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1.
J Consult Clin Psychol ; 92(6): 367-384, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39023984

RESUMO

OBJECTIVE: Web-based cognitive bias modification for interpretation (CBM-I) can improve interpretation biases and anxiety symptoms but faces high rates of dropout. This study tested the effectiveness of web-based CBM-I relative to an active psychoeducation condition and the addition of low-intensity telecoaching for a subset of CBM-I participants. METHOD: 1,234 anxious community adults (Mage = 35.09 years, 81.2% female, 72.1% white, 82.6% not Hispanic) were randomly assigned at Stage 1 of a sequential, multiple-assignment randomized trial to complete five weekly sessions of CBM-I or psychoeducation on our team's public research website. After the first session, for Stage 2, an algorithm attempted to classify CBM-I participants as higher (vs. lower) risk for dropping out; those classified as higher risk were then randomly assigned to complete four brief weekly telecoaching check-ins (vs. no coaching). RESULTS: As hypothesized (https://doi.org/j2xr; Daniel, Eberle, & Teachman, 2020), CBM-I significantly outperformed psychoeducation at improving positive and negative interpretation biases (Recognition Ratings, Brief Body Sensations Interpretation Questionnaire) and anxiety symptoms (Overall Anxiety Severity and Impairment Scale, Anxiety Scale from Depression Anxiety Stress Scales-Short Form), with smaller treatment gains remaining significant at 2-month follow-up. Unexpectedly, CBM-I had significantly worse treatment dropout outcomes than psychoeducation, and adding coaching (vs. no coaching) did not significantly improve efficacy or dropout outcomes (notably, many participants chose not to interact with their coach). CONCLUSIONS: Web-based CBM-I appears effective, but supplemental coaching may not mitigate the challenge of dropout. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Ansiedade , Terapia Cognitivo-Comportamental , Humanos , Feminino , Masculino , Adulto , Terapia Cognitivo-Comportamental/métodos , Ansiedade/terapia , Intervenção Baseada em Internet , Pessoa de Meia-Idade , Internet , Transtornos de Ansiedade/terapia , Pacientes Desistentes do Tratamento/psicologia
2.
J Nerv Ment Dis ; 212(8): 419-429, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39008893

RESUMO

ABSTRACT: This study evaluated the impact of a direct-to-consumer (DTC) marketing video designed to educate the public about patients' rights to evidence-based mental health care (EBMHC). Participants ( N = 632) were randomly assigned to an active DTC video condition, a control video condition, or a control condition without a video. Participants who watched the DTC video ( vs . both control conditions) had significantly greater knowledge of patients' rights to EBMHC. Further, individuals who watched the DTC ( vs . control) video reported significantly greater comfort with accessing care and perceived their assigned video as significantly more culturally sensitive. However, participants who watched the DTC video were not significantly different from both control conditions on self-report measures of self-efficacy in working with a provider, likelihood of asking a provider about one's rights, treatment-seeking intentions, and self-stigma. Findings suggest the potential for a DTC video to promote knowledge of EBMHC, though its impact on help-seeking perceptions and intentions was less promising.


Assuntos
Publicidade Direta ao Consumidor , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Publicidade Direta ao Consumidor/métodos , Conhecimentos, Atitudes e Prática em Saúde , Gravação em Vídeo , Serviços de Saúde Mental , Adulto Jovem , Adolescente , Transtornos Mentais/terapia , Autoeficácia , Prática Clínica Baseada em Evidências , Aceitação pelo Paciente de Cuidados de Saúde/psicologia
3.
Psychol Serv ; 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38842849

RESUMO

This study developed and validated the Telepsychology Facilitators Scale (TFS), a novel measure that uses the theory of reasoned action and technology acceptance model as frameworks to assess factors that influence psychologists' openness to using telepsychology. At the beginning of the COVID-19 pandemic, an online sample of 2,619 psychologists completed initial items considered for the TFS, along with a measure assessing their actual use of telepsychology. The sample was split in half, with a preliminary exploratory factor analysis ultimately revealing a 13-item general scale with four distinct subscales (Positive Attitudes, Facilitating Infrastructure, Organizational Support, and External Policies). Higher scores on each subscale positively correlated with psychologists' percentage of patient treatment conducted with telepsychology. The exploratory factor analysis subscale structure was subsequently supported via confirmatory factory analyses of a four-factor structure and bifactor structure (tested separately) with the other half of the sample, revealing adequate model fit for both models and similar convergent validity. The TFS may help the field assess the potential barriers and drivers of telepsychology use among psychologists and be used to inform future organizational and policy efforts to increase telepsychology implementation and use across health service settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

