations continue beyond the pandemic to maximize adaptive psychosocial outcomes for a group vulnerable to ongoing mental health concerns. IMPACT: While the COVID-19 pandemic was associated with increased psychosocial need for cancer patients, evidence in the review suggested that adaptations made to service delivery facilitated increased access for patients who may not previously have been able to access support. Additionally, improvements in psychosocial well-being were achieved. These findings are relevant for clinicians and decision-makers who fund and design psychosocial support services for cancer patients. REPORTING METHOD: The review was guided by PRISMA Guidelines and the SWiM Reporting Guideline. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Assessing the relationship between early maladaptive schemas and interpersonal problems using interpersonal scenarios depicting rejection.

BACKGROUND: Early maladaptive schemas (EMSs) have been theorised to contribute to reoccurring interpersonal problems. This study developed a novel experimental paradigm that aimed to assess if EMSs moderate the impact of interpersonal situations on interpersonal responses by manipulating the degree of rejection in a series of interpersonal vignettes depicting acceptance, ambiguous rejection and rejection. METHOD: In a sample of 158 first-year psychology students (27.2% male; 72.2% female; 0.6% other) participant responses to interpersonal scenarios were measured including degree of perceived rejection, emotional distress, conviction in varying cognitive appraisals consistent with attribution theory and behavioural responses to scenarios. Qualitative data was analysed using inductive content analysis and statistical analyses were conducted using multi-level mixed effect linear and logistic regression models using the software Jamovi. RESULTS: People reporting higher EMSs reported increased emotional distress (F(1, 156) = 24.85, p < .001), perceptions of rejection (F(1, 156) = 34.33, p < .001), self-blame (F(1, 156) = 53.25, p < .001), other-blame (F(1, 156) = 13.16, p < .001) and more intentional (F(1, 156) = 9.24, p = .003), stable (F(1, 156) = 25.22, p < .001) and global (F(1, 156) = 19.55, p < .001) attributions but no differences in reported behavioural responses. The results also supported that EMSs moderate the relationship between interpersonal rejection and perceptions of rejection (F(2, 1252) = 18.43, p < .001), emotional distress (F(2, 1252) = 12.64, p < .001) and self-blame (F(2, 1252) = 14.00, p < .001). CONCLUSION: Together these findings suggest that people with EMSs experience increased distress and select negative cognitions in situations where there are higher levels of rejection but that distress and negative cognitions are generally higher in people with EMSs irrespective of the situation.

Birth related PTSD and its association with the mother-infant relationship: A meta-analysis.

OBJECTIVE: There is a growing body of research showing that birth related posttraumatic stress disorder (PTSD) symptoms may impact the mother-infant relationship. The present study assessed the strength of the association between birth related PTSD symptoms and the mother-infant relationship. METHOD: A total of twelve studies (5,572 participants) were included based on database searches using PubMed, EBSCO and ProQuest. RESULTS: The findings showed that greater levels of birth related PTSD symptoms were associated with poorer mother-infant relationship, r = -0.36, 95% CI: [-0.43 - -0.28], random effects model. The outcomes appeared to be heterogeneous (Q(11) = 81.63, p <.001, tau2 = 0.0123, I2 = 80.73%), despite all outcomes being in the same direction as the overall outcome. CONCLUSIONS: The results indicated that birth related PTSD symptoms are negatively associated with the mother-infant relationship. Further investigation into the prevention of birth related trauma is suggested. Improving birthing experiences for mothers is likely to contribute to improved infant mental health, thereby reducing overall social and economic costs.

The Correlation between Adolescent Daily Breakfast Consumption and Socio-Demographic: Trends in 23 European Countries Participating in the Health Behaviour in School-Aged Children Study (2002-2018).

