Participation in creative workshops supports mental health consumers to share their stories of recovery: A one-year qualitative follow-up study.

Participation in creative activities has been linked with positive outcomes for people with mental illness. This longitudinal qualitative study is a one-year follow-up of eight mental health consumers who participated in a series of creative workshops in Brisbane, Australia that aimed to increase participants' capacity and skills in sharing their stories of recovery with others. It also sought to understand successful factors of the creative workshops to inform future workshops. Semi-structured interviews gathered information regarding participants' memories of the workshops and how they had shared their stories with others over the preceding 12 months. Interpretative phenomenological analysis identified that participants' enjoyed being engaged in a range of creative mediums in a group setting; that peer mentor support was highly valued; and that participants' recovery stories had become more positive and were shared more often and openly with others. Overall, participation in the creative workshops had long-lasting benefits for participants with respect to improved confidence and understanding about their illness. Future creative workshops should consider the inclusion of peer mentors with lived experience as a support for participants to reauthor their recovery story.

Quality of Care Perceived by Older Patients and Caregivers in Integrated Care Pathways With Interviewing Assistance From a Social Robot: Noninferiority Randomized Controlled Trial.

BACKGROUND: Society is facing a global shortage of 17 million health care workers, along with increasing health care demands from a growing number of older adults. Social robots are being considered as solutions to part of this problem. OBJECTIVE: Our objective is to evaluate the quality of care perceived by patients and caregivers for an integrated care pathway in an outpatient clinic using a social robot for patient-reported outcome measure (PROM) interviews versus the currently used professional interviews. METHODS: A multicenter, two-parallel-group, nonblinded, randomized controlled trial was used to test for noninferiority of the quality of care delivered through robot-assisted care. The randomization was performed using a computer-generated table. The setting consisted of two outpatient clinics, and the study took place from July to December 2019. Of 419 patients who visited the participating outpatient clinics, 110 older patients met the criteria for recruitment. Inclusion criteria were the ability to speak and read Dutch and being assisted by a participating health care professional. Exclusion criteria were serious hearing or vision problems, serious cognitive problems, and paranoia or similar psychiatric problems. The intervention consisted of a social robot conducting a 36-item PROM. As the main outcome measure, the customized Consumer Quality Index (CQI) was used, as reported by patients and caregivers for the outpatient pathway of care. RESULTS: In total, 75 intermediately frail older patients were included in the study, randomly assigned to the intervention and control groups, and processed: 36 female (48%) and 39 male (52%); mean age 77.4 years (SD 7.3), range 60-91 years. There was no significant difference in the total patient CQI scores between the patients included in the robot-assisted care pathway (mean 9.27, SD 0.65, n=37) and those in the control group (mean 9.00, SD 0.70, n=38): P=.08, 95% CI -0.04 to 0.58. There was no significant difference in the total CQI scores between caregivers in the intervention group (mean 9.21, SD 0.76, n=30) and those in the control group (mean 9.09, SD 0.60, n=35): P=.47, 95% CI -0.21 to 0.46. No harm or unintended effects occurred. CONCLUSIONS: Geriatric patients and their informal caregivers valued robot-assisted and nonrobot-assisted care pathways equally. TRIAL REGISTRATION: ClinicalTrials.gov NCT03857789; https://clinicaltrials.gov/ct2/show/NCT03857789.

Undergraduate pharmacy students' experiences of a mindfulness-based intervention.

INTRODUCTION: Stress negatively impacts upon physical and mental health, and pharmacy students demonstrate higher levels of stress than the general population. Mindfulness may be a suitable way to improve pharmacy students' stress and distress levels in order to cope with academic pressures and professional responsibilities. The objective of this study was to obtain students' views and insights into the content and design of a mindfulness-based intervention. METHODS: Undergraduate pharmacy students in University College Cork who had completed at least 75% of a four-week mindfulness course offered during the 2016 to 2017 academic year were invited to participate in follow-up interviews. Local ethical approval was obtained. Recruitment occurred via email. Audio-recorded interviews were conducted, transcribed, and de-identified by the mindfulness tutor and primary researcher. Transcripts were analysed using thematic analysis. RESULTS: A total of 21 participants (62% female) representing all year groups were interviewed in March 2017. Thematic analysis generated the following four key themes regarding the mindfulness course: 1) common humanity - an essential foundation, 2) personal development and self-awareness, 3) implementation - striking a balance, and 4) challenges of social influences. CONCLUSIONS: The results of this study will be instrumental in deciding how to best bring this research forward. Mindfulness may have an important future role to play in pharmacy and healthcare education.