4.
Prof Psychol Res Pr ; 54(3): 252-263, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37868738

RESUMO

This study evaluated the effectiveness of different recruitment messages for encouraging enrollment in a digital mental health intervention (DMHI) for anxiety among 1,600 anxious patients in a large healthcare system. Patients were randomly assigned to receive a standard message, or one of five messages designed to encourage enrollment: Three messages offered varying financial incentives, one message offered coaching, and one message provided consumer testimonials. Patients could then click a link in the message to visit the DMHI website, enroll, and start the first session. We examined the effects of message features and message length (short vs. long) on rates of site clicks, enrollment, and starting the first session. We also tested whether demographic and clinical factors derived from patients' electronic health records were associated with rates of enrollment and starting the first session to understand the characteristics of patients most likely to use DMHIs in this setting. Across messages, 19.4% of patients clicked a link to visit the DMHI website, but none of the messages were significantly associated with rates of site clicks, enrollment, or starting the first session. Females (vs. males) had a greater probability of enrollment. No other demographic or clinical variables were significantly associated with enrollment or starting the first session. Findings provide guidance for resource allocation decisions in larger scale DMHI implementations in healthcare settings.

5.
J Pers Med ; 13(9)2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37763086

RESUMO

Hydrocephalus is a clinical disorder caused by excessive cerebrospinal fluid (CSF) buildup in the ventricles of the brain, often requiring permanent CSF diversion via an implanted shunt system. Such shunts are prone to failure over time; an ambulatory intracranial pressure (ICP) monitoring device may assist in the detection of shunt failure without an invasive diagnostic workup. Additionally, high resolution, noninvasive intracranial pressure monitoring will help in the study of diseases such as normal pressure hydrocephalus (NPH) and idiopathic intracranial hypertension (IIH). We propose an implantable, continuous, rechargeable ICP monitoring device that communicates via Bluetooth with mobile applications. The design requirements were met at the lower ICP ranges; the obtained error fell within the idealized ±2 mmHg margin when obtaining pressure values at or below 20 mmHg. The error was slightly above the specified range at higher ICPs (±10% from 20-100 mmHg). The system successfully simulates occlusions and disconnections of the proximal and distal catheters, valve failure, and simulation of A and B ICP waves. The mobile application accurately detects the ICP fluctuations that occur in these physiologic states. The presented macro-scale prototype is an ex-vivo model of an implantable, rechargeable ICP monitoring system that has the potential to measure clinically relevant ICPs and wirelessly provide accessible and continuous data to aid in the workup of shunt failure.

6.
J Clin Psychol ; 79(4): 909-936, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36170010

RESUMO

OBJECTIVES: This study developed and pilot-tested an adaptation of Cognitive Bias Modification (CBM) to target two aspects of relational flexibility in couples: the ability to generate alternative perspectives, and the ability to respond nondefensively when alternative partner perspectives are raised within challenging relationship situations (referred to as flexibility in partner perspectives). METHODS: CBM-FlexC training materials were developed in Phase 1, and expert users (N = 4) and end-point users (N = 7) provided qualitative feedback. Feasibility and preliminary efficacy of CBM-FlexC were evaluated in Phase 2, using an online sample of distressed couples (N = 18). Using a multiple baseline design, participants completed three baseline assessments, six CBM-FlexC sessions over 2 weeks, and a 1-month follow-up. RESULTS: CBM-FlexC training resulted in greater flexibility in partner perspectives, relationship satisfaction, and general psychological flexibility compared to baseline, and improvements were maintained 1-month after training when using mixed-effects models. However, analyses of reliable change (based on graphical inspection and the Reliable Change Index) indicated that most participants did not experience reliable improvement in flexibility in partner perspectives, or relationship satisfaction. CONCLUSION: This pilot study provides some positive signals regarding the potential efficacy of CBM-FlexC, while pointing to the need for further development to strengthen its effects.