Breakfast is often considered the most important meal of the day and can benefit adolescent health in several ways. The aims of the present study were (1) to identify adolescents' socio-demographic (sex, family affluence and family structure) determinants of daily breakfast consumption (DBC) and (2) to describe trends in DBC among adolescents across 23 countries. Cross-sectional surveys of nationally representative samples of adolescents (aged 11, 13, and 15 years) (n = 589,737) participating in the Health Behaviour in School-aged Children (HBSC) survey from 2002 to 2018 were used. Multilevel logistic regression analyses modeled DBC over time, adjusted for family affluence, family structure and year of survey. Four countries showed an increased trend in DBC (the Netherlands, Macedonia, Slovenia, and England). A significant decrease in DBC was observed in 15 countries (Belgium-Fr, France, Germany, Croatia, Portugal, Spain, Hungary, Poland, Russian Federation, Ukraine, Denmark, Finland, Latvia, Lithuania and Sweden). In 4 countries no significant change was observed (Czech Republic, Scotland, Ireland and Norway). In most of the countries (n = 19), DBC was higher among the adolescents from high-affluence homes. In all the countries analysed, the adolescents living in two-parent households report higher DBC use than those in single-parent households. More than half of the countries showed a decrease in DBC. There is a need to implement key interventions by developing different strategies (education, incorporating educational curriculum and counselling programmes) to increase DBC. Comparing DBC patterns across HBSC countries is important for understanding regional and global trends, monitoring strategies, and developing health promotion programmes.

The Impact of COVID-19 Related Distress on Antenatal Depression in Australia.

Globally, the impact of COVID-19 on mental health has been significant. Pregnant women are known to be a vulnerable population in relation to mental health. In Australia, there was an unprecedented demand during the pandemic for mental health services, including services for pregnant women. Maternal mental health has unique and enduring features that can significantly shape a child's overall development and poor maternal mental health can have considerable social and economic costs. This cross-sectional study evaluated symptoms of antenatal depression and COVID-19-related distress in a sample of two hundred and sixty-nine pregnant women residing in Australia aged between 20 and 43 (M = 31.79, SD = 4.58), as part of a larger study. Social media advertising was used to recruit participants between September 2020 and November 2021. Prevalence rates for antenatal depression were found to be higher in this study (16.4%) compared with previous Australian prevalence rates (7%). COVID-19 distress in relation to having a baby during a COVID-19 outbreak significantly predicted symptoms of antenatal depression, B = 1.46, p < 0.001. Results from this study suggest that mothers and families may have increased mental health vulnerabilities as a consequence of the pandemic for some time yet.

Validation of the brief Adjustment Disorder New Modules with Australian oncology patients.

BACKGROUND: Evidence suggests that up to 30% of cancer patients may meet the criteria for adjustment disorder. However, no assessment instruments have been validated for use with cancer patients. The Adjustment Disorder New Module (ADNM)-8 and ADNM-4 are brief screening tools for adjustment disorder mapped directly to the new ICD-11 criteria. The aim of this study was to investigate the factor structure and validity of both instruments in an Australian sample of adult oncology patients.  METHODS: A total of 405 participants with a cancer diagnosis were recruited online from across Australia. Participants reported cancer-specific information, such as time since diagnosis, treatment stage, cancer stage, type of cancer, and the following questionnaires: 8-item Adjustment Disorder New Module (ADNM-8), the World Health Organisation Well-Being Index (WHO-5), and the short form Depression Anxiety and Stress Scale (DASS-21). The predictiveness of stressors was assessed using multiple regression analysis and the structure of the ADNM-8 and the ADNM-4 was tested using confirmatory factor analysis.  RESULTS: Six previously tested models were examined, and the results suggested a 2-factor structure reflecting the two ICD-11 diagnostic criteria clusters of preoccupation with the stressor and failure to adapt was a good fit for both scales. The ADNM-4 outperformed the longer version of the scale on numerous fit indices though the ADNM-8 and ADNM-4 were highly correlated. Correlations of both scales with the psychological distress scale, the stress subscale, and the wellbeing index indicated good construct validity. CONCLUSIONS: Our results suggest that the ADNM-8 and ADNM-4 are useful screening tools for assessing adjustment disorder symptoms in cancer patients. The prompt screening of cancer patients encourages early intervention for those at risk of adaptation difficulties and informs research and clinical decisions regarding appropriate treatments.

