Approaches to improving mental healthcare for autistic people: systematic review.

BACKGROUND: Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental healthcare. Therefore, there is a need to identify and examine strategies to improve mental healthcare for autistic people. AIMS: To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults, and to examine evidence on their acceptability, feasibility and effectiveness. METHOD: A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach. RESULTS: A total of 30 articles were identified. These included 16 studies of adapted mental health interventions, eight studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences and modifying the structure and content of interventions. CONCLUSION: Many identified strategies are feasible and acceptable, and can be readily implemented in services with the potential to make mental healthcare more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.

Substance Use Among African American College Students: Testing the Theory of African American Offending.

BACKGROUND:  General criminological theories contend that African Americans' substance use is due to overexposure to criminological risk factors. However, some scholars suggest that racial injustices (i.e., racial discrimination and criminal justice injustices) and racial socialization practices, which includes religiosity (church involvement), impact African American substance use. OBJECTIVE:  Drawing on Unnever and Gabbidon's theory of African American offending, which considers racial injustices and racial socialization when explaining African American offending, the current research examined African American college students' substance use behavior. METHODS:  African American college students (n = 131) completed an online and anonymous survey measuring substance use, criminal justice injustices, racial discrimination, racial socialization, religiosity, negative emotions, and school bonds. RESULTS:  African American college students who reported marijuana use had less confidence in the police and those who engaged in heavy/binge drinking reported more negative emotions and negative encounters with the police. Additionally, negative police encounters and racial socialization practices increased the odds of heavy/binge drinking, whereas religiosity decreased the odds of heavy/binge drinking. CONCLUSION:  These results suggest that a relationship exists among criminal justice injustices, perceived racial bias, racial socialization, religiosity, and African American college students' substance use. As such, the current research provides partial support for the Theory of African American Offending while demonstrating the need to consider racial experiences when examining African American substance use.

The kinematics of false intent Conveyed by deceptive sidestep actions.

Researchers have identified kinematic differences between deceptive and non-deceptive rugby reorientation actions. However, the honest and deceptive signals corresponded to 'deception detection' (accuracy increasing) rather than signals that caused deception (accuracy decreasing). In this study, statistical parametric mapping and multilevel modelling were applied to examine the kinematic differences between sidestep and non-deceptive actions during the time window of deception. The analysis compared three-dimensional motion capture data from 144 deceptive actions and 144 genuine actions performed by six high-skilled rugby players. Results indicated that the kinematics of deceptive actions were characterized by a combination of exaggerated head roll, outside foot and centre-of-mass displacement, and attenuated thorax roll and yaw relative to genuine actions. These are candidate sources for the cause of deception, either individually or in combination with other sources. Furthermore, the results indicate that previously identified 'honest' signals may not be reliable sources of information earlier in the action sequence.

Are alcohol-related attentional biases and holistic perception independent processes?

Excessive alcohol consumption is associated with the development of attentional biases for alcohol-related cues and their prioritization in heavy drinkers. Recently, it has been hypothesized that holistic processing may also play a role in this prioritization, with higher alcohol consumers exhibiting stronger holistic perception for alcohol cues. However, it is unclear how processing stimuli holistically may be related to attentional biases. We explored potential relationships between attentional biases, holistic processing, and alcohol consumption in a sample of drinkers using two tasks. In the first, a visual probe task replicated previous findings by showing an increased attentional bias for alcohol-related stimuli in individuals with higher alcohol consumption. Surprisingly, using an inversion paradigm to measure holistic perception in our second task, we showed reduced holistic processing for both alcohol and nonalcohol cues in higher alcohol consumers compared to light alcohol consumers. Although alcohol consumption was positively associated with attentional biases and negatively associated with holistic processing, these cognitive processes were not associated with each other. This study supports a model of visual perception in which attentional biases and holistic processing are independently linked with alcohol use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis.

Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

Temporal and spectral electrooculographic features in a discrete precision task.