Assuntos
Intervenção Baseada em Internet , Amor , Humanos , Projetos Piloto , Resultado do Tratamento , Emoções
7.
Cogn Behav Pract ; 29(1): 97-104, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35599835

RESUMO

The papers in this special issue make a compelling case for the value of digital mental health services (DMHS; including technology-based interventions, assessments, and prevention programs) to help address some of the currently unmet needs in mental health care. At the same time, the papers highlight the work that needs to be accomplished for DMHS to fulfill their promise. We review the papers' contributions in terms of (a) the imperative to increase access to evidence-informed, high-quality care, especially for underserved populations, both in the United States and globally; (b) ways to use DMHS to improve the ways that clinical care is provided to make treatment provision more effective and efficient; and (c) the current state of the research on DMHS for emotional disorders. We then consider lessons learned and recommendations to move the field forward, such as increasing (and making transparent) the research base on DMHS, adopting regulatory standards for DMHS, attending carefully to training issues for DMHS and best practices for dissemination and implementation, designing specifically for digital platforms, and being intentional about efforts to reduce disparities regarding who benefits from DMHS.

8.
Behav Ther ; 53(3): 492-507, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35473652

RESUMO

Technology-delivered interventions have the potential to help address the treatment gap in mental health care but are plagued by high attrition. Adding coaching, or minimal contact with a nonspecialist provider, may encourage engagement and decrease dropout, while remaining scalable. Coaching has been studied in interventions for various mental health conditions but has not yet been tested with anxious samples. This study describes the development of and reactions to a low-intensity coaching protocol administered to N = 282 anxious adults identified as high risk to drop out of a web-based cognitive bias modification for interpretation intervention. Undergraduate research assistants were trained as coaches and communicated with participants via phone calls and synchronous text messaging. About half of the sample never responded to coaches' attempts to schedule an initial phone call or did not answer the call, though about 30% completed the full intervention with their coach. Some anxious adults may choose technology-delivered interventions specifically for their lack of human contact and may fear talking to strangers on the phone; future recommendations include taking a more intensive user-centered design approach to creating and implementing a coaching protocol, allowing coaching support to be optional, and providing users with more information about how and why the intervention works.


Assuntos
Transtornos de Ansiedade , Intervenção Baseada em Internet , Adulto , Ansiedade/terapia , Humanos , Responsabilidade Social
9.
J Clin Psychol ; 78(6): 1020-1045, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34993965

RESUMO

OBJECTIVE: This study examined whether variables related to unequal access to mental health resources (including Black and Latinx racial-ethnic group membership, lower education level, and lower number of community-level treatment providers, and facilities) were associated with current mental health treatment use; and, whether these variables moderated the likelihood that individuals would receive their preferred effective treatment. METHODS: In a preregistered (osf.io/z28wr) study, 5626 individuals completed a mental health history form and measures of implicit and explicit beliefs about the effectiveness of therapy versus medication. RESULTS: Individuals with more (vs. less) education were more likely to report current treatment use. Individuals who were Black/Latinx (vs. non-Latinx White) or who lived in a community with fewer (vs. more) providers sometimes had a lower probability of accessing preferred effective treatment, though results varied across implicit and explicit measures. CONCLUSIONS: Findings highlight the need to increase access to mental health resources among marginalized groups.


Assuntos
Recursos em Saúde , Saúde Mental , Etnicidade , Humanos , Psicoterapia , Grupos Raciais
10.
Macromol Biosci ; 22(3): e2100144, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34856056

RESUMO

While de novo collagen fibril formation is well-studied, there are few investigations into the growth and remodeling of extant fibrils, where molecular collagen incorporation into and erosion from the fibril surface must delicately balance during fibril growth and remodeling. Observing molecule/fibril interactions is difficult, requiring the tracking of molecular dynamics while, at the same time, minimizing the effect of the observation on fibril structure and assembly. To address the observation-interference problem, exogenous collagen molecules are tagged with small fluorophores and the fibrillogenesis kinetics of labeled collagen molecules as well as the structure and network morphology of assembled fibrils are examined. While excessive labeling significantly disturbs fibrillogenesis kinetics and network morphology of assembled fibrils, adding less than ≈1.2 labels per collagen molecule preserves these characteristics. Applications of the functional, labeled collagen probe are demonstrated in both cellular and acellular systems. The functional, labeled collagen associates strongly with native fibrils and when added to an in vitro model of corneal stromal development at low concentration, the labeled collagen is incorporated into a fine extracellular matrix (ECM) network associated with the cells within 24 h.


