Change in mental health symptoms during the COVID-19 pandemic: The role of appraisals and daily life experiences.

OBJECTIVE: When confronted with major threats, people often experience decline in well-being. The central purpose of this study was to identify mechanisms underlying change of well-being in times of threat, using the example of the COVID-19 pandemic, with a focus on appraisals of the pandemic and affective states, stress, as well as mindfulness in daily life. METHOD: We conducted a study across 3.5 weeks, including pretest, posttest, and a diary phase in-between. We worked with a sample of 460 adults, pre- and post-test information, as well as 7,189 observations from the diary phase. RESULTS: Results showed that deterioration in mental health symptoms across the duration of the study was associated with (a) change towards less fortunate appraisals of the pandemic and (b), more negative affect and less mindfulness in daily life. Furthermore, appraisals of the pandemic at pretest predicted experiences in daily life, with more negative appraisals of the pandemic predicting more negative affect and stressor occurrence as well as less mindfulness. CONCLUSIONS: These findings speak to the dynamic nature of well-being and appraisals in times of threat, and highlight the role of experiences in daily life in changes in well-being.

Effects of gut microbial-based treatments on gut microbiota, behavioral symptoms, and gastrointestinal symptoms in children with autism spectrum disorder: A systematic review.

Many studies have identified some abnormalities in gastrointestinal (GI) physiology (e.g., increased intestinal permeability, overall microbiota alterations, and gut infection) in children with autism spectrum disorder (ASD). Furthermore, changes in the intestinal flora may be related to GI and ASD symptom severity. Thus, we decided to systematically review the effects of gut microbial-based interventions on gut microbiota, behavioral symptoms, and GI symptoms in children with ASD. We reviewed current evidence from the Cochrane Library, EBSCO PsycARTICLES, PubMed, Web of Science, and Scope databases up to July 12, 2020. Experimental studies that used gut microbial-based treatments among children with ASD were included. Independent data extraction and quality assessment of studies were conducted according to the PRISMA statement. Finally, we identified 16 articles and found that some interventions (i.e., prebiotic, probiotic, vitamin A supplementation, antibiotics, and fecal microbiota transplantation) could alter the gut microbiota and improve behavioral symptoms and GI symptoms among ASD patients. Our findings highlight that the gut microbiota could be a novel target for ASD patients in the future. However, we only provided suggestive but not conclusive evidence regarding the efficacy of interventions on GI and behavioral symptoms among ASD patients. Additional rigorous trials are needed to evaluate the effects of gut microbial-based treatments and explore potential mechanisms.

Examination of the influence of cedar fragrance on cognitive function and behavioral and psychological symptoms of dementia in Alzheimer type dementia.

We examined whether symptoms of dementia are improved by olfactory nerve stimulation in Alzheimer type dementia patients. First, a stick-type olfactory identification ability test was performed in patients with Alzheimer type dementia, to select patients without olfactory dysfunctions. Then, these patients were randomly assigned into the intervention (n = 19) and the control groups (n = 17). To evaluate the effects of olfactory nerve stimulation, we exposed the intervention group to a disinfecting ethanol with added aroma extracts from ceder and the control group to the ethanol without the added aroma extracts. Each group underwent the intervention for 8 weeks, cognitive and behavioral functions were evaluated before and after treatments using the Neuropsychiatric Inventory (NPI), the Japanese version of Zarit Caregiver Burden interview (J-ZBI), and the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog). A significant improvement was observed in the NPI score and J-ZBI in the intervention group compared to the control group at 4 and 8 weeks. On the other hand, there was no significant difference in the score of ADAS-cog. Exposure to cedar fragrance improved behavioral and psychological symptoms of dementia (BPSD) in Alzheimer type dementia and may reduce the burden of nursing care. In addition to its effectiveness, the procedure is simple and minimally invasive and would be a valuable non-pharmaceutical treatment.

Coping, mental health, and subjective well-being among mental health staff working in secure forensic psychiatric settings: Results from a workplace health assessment.