Intensive and standard group-based treatment for persons with social communication difficulties after an acquired brain injury: study protocol for a randomised controlled trial.

INTRODUCTION: Social communication difficulties (SCDs) occur frequently after an acquired brain injury (ABI) and have disabling consequences, but effective interventions are scant. Group Interactive Structured Treatment (GIST) is a holistic group treatment targeting SCD that has received empirical support. OBJECTIVE: To determine the efficacy of two GIST protocols, standard GIST and a newly developed intensive GIST, comparing standard GIST results to a wait-list control group (WL), as well as to intensive GIST received by participants following WL. The within subject results for WL and intensive GIST will also be examined. METHODS AND ANALYSIS: Sixty adults (18-75 years) with SCD after ABI will be recruited for this randomised controlled trial. Standard GIST (n=30) will be delivered via outpatient sessions for 2.5 hours once per week for 12 weeks, plus one initial orientation session. Participants will be assessed at preintervention and postintervention and at 3-month and 6-month follow-ups (T1-T4). Intensive GIST (n=30) participants will be admitted to an inpatient rehabilitation unit for 4 weeks (two times 3 days/week, two times 4 days/week) and receive full-day sessions each week. Those participants will complete four assessments (T1-T4) in 12-week intervals as part of WL, assessments preintensive and postintensive GIST and at 3-month and 6-month follow-ups (T4-T7). The primary outcome measure is the La Trobe Questionnaire (self-report). Secondary outcome measures include the Profile of Pragmatic Impairment in Communication, a test of emotion recognition, the Goal Attainment Scale and questionnaires addressing social, emotional and cognitive functions, self-efficacy and quality of life. ETHICS AND DISSEMINATION: Results will be communicated through international, peer-reviewed and popular science journals and presentations at scientific conferences. The study is approved by the Regional Committees for Medical and Health Research Ethics Norway (2017/1360). The trial will be conducted in accordance with the Declaration of Helsinki and reported in accordance with the Consolidated Standards of Reporting Trials 2010 statement and Standard Protocol Items: Recommendations for Interventional Trials recommendations. TRIAL REGISTRATION NUMBER: NCT03636399.

Explaining experiences of community-dwelling older adults with a pro-active comprehensive geriatric assessment program - a thorough evaluation by interviews.

INTRODUCTION: Pro-active assessment programs are increasingly used to improve care for older adults. These programs include comprehensive geriatric tailored to individual patient preferences. Evidence for the effects of these programs on patient outcomes is nevertheless scarce or ambiguous. Explaining these dissatisfying results is difficult due to the multi-component nature of the programs. The objective of the current study was to explore and explain the experience of older adults participating in a pro-active assessment program, to help to clarify the effects. METHODS: Semi-structured in-depth interviews were held with 25 participants of a pro-active assessment program for frail community-dwelling adults aged 65+. This study was part of an evaluation study on the effects of the program. Transcripts were analysed with thematic analysis and cross-case analysis. RESULTS: The participants' mean age was 78.5 (SD 6.9) and 56% was female. The majority of the participants were satisfied with the program but based this on communication aspects, since only a few of them expressed real program benefits. Participant experiences could be clustered in six themes: (1) All participants expressed the need for a holistic view which was covered in the program, (2) the scope of the CGA was broader than expected or unclear, (3) the program delivered unexpected but valued help, (4) participants described a very low sense of ownership, (5) timing of the program implementation or the CGA was difficult and(6), participants and care workers had a different view on what to consider as a problem. These experiences could be explained by three program components: the degree of (the lack of) integration of the program within usual care, the pro-active screening method and the broader than expected, but appreciated multi-domain approach. CONCLUSION: Older adults' need for a holistic view is covered by this outpatient assessment program. However, their engagement and the correct timing of the program are hampered by the pro-active recruitment and the limited integration of the program within existing care. Furthermore, satisfaction seems an insufficient guiding factor when evaluating CGA programs for older adults because it does not reflect the impact of the program.

Hypnosis is More Effective than Clinical Interviews.