This study aimed to evaluate the utility and applicability of electrooculography (EOG) when studying ocular activity during complex motor behavior. Due to its lower spatial resolution relative to eye tracking (ET), it is unclear whether EOG can provide valid and accurate temporal measurements such as the duration of the Quiet Eye (QE), that is the uninterrupted dwell time on the visual target prior to and during action. However, because of its greater temporal resolution, EOG is better suited for temporal-spectral decomposition, a technique that allows us to distinguish between lower and higher frequency activity as a function of time. Sixteen golfers of varying expertise (novices to experts) putted 60 balls to a 4-m distant target on a flat surface while we recorded EOG, ET, performance accuracy, and putter kinematics. Correlational and discrepancy analyses confirmed that EOG yielded valid and accurate QE measurements, but only when using certain processing parameters. Nested cross-validation indicated that, among a set of ET and EOG temporal and spectral oculomotor features, EOG power was the most useful when predicting performance accuracy through robust regression. Follow-up cross-validation and correlational analyses revealed that more accurate performance was preceded by diminished lower-frequency activity immediately before movement initiation and elevated higher-frequency activity during movement recorded from the horizontal channel. This higher-frequency activity was also found to accompany a smoother movement execution. This study validates EOG algorithms (code provided) for measuring temporal parameters and presents a novel approach to extracting temporal and spectral oculomotor features during complex motor behavior.

Napping behaviour, daytime sleepiness, and arousal in high performance athletes and non-athlete controls.

Napping offers a strategy to manage sleep, aid recovery and enhance performance in elite sport. However, relatively little research attention has focussed on the natural history of athlete napping or tested the widely held assumption that athlete napping is mainly a consequence of degraded night-time sleep. Within a sample of 158 team (n = 76) and individual (n = 80) sport athletes, and 82 non-athlete controls, we analysed napping behaviour in relation to sleep quality, daytime sleepiness, and pre-sleep somatic and cognitive arousal. There was no significant association between athlete/non-athlete status and the prevalence, frequency, or duration of naps. Comparisons of athlete nappers and non-nappers found no significant differences in sleep quantity or quality. While nap propensity was significantly related to higher daytime sleepiness, this influence was moderated or augmented by levels of pre-sleep cognitive arousal. For some nappers, those with higher levels of arousal may need to be sleepier than those with lower levels of arousal in order to successfully initiate daytime sleep. Approximately 50% of athletes did not nap. If the benefits of athlete napping are to be fully exploited, the needs of this substantial group for whom napping may be problematic should be recognised and addressed.

Action outcome probability influences the size of the head-fake effect in basketball.

Both kinematic and contextual information (e.g., action outcome probability) play a significant role in action anticipation. However, few researchers have examined the reciprocal influence of the two types of information and fewer still have investigated this issue for deceptive actions in sports. In the present study, we investigate the impact of action outcome probability on the processing of deceptive kinematic cues for the head fake in basketball. We manipulated the probability of the action outcome to either pass the ball to the left or to the right side (i.e., 75%, 50%, 25%) and examined how this contextual information affected the influence of head orientation on pass direction judgments. Outcome probability information was either provided explicitly (Experiment 1) or implicitly (Experiment 2). Both experiments indicated an increased head-fake effect with increasing outcome probability. Moreover, the bias to respond in line with the player's head direction increased linearly with outcome probability. Also, discriminability between deceptive and genuine actions was poorer for high outcome probability (75%) associated with head orientation than for the 25% and 50% values. Last, a stronger response bias toward the higher probability side for deceptive trials than for genuine trials was only significant when the outcome probability information was processed implicitly in Experiment 2. The results of this study fit well with recent literature on contextual information in action prediction and are discussed in light of confirmation bias and signal detection theory.

Alcohol Use Predicts Face Perception Impairments and Difficulties in Face Recognition.

Background: Risky alcohol use is related to a variety of cognitive impairments, including memory and visuo-perceptual difficulties. Remarkably, no prior work has assessed whether usage of alcohol can predict difficulties perceiving facial identity. Objectives: Therefore, this study aimed to investigate whether riskier alcohol consumption predicted impairments in face perception and self-reported difficulties in face recognition. Results: Participants (N = 239, male = 77) were over 18 years old and had normal or corrected-to-normal vision. Alcohol use was assessed using the Alcohol Use Disorder Identification Test (AUDIT), while face recognition difficulties were determined by the 20-item Prosopagnosia Index questionnaire (PI20). A subsample of participants (N = 126, male = 51) completed the Cambridge Face Perception task (CFPT) to assess their face perception ability. Multiple linear regressions showed significant models of prediction on both face perception and face recognition when considering AUDIT score and age as predictors. Conclusion: This study suggested, for the first time, that risky alcohol use predicts both poorer visuo-perceptual processing for faces and self-reported difficulties in face recognition.

Tilla König and the birth of the Camphill movement: an appreciation.

The purpose of this paper is to bring to the foreground someone who, through her own choice, sought to remain the background in the development of the worldwide Camphill Movement - Tilla Konig.