Given raised rates of patient suicide and violence in secure psychiatric facilities, staff in such settings are arguably at increased risk for burnout and reduced mental health. The present article responds to the recent U.K. National Institute for Health and Care Excellence (NICE) call to assess workforce well-being. This article held the following aims: (1) to quantify existing levels of mental health (i.e., depression, anxiety, distress, and posttraumatic stress) and subjective well-being (i.e., job satisfaction, life satisfaction, and four domains of burnout) and (2) to evaluate Coping Self-Efficacy (CSE) and Need for Affect (NFA) as factors associated with staff mental health and subjective well-being. We conducted a voluntary cross-sectional health needs assessment of forensic mental health staff (N = 170) between 2017 and 2018 from one National Health Service (NHS) Trust. Descriptive findings suggest staff possessed nonclinical average ranges of mental health symptoms. Subjective well-being findings showed burnout was relatively low, whereas job and life satisfaction were modest. Regression models demonstrated that (a) thought/emotion stopping beliefs were negatively associated with psychological exhaustion; (b) social support beliefs were positively associated with life satisfaction and job enthusiasm; (c) NFA Avoidance was linked with poor mental health and burnout, and; (d) NFA Approach was positively associated with two health subjective well-being indicators. Overall, assessment results suggest NHS forensic mental health staff reported relatively good health. Cognitive- and emotion-focused coping beliefs demonstrate promise as content for prevention programming. Using Emotional Labor Theory, we offer psychological services-based recommendations for future prevention programming and research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Feasibility of Home-Based Neurologic Music Therapy for Behavioral and Psychological Symptoms of Dementia: A Pilot Study.

Family caregivers often feel ill-equipped to handle bothersome behavioral and psychological symptoms of dementia, such as agitation, apathy, and sleep disturbances, leading to increased caregiver distress and nursing home placement for people with dementia. Therapies for such symptoms are currently limited and non-pharmacological options are preferred, given potential side effects of medications. Neurologic music therapy (NMT) could provide an additional treatment option for managing behavioral and psychological symptoms for community-dwelling people with dementia and their caregivers. This pilot study sought to evaluate the feasibility, acceptability, and effectiveness of home-based NMT for behavioral and psychological symptoms of dementia. Eighteen persons with dementia-caregiver dyads were enrolled to receive one-hour weekly sessions of home-based NMT for 6 weeks. Demographic, quality of life, neuropsychiatric symptom, and caregiver burden and self-efficacy information was collected at baseline, 6 weeks, and 12 weeks. Seven dyads (38.9%) withdrew from therapy before completing all sessions; these participants had higher Neuropsychiatric Inventory scores and were of older age at baseline. For those who completed therapy, neuropsychiatric symptom scores improved at 6 weeks, an effect that was sustained at 12 weeks. No other outcome measures changed significantly after therapy. Initiating NMT too late in the course of dementia, when behavioral symptoms are already present, may be impractical for people with dementia and increase caregiver stress, even when provided within the home. Introducing and incorporating the principles of NMT earlier in the course of dementia could allow for increased comfort and benefit for people with dementia and their caregivers.

Symptoms, Mobility and Function, and Quality of Life in Adults With Acute Leukemia During Initial Hospitalization.

OBJECTIVES: To examine longitudinal symptoms, mobility and function, and quality of life (QOL) in adults newly diagnosed with acute leukemia. SAMPLE & SETTING: 55 adults undergoing induction chemotherapy at the University of North Carolina Lineberger Comprehensive Cancer Center and the Duke Cancer Institute. METHODS & VARIABLES: A prospective, longitudinal study with measures of mobility and function, global physical and mental health, cancer-related fatigue, anxiety, depression, sleep disturbance, pain intensity, and leukemia-specific QOL was conducted. Data were analyzed using descriptive statistics, linear mixed modeling, and one-way analysis of variance. RESULTS: 49 adults with acute leukemia completed assessments during hospitalizations. Global mental health and pain intensity did not change significantly. Global physical health significantly improved. Fatigue, anxiety, depression, and sleep disturbance decreased significantly. QOL increased significantly. IMPLICATIONS FOR NURSING: The significant decrease in anxiety and fatigue during hospitalization may be attributable to understanding of the disease process, familiarity with the staff, and ability to communicate concerns.

