Virtual individual cognitive stimulation therapy in Hong Kong: A mixed methods feasibility study.

OBJECTIVES: We aimed to translate and culturally adapt Virtual Individual Cognitive Stimulation Therapy (V-iCST) for the Hong Kong (HK) Chinese population, and to evaluate its feasibility and acceptability. METHODS: A mixed methods case series (N=8) was used to assess the feasibility of V-iCST and changes in cognition, quality of life (QoL), mood, and communication pre and post-test. Data were analyzed with the reliable change index. Thematic analysis of post-therapy interviews and content analysis of session rating forms were used to evaluate the acceptability. RESULTS: V-iCST was feasible with low attrition (0%) and high attendance (100%). Participants had reliable improvements in all outcomes. Six had improved and stable cognition; four had clinically significant changes in depression. There were no reliable changes in QoL. Qualitative analyses indicated V-iCST as acceptable but required assistance. CONCLUSIONS: V-iCST can be adapted for HK Chinese with dementia and potentially improve cognition, QoL, mood, and communication.

Treatment Engagement in Specific Psychological Treatment vs. Treatment as Usual for Adolescents With Self-Harm: Systematic Review and Meta-Analysis.

Background: Self-harm is a major public health problem. It is one of the best predictors of suicide in adolescents. Despite recent advances in the understanding of self-harm, poor treatment engagement remains a significant clinical obstacle. Objectives: The purpose of this meta-analysis is to update and extend previous research investigating treatment engagement with specific psychological treatments (SPT) vs. treatment as usual (TAU) in adolescents who self-harm. Methods: Data sources were identified by searching the Medline, PsychINFO, EMBASE, and PubMed databases as of October 2017. Randomized Controlled Trials (RCTs) comparing SPT and TAU in adolescents (through age 18 years) with self-harm were included. Results: The results show that 12 RCTs investigating 1,255 young people were included in the meta-analysis. The proportion of adolescents not completing four or more sessions in SPT was significantly lower (28.4%, 179/630) than TAU (45.9%, 287/625), RR = 0.64 (95% CI:0.51 -0.79), p < 0.0001. There were significantly more adolescents engaged with SPT than TAU. Conclusions: Specific psychological treatments should be offered to adolescents with self-harm to maximize treatment engagement. Engaging adolescents with psychological treatment is necessary although not sufficient to achieve treatment goals.

Using virtual reality to train emotional and social skills in children with autism spectrum disorder.

With emerging technology, computerised, internet-based and virtual reality (VR)-based treatment and training became increasingly popular. VR provides an immersive experience into a simulated environment. Autism spectrum disorder (ASD) is characterised by social communication deficits and repetitive behaviours. Children with ASD often require social skills training while VR provides a safe, controllable environment to practice skills repeatedly. The Centre for Innovative Applications of Internet and Multimedia Technologies (AIMTech Centre) at City University of Hong Kong developed a VR-enabled training program to examine its efficacy on emotional and social skills with six VR scenarios depicting the daily lives of typical children in Hong Kong. 94 children from mainstream primary schools in Hong Kong completed the study and 72 children were included in the analysis. Children from training group scored higher on emotion expression and regulation (M = 20.2, SD = 3.00) than before the training (M = 18.9, SD = 3.57, t(35) = -2.174, p = .037) and higher on social interaction and adaptation after the training (M = 21.8, SD = 2.99) than before training (M = 20.2, SD = 3.43, t(35) = -3.987, p < .0005). There was a statistically significant interaction between group and time on affective expressions, F(1, 70) = 5.223, p = .025, partial η2 = .069, and on social reciprocity, F(1, 70) = 7.769, p = .007, partial η2 = .100. Children were able to engage in VR training despite initial challenges with viewing goggles. Some children declined to participate due to scheduling reasons which may be minimised through the adoption of head-mounted displays as a portable, cost-effective device. VR seems to be a promising asset to traditional training and therapy while the importance trainers' or therapists' support has yet to be further investigated.

Parental socioeconomic status and binge drinking in adolescents: A systematic review.

BACKGROUND AND OBJECTIVES: Binge drinking is a phenomenon of excessive alcohol use seen in many countries. The objectives of this systematic review are a) to investigate the effect of parental socioeconomic status on binge drinking in adolescents, b) to compare how binge drinking and parental socioeconomic status was measured across studies, and c) to compare the differences between developed and developing countries. METHOD: We searched PsycINFO and Ovid Medline databases for articles up to January 2016. Parental socioeconomic status is defined as household income, parental educational level, and parental occupational status. Binge drinking is defined as at least 4/5 alcohol drinks on a single occasion. RESULTS: Four hundred and fourteen articles were granted from the databases search with an additional 28 articles were hand-searched through bibliographies. After abstracts and full-text were reviewed, a total of 20 studies have met inclusion criteria for this systematic review. In developed countries, included studies were done in the United States, United Kingdom, Norway, Sweden, France, Netherlands, Hong Kong, and Canada. In developing countries, included studies were done in China and Brazil. CONCLUSIONS: The majority of studies find no relationship between parental socioeconomic status and binge drinking in adolescents. However, studies that were done in developing countries yielded a weak positive association when no such association was found in developed countries. The variation on measuring binge drinking and parental socioeconomic status is discussed. SCIENTIFIC SIGNIFICANCE: These findings may inform healthcare systems in prevention and intervention for binge drinking among adolescents (Am J Addict 2016;25:610-619).

Review: Alternatives to inpatient care for children and adolescents with mental health disorders.

BACKGROUND: Intensive community services may provide an alternative to inpatient care but there is little systematic evidence of their efficacy. This article provides a systematic review of randomized controlled trials (RCTs) reporting efficacy of intensive community services versus inpatient care in youth. METHOD: Data sources were identified by searching Medline, PsychINFO and EMBASE databases as of December 2014. RCTs comparing intensive community services versus inpatient care in children and adolescents (through age 18) were included. RESULTS: Six unique RCTs including 569 youth were identified. The RCTs examined the efficacy of specialist outpatient treatment, multisystemic therapy, day patient treatment, intensive home treatment and supported discharge services versus inpatient care. Using intensive community services was associated with clinical improvements similar to inpatient care in most studies. Where differences in clinical outcomes existed, they tended to favour intensive community treatment. Using intensive community services was associated with shorter hospitalizations, lower costs and greater patient satisfaction. There were no independent replications of the results. Few studies investigated the use of intensive community treatment as an alternative to inpatient care in children and adolescents with severe immediate risk to self and others. CONCLUSIONS: Intensive community services appear to be a viable alternative to inpatient care. Independent replication of results achieved by specific intensive community treatment models is a research priority.