Assuntos
Colágeno Tipo I , Colágeno , Colágeno/metabolismo , Colágeno Tipo I/metabolismo , Matriz Extracelular/metabolismo , Cinética
11.
J Psychiatr Res ; 144: 397-404, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34741837

RESUMO

OBJECTIVE: This study examined the prevalence and cross-sectional correlates of past-month suicidal thoughts, suicide attempts, interrupted attempts, aborted attempts, and non-suicidal self-injury (NSSI) among patients seeking treatment at a partial hospitalization program (PHP). METHOD: 1063 patients (54% female, 87% white, mean age = 33.6 years) receiving treatment at a PHP completed self-report questionnaires and the Columbia-Suicide Severity Rating Scale as part of routine clinical monitoring upon admission to the program. We examined demographic and clinical cross-sectional correlates of self-injurious thoughts and behaviors (SITBs) using descriptive statistics, ordinal regression, and logistic regression analyses. RESULTS: In the past month, 44.6% of patients reported active suicidal thoughts, 5.6% reported a suicide attempt, 1.8% reported an interrupted attempt, 5.5% reported an aborted attempt, and 16.6% reported NSSI. Inpatient referral source (ORs = 2.45-5.28), minority sexual orientation (ORs = 1.43-6.94), and more Borderline Personality Disorder (BPD) symptoms (ORs = 1.09-1.23) were each associated with at least three of the five SITBs examined. CONCLUSIONS: This study highlights elevated rates of suicidal thoughts, suicide attempts, and NSSI in a partial hospital sample. Given that past attempts predict future attempts and death by suicide, support during the transition from inpatient to outpatient care via programs such as PHPs is needed. Patients referred from inpatient treatment, who identity as a sexual minority, and with more BPD symptoms may require additional support and safety monitoring. Further work is indicated to better understand how PHP patients' SITBs change during and after partial hospitalization.


Assuntos
Comportamento Autodestrutivo , Tentativa de Suicídio , Adulto , Estudos Transversais , Feminino , Hospitais , Humanos , Masculino , Prevalência , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/terapia , Ideação Suicida
12.
J Nerv Ment Dis ; 209(11): 783-795, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34238893

RESUMO

ABSTRACT: One exploratory study (N = 10,335) and one preregistered replication and extension study (N = 6648) evaluated implicit and explicit beliefs in the effectiveness of psychotherapy versus medication, and whether these beliefs vary as a function of demographics, mental health difficulties, and treatment experiences. Data were collected from a sample of visitors to a mental health research website who completed the Therapy vs. Medication Effectiveness Implicit Association Test (IAT). The IAT demonstrated evidence of convergent validity with two measures of explicit therapy versus medication effectiveness beliefs. Across both studies, individuals held greater implicit and explicit beliefs that therapy is more effective than medication, and individuals who were Black (versus all other races, excluding "other/unknown") and who had experienced past (versus current) mental health difficulties had stronger implicit and explicit beliefs in the effectiveness of therapy versus medication. More work is needed to understand how these differences in beliefs arise, as well as to evaluate the clinical utility of this novel measure.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/terapia , Pessoas Mentalmente Doentes , Psicoterapia , Psicotrópicos , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Transtornos Mentais/tratamento farmacológico , Pessoa de Meia-Idade
13.
J Struct Biol ; 213(1): 107697, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33545351