To determine whether hypnosis is more effective than conventional interviewing to find traumatic life events in patients with fibromyalgia, we carried out a within-subject experimental design with complete intragroup counterbalancing. Thirty-two women under care in a public primary care center gave 2 identical interviews, with an interval of 3 months, in which the occurrence of traumatic life events was explored, once in a state of wakefulness and once in a state of hypnosis. The state of consciousness was evaluated using 3 measures: bispectral index, skin conductance level, and pain intensity. In the hypnotic state, the patients expressed 9.8 times more traumatic life events than in the waking state, a statistically significant difference with a large effect size.

Using narrative inquiry to listen to the voices of adolescent mothers in relation to their use of social networking sites (SNS).

AIM: This article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers. BACKGROUND: Narrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences with SNS as a means of providing social support. DESIGN: Discussion paper. DATA SOURCES: This paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, "social networking sites", online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995-June 2017. IMPLICATIONS FOR PRACTICE/RESEARCH: Narrative research inherently values the individual "story" of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents. CONCLUSION: Narrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process.

Spirituality, Religion, and Suicidality Among Veterans: A Qualitative Study.

This qualitative study explores the relationship between veterans' spirituality/religion and suicide ideation and attempts. Qualitative semi-structured interviews were conducted with 30 veterans who either endorsed chronic suicidal ideation or had made suicide attempt(s). Interviews explored the bi-directional relationship between spirituality/religion (e.g., beliefs, practices, and experiences), and suicide ideation and behaviors. Interviews were analyzed using thematic analysis. Veterans' responses indicate that spirituality/religion can discourage or permit suicidal ideation, help in coping with ideation, and facilitate meaning making and coping in the presence of self-perceived suffering. Veterans who survived a suicide attempt explored the impact of their spirituality/religion on their recovery. Findings highlight a complex and diverse relationship between spirituality/religion and suicidality. These findings may inform further research on treatment strategies that assess the function of spirituality/religion, and incorporate protective aspects of spirituality/religion into mental health treatment.

Schema Therapy for Personality Disorders: a Qualitative Study of Patients' and Therapists' Perspectives.

BACKGROUND: Several studies have evaluated the (cost) effectiveness of schema therapy for personality disorders, but little research has been done on the perspectives of patients and therapists. AIM: The present study aims to explore patients' and therapists' perspectives on schema therapy. METHOD: Qualitative data were collected through in-depth semi-structured interviews with 15 patients and a focus group of 8 therapists. A thematic analysis was performed. RESULTS: Most patients and therapists agreed that helpful aspects in schema therapy were the highly committed therapeutic relationship, the transparent and clear theoretical model, and the specific schema therapy techniques. About unhelpful aspects, several patients and some therapists shared the opinion that 50 sessions was not enough. Furthermore, patients lacked clear advance information about the possibility that they might temporarily experience stronger emotions during therapy and the possibility of having telephone contact outside session hours. They missed practical goals in the later stage of therapy. With regard to imagery, patients experienced time pressure and they missed a proper link between the past and the present. For therapists, it was hard to manage the therapeutic relation, to get used to a new kind of therapy and to keep the treatment focused on personality problems. CONCLUSIONS: Patients and therapists found some aspects of the schema therapy protocol helpful. Their views about which aspects are unhelpful and their recommendations need to be taken into consideration when adjusting the protocol and implementing schema therapy.

Journalists’occupational stress: a comparative study between reporting critical events and domestic news

Nowadays, journalism is considered a stressful occupation, not only due to the stress perceived in journalists’ daily work but also due to the critical, potentially traumatic events they report. However, research on journalists’ occupational stress in both these professional settings is still scarce. This study aims to characterize and compare occupational stress variables perceived by journalists in their daily work and in critical scenarios. Taking the Holistic Model of Occupational Stress by Nelson and Simmons (2003) as a framework, 25 Portuguese journalists, all with experience in reporting critical events, were interviewed on their perceptions of some core variables of the model: occupational stressors, distress and eustress emotional reactions, and the consequences of these experiences on their well-being. Differences among these core variables, according to the number of deployments to a critical event, were statistically analysed in order to ascertain whether repeated exposure to trauma influenced journalists’ occupational stress perceptions. The data content analysis showed that occupational stressors and emotional reactions differed across settings, while the consequences associated with journalists’ experiences were perceived as being mainly negative in both occupational contexts. Significant differences were identified in some of these variables according to the number of deployments to a critical event (p < .05). These findings may contribute to a reflection on the role of media organizations in preparing and supporting journalists in their work performance, and on the promotion of occupational health within the scope of journalists’ daily work and critical events. The article closes with considerations for future studies (AU)

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An investigation of mental imagery in bipolar disorder: Exploring "the mind's eye".