Assessing Non-Suicidal Self-Injury in the Laboratory.

The majority of non-suicidal self-injury (NSSI) research has used self- or clinician-rated measures of behavior which (a) are subject to reporting biases, or (b) have limited use in experimental designs that could illuminate causal relationships. Laboratory-based behavioral tasks have therefore been developed to assess NSSI-related behaviors more directly. We reviewed the behavioral methods that have been developed to assess NSSI tendencies or behaviors over the past 30 years. Several categories of laboratory analogues were identified: NSSI-related stimuli (e.g., NSSI pictures, implicit association tasks, guided imagery), experimenter administered pain stimuli (e.g., cold, heat, pressure, shock, and blade), and self-selected pain stimuli (e.g., cold and shock). These behavioral methods assess various aspects of NSSI and all have distinct advantages and shortcomings. Overall, these approaches have made significant contributions to the field complementing self- and clinician-ratings.

Supplementation with macular carotenoids reduces psychological stress, serum cortisol, and sub-optimal symptoms of physical and emotional health in young adults.

PURPOSE: Oxidative stress and systemic inflammation are the root cause of several deleterious effects of chronic psychological stress. We hypothesize that the antioxidant and anti-inflammatory capabilities of the macular carotenoids (MCs) lutein, zeaxanthin, and meso-zeaxanthin could, via daily supplementation, provide a dietary means of benefit. METHODS: A total of 59 young healthy subjects participated in a 12-month, double-blind, placebo-controlled trial to evaluate the effects of MC supplementation on blood cortisol, psychological stress ratings, behavioural measures of mood, and symptoms of sub-optimal health. Subjects were randomly assigned to one of three groups: placebo, 13 mg, or 27 mg / day total MCs. All parameters were assessed at baseline, 6 months, and 12 months. Serum MCs were determined via HPLC, serum cortisol via ELISA, and macular pigment optical density (MPOD) via customized heterochromatic flicker photometry. Behavioural data were obtained via questionnaire. RESULTS: Significant baseline correlations were found between MPOD and Beck anxiety scores (r = -0.28; P = 0.032), MPOD and Brief Symptom Inventory scores (r = 0.27; P = 0.037), and serum cortisol and psychological stress scores (r = 0.46; P < 0.001). Supplementation for 6 months improved psychological stress, serum cortisol, and measures of emotional and physical health (P < 0.05 for all), versus placebo. These outcomes were either maintained or improved further at 12 months. CONCLUSIONS: Supplementation with the MCs significantly reduces stress, cortisol, and symptoms of sub-optimal emotional and physical health. Determining the basis for these effects, whether systemic or a more central (i.e. brain) is a question that warrants further study.

Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis.

Demographic aging is a worldwide phenomenon, cognitive and behavioral impairment is becoming global burden of nerve damage. However, the effect of pharmacological treatment is not satisfying. Therefore, we analyzed the efficacy of music therapy in elderly dementia patients, and if so, whether music therapy can be used as first-line non-pharmacological treatment. A comprehensive literature search was performed on PubMed, EMbase and the Cochrane Library from inception to September 2016. A total of 34 studies (42 analyses, 1757 subjects) were included; all of them had an acceptable quality based on the PEDro and CASP scale scores. Studies based on any type of dementia patient were combined and analyzed by subgroup. The standardized mean difference was -0.42 (-0.74 to -0.11) for disruptive behavior and 0.20 (-0.09 to 0.49) for cognitive function as primary outcomes in random effect models using controls as the comparator; the secondary outcomes were depressive score, anxiety and quality of life. No evidence of publication bias was found based on Begg's and Egger's test. The meta-analysis confirmed that the baseline differences between the two groups were balanced. Subgroup analyses showed that disease sub-type, intervention method, comparator, subject location, trial design, trial period and outcome measure instrument made little difference in outcomes. The meta-regression may have identified the causes of heterogeneity as the intervention method, comparator and trial design. Music therapy was effective when patients received interactive therapy with a compared group. There was positive evidence to support the use of music therapy to treat disruptive behavior and anxiety; there were positive trends supporting the use of music therapy for the treatment of cognitive function, depression and quality of life. This study is registered with PROSPERO, number CRD42016036153.

