RESUMO
The 2019 novel coronavirus (COVID-19) pandemic causes much disruption globally on sociopolitical, economic and healthcare fronts. While much of the impact has focused on the epidemiology and medical management of the pandemic, more need to be focused on the mental health impact of COVID-19. This article describes the impact of COVID-19 pandemic on Singapore's schools and the response and adaptation of the school community mental health services. Singapore's response is one of balancing the needs of the population and demands in this crisis, with the utilization of technology and outbreak and support control measures. Further consideration needs to be afforded to increase capacity of the school and mental health services to support youth and tapping on technological innovations.
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Infecções por Coronavirus , Serviços de Saúde Mental/organização & administração , Pandemias , Pneumonia Viral , Serviços de Saúde Escolar/organização & administração , Instituições Acadêmicas , Adolescente , COVID-19 , Criança , Serviços de Saúde da Criança , Pré-Escolar , Humanos , Saúde Mental , Encaminhamento e Consulta , SingapuraRESUMO
BACKGROUND: While studies suggest that nutritional supplementation may reduce aggressive behavior in children, few have examined their effects on specific forms of aggression. This study tests the primary hypothesis that omega-3 (ω-3), both alone and in conjunction with social skills training, will have particular post-treatment efficacy for reducing childhood reactive aggression relative to baseline. METHODS: In this randomized, double-blind, stratified, placebo-controlled, factorial trial, a clinical sample of 282 children with externalizing behavior aged 7-16 years was randomized into ω-3 only, social skills only, ω-3 + social skills, and placebo control groups. Treatment duration was 6 months. The primary outcome measure was reactive aggression collected at 0, 3, 6, 9, and 12 months, with antisocial behavior as a secondary outcome. RESULTS: Children in the ω-3-only group showed a short-term reduction (at 3 and 6 months) in self-report reactive aggression, and also a short-term reduction in overall antisocial behavior. Sensitivity analyses and a robustness check replicated significant interaction effects. Effect sizes (d) were small, ranging from 0.17 to 0.31. CONCLUSIONS: Findings provide some initial support for the efficacy of ω-3 in reducing reactive aggression over and above standard care (medication and parent training), but yield only preliminary and limited support for the efficacy of ω-3 in reducing overall externalizing behavior in children. Future studies could test further whether ω-3 shows promise in reducing more reactive, impulsive forms of aggression.
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Comportamento do Adolescente , Agressão , Sintomas Comportamentais/terapia , Comportamento Infantil , Ácidos Graxos Ômega-3/farmacologia , Psicoterapia , Comportamento Social , Habilidades Sociais , Adolescente , Sintomas Comportamentais/dietoterapia , Criança , Terapia Combinada , Método Duplo-Cego , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Seguimentos , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Comportamento ProblemaRESUMO
Parent-teacher cross-informant agreement, although usually modest, may provide important clinical information. Using data for 27,962 children from 21 societies, we asked the following: (a) Do parents report more problems than teachers, and does this vary by society, age, gender, or type of problem? (b) Does parent-teacher agreement vary across different problem scales or across societies? (c) How well do parents and teachers in different societies agree on problem item ratings? (d) How much do parent-teacher dyads in different societies vary in within-dyad agreement on problem items? (e) How well do parents and teachers in 21 societies agree on whether the child's problem level exceeds a deviance threshold? We used five methods to test agreement for Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) ratings. CBCL scores were higher than TRF scores on most scales, but the informant differences varied in magnitude across the societies studied. Cross-informant correlations for problem scale scores varied moderately across societies studied and were significantly higher for Externalizing than Internalizing problems. Parents and teachers tended to rate the same items as low, medium, or high, but within-dyad item agreement varied widely in every society studied. In all societies studied, both parental noncorroboration of teacher-reported deviance and teacher noncorroboration of parent-reported deviance were common. Our findings underscore the importance of obtaining information from parents and teachers when evaluating and treating children, highlight the need to use multiple methods of quantifying cross-informant agreement, and provide comprehensive baselines for patterns of parent-teacher agreement across 21 societies.