Quality of life and fear of cancer recurrence in patients and survivors of non-Hodgkin lymphoma.

Non-Hodgkin lymphoma (NHL) is a common haematological cancer that is comprised of approximately 30 subtypes, of which Waldenström Macroglobulinemia (WM) is a rare incurable form. It is typically managed using a watch-and-wait strategy that can contribute to illness uncertainty which may result in fear of cancer recurrence (FCR) and poor health-related quality of life (QOL). However, few studies have examined the correlates of FCR and QOL in NHL patients, including WM patients. One-hundred males and 92 females with a mean age of 62.7 years who were an average of 6.8 years from diagnosis completed the online questionnaire which asked about demographics, medical history, QOL, FCR, stress, anxiety and depression. Few NHL patients reported significant stress or affective distress, most had moderate-high QOL and 41% experienced recent FCR, relative to published cut-off scores. Poorer QOL was related to depression symptoms, FCR, higher illness burden (i.e. comorbidity) and fewer personal resources (i.e. unemployed), whereas FCR was related to shorter time since diagnosis and more depressive symptoms. Results suggest that FCR and depressive symptoms may adversely impact QOL, whereas a recent cancer diagnosis and depression-related pessimism may contribute to FCR.

Controlling metal-insulator transitions in reactively sputtered vanadium sesquioxide thin films through structure and stoichiometry.

We present a study of [Formula: see text] thin films grown on c-plane [Formula: see text] substrates by reactive dc-magnetron sputtering. Our results reveal three distinct types of films displaying different metal-insulator transitions dependent on the growth conditions. We observe a clear temperature window, spanning 200 [Formula: see text]C, where highly epitaxial films of [Formula: see text] can be obtained wherein the transition can be tuned by controlling the amount of interstitial oxygen in the films through the deposition conditions. Although small structural variations are observed within this window, large differences are observed in the electrical properties of the films with strong differences in the magnitude and temperature of the metal-insulator transition which we attribute to small changes in the stoichiometry and local strain in the films. Altering the sputtering power we are able to tune the characteristics of the metal-insulator transition suppressing and shifting the transition to lower temperatures as the power is reduced. Combined results for all the films fabricated for the study show a preferential increase in the a lattice parameter and reduction in the c lattice parameter with reduced deposition temperature with the film deviating from a constant volume unit cell to a higher volume.

Effect of task complexity on ipsilateral motor response programming to physically presented and imagined stimuli.

It is unclear whether task representation generated in imagery simulates performance demands in reacting to stimuli. This study investigated whether perceptual and motor control processes used to react to unpredictable stimuli and initiate an ipsilateral movement were replicated during imagery. Fifty-nine undergraduate students (Mage = 27.01 years, SD = 8.30) completed 30 simple, two-choice congruent and two-choice incongruent ipsilateral finger-foot movement trials in response to a physically presented or imagined stimulus. The results appear to indicate that participants were reacting to imagined and actual stimuli, as the ipsilateral finger-foot programming rule was maintained and reaction time initially slowed as task difficulty increased. These findings support theoretical similarities between imagery and physical performance of reaction tasks, with imagers generating and reacting to unpredictable stimuli. Slower imagery performance than physical performance on the two-choice incongruent task may indicate that task complexity is limited during imagery. Variation in results between the imagery and physical conditions potentially supports that imagers were able to react to the imagined stimulus. However, exploratory processes used to react to stimuli were not replicated during imagery. The present findings have potentially significant implications for the functional and applied use of imagery for skill acquisition.

The Restorative Effect of the Natural Environment on University Students' Psychological Health.