Experiences with a low-iodine diet: A qualitative study of patients with thyroid cancer receiving radioactive iodine therapy.

PURPOSE: This study aimed to describe hormone interruption experiences related to not only physical problems, but also psychological, social, and spiritual problems, in patients who had undergone total thyroidectomy. METHODS: In-depth interviews were performed with five participants, four women and one man, aged between 28 and 58. The participants were subjected to high-dose radiation of 100-150 mCi and had experienced abrupt hormonal interruptions after undergoing total thyroidectomy. The analysis was conducted using Giorgi's descriptive phenomenological method. RESULTS: Five essential components emerged as the interviews were dissected: dietary disruption due to discomfort, distress from overall bodily congestion, feelings of isolation as normalcy is lost from their daily routine, spending daily life with unfamiliar functional declines due to the LID, a lethargic state due to the lack of a place to which patients could retreat from the stress of hormone absence. CONCLUSIONS: The participants showed insecurity and depression due to an unbalanced diet, limited activities, and an abnormal lifestyle induced by the treatment. This treatment-related information can help healthcare providers readily understand and alleviate symptoms of thyroid cancer patients treated with RAI therapy.

Psychomotor Dance Therapy Intervention (DANCIN) for people with dementia in care homes: a multiple-baseline single-case study.

BACKGROUND: A Psychomotor DANCe Therapy INtervention (DANCIN) using Latin Ballroom (Danzón) in care homes has previously been shown to enhance well-being for both residents with dementia and staff. The aim of this study was to understand the effect of this approach on the mood and behavior of individual people living with mild to moderate dementia. METHOD: A multiple-baseline single-case study across two care homes and one nursing home with 3-6 weeks baseline, 12-weeks DANCIN (30 minutes/twice-weekly sessions), and 12-weeks follow-up was conducted. Seventeen items from the Dementia Mood Assessment Scale (DMAS) outcome measure were adapted with input from senior staff to match participants' behavior and mood symptoms. Daily monitoring diaries were collected from trained staff on reporting individualized items for ten residents. Data were analyzed, using a non-parametric statistical method known as Percentage of All Non-Overlapping Data (PAND) which provides Phi effect size (ES). Medication use, falls, and life events were registered. RESULTS: Seven residents participated throughout DANCIN whilst three became observers owing to health deterioration. One participant showed adverse effects in three DMAS items. Nine participants, dancers and observers, showed a small to medium magnitude of change (PAND) in 21 DMAS items, indicating a decrease in the frequency of behavior and mood indices which were regarded as problematic; eight items showed no change. CONCLUSION: Despite methodological challenges, the DANCIN model has the potential to facilitate and sustain behavior change and improve mood (e.g. decrease irritability, increase self-esteem) of the residents living with dementia. The study was conducted in two care homes and one nursing home, strengthening the interventions' validity. Findings suggest DANCIN is appropriate for a larger controlled feasibility study.

An Introduction to Using the Method of Levels (MOL) Therapy to Work with People Experiencing Psychosis.

This paper provides a basic introduction to using method of levels (MOL) therapy with people experiencing psychosis. As MOL is a direct application of perceptual control theory (PCT), a brief overview of the three main theoretical principles of this theory--control, conflict, and reorganization will be outlined in relation to understanding psychosis. In particular, how these principles form the basis of problem conceptualisation and determine what an MOL therapist is required to do during therapy will be illustrated. A practical description of MOL will be given, using case examples and short excerpts of therapeutic interactions. Some direct contrasts will also be made with cognitive behaviour therapy for psychosis (CBTp) and psychodynamic approaches (PA) in order to help illustrate the theory and practice of MOL.

Explanations and expectations: drug narratives among young cannabis users in treatment.

This article analyses how young people enrolled in drug addiction treatment in Copenhagen, Denmark, explain their cannabis careers and how they view their possibilities for quitting drug use again. Inspired by Mead and narrative studies of health and illness, the article identifies four different drug use 'aetiologies' drawn upon by the interviewees. These cover childhood experiences, self-medication, the influence of friends and cannabis use as a specific lifestyle. A central argument of the article is that these explanations not only concern the past but also point towards the future by assigning the interviewee a more or less agential position in relation to drugs. Further, the drug narratives are viewed as interactional achievements, related to the social context in which they were produced, namely, the institutional setting of the treatment centres. The article is based on 30 qualitative interviews with young people in drug addiction treatment.

Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials.

BACKGROUND: Agitation in dementia is common, persistent and distressing and can lead to care breakdown. Medication is often ineffective and harmful. AIMS: To systematically review randomised controlled trial evidence regarding non-pharmacological interventions. Method We reviewed 33 studies fitting predetermined criteria, assessed their validity and calculated standardised effect sizes (SES). RESULTS: Person-centred care, communication skills training and adapted dementia care mapping decreased symptomatic and severe agitation in care homes immediately (SES range 0.3-1.8) and for up to 6 months afterwards (SES range 0.2-2.2). Activities and music therapy by protocol (SES range 0.5-0.6) decreased overall agitation and sensory intervention decreased clinically significant agitation immediately. Aromatherapy and light therapy did not demonstrate efficacy. CONCLUSIONS: There are evidence-based strategies for care homes. Future interventions should focus on consistent and long-term implementation through staff training. Further research is needed for people living in their own homes.

Behavioural and psychological symptoms of dementia in an Alzheimer's disease case successfully treated with natural medicine: association with gonadotropins.

Pharmacotherapies for the behavioural and psychological symptoms of dementia are limited; novel agents for the symptoms are still needed. Herein, we report the case of an 80-year-old male patient with Alzheimer's disease whose severe agitation, insomnia and sexual delusions were successfully treated with a traditional natural Japanese (Kampo) medicine, keishi-ka-ryukotsu-borei-to. We found that administrating keishi-ka-ryukotsu-borei-to increased his serum luteinizing hormone level, which could be inversely associated with his behavioural and psychological symptoms. This report suggests that keishi-ka-ryukotsu-borei-to is a possible alternative treatment for the behavioural and psychological symptoms of dementia, especially sexual delusions.

Repeated administration of AC-5216, a ligand for the 18 kDa translocator protein, improves behavioral deficits in a mouse model of post-traumatic stress disorder.

Post-traumatic stress disorder (PTSD) is a severely disabling anxiety disorder that may occur following exposure to a serious traumatic event. It is a psychiatric condition that can afflict anyone who has experienced a life-threatening or violent event. Previous studies have shown that changes in 18 kDa translocator protein (TSPO) expression (or function), a promising target for treating neurological disorders without benzodiazepine-like side effects, may correlate with PTSD. However, few studies have investigated the anti-PTSD effects of TSPO ligands. AC-5216, a ligand for TSPO, induces anxiolytic- and anti-depressant-like effects in animal models. The present study aimed to determine whether AC-5216 ameliorates PTSD behavior in mice. Following the training session consisting of exposure to inescapable electric foot shocks, animals were administered AC-5216 daily during the behavioral assessments, i.e., situational reminders (SRs), the open field (OF) test, the elevated plus-maze (EPM) test, and the staircase test (ST). The results indicated that exposure to foot shocks induced long-term behavioral deficiencies in the mice, including freezing and anxiety-like behavior, which were significantly ameliorated by repeated treatment with AC-5216 but without any effect on spontaneous locomotor activity or body weight. In summary, this study demonstrated the anti-PTSD effects of AC-5216 treatment, suggesting that TSPO may represent a therapeutic target for anti-PTSD drug discovery and that TSPO ligands may be a promising new class of drugs for the future treatment of PTSD.

Comparing the effects of different individualized music interventions for elderly individuals with severe dementia.