Timing a fake punch: Inhibitory effects in a boxing-specific spatial attention task.

The ability to respond quickly and accurately to spatial cues is of great importance to performance on any task where quick decision-making is required. The two main effects of spatial attention are priming, when a response to a target is facilitated after being cued at the same location, and inhibition of return (IOR), when the response to the target is slower to the cued area. Whether priming or IOR occurs is largely dependent on the length of the interval between the cue and the target. To determine whether these effects are relevant to dueling sports with deceptive actions we created a boxing-specific task that mimicked combinations of feints and punches. Altogether, we recruited 20 boxers and 20 non-boxers and found significantly longer reaction times to a punch thrown on the same side as a fake punch after a 600 ms interval, consistent with the IOR effect. We also found a moderate positive correlation between years of training and the magnitude of the IOR effect. This latter finding indicates that even athletes trained to avoid deception can be as susceptible as novices if the timing of the feint is right. Finally, our approach highlights the benefits of studying IOR using more sport specific settings, broadening the scope of the field.

Expert Views on Evidence-Based Classification for Goalball: A Delphi Study.

Para sport classification aims to minimize the impact of impairments on the outcome of competition. The International Paralympic Committee requires classification systems to be evidence based and sport specific, yet the sport of goalball uses a structure that is not supported by evidence demonstrating its legitimacy for competition. This study aimed to establish expert opinions on how a sport-specific system of classification should be structured in the sport of goalball. Using a three-round Delphi survey, 30 international experts expressed their views across topics linked to goalball classification. Participants were divided as to whether the current system fulfills the aim to minimize the impact of impairment on competition. Most felt that less impairment should be required to compete but that the one-class structure should remain. Experts identified measures of visual function that should be considered and 15 core components of individual goalball performance. Findings constitute a crucial first step toward evidence-based classification in goalball.

Building a transdisciplinary expert consensus on the cognitive drivers of performance under pressure: An international multi-panel Delphi study.

Introduction: The ability to perform optimally under pressure is critical across many occupations, including the military, first responders, and competitive sport. Despite recognition that such performance depends on a range of cognitive factors, how common these factors are across performance domains remains unclear. The current study sought to integrate existing knowledge in the performance field in the form of a transdisciplinary expert consensus on the cognitive mechanisms that underlie performance under pressure. Methods: International experts were recruited from four performance domains [(i) Defense; (ii) Competitive Sport; (iii) Civilian High-stakes; and (iv) Performance Neuroscience]. Experts rated constructs from the Research Domain Criteria (RDoC) framework (and several expert-suggested constructs) across successive rounds, until all constructs reached consensus for inclusion or were eliminated. Finally, included constructs were ranked for their relative importance. Results: Sixty-eight experts completed the first Delphi round, with 94% of experts retained by the end of the Delphi process. The following 10 constructs reached consensus across all four panels (in order of overall ranking): (1) Attention; (2) Cognitive Control-Performance Monitoring; (3) Arousal and Regulatory Systems-Arousal; (4) Cognitive Control-Goal Selection, Updating, Representation, and Maintenance; (5) Cognitive Control-Response Selection and Inhibition/Suppression; (6) Working memory-Flexible Updating; (7) Working memory-Active Maintenance; (8) Perception and Understanding of Self-Self-knowledge; (9) Working memory-Interference Control, and (10) Expert-suggested-Shifting. Discussion: Our results identify a set of transdisciplinary neuroscience-informed constructs, validated through expert consensus. This expert consensus is critical to standardizing cognitive assessment and informing mechanism-targeted interventions in the broader field of human performance optimization.

Earlier detection facilitates skilled responses to deceptive actions.

High-skilled and recreational rugby players were placed in a semi-immersive CAREN Lab environment to examine susceptibility to, and detection of, deception. To achieve this, a broad window of seven occlusion times was used in which participants responded to life-size video clips of an opposing player 'cutting' left or right, with or without a deceptive sidestep. Participants made full-body responses to 'intercept' the player and gave a verbal judgement of the opponent's final running direction. Response kinematic and kinetic data were recorded using three-dimensional motion capture cameras and force plates, respectively. Based on response accuracy, the results were separated into deception susceptibility and deception detection windows then signal detection analysis was used to calculate indices of discriminability between genuine and deceptive actions (d') and judgement bias (c). Analysis revealed that high-skilled and low-skilled players were similarly susceptible to deception; however, high-skilled players detected deception earlier in the action sequence, which enabled them to make more effective behavioural responses to deceptive actions.