The present study evaluated the effect of a three-week intervention aimed at improving psychological health in university students. Participants included 200 Australian students randomly assigned to an experimental or waitlist control group, with 42 adhering to intervention instructions. Participants in the experimental group read a story about someone who used the natural environment to decrease stress and burnout levels and to increase their perceived satisfaction with life. They were then instructed to spend 20 minutes each week, for three weeks, in any chosen natural environment. Waitlist control participants received intervention instructions three weeks later. Restorativeness was positively associated with life satisfaction and negatively related to stress and burnout. Experimental participants, compared to waitlist control participants, experienced a significant decrease in stress; however, the intervention had no effect on life satisfaction or burnout. More research is still needed to determine the practical significance of nature exposure on university students' psychological health.

To Vaccinate or Not: The Relative Impact of Attitudes toward Autism Spectrum Disorders and the Ability to Interpret Scientific Information on Vaccination Decisions.

BACKGROUND: This pilot study investigated vaccine decision making, i.e., the relationships between knowledge and attitudes towards autism spectrum disorders (ASD), scientific literacy, attitudes toward the (MMR) vaccine, and children's MMR vaccination status. METHODS: A sample of 132 parents and expectant parents (mean age 38.40 years; >60% with university education) participated in a survey where they were asked about their knowledge of ASD, attitudes towards ASD and MMR, and their children's MMR vaccine status. The participants also completed a standardized science test (The American College Test) to test their scientific literacy. RESULTS: Knowledge of ASD was positively correlated with attitudes towards ASD. Attitudes towards ASD were positively correlated with scientific literacy and attitudes towards MMR. Attitudes towards MMR were positively correlated with MMR vaccine status (i.e., vaccination decision). DISCUSSION: Factors other than scientific literacy seem to contribute towards children's MMR vaccine status such as attitudes towards MMR. However, these are preliminary findings and need to be interpreted with caution.

The relationship between early maladaptive schemas and interpersonal problems: A meta-analytic review.

Early maladaptive schemas (EMSs) have been hypothesized to be associated with interpersonal problems. Furthermore, a stronger contention is that EMSs impact negatively on, or cause, interpersonal problems. The aims of this meta-analysis were (a) to assess the strength of the association between EMSs and interpersonal problems, (b) clarify which EMSs are most strongly associated with interpersonal problems, (c) examine any possible moderators on the relationship between EMSs and interpersonal problems, and (d) examine whether any empirical evidence exists supporting a causal relationship between EMSs and interpersonal problems. A comprehensive systematic literature search and meta-analysis were conducted using the PRISMA guidelines for systematic reviews. A total of 49 empirical studies were reviewed investigating EMSs and interpersonal problems. EMSs were found to have a moderate positive association with interpersonal problems with different EMSs having small to moderate effect sizes. To date, there has been limited evidence supporting a causal effect of EMSs on interpersonal problems. Possible limitations and avenues for future research were discussed.

Self-Reported Health and Patterns of Romantic Love in Adolescents from Eight European Countries and Regions.

Purpose: Sexual minority youth (SMY) are at increased risk of poor health, but it remains unclear whether this phenomenon is universal. In this study, nationally representative samples of 15-year olds from eight European countries and regions were investigated to test if adolescents who have been in love with same- or both-gender partners report poorer health than those exclusively in love with opposite-gender partners or who have never been in love. Methods: A subsample of 13,674 adolescents participating in the 2014 Health Behaviour in School-aged Children (HBSC) study was used. We conducted binary logistic regression, adjusted for gender, region, and relative family affluence, to analyze associations between self-reported romantic love, multiple psychosomatic symptoms, and poor self-rated health. Results: Adolescents reporting same-gender love (adjusted odds ratio [aOR] = 1.50, 95% confidence interval [CI]: 1.11-2.02) and both-gender love (aOR = 3.57, 95% CI: 2.65-4.83) had significantly higher odds for multiple psychosomatic symptoms than those who reported opposite-gender love. Similarly, both SMY groups had higher odds of poor self-rated health (aOR = 2.95, 95% CI: 1.64-5.31 and aOR = 3.08, 95% CI: 1.79-5.31, respectively). Those who reported that they have never been in love had significantly lower odds for multiple symptoms. Adjustment for sociodemographic variables and stratifying by gender did not substantially change the odds ratios. Conclusion: Adolescents in love with same- and both-gender partners reported poorer subjective health outcomes than those in love with opposite-gender partners or who reported never being in love, suggesting that SMY health inequalities are found across various European countries and regions.