BACKGROUND: Individuals with dementia often experience poor quality of life (QOL) due to behavioral and psychological symptoms of dementia (BPSD). Music therapy can reduce BPSD, but most studies have focused on patients with mild to moderate dementia. We hypothesized that music intervention would have beneficial effects compared with a no-music control condition, and that interactive music intervention would have stronger effects than passive music intervention. METHODS: Thirty-nine individuals with severe Alzheimer's disease were randomly and blindly assigned to two music intervention groups (passive or interactive) and a no-music Control group. Music intervention involved individualized music. Short-term effects were evaluated via emotional response and stress levels measured with the autonomic nerve index and the Faces Scale. Long-term effects were evaluated by BPSD changes using the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) Rating Scale. RESULTS: Passive and interactive music interventions caused short-term parasympathetic dominance. Interactive intervention caused the greatest improvement in emotional state. Greater long-term reduction in BPSD was observed following interactive intervention, compared with passive music intervention and a no-music control condition. CONCLUSION: Music intervention can reduce stress in individuals with severe dementia, with interactive interventions exhibiting the strongest beneficial effects. Since interactive music intervention can restore residual cognitive and emotional function, this approach may be useful for aiding severe dementia patients' relationships with others and improving QOL. The registration number of the trial and the name of the trial registry are UMIN000008801 and "Examination of Effective Nursing Intervention for Music Therapy for Severe Dementia Elderly Person" respectively.

Jacques Lacan's theory of the subject as real, symbolic and imaginary: how can Lacanian theory be of help to mental health nursing practice?

This paper presents an outline of Lacan's theory of the human subject, in particular focusing on Lacan's concepts of the real, symbolic and imaginary registers, and how an understanding of these can inform change and practice in mental health nursing. Mental health nursing is under pressure to define itself as a practice distinct from other professions in the field, and to respond in new ways to promoting mental health to the individual and a wider public. Lacan's theory of the subject is of particular relevance to mental health nurses working with mental distress but has received little attention in mental health nursing literature. Six implications for practice are outlined in terms of: against normalization, the importance of the function of the symptom, what cannot be known, meaning as ever-changing, against empathy and against holistic ideas of the self.

Motivación psicológica en los juegos de rol online: un estudio de jugadores españoles del World of Warcraft / Psychological motivation in online role-playing games: A study of Spanish World of Warcraft players

La popularidad de los videojuegos ha aumentado considerablemente en los últimos años, convirtiéndose en uno de los mayores productos de ocio siendo los Juegos de Rol Online (MMORPGs) uno de los mayores exponentes; sin embargo, también ha aumentado la sospecha y alarma social de que puedan poseer cierto potencial adictivo enmarcado en el contexto de las adicciones conductuales o que los usuarios puedan desarrollar conductas desadaptativas entorno a esta tecnología. El objetivo del presente estudio evalúa las motivaciones psicológicas para jugar al al World of Warcraft (WoW) y las relaciona con variables sociodemográficas y estilos de juego. Se aplicó un cuestionario para evaluar diferentes motivaciones online a un colectivo de jugadores de WoW. A partir de una muestra final de 253 jugadores españoles (hombres jóvenes) el análisis factorial mostró la presencia de cuatro motivos de juego: socialización, exploración, logro y disociación. Además, los jugadores españoles, preferían el entorno Jugador contar Jugador, un aspecto que parece prevenir las potenciales consecuencias negativas al impedir el juego solitario. Los resultados indican que una de las motivaciones más importantes es la socialización y el estilo de Jugador contra Jugador, lo cual indica en gran parte el uso de este juego se hace de forma psicológicamente adaptativo (AU)

The popularity of playing videogames has increased considerably during the last few decades, and has become one of the most popular leisure activities worldwide. Some of the most popular game types are the Massively Multiplayer Online Role-Playing Games (MMORPGs). However, there has also been increased suspicion and social alarm that these games may possess an addictive potential, similar to other behavioural addictions, and that the user may develop maladaptive behaviours with respect to these games. The purpose of the present study was to assess the psychological motivations of playing World of Warcraft (WoW) and to relate them to sociodemographic variables and gaming styles. A questionnaire for assessing these motivations was developed and applied online to a collective of games. The final sample comprised 253 Spanish WoW players (all young males). Factor analysis of the questionnaire scores showed the presence of four motivations for gaming: socialisation, exploration, achievement, and dissociation. Results indicated that socialisation was one of the main motivational factors and that the gamers preferred the Player-versus-Player environment. Both of these aspects appear to be factors that may prevent potentially negative outcomes by inhibiting solitary play (AU)