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Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Docentes , Pais , Adolescente , Criança , Comparação Transcultural , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos TestesRESUMO
This study examined the criterion validity of the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) problem scales and items in demographically-matched Singapore samples of referred and non-referred children (840 in each sample for the CBCL and 447 in each sample for the TRF). Internal consistency estimates for both the CBCL and TRF scales were good. Almost all CBCL and TRF problem scales and items significantly discriminated between referred and non-referred children, with referred children scoring higher, as expected. The largest referral status effects were on attention problems scales and their associated items, with the TRF having larger effects than the CBCL. Effect sizes for demographic variables such as age, gender, ethnicity and SES were much smaller than effect sizes for referral status, across both the CBCL and TRF forms and at both the scale and item levels. These findings suggest that teachers can be effective partners in identifying children who need mental health services and those who do not.
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Transtornos do Comportamento Infantil/diagnóstico , Comparação Transcultural , Determinação da Personalidade/estatística & dados numéricos , Criança , Transtornos do Comportamento Infantil/psicologia , Docentes , Feminino , Humanos , Masculino , Psicometria/estatística & dados numéricos , Valores de Referência , Encaminhamento e Consulta , Reprodutibilidade dos Testes , SingapuraRESUMO
International comparisons were conducted of preschool children's behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½-5 by parents in 24 societies (N = 19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental Disorders-oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3-12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0-198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes < 1%). Across all pairs of societies, correlations between mean item ratings averaged .78, and correlations between internal consistency alphas for the scales averaged .92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies.
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Sintomas Afetivos/psicologia , Transtornos do Comportamento Infantil/psicologia , Comportamento Infantil/psicologia , Comparação Transcultural , Sintomas Afetivos/etnologia , Fatores Etários , Lista de Checagem , Comportamento Infantil/etnologia , Transtornos do Comportamento Infantil/etnologia , Pré-Escolar , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Fatores SexuaisRESUMO
We compared the effects of a 16-week Cognitive-Behavioral Therapy (CBT) program and a Social Recreational (SR) program on anxiety in children with Autism Spectrum Disorders (ASD). Seventy children (9-16 years old) were randomly assigned to either of the programs (n (CBT) = 36; n (SR) = 34). Measures on child's anxiety using the Spence Child Anxiety Scale--Child (SCAS-C) and the Clinical Global Impression-Severity scale (CGI--S) were administered at pre-, post-treatment, and follow-ups (3- and 6-month). Children in both programs showed significantly lower levels of generalized anxiety and total anxiety symptoms at 6-month follow-up on SCAS-C. Clinician ratings on the CGI-S demonstrated an increase in the percentage of participants rated as "Normal" and "Borderline" for both programs. Findings from the present study suggest factors such as regular sessions in a structured setting, consistent therapists, social exposure and the use of autism-friendly strategies are important components of an effective framework in the management of anxiety in children and adolescents with ASD.
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Ansiedade , Sintomas Comportamentais/classificação , Transtornos Globais do Desenvolvimento Infantil/complicações , Terapia Cognitivo-Comportamental/métodos , Avaliação de Programas e Projetos de Saúde , Adolescente , Ansiedade/etiologia , Ansiedade/psicologia , Ansiedade/terapia , Criança , Comportamento Infantil , Transtornos Globais do Desenvolvimento Infantil/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/normas , Índice de Gravidade de Doença , Apoio Social , Resultado do TratamentoRESUMO
BACKGROUND: The advances in experimental psychology in the last decade have led to a greater understanding of cognitive bias, and the investigation of cognitive bias modifications as a therapeutic option. Whilst conventionally such interventions are delivered in a laboratory, technological advances are changing the potential modes of delivery of these interventions. Whereas mobile delivery of interventions might seem to increase accessibility and encourage compliance, this might not be the case for cognitive bias modification interventions. To reduce boredom, researchers have investigated whether gamification of the task could help reduce repetitiveness, and the diminished motivation that participants had over time. In a prior review of cognitive bias modification interventions, a collaboration between academics and developers was recommended to ensure that the developed product is evidence-based. With the increased recognition of the importance of participatory action research, participants could better help conventional intervention to meet their needs. OBJECTIVE: The aim of this article was to describe the iterative steps in the conceptualization of the co-designed gamified cognitive bias modification intervention for individuals with opioid use disorders. METHODS AND RESULTS: A multidisciplinary team worked through the differences in the perspectives offered by healthcare professionals and patient participants, and jointly worked with a developer to conceptualize a new co-designed gamified attention bias modification intervention. The methods shared in this article could be considered and applied to future conceptualization of co-designed interventions.