RESUMO

Collagen fibrils, linear arrangements of collagen monomers, 20-500 nm in diameter, comprising hundreds of molecules in their cross-section, are the fundamental structural unit in a variety of load-bearing tissues such as tendons, ligaments, skin, cornea, and bone. These fibrils often assemble into more complex structures, providing mechanical stability, strength, or toughness to the host tissue. Unfortunately, there is little information available on individual fibril dynamics, mechanics, growth, aggregation and remodeling because they are difficult to image using visible light as a probe. The principle quantity of interest is the fibril diameter, which is difficult to extract accurately, dynamically, in situ and non-destructively. An optical method, differential interference contrast (DIC) microscopy has been used to visualize dynamic structures that are as small as microtubules (25 nm diameter) and has been shown to be sensitive to the size of objects smaller than the wavelength of light. In this investigation, we take advantage of DIC microscopy's ability to report dimensions of nanometer scale objects to generate a curve that relates collagen diameter to DIC edge intensity shift (DIC-EIS). We further calibrate the curve using electron microscopy and demonstrate a linear correlation between fibril diameter and the DIC-EIS. Using a non-oil immersion, 40x objective (NA 0.6), collagen fibril diameters between ~100 nm to ~ 300 nm could be obtained with ±11 and ±4 nm accuracy for dehydrated and hydrated fibrils, respectively. This simple, nondestructive, label free method should advance our ability to directly examine fibril dynamics under experimental conditions that are physiologically relevant.


Assuntos
Colágeno/química , Animais , Bovinos , Ligamentos/química , Microscopia Eletrônica/métodos , Pele/química , Tendões/química
14.
J Affect Disord ; 281: 279-288, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33341010

RESUMO

BACKGROUND: Prior studies have established inconsistent associations between body weight and mental health. However, most work has relied on body mass index (BMI) and examination of a single mental health variable. The present study examined associations of BMI and waist circumference with multiple mental health variables in a transdiagnostic psychiatric sample. METHODS: Nursing staff measured waist circumference and calculated the BMI of 742 adults (54.6% female, 45.4% male) presenting for psychiatric treatment. Participants completed the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Behavior and Symptom Identification Scale (BASIS-24), and Mental Health Continuum-Short Form (MHC-SF) as part of standard clinical monitoring. Suicide risk was assessed using the clinician-administered Mini International Neuropsychiatric Interview (M.I.N.I.). For curve fit estimation regression models, we entered BMI and waist circumference as independent variables separately; we entered seven dependent variables separately: 1) depression, 2) anxiety, 3) substance use, 4) self-harm, 5) interpersonal functioning, 6) well-being, and 7) suicide risk. RESULTS: Increased BMI was associated with decreased well-being and increased depression. Increased waist circumference was associated with worse interpersonal functioning. Non-linear (quadratic) associations were observed between weight and depression, substance use, self-harm, and suicide. LIMITATIONS: Most of the sample was White and only 2.6% was in the underweight category, limiting broad applicability of findings. Cross-sectional design precludes causal attributions. CONCLUSIONS: Given associations between well-being, depression, interpersonal functioning, substance use, self-harm, and suicide with weight, findings may be used to inform mental health treatment, particularly by tailoring interventions to high-risk weight categories (underweight, obese) in psychiatric populations.


Assuntos
Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Adulto , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Circunferência da Cintura
15.
Psychol Med ; 51(7): 1157-1165, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32008591

RESUMO

BACKGROUND: Little is known about the everyday experiences of individuals transitioning from acute to outpatient psychiatric care, an important period of risk for mood symptom relapse. This study used ecological momentary assessment (EMA) to examine whether specific daily experiences were related to momentary affective states following discharge from a partial hospitalization program (PHP). METHODS: A sample of 114 adults (Mage = 36 years old, 52% female, 83% White) completed four brief EMA surveys every day for 2 weeks assessing intensity/type of stressful events and social contact, as well as positive/negative affect (PA/NA). Half of participants reported therapeutic skills use. RESULTS: Stress severity ratings prospectively predicted increased NA. NA predicted spending less time with close relationships. However, interacting with close relationships predicted increased positive affect (PA). Finally, PA predicted spending time with more people. The use of two skills (behavioral activation and interpersonal effectiveness) was concurrently, but not prospectively, associated with improved affect. CONCLUSIONS: Examining daily experiences of individuals discharging from partial hospitalization provides important information about factors that may influence affective states during the transition from acute to outpatient care. Findings from this study can be used to help prepare patients for discharge and develop interventions for the post-acute period.


