Análise comparativa do comportamento verbal nos três níveis de suporte do autismo / Comparative analysis of verbal behavior in the three levels of autism support / Análisis comparativo de la conducta verbal en los tres niveles de apoyo al autismo

OBJETIVO: O presente trabalho teve por objetivo avaliar e comparar a habilidade do comportamento verbal em crianças com distintos níveis de suporte do TEA. MÉTODO: Foram avaliadas onze crianças diagnosticadas com autismo e com faixa etária entre 2 e 7 anos e que apresentassem diversidade entre si quanto ao nível de suporte TEA. Para a averiguação do repertório de comunicação, eles foram avaliados a partir de um instrumento elaborado por uma equipe de profissionais especializados, investigando o comportamento não verbal, ecoico, mando, tato e intraverbal em três tentativas. RESULTADOS: Apesar do número reduzido de participantes, os resultados indicaram que pacientes no nível 3 de suporte apresentam maior comprometimento na comunicação comparado aos demais. O estudo destacou a importância do rastreio de habilidades comportamentais para um planejamento com maior eficácia para a intervenção e concomitantemente evolução clínica, respeitando assim as particularidades e singularidades de cada pessoa no espectro. CONCLUSÃO: Concluiu-se assim, a importância da análise de comportamentos e a investigação detalhada para cada paciente, a fim de que as intervenções sejam focadas em suas reais necessidades.

OBJECTIVE: The present work aimed to evaluate and compare the verbal behavior ability in children with different levels of ASD support. METHOD: Eleven children diagnosed with autism and aged between 2 and 7 years old and who presented diversity among themselves in terms of the level of ASD support were evaluated. To investigate their communication repertoire, they were evaluated using an instrument developed by a team of specialized professionals, investigating non-verbal, echoic, command, tact and intraverbal behavior in three attempts. RESULTS: Despite the small number of participants, the results indicated that patients at level 3 of support have greater impairment in communication compared to the others. The study highlighted the importance of screening behavioral skills for more effective planning for intervention and concomitant clinical evolution, thus respecting the particularities and singularities of each person on the spectrum. CONCLUSION: This concludes the importance of behavioral analysis and detailed investigation for each patient, so that interventions are focused on their real needs.

OBJETIVO: El presente trabajo tuvo como objetivo evaluar y comparar la capacidad de conducta verbal en niños con diferentes niveles de apoyo al TEA. MÉTODO: Se evaluaron once niños diagnosticados con autismo, con edades entre 2 y 7 años y que presentaban diversidad entre sí en cuanto al nivel de apoyo al TEA. Para investigar su repertorio comunicativo, fueron evaluados mediante un instrumento desarrollado por un equipo de profesionales especializados, investigando el comportamiento no verbal, ecoico, de mando, tacto e intraverbal en tres intentos. RESULTADOS: A pesar del pequeño número de participantes, los resultados indicaron que los pacientes en el nivel 3 de apoyo tienen un mayor deterioro en la comunicación en comparación con los demás. El estudio destacó la importancia del cribado de habilidades conductuales para una planificación más eficaz de la intervención y la evolución clínica concomitante, respetando así las particularidades y singularidades de cada persona del espectro. CONCLUSIÓN: Se concluye la importancia del análisis conductual y la investigación detallada de cada paciente, para que las intervenciones estén enfocadas a sus necesidades reales.

Freiburg personality inventory in inflammatory bowel disease: diagnosis and psychotherapeutic needs / Inventario de personalidad de Freiburg en la enfermedad inflamatoria intestinal: diagnóstico y necesidades psicoterapéuticas

A pesar de los descubrimientos recientes, los pacientes con enfermedad inflamatoria intestinal (EII) aún enfrentan desafíos para lograr la remisión. Los objetivos del estudio fueron identificar las características de los pacientes con el Inventario de Personalidad de Freiburg y la intensidad de la enfermedad colónica, comorbilidades que podrían estar relacionadas con la personalidad de los sujetos. Los datos se recopilaron en el período 2019-2020 de 46 pacientes y utilizaron métodos no paramétricos. En comparación con el grupo de control, las escalas de Inhibición, Problemas de salud y Emocionalidad tenían puntuaciones brutas significativamente más altas. Las escalas de Orientación Social, Franqueza y Extraversión tuvieron puntajes brutos significativamente más bajos. El estado de salud fue un factor médico que influyó en la escala de Quejas Somáticas, los pacientes que tenían lesiones o comorbilidades tenían puntuaciones brutas significativamente más altas. Los pacientes que tenían comorbilidades además de la EII tenían puntuaciones brutas considerablemente más altas en la escala de Excitabilidad. Se requieren intervenciones psicoterapéuticas de cambio en la percepción de la vida para abordar la descripción del sufrimiento subjetivo relacionado con molestias físicas (escala de quejas somáticas), una fuerte orientación hacia el rendimiento (escala de tensión), cambios de humor, ansiedad y pesimismo (escala de emocionalidad). Otra intervención es la reconsideración y (re)priorización de valores, como la familia, las relaciones íntimas, los amigos, la salud, el crecimiento, el desarrollo, el trabajo equilibrado, todos los cuales pueden promover una sensación de bienestar y equilibrio.(AU)