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Viés de Atenção , Aplicativos Móveis , Transtornos Relacionados ao Uso de Opioides , Viés , Pesquisa sobre Serviços de Saúde , Humanos , Transtornos Relacionados ao Uso de Opioides/terapiaRESUMO
Bullying through online medium has afflicted many adolescents to cause severe mental health concerns, including self-harm and suicide. The aims of this study are to examine the prevalence of cyberbullying in Singapore adolescents, its associations with psychosocial difficulties, and how do the adolescents seek help after being cybervictimized. A representative sample of 3,319 school students aged between 12 and 17 years responded to a survey with scales measuring cyberbullying, psychosocial difficulties, and help-seeking behaviors. In the present study, 7.3 percent of adolescents reported being cybervictims only, 1.8 percent were cyberbullies only, and 4.8 percent were cyberbully-victims. Compared with the non-involved group, both cybervictim and cyberbully-victim groups were associated with more internalizing problems, but all the three cyberbullying-involved groups were associated with higher externalizing problems. Approximately half of the cybervictimized participants reported that they have sought help, with most of them (81.7 percent) choosing to tell their friends. Our findings are consistent with previous overseas studies showing increased associations of psychosocial difficulties among adolescents who are involved in cyberbullying. Public awareness of the consequences of unhealthy cyber-usage could be raised to aid in the early detection of cyberbullying among school children and adolescents. Moreover, cyberwellness programs should be considered as a component of larger anti-bullying programs in schools and in the community.
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Bullying , Vítimas de Crime , Cyberbullying , Comportamento de Busca de Ajuda , Adolescente , Criança , Humanos , Internet , Instituições Acadêmicas , Singapura/epidemiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Pervasive developmental disorder (PDD) is associated with emotional and behavioural problems. There is no pharmacological cure for PDD, but some comorbidities and dysfunctional behaviours in PDD can be managed pharmacologically. The aim of the present study was to provide a better understanding of the efficacy and limitations in the currently available agents. METHODS: Electronic literature searches were conducted from the following sources: MEDLINE, Cochrane Library, PSYARTICLES and PsycINFO. Search terms included, but were not limited to, 'autism', 'PDD', 'autism spectrum disorder' ('ASD'), and 'pharmacological management'. RESULTS: A range of pharmacological agents are available for the management of various dysfunctional symptoms in PDD. Broadly speaking, these agents help in the management of repetitive stereotyped behaviours, anxiety, aggression/irritability/self-injurious behaviour, hyperactivity/inattention and in sleep. CONCLUSIONS: There is a paucity of systemic, well-conducted trials on the use of pharmacological agents in the management of PDD, and more research in this area is warranted.
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Transtornos Globais do Desenvolvimento Infantil/tratamento farmacológico , Transtornos Globais do Desenvolvimento Infantil/psicologia , Psicotrópicos/uso terapêutico , Adolescente , Agressão/efeitos dos fármacos , Agressão/psicologia , Ansiedade/tratamento farmacológico , Ansiedade/psicologia , Criança , Comorbidade , Feminino , Humanos , Humor Irritável/efeitos dos fármacos , Masculino , Agitação Psicomotora/tratamento farmacológico , Agitação Psicomotora/psicologia , Comportamento Autodestrutivo/tratamento farmacológico , Comportamento Autodestrutivo/psicologia , Comportamento Estereotipado/efeitos dos fármacos , Resultado do TratamentoRESUMO
PURPOSE OF REVIEW: Technological advancement has led to the development of novel treatment approaches for attention deficit hyperactivity disorder (ADHD). This review aims to review recent studies which employ the use of technology to treat ADHD, with particular focus on studies published during a 1-year period from February 2019 to February 2020. RECENT FINDINGS: Most recent studies involved children aged 12 years and below. Interventions included cognitive training through games, neurofeedback and a combination of several approaches. More novel approaches included trigeminal nerve stimulation and brain-computer interface, and studies had utilized technology such as X-box Kinect and eye tracker. There was a shift towards delivering intervention at home and in school, enabled by technology. The study outcomes were variable and mainly included executive functioning measures and clinical ratings. These interventions were generally safe with few reported adverse events. SUMMARY: Technology has enabled interventions to be delivered outside of the clinic setting and presented an opportunity for increased access to care and early intervention. Better quality studies are needed to inform on the efficacy of these interventions.