Assuntos
Afeto , Hospital Dia/psicologia , Transtornos Mentais/terapia , Alta do Paciente , Adulto , Idoso , Avaliação Momentânea Ecológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicoterapia
16.
Arch Suicide Res ; 24(3): 367-383, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31159675

RESUMO

Urgency-rash action during strong emotion-is a robust correlate of nonsuicidal self-injury (NSSI). This study tested whether urgency is associated with time between NSSI urges and NSSI, and sought to replicate the finding that urgency is associated with NSSI history. Participants attending a partial hospitalization program (N = 669) completed self-report measures of urgency, NSSI history and latency, and psychiatric symptoms. Consistent with previous research in clinical samples, rates of lifetime engagement in NSSI were high. Using logistic regression to predict short vs. long latency between urges and NSSI, no significant relationship emerged between negative urgency and latency to self-injure. Negative urgency more than doubled the likelihood of NSSI history (p < .001, OR = 2.39). In addition, exploratory analyses revealed several links between NSSI latency and negative urgency. Results confirm that urgency is robustly related to NSSI, yet also suggest that more research is needed to understand how urgency relates to the parameters of NSSI within those who self-injure. Use of retrospective self-report measures may limit the ability to test links between urgency and latency of NSSI.


Assuntos
Desvalorização pelo Atraso , Comportamento Impulsivo , Angústia Psicológica , Intervenção Psicossocial/métodos , Comportamento Autodestrutivo , Prevenção do Suicídio , Adulto , Hospital Dia/métodos , Regulação Emocional , Feminino , Comportamento de Busca de Ajuda , Hospitais Psiquiátricos/estatística & dados numéricos , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Tempo de Reação , Autorrelato , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/terapia , Fatores Sexuais , Suicídio/psicologia
17.
J Clin Psychol ; 76(4): 749-768, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31825097

RESUMO

OBJECTIVE: Treatment utilization for psychiatric illness is low, perhaps influenced by limited consumer knowledge of evidence-based psychological treatments (EBPTs). To inform consumer-directed dissemination efforts, we characterized preferences, beliefs, and knowledge about specific EBPTs (cognitive behavioral therapy [CBT], dialectical behavior therapy [DBT], and acceptance and commitment therapy [ACT]); and examined potential sociodemographic and treatment history correlates. METHOD: Before receiving treatment at a psychiatric partial hospital, patients (n = 249) completed the Psychological Treatment Consumer Questionnaire. RESULTS: Most (75%) patients felt responsible for being aware of psychotherapy options and that it was important to receive research-supported psychotherapy (80%), but were split on whether research (42%) or their provider's recommendation (58%) carried greater decisional weight. Most (93%) patients had heard of CBT (93%) and DBT (71%), but not ACT (35%). Prior exposure to these EBPTs increased the likelihood of recommending them to others. CONCLUSIONS: Findings support initiatives to enhance consumer familiarity with these EBPTs and inform dissemination efforts.


Assuntos
Terapia de Aceitação e Compromisso , Conscientização , Terapia Cognitivo-Comportamental , Terapia do Comportamento Dialético , Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/terapia , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
18.
JMIR Mhealth Uhealth ; 7(6): e13364, 2019 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-31199338

RESUMO

BACKGROUND: Despite high rates of smartphone ownership in psychiatric populations, there are very little data available characterizing smartphone use in individuals with mental illness. In particular, few studies have examined the interest and use of smartphones to support mental health. OBJECTIVE: This study aimed to (1) characterize general smartphone app and social media usage in an acute transdiagnostic psychiatric sample with high smartphone ownership, (2) characterize current engagement and interest in the use of smartphone apps to support mental health, and (3) test demographic and clinical predictors of smartphone use. METHODS: The survey was completed by all patients attending an adult partial hospital program, with no exclusion criteria. The primary outcomes were frequency of use of general and mental health smartphone apps (smartphone use survey) and the frequency of social media use and phone-checking behavior (mobile technology engagement scale). RESULTS: Overall, 322 patients (aged mean 33.49, SD 13.87 years; 57% female) reported that their most frequently used app functions were texting, email, and social media. Younger individuals reported more frequent use across most types of apps. Baseline depression and anxiety symptoms were not associated with the frequency of app use. Participants reported health care, calendar, and texting apps as most supportive of their mental health and social media apps as most negatively affecting their mental health. Most patients reported an interest in (73.9% [238/322]) and willingness to use (81.3% [262/322]) a smartphone app to monitor their mental health condition. Less than half (44%) of the patients currently had a mental health app downloaded on their smartphone, with mindfulness and meditation apps being the most common type. CONCLUSIONS: The high interest in and willingness to use mental health apps, paired with the only moderate current reported usage, indicate a potential unmet treatment opportunity in psychiatric populations. There is potential to optimize non-mental health-specific apps to better support the needs of those with mental illness and to design a new wave of mental health apps that match the needs of these populations as well as the way they use smartphones in daily life.