OBJECTIVES: Mental imagery abnormalities occur across psychopathologies and are hypothesized to drive emotional difficulties in bipolar disorder (BD). A comprehensive assessment of mental imagery in BD is lacking. We aimed to test whether (i) mental imagery abnormalities (abnormalities in cognitive stages and subjective domains) occur in BD relative to non-clinical controls; and (ii) to determine the specificity of any abnormalities in BD relative to depression and anxiety disorders. METHODS: Participants included 54 subjects in the BD group (depressed/euthymic; n=27 in each subgroup), subjects with unipolar depression (n=26), subjects with anxiety disorders (n=25), and non-clinical controls (n=27) matched for age, gender, ethnicity, education, and premorbid IQ. Experimental tasks assessed cognitive (non-emotional) measures of mental imagery (cognitive stages). Questionnaires, experimental tasks, and a phenomenological interview assessed subjective domains including spontaneous imagery use, interpretation bias, and emotional mental imagery. RESULTS: (i) Compared to non-clinical controls, the BD combined group reported a greater impact of intrusive prospective imagery in daily life, more vivid and "real" negative images (prospective imagery task), and higher self-involvement (picture-word task). The BD combined group showed no clear abnormalities in cognitive stages of mental imagery. (ii) When depressed individuals with BD were compared to the depressed or anxious clinical control groups, no significant differences remained-across all groups, imagery differences were associated with affective lability and anxiety. CONCLUSIONS: Compared to non-clinical controls, BD is characterized by abnormalities in aspects of emotional mental imagery within the context of otherwise normal cognitive aspects. When matched for depression and anxiety, these abnormalities are not specific to BD-rather, imagery may reflect a transdiagnostic marker of emotional psychopathology.

Validez predictiva e impacto adverso de la entrevista conductual estructurada en el sector público / Predictive validity and adverse impact of the structured behavioral interview in the public sector

En este trabajo se estudia el papel de la entrevista conductual estructurada (ECE) en los procedimientos de selección del sector público, cuya legislación insta a comprobar si los procedimientos selectivos están vinculados con el desempeño y si se cumple el principio de igualdad de oportunidades entre sexos. Para ello se ha analizado en una muestra de 379 candidatos si existían diferencias de género en la puntuación de la entrevista. Por otro lado, se midió el desempeño de las 125 personas contratadas, lo que permitió estudiar la validez predictiva de la ECE. Los resultados son similares a los obtenidos por investigaciones precedentes -la ECE predice de manera significativa el desempeño y no produce impacto de género. Finalmente se discuten las implicaciones de estos resultados (AU)

This paper studies the role of the structured behavioral interview (SBI) in the selection procedures of the public sector. The Spanish legislation calls on to examine whether selection procedures are linked to performance and whether the principle of equal opportunities regarding gender is respected. Hence, it was analyzed if there were gender differences in the interview scores in a sample of 379 candidates. Furthermore, performance of 125 hired subjects was assessed, allowing us to measure the predictive validity of the SBI. Results are similar to those obtained by previous research -SBIs are a significant predictor of performance and they do not produce adverse gender impact. Finally, implications of these results are discussed (AU)

La eficacia del tratamiento individual de los acúfenos subjetivos con terapia cognitiva-conductual / The efficacy of individual treatment of subjective tinnitus with cognitive behavioural therapy

Introducción: Los acúfenos subjetivos, a pesar del tiempo transcurrido desde que fueron descritos por primera vez, continúan sin tener un tratamiento con eficacia demostrada. El objetivo de este artículo es valorar la eficacia de la terapia cognitiva-conductual en el tratamiento de estos enfermos. Pacientes y métodos: Durante un periodo de tiempo de los años 2012-2013 se estudia a 310 enfermos que presentaban acúfenos subjetivos. De ellos, 267 fueron incluidos en un tratamiento basado en terapia cognitiva-conductual. El periodo de seguimiento fue de 18 meses y en 11 enfermos de 21 meses. Resultados: Considerando los enfermos que interrumpieron el tratamiento como fracasos, el porcentaje de curación fue de 95,7%. Conclusión: La terapia cognitiva-conductual debe estar siempre incluida en el tratamiento de los enfermos de acúfenos (AU)