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Transtorno do Deficit de Atenção com Hiperatividade , Terapia Comportamental , Terapia Cognitivo-Comportamental , Metodologias Computacionais , Avaliação da Tecnologia Biomédica , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Escala de Avaliação Comportamental , Terapia Comportamental/instrumentação , Terapia Comportamental/métodos , Terapia Comportamental/tendências , Criança , Terapia Cognitivo-Comportamental/instrumentação , Terapia Cognitivo-Comportamental/métodos , HumanosRESUMO
Introduction: Globally, there is an epidemic of opioid use disorders. Locally, in Singapore, there is an increase in the number of individuals abusing opioids. The advances in experimental psychology have highlighted the need to modify unconscious, automatic biases. These automatic, unconscious biases result in individuals having preferential attention to substance-related cues in their natural environment, thus leading to a slip or relapse back into their underlying addictive disorders. Prior studies have demonstrated not only the presence of robust attentional biases amongst individuals with opioid use disorder, even when maintained on methadone; and the effectiveness of bias modification amongst these individuals. There remains limited evaluation of attention bias modification amongst a treatment-seeking cohort of Asian individuals. The objective of this pilot is to ensure that the methods of the planned definitive randomized trial could be conducted. Methods and Analysis: A non-blinded pilot randomized trial will be conducted. A total of 30 participants will be randomized to receive either the conventional application or the newly designed co-designed application. In order to identify these 30 participants, 60 participants will be recruited and screened to determine if they have baseline biases. Participants will be recruited from the inpatient unit at the National Addictions Management Service (NAMS) Singapore. All participants who are enrolled into the trial will complete a baseline assessment task, and a bias modification assessment and modification task daily. They will have to complete a baseline demographic and clinical information questionnaire, as well as a cravings rating scale before and after the intervention daily. Perspectives-that of self-reported experiences-will be sought from the participants following their completion of three intervention tasks. Descriptive statistical analyses will be performed, and chi-square and ANOVA analyses will be performed. Qualitative analyses will be undertaken for the perspectives shared. Ethics and Dissemination: Ethical approval has been obtained from the National Healthcare Group's Domain Specific Research Board (DSRB) (approval number that of 2019/00934). The findings arising from this study will be disseminated by means of conferences and publications.
Assuntos
Viés de Atenção , Terapia Cognitivo-Comportamental/métodos , Transtornos Relacionados ao Uso de Opioides/terapia , Telemedicina , Humanos , Transtornos Relacionados ao Uso de Opioides/reabilitação , Projetos Piloto , SingapuraRESUMO
Advances in experimental psychology have provided evidence for the presence of attentional and approach biases in individuals with substance use disorders. Traditionally, reaction time tasks, such as the Stroop or the Visual Probe Task, are commonly used in the assessment of attention biases. The Visual Probe Task has been criticized for its poor reliability, and other research has highlighted that variations remain in the paradigms adopted. However, a gap remains in the published literature, as there have not been any prior studies that have reviewed stimulus timings for different substance use disorders. Such a review is pertinent, as the nature of the task might affect its effectiveness. The aim of this paper was in comparing the different methods used in the Visual Probe Task, by focusing on tasks that have been used for the most highly prevalent substance disorders-that of opiate use, cannabis use and stimulant use disorders. A total of eight published articles were identified for opioid use disorders, three for cannabis use disorders and four for stimulant use disorders. As evident from the synthesis, there is great variability in the paradigm adopted, with most articles including only information about the nature of the stimulus, the number of trials, the timings for the fixation cross and the timings for the stimulus set. Future research examining attentional biases among individuals with substance use disorders should take into consideration the paradigms that are commonly used and evaluate the optimal stimulus and stimulus-onset asynchrony timings.