Romantic Attraction and Substance Use in 15-Year-Old Adolescents from Eight European Countries.

Sexual minority youth are at higher risk of substance use than heterosexual youth. However, most evidence in this area is from North America, and it is unclear whether the findings can be generalized to other cultures and countries. In this investigation, we used data from the 2014 Health Behaviour in School-aged Children (HBSC) study to compare substance use in same- and both-gender attracted 15-year-old adolescents from eight European countries (n = 14,545) to that of their peers who reported opposite-gender attraction or have not been romantically attracted to anyone. Both-gender attracted, and to a lesser extent, same-gender attracted adolescents were significantly more likely to smoke cigarettes, consume alcohol, get drunk and use cannabis, or be involved in multiple substance use in the last 30 days compared to their opposite-gender attracted peers. Those adolescents who have not been in love had significantly lower odds for substance use than all other youth. The pattern of results remained the same after adjusting for country, gender and family affluence. These findings are compatible with the minority stress and romantic stress theories. They suggest that sexual minority stigma (and love on its own) may contribute to higher substance use among adolescents in European countries.

Psychological flexibility and attitudes toward evidence-based interventions by amyotrophic lateral sclerosis patients.

OBJECTIVE: Declining a percutaneous endoscopic gastrostomy (PEG) or non-invasive ventilation (NIV) by people with amyotrophic lateral sclerosis (ALS) is often contrary to advice provided by health-care-professionals guided by evidence-based principles. This study proposes relational frame theory (RFT) to offer a viable explanation of this phenomenon. DESIGN: A total of 35 people (14 female, 21 male) aged between 34 and 73 years, with ALS, participated in this cross-sectional research. MAIN OUTCOME MEASURES: This research examined the predictive power and interaction effect of psychological flexibility (the fundamental construct of RFT) and psychological well-being on attitudes toward intervention options. RESULTS: Participants with high psychological flexibility reported lower depression, anxiety, and stress, and higher quality of life. In addition, psychological flexibility was predictive of a participant's understanding and acceptance of a PEG as an intervention option. Psychological flexibility was not found to be a significant predictor of understanding and acceptance of NIV. CONCLUSION: Although the criterion measure had not been piloted or validated outside of the current study and asks about expected rather than actual acceptance, findings suggest that applied RFT may be helpful for clients with ALS.

Modeling the Effects of Stress, Anxiety, and Depression on Rumination, Sleep, and Fatigue in a Nonclinical Sample.

Stress and affective distress have previously been shown to predict sleep quality, and all the factors have been shown to predict fatigue severity. However, few prior studies have examined the likely indirect mediational relationships between stress, affective distress, and sleep quality in predicting fatigue severity, and the potential role played by ruminative thinking. A short questionnaire asked 229 participants about their recent experiences of stress, affective distress, rumination, sleep, and fatigue in a community sample. High stress, anxiety, and depression were related to more ruminative thinking, which in turn was related to poor sleep quality (composed of subjective sleep quality, daytime dysfunction, sleep latency, and sleep disturbance) and poor sleep quality predicted worse fatigue. The results suggest that rumination parsimoniously explains the tendency of stress and affective distress to contribute to poor sleep quality, and together with poor sleep, it may also contribute to worse fatigue in some individuals.

Schizophrenia literacy: the effects of an educational intervention on populations with and without prior health education.