Assuntos
Serviços de Saúde Mental/tendências , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Mídias Sociais/instrumentação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , Mídias Sociais/estatística & dados numéricos , Inquéritos e Questionários
19.
Psychiatry Res ; 273: 788-797, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31207867

RESUMO

Depression, anxiety, sleep disturbances and poor relationship functioning often co-occur with the confluence of these factors contributing to greater suicide risk. This study investigated whether the pathways between depression, anxiety, sleep disturbances, and relationship functioning differentiated patients with suicide attempt history from those with suicidal ideation history. Patients seeking partial hospital treatment for severe psychiatric symptoms (N = 180) completed interviews assessing psychiatric and suicidal symptom histories, and self-report measures of sleep behaviors, anxiety, depression, and relationship functioning. Multiple sleep behaviors were examined: duration, sleep onset latency, and bedtime. Bias-corrected bootstrap mediation and moderated mediation analyses with suicide attempt as the moderator were used to evaluate pathways between variables. Among patients with ideation and attempt history, (1) sleep onset latency significantly mediated the association between depression and relationship functioning and that between anxiety and relationship functioning; (2) relationship functioning significantly mediated the association between depression and sleep onset latency and that between anxiety and sleep onset latency. These pathways were not significant among patients with suicidal ideation only. No other sleep behaviors were related to study variables. The reciprocal relationship between disrupted sleep onset latency and poor relationship functioning was specifically linked to more severe psychiatric symptoms among acute patients with suicide attempt histories.


Assuntos
Afeto/fisiologia , Relações Interpessoais , Latência do Sono/fisiologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adulto , Ansiedade/diagnóstico , Ansiedade/fisiopatologia , Ansiedade/psicologia , Depressão/diagnóstico , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Autorrelato , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/fisiopatologia , Comportamento Autodestrutivo/psicologia , Adulto Jovem
20.
Behav Ther ; 50(3): 515-530, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31030870

RESUMO

Cognitive bias modification for interpretation (CBM-I) is an appealing augmentation to cognitive-behavioral therapy (CBT) because it targets cognitive bias efficiently via computerized training. Few studies have tested the combination of CBM-I and CBT, and none have translated lab-based CBM-I protocols to an acute psychiatric setting. The present study describes the development and implementation of CBM-I as an augmentation to a CBT-based partial hospital. We developed a transdiagnostic CBM-I based on the word-sentence association paradigm (WSAP), which reinforces individuals for endorsing benign interpretations and rejecting negative interpretations of ambiguous sentences. Over two iterations of development, we randomly assigned patients (N = 127; M age = 34.21; 58% female, 40% male, 2% nonbinary) to either CBM-I or a control group (Phase 1: neutral WSAP task; Phase 2: treatment as usual). CBM-I comprised daily sessions (10 minutes) completed during program hours, and number of sessions varied naturalistically according to patient length of stay. Primary outcomes included feasibility, acceptability, and target engagement (interpretation bias). CBM-I was feasible and acceptable to acute psychiatric patients, and successfully shifted interpretation for novel stimuli. Patient feedback suggested that participants viewed CBM-I as bolstering their primary CBT-based care. Exploratory analyses examining clinical benefit revealed a small between-group effect on anxiety severity (d = 0.378), but no group differences on depression outcomes (d = 0.008). Findings indicate that CBM-I is a feasible and acceptable augmentation to CBT-based partial hospital care. Future studies are warranted to determine who is most likely to benefit from this low-intensity approach.


Assuntos
Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Depressão/terapia , Hospitais Psiquiátricos , Pesquisa Translacional Biomédica/métodos , Adolescente , Adulto , Idoso , Ansiedade/psicologia , Terapia Cognitivo-Comportamental/tendências , Depressão/psicologia , Feminino , Hospitais Psiquiátricos/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pesquisa Translacional Biomédica/tendências , Resultado do Tratamento , Adulto Jovem
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