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Viés de Atenção , Tempo de Reação , Transtornos Relacionados ao Uso de Substâncias/patologia , Humanos , Reprodutibilidade dos Testes , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Percepção VisualRESUMO
BACKGROUND: Cognitive biases refer to automatic attentional or interpretational tendencies, which result in individuals with addictive disorders to automatically attend to substance-related stimuli and those with anxiety disorders to attend to threatening stimuli. To date, several studies have examined the efficacy of cognitive bias modification, and meta-analytical studies have synthesized the evidence for overall efficacy. The clinical utility of cognitive bias modification interventions has previously been limited to the confines of a laboratory, but recent advances in Web technologies can change this. OBJECTIVE: This scoping review aimed to determine the scope of Web-based cognitive bias interventions and highlight their effectiveness. METHODS: Databases (PubMed and MEDLINE, EMBASE, PsycINFO, ScienceDirect, and Cochrane Central) were searched from inception to December 5, 2017. The following search terminologies were used: ("attention bias" OR "cognitive bias" OR "approach bias" OR "avoidance bias" OR "interpretative bias") AND ("Internet" OR "Web" OR "Online"). The methods for this scoping review are based on the previously published protocol. For the synthesis of the evidence, a narrative synthesis was undertaken, as a meta-analysis was not appropriate, given the lack of reported effect sizes and the heterogeneity in the outcomes reported. RESULTS: Of the 2674 unique articles identified, we identified 22 randomized controlled studies that met our inclusion criteria: alcohol use disorder (n=2), tobacco use disorder (n=2), depressive disorder (n=3), anxiety and depressive symptoms in adolescents (n=3), obsessive-compulsive disorder (OCD; n=2), social anxiety disorder (n=9), and anxiety disorder (n=1). The sample sizes of these studies ranged from 16 to 434 participants. There is preliminary evidence to suggest that Web-based interventions could reduce biases among adolescents with heightened symptoms of anxiety and depression and among individuals with OCD. CONCLUSIONS: This is the first scoping review that mapped out the scope of cognitive bias modification interventions for psychiatric disorders. Web-based interventions have been applied predominantly for social anxiety and addictive disorders. Larger cohorts must be used in future studies to better determine the effectiveness of Web-based cognitive bias interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/10427.
RESUMO
BACKGROUND: Conventional psychology therapies are unable to address automatic biases that result in individuals relapsing into their substance use disorder. Advances in experimental psychology have led to a better understanding of attention and approach biases and methods to modify these biases. Several studies have demonstrated the effectiveness of bias modification among clinical cohorts. The advances in mobile health technologies have allowed remote delivery of these interventions. To date, there is a lack of studies examining bias modification in a substance-using non-Western sample. OBJECTIVE: This study was designed to determine the feasibility of an attention bias modification intervention and an attention bias modification smartphone app for the reduction of attention biases among treatment-seeking individuals. The secondary aim is to determine the acceptability of the intervention. METHODS: A feasibility study was conducted among inpatients who were in their rehabilitation phase at the National Addictions Management Service. Participants were to complete a set of baseline questionnaires, and on each day that they are in the study, undertake an attention bias assessment and modification task while completing a visual analogue scale to assess their craving. Feasibility was determined by the acceptance rate of participation and participants' adherence to the interventions. Acceptability was assessed by a perception questionnaire. Descriptive statistical analyses were performed using SPSS version 22. A thematic analysis approach was used in the qualitative synthesis of users' perceptions. RESULTS: Of the 40 participants invited to participate in the feasibility study, 10 declined, yielding an acceptance rate of 75%. Of the recruited participants, 6 participants were diagnosed with alcohol dependence; 17, with opioid dependence; 2, with cannabis dependence; and 5, with stimulant dependence. In addition, of the final 30 participants, 11 (37%) failed to complete all the planned interventions and 22 (73%) completed the perspective questionnaires; of these 22 participants, 100% rated the app as extremely and very easy, 77% rated it as extremely or very interactive, 54% rated it as extremely or very motivating, and 33% reported a change in their confidence levels. CONCLUSIONS: Our results highlight the feasibility of recruiting participants to undertake attention bias modification interventions. Participants generally accept use of a mobile version of such an intervention. Nevertheless, our acceptability data indicate that there could be improvements in the existing app, and a participatory design approach might be helpful in its future conceptualization. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/11822.