BACKGROUND: Mental health literacy is an important predictor of appropriate help-seeking behaviour. AIMS: This study investigated (a) the effects of an educational intervention on schizophrenia mental health literacy, beliefs about causes, discrimination, treatment, and attitudes that promote recognition, and (b) whether schizophrenia literacy would be higher in people with prior education in a health-related area than people without such education. METHOD: A randomised control design tested the effects of an educational intervention on schizophrenia literacy relative to a control group. Participants (N = 260; mean age = 31.18 years, SD = 11.43, female = 78.8%) answered a mental health literacy questionnaire, based on a vignette of a person with schizophrenia, before and after watching either an educational video on schizophrenia or a control video. RESULTS: The intervention significantly increased schizophrenia identification and literacy, reduced personal stigma, and increased perceived discrimination in society. The health background group reported significantly greater schizophrenia identification than the no health background group. Participants thought help should be sought from health care professionals and through psychotherapy, close friends and physical activity. CONCLUSIONS: Targeted education can significantly improve the ability to identify schizophrenia which may have positive implications for reducing the time individuals take to seek help.

Changes in stigma and help-seeking in relation to postpartum depression: non-clinical parenting intervention sample.

Postpartum depression (PPD) is a prevalent mental illness affecting women, and less commonly, men in the weeks and months after giving birth. Despite the high incidence of PPD in Australia, rates for help-seeking remain low, with stigma and discrimination frequently cited as the most common deterrents to seeking help from a professional source. The present study sought to investigate PPD stigma in a sample of parents and to examine the effects of an intervention on stigma and help-seeking behaviour. A total of 212 parents aged 18-71 years (M = 36.88, 194 females) completed measures of personal and perceived PPD stigma and attitudes towards seeking mental health services and were randomly assigned to one of four groups: an intervention group (video documentary or factsheet related to PPD) or a control group (video documentary or factsheet not related to PPD). Results showed that there were no effects for type of intervention on either personal or perceived PPD stigma scores. No effect was found for help-seeking propensity. Males had higher personal PPD stigma than females and older age was associated with lower personal PPD stigma. Familiarity with PPD was associated with perceived PPD stigma in others but not personal PPD stigma. More work needs to be conducted to develop interventions to reduce PPD stigma in the community.

Empathy and the Public Perception of Stillbirth and Memory Sharing: An Australian Case.

Objective: Stillbirth devastates families and leaves them struggling to grieve the death of their baby in a society that expects grief symptoms to decrease over time. Previous research has suggested that increased memory sharing opportunities can lead to positive mental health outcomes. The aim of the current study was to examine people's perceptions of stillbirth as well as the perceived appropriateness of affected parents sharing memories of their child. In addition, we examined whether manipulating empathy would have an effect on people's perceptions of stillbirth. Method: Participants included 200 Australian men and women 18 to 74 years of age (M = 36.76, SD = 12.59) randomly allocated to one of three experimental conditions (i.e., low empathy, high empathy, and control). The high empathy group watched a video about stillbirth and was instructed to imagine how the people portrayed felt; the low empathy group watched the same video but was instructed to remain detached; and the control group watched an unrelated video. Participants were then asked how much money they would be willing to donate to a fictional stillbirth organization, followed by the completion of questionnaires measuring (a) perceptions of stillbirth, (b) empathy, and (c) the appropriateness of parents sharing memories of a stillborn child with different groups of people over time. Results: The empathy manipulation had an effect on empathy and the willingness to help effected parents (high empathy vs. control). However, empathy did not have an effect on participants' perceptions toward stillbirth nor appropriateness of sharing memories. The appropriateness of sharing memories decreased as time passed and social distance increased. Discussion: Individuals who have experienced stillbirth need to be aware that societal expectations and their own expectations in relation to sharing memories may not correspond to each other and that they may need to educate their social group about their need to share memories. Removing the taboo surrounding stillbirth is vital for both parents and those to whom they would wish to communicate.