Introduction: It has been a long time since subjective tinnitus cases were described for the first time but they still lack a treatment with proven effectiveness. The main goal of this study was to evaluate the effectiveness of cognitive behavioural therapy in these patients. Patients and method: Between 2012 and 2013, 310 patients that suffered from subjective tinnitus were studied. Of these, 267 were included in treatment based on cognitive behavioural therapy. The monitoring period lasted 18 months for most cases, while it lasted 21 months for 11 patients. Results: Considering patients that interrupted their treatment as failures, the percentage of recovery was 95.7%. Conclusion: Cognitive behavioural therapy should always be included in the treatment of people suffering from tinnitus (AU)

Insights into Chronic Functional Movement Disorders: The Value of Qualitative Psychiatric Interviews.

BACKGROUND: Patients with functional movement disorders (FMDs) are commonly seen by neurologists and psychosomatic medicine psychiatrists. Research literature provides scant information about the subjective experiences of individuals with this often chronic problem. OBJECTIVE: To enhance our understanding of psychologic aspects of FMDs by conducting qualitative interviews of research subjects. METHODS: In total, 36 patients with FMDs were recruited from the Human Motor Control clinic at the National Institutes of Health. Each subject participated in a qualitative psychiatric interview and a structured diagnostic psychiatric interview. RESULTS: Of our 36 subjects, 28 had current or lifetime psychiatric disorders in addition to conversion disorder and 22 had current disorders. Qualitative interviews provided rich information on patients' understanding of their illnesses and impaired cognitive processing of emotions. CONCLUSION: Our study supports the addition of open-ended qualitative interviews to delineate emotional dynamics and conceptual frameworks among such patients. Exploratory interviews generate enhanced understanding of such complex patients, above and beyond that gained by assessing DSM diagnostic comorbidities.

Characteristics of Spirituality and Religion Among Suicide Attempters.

Spirituality and religiousness are associated with a lower risk of suicide. A detailed assessment of spirituality among 88 suicide attempters hospitalized after a suicide attempt was performed. Factors associated with the recurrence of suicide attempts over 18 months were looked into. Spirituality was low among most suicide attempters in comparison with the general population. Two groups were identified: those with a high score of depression who featured "low" in spirituality and those with a more heterogeneous profile, for example, involving personality disorders, characterized by a "high" spirituality. At the follow-up, the "meaning in life" score appeared to correlate with recurrence of suicide. Clinical implications are discussed herein.

Evaluación de un caso de trastorno obsesivo compulsivo e intervención / Assessment of and intervention in a child with an obsessive-compulsive disorder

Se describe el caso de un niño de 11 años que presenta un trastorno obsesivo compulsivo (TOC). Desde bebé era un niño miedoso con características temperamentales de inflexibilidad y persistencia. Los síntomas del cuadro surgen a partir de un episodio familiar negativo y se intensificaron en los últimos dos años. En el momento de la evaluación, el TOC interfería negativamente en la dinámica familiar, personal y social del niño. Se realizó un diagnóstico de sus dificultades por medio de entrevista clínica, instrumentos de observación y pruebas estandarizadas. Se llevó a cabo una intervención basada en el entrenamiento cognitivo-conductual, en el que se incluyó tanto a los padres como a los profesores de su colegio. Se relata la evolución del problema y el seguimiento del caso

The case of an eleven-year old child with an obsessive compulsive disorder is described. He was coward since he was a baby, with temperamental characteristics of inflexibility and persistence. The symptoms appeared from a negative family event and increased over the last two years. At the moment of evaluation the disorder interfered negatively in the child's family, personal, and social dynamics. A diagnosis of his difficulties was made by means of a clinical interview, observation, and standard tests. An intervention consisting of cognitive behavioral training was carried out, with the participation of parents and teachers. The case's evolution and follow up are described

The effects of low-intensity narrow-band blue-light treatment compared to bright white-light treatment in sub-syndromal seasonal affective disorder.