Assuntos
Atenção/fisiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Idoso , Terapia Comportamental/instrumentação , Terapia Comportamental/métodos , Terapia Comportamental/normas , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Singapura , Transtornos Relacionados ao Uso de Substâncias/complicações , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Many studies have reported various levels of association between sleep disorders and attention deficit hyperactivity disorder (ADHD). This study aims to investigate sleep disturbances in children with ADHD prior to treatment and during treatment. MATERIALS AND METHODS: This study recruited 114 child and adolescent patients diagnosed with ADHD and 60 normal patients. Sleep disturbances are assessed using the parent-rated Child Behaviour Checklist (CBCL) questionnaire. In addition, chart reviews and semi-structured clinical interviews were conducted for 54 patients with ADHD who had been seen at the clinic since 2002 to examine the sleep disturbances they experienced during treatment over a 4-year period. RESULTS: Compared to the normal subjects, parents of children with ADHD reported that their children slept less. The summation score of the sleep items on the CBCL was also significantly higher in the ADHD group. Girls with ADHD also had more "trouble sleeping". When children with ADHD received treatment with medications, they experienced sleep-related side effects. Out of the 54 children with ADHD, 18.5% experienced sleep disturbance related to medication, with 13.0% reporting daytime somnolence and 5.5% reporting insomnia. CONCLUSION: Our study showed that there was an increased frequency of sleep disturbances in children with ADHD prior to treatment with medications. The children in our study appeared to sleep less. A significant proportion also experienced sleep disturbance during treatment with medication, of which daytime somnolence and insomnia were the most commonly reported problems. Future research in this area is needed to further examine the range of sleep disorders in ADHD children locally.
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Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Criança , Pré-Escolar , Comorbidade , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Singapura , Distúrbios do Início e da Manutenção do Sono/epidemiologiaRESUMO
The advances in Mobile Health (M-health) technologies has led to an increase in the numbers of alcohol and drugs applications on the commercial stores. Content analyses and reviews of applications to date have demonstrated that most of these applications are for entertainment or information purposes. More recent content analyses have identified common behavioural change techniques in substance applications. Nevertheless, there remain several limitations of existing content analyses and reviews of applications. There is an increasing prevalence of other substance-related disorders, such as that of stimulants and opioids, but the existing content analyses are limited to an analysis of alcohol and cannabis applications. Only two of the content analyses performed to date have attempted to identify applications that have their basis on a theoretical approach, based on the identification of behavioural change techniques or motivational techniques. There is a need to identify applications on the commercial stores that replicate conventional psychological interventions, or at least provide elements of conventional psychological interventions using behavioural change techniques that are integrated into the application. Further evaluative research could be done on these applications to determine if they are efficacious before using them for patient care. To address the limitation that existing content analyses have only focused on reviews of alcohol and cannabis applications, we propose for there to be updated content analyses for alcohol and cannabis, and new content analyses for other substances of abuse (such as opioids and stimulants). We like to suggest that future reviews consider keywords such as abstinence or recovery, and ones that relate to psychological therapies, such as self-determination or attention bias retraining, as commercial applications that have an underlying psychological basis might be categorised differently, under different keyword terms. We have evidence of how a better search strategy identifies previously unrecognised applications for attentional bias modification.
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Aplicativos Móveis , Transtornos Relacionados ao Uso de Substâncias , Humanos , TelemedicinaRESUMO
Research into parenting influences on child conduct problems in Asian countries has been limited compared to that conducted in Western countries, especially with regard to interplay between parenting and callous unemotional (CU) traits (e.g., lack of guilt and empathy). This study examined associations between dimensions of aggressive parenting practices (psychological aggression, mild and severe physical aggression), dimensions of child aggression (proactive, reactive), and child CU traits, in Singapore. Participants were children and adolescents with clinic-referred externalizing problems (Nâ¯=â¯282; 87.6% boys), aged 7-16 years. Mild and severe parental physical aggression was found to be uniquely associated with children's proactive aggression, whereas parental psychological aggression was uniquely associated with both proactive and reactive aggression. Consistent with previous evidence regarding CU traits as moderators of the relationship between negative parenting and child conduct problems, physically aggressive parenting was found to be more strongly associated with children's proactive aggression among children with low levels of CU traits, than those with high CU traits. These findings support the need for ongoing research into CU traits in Asian cultures, focused on heterogeneous risk pathways to antisocial behavior and individual differences in response to family-based interventions.
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Agressão/psicologia , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Conduta/etiologia , Emoções , Família/psicologia , Poder Familiar/psicologia , Adolescente , Ásia , Criança , Transtorno da Conduta/psicologia , Feminino , Humanos , Masculino , Singapura , Inquéritos e QuestionáriosRESUMO
Background: Opiates, cannabis, and amphetamines are highly abused, and use of these substances are prevalent disorders. Psychological interventions are crucial given that they help individuals maintain abstinence following a lapse or relapse into substance use. Advances in experimental psychology have suggested that automatic attention biases might be responsible for relapse. Prior reviews have provided evidence for the presence of these biases in addictive disorders and the effectiveness of bias modification. However, the prior studies are limited, as they failed to include trials involving participants with these prevalent addictive disorders or have failed to adopt a systematic approach in evidence synthesis. Objectives: The primary aim of this current systematic review is to synthesise the current evidence for attention biases amongst opioid use, cannabis use, and stimulant use disorders. The secondary aim is to determine the efficacy of attention bias modification interventions and other addictions related outcomes. Methods: A search was conducted from November 2017 to January 2018 on PubMed, MEDLINE, Embase, PsycINFO, Science Direct, Cochrane Central, and Scopus. The selection process of the articles was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A qualitative synthesis was undertaken. Risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Six randomised trials were identified. The evidence synthesized from these trials have provided strong evidence that attentional biases are present in opioid and stimulant use disorders. Evidence synthesis for other secondary outcome measures could not be performed given the heterogeneity in the measures reported and the limited number of trials. The risk of bias assessment for the included trials revealed a high risk of selection and attrition bias. Conclusions: This review demonstrates the potential need for interventions targeting attention biases in opiate and cocaine use disorders.
Assuntos
Analgésicos Opioides , Viés de Atenção , Cannabis , Transtornos Relacionados ao Uso de Cocaína , Estimulantes do Sistema Nervoso Central , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Background: Opiates, cannabis, and stimulants are highly abused and are prevalent disorders. Psychological interventions are crucial given that they help individuals maintain abstinence following a lapse or relapse into substance use. The dual-process theory has posited that while the repeated use of a substance leads to increased automatic processing and increased automatic tendencies to approach substance-specific cues, in addition to the inhibition of other normal cognitive processes. Prior reviews are limited, as they failed to include trials involving participants with these prevalent addictive disorders or have not reviewed the published literature extensively. Objectives: The primary aim of this review is to synthesize the evidence for cognitive biases in opioid use, cannabis use, and stimulant use disorders. The secondary aim of the review is to determine if cognitive bias could be consistently detected using the different methods. Lastly, this review will narratively synthesize the evidence of possible associations between cognitive biases and other addiction-related outcomes. Methods: A search was conducted from November 2017 to January 2018 on PubMed, MEDLINE, Embase, PsycINFO, Science Direct, Cochrane Central, and Scopus. Articles were included if participants had a primary diagnosis of opioid use, cannabis use, or stimulant use disorder. The selection process of the articles was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A qualitative synthesis was undertaken. Results: A total of 38 studies were identified. The main finding is the evidence that cognitive biases are present in the 38 studies identified, except for a single study on opioid use and stimulant use disorders. Cognitive biases were reported despite a variety of different methods being utilized. Synthesis of secondary outcome was not feasible, due to the varied outcomes reported. Conclusions: Cognitive biases have been consistently observed in opioid use, cannabis use, and stimulant use disorders, despite a range of assessment tools being utilized in the assessment for these biases.
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Research on attentional bias modification has increased since 2014. A recent meta-analysis demonstrates evidence for bias modification for substance disorders, including alcohol and tobacco use disorders. Several pharmacological trials have shown that pharmacological agents can attenuate and modify such attentional bias. The pharmacological trials that have appeared to date have produced mixed results, which has clinical implications. Developments in Internet and mobile technologies have transformed how attention bias modification is currently being achieved. There remains great potential for further research that examines the efficacy of technology-aided attention bias interventions.