BACKGROUND: The discovery of a novel photoreceptor in the retinal ganglion cells with a highest sensitivity of 470-490 nm blue light has led to research on the effects of short-wavelength light in humans. Several studies have explored the efficacy of monochromatic blue or blue-enriched light in the treatment of SAD. In this study, a comparison has been made between the effects of broad-wavelength light without ultraviolet (UV) wavelengths compared to narrow-band blue light in the treatment of sub-syndromal seasonal affective disorder (Sub-SAD). METHOD: In a 15-day design, 48 participants suffering from Sub-SAD completed 20-minute sessions of light treatment on five consecutive days. 22 participants were given bright white-light treatment (BLT, broad-wavelength light without UV 10 000 lux, irradiance 31.7 Watt/m(2)) and 26 participants received narrow-band blue light (BLUE, 100 lux, irradiance 1.0 Watt/m(2)). All participants completed daily and weekly questionnaires concerning mood, activation, sleep quality, sleepiness and energy. Also, mood and energy levels were assessed by means of the SIGH-SAD, the primary outcome measure. RESULTS: On day 15, SIGH-SAD ratings were significantly lower than on day 1 (BLT 54.8 %, effect size 1.7 and BLUE 50.7 %, effect size 1.9). No statistically significant differences were found on the main outcome measures. CONCLUSION: Light treatment is an effective treatment for Sub-SAD. The use of narrow-band blue-light treatment is equally effective as bright white-light treatment. TRIAL REGISTRATION: This study was registered in the Dutch Trial Register (Nederlands Trial Register TC = 4342 ) (20-12-2013).

Community-based intervention for depression management at the primary care level in Ha Nam Province, Vietnam: a cluster-randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of an intervention including psychoeducation and yoga for depression management at the primary healthcare level in one district in the Hà Nam province, Vietnam. METHOD: The Patient Health Questionnaire-9 (PHQ-9) was used for depression screening and follow-up. Screened patients were further diagnosed with the Mini-International Neuropsychiatric Diagnostic Interview, by a trained general doctor. A linear regression model, adjusted for age, gender and baseline PHQ-9 score was used to assess whether the intervention leads to decreased depression severity compared to standard care in the control communes. RESULTS: Both groups had similar PHQ-9 scores at baseline. The intervention group had on average significantly lower PHQ-9 scores after the intervention than the control group. Almost half of the patients in the intervention group recovered from depression, whereas nobody did in the control group. CONCLUSION: The results indicate that the intervention can be more effective than standard care in treating depression. The mean change of the PHQ-9 score after the intervention is deemed to be of clinical relevance.

Exploring the Role of Mental Imagery in the Experience of Self-injury: An Interpretative Phenomenological Analysis.

BACKGROUND: Research has implicated causal, mediating and meaningful roles for mental imagery in the experience of psychological distress, including self-injury. AIMS: The present study aimed to further the understanding of this relationship through exploring the lived experiences of mental imagery from the perspective of those who self-injure. METHOD: This study employed an inductive qualitative design using semi-structured interviews and Interpretative Phenomenological Analysis (IPA). Ten participants were recruited from universities in North West England. RESULTS: Three main themes were identified from the analysis: (i) The origins and precipitants of self-injurious imagery; (ii) What it is like to experience self-injurious imagery; and (iii) The meaning and interpretation of self-injurious imagery. CONCLUSIONS: The study findings indicate that mental imagery is an important experience for those who self-injure. Clinical and research implications of the findings are discussed.

Forensic Interviews for Child Sexual Abuse Allegations: An Investigation into the Effects of Animal-Assisted Intervention on Stress Biomarkers.

The use of therapy animals during forensic interviews for child sexual abuse allegations is a recommendation by the Therapy Animals Supporting Kids Program to help ease children's discomfort during the forensic interview process. Based on this recommendation, this study incorporated a certified therapy canine into the forensic interview process for child sexual abuse allegations. This study investigated changes in salivary cortisol, immunoglobulin A, blood pressure, and heart rate as a result of forensic interview phenomenon (e.g., outcry) incorporating animal-assisted intervention versus a control condition in children (N = 42) interviewed for alleged child sexual abuse. The results supported significantly greater heart rate values for the control group (n = 23) who experienced sexual contact and/or indecency than the experience of aggravated sexual assault compared to no difference in HR for the intervention group (n = 19). The results suggest that the presence of the canine in the forensic interview may have acted as a buffer or safeguard for the children when disclosing details of sexual abuse. In the intervention group, children's HR was lower at the start of the forensic interview compared to the control group. Finding an effect of having a certified handler-canine team available during the forensic interview on physiological measures of stress has real-world value for children, child welfare personnel, and clinical therapists. It is suggested that animal-assisted intervention be expanded to children facing other types of trauma and to treatment programs for child survivors of sexual abuse.