Despite recent discoveries, patients with inflammatory bowel disease (IBD) still face challenges with attainment of remission. The objectives of the study were to identify the characteristics of patients with the Freiburg Personality Inventory and the intensity of the intestinal disease, comorbidities that could be related to the personality of the subjects. Data were collected in the period 2019–2020 from 46 patients and used nonparametric methods. Compared to the normative sample, the Inhibitedness, Health Concerns, and Emotionality scales had significantly higher raw scores. The Social Orientation, Frankness, and Extraversionscales had significantly lower raw scores. Health status was a medical factor that influenced the Somatic Complaintsscale, patients who had lesions or comorbidities had significantly higher raw scores. Patients who had comorbidities in addition to IBD had considerably higher raw scores on the Excitability scale. Psychotherapeutic change interventions regarding life perception are required to tackle the description of subjective suffering related to physical inconveniences (Somatic Complaintsscale), a strong orientation toward performance (Strainscale), mood swings, anxiety, and pessimism (Emotionality scale). Another intervention is reconsidering values and (re) prioritization, such as family, intimate relationships, friends, health, growth, development, balanced work, all of which can promote a feeling of well-being and balance.(AU)

POSITION STATEMENT: Pass the RESTORE (Re-entry Support Through Opportunities for Resources and Essentials) Act.

Under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), current federal policy mandates a lifetime ban for individuals with a past felony drug conviction from receiving Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) benefits. Denying nutritional and financial assistance to individuals with a past felony conviction will widen existing structural health inequities, set back individuals' successful re-entry into society, and contribute to recidivism and poorer health outcomes. Therefore, the Society of Behavioral Medicine supports the RESTORE ACT (Re-Entry Support Through Opportunities for Resources and Essentials Act), which would repeal the lifetime ban on receiving SNAP and TANF benefits for individuals convicted of a drug felony.

Current US law bans people who have been convicted of felony drug crime from participating in nutritional and financial assistance programs (i.e. Supplemental Nutrition Assistance Program [SNAP] and Temporary Assistance for Needy Families [TANF]). By not allowing people who have been convicted of a drug felony to access these programs, this law risks worsening health outcomes and perpetuating existing health disparities. The Society of Behavioral Medicine supports the RESTORE Act (Re-Entry Support Through Opportunities for Resources and Essentials Act), which would end the federal ban and allow all income-eligible people to access SNAP and TANF benefits.

Integrating spiritual disposition intervention into behavioral medicine: A case report on systemic lupus erythematosus from India.

Background: Systemic Lupus Erythematosus (SLE) is a chronic inflammatory systemic autoimmune disease. The disease manifests as the body's immune cells start attacking healthy connective tissue, which affects the skin, kidneys, blood vessels, brain, and other vital organs. As with any other chronic illness, the disease has psychological implications.Purpose: Literature suggests patients with SLE experience anxiety, depression, anger, and stress along with physiological symptoms. There is a strong association between the occurrence of stress and the onset of the disease. These psychological symptoms can be ameliorated through spiritual activities such as meditation, mindfulness, journaling, and reading.Mehtod: This case report is based on the importance of spirituality in the healthcare system. The study focuses on the concept of a whole-person-centered approach to the medical care industry. Spirituality has been proven to have a positive effect on health and illness. Hence, a 10-week intervention with 30 sessions focusing on spiritual dispositions was provided to the patient for this study, along with regular pharmacological treatment. The present case report is of a 56-year-old woman from New Delhi, India, who was diagnosed with SLE 2 years ago.Results: The results reveal the positive effect of the intervention, as it led to a significant decrease in stress levels and depressive symptoms; it also resulted in improved quality of life, an enhanced coping style, and bolstered health hardiness. There was an increase in the score of a spiritual personality.Conlcusion: Spiritual Disposition as an intervention was sucessfull in reducing psychological implications of the disease thus leading to overall positve growth in the patient.

The urgency of restructuring the landscape of behavioral medicine: Commentary from early-career diversity institute scholars.

Structural and systemic barriers entrenched in academia have sustained for decades, and resulted in a lack of diversity in leadership positions, inequitable workloads for women and underrepresented racial/ethnic groups, and increasing issues with retention of faculty, particularly following the COVID-19 pandemic. Increasing opposition to diversity, equity, and inclusion (DEI) efforts in higher education via legislation, policies, and general anti-DEI sentiment contextualizes the importance of prioritizing DEI. The goal of this commentary is to open discussion among academic institutions regarding changes in DEI culture that will facilitate the growth of diverse early-career faculty (ECF). We use an adapted framework which incorporates DEI into a faculty competency model to (i) guide our discussion of the rationale for restructuring academic systems to promote DEI and (ii) recommend strategies for institutional progress for ECF that can translate across academic institutions. Implementing policies and practices that seek to recruit, retain, and support historically underrepresented ECF are needed, and may involve faculty mentorship programs, establishing equitable funding mechanisms, reforming faculty evaluation practices, and examining and correcting inequities in faculty workloads. The onus is on institutions to recognize and replace the exclusionary practices and biases that have existed within their walls, and continuously promote and monitor their DEI efforts and initiatives to ensure their efficacy. Inclusive academic cultures that demonstrate their value of diversity and commitment to equity promotion at all levels of the organization, including among ECF, are necessary for ensuring excellence in scholarship in academia.

Existing structural and systemic barriers in academia have continued for decades, and resulted in a lack of diversity in leadership positions, inequitable workloads for underrepresented gender and racial/ethnic groups, and increasing issues with retention of faculty, particularly following the COVID-19 pandemic. We outline the need for promoting diversity, equity, and inclusion (DEI) practices in academia, and that it will involve changes to the existing structures within universities. This is especially important as we want our higher education workforce to reflect our increasingly diverse society in its own diversity, but current policies and structures do not promote diversity in our institutions and in our research. Our rationale for restructuring academic systems to promote DEI also stems from a need for behavioral medicine and research more broadly to recognize and challenge the biases and practices that sustain inequity in our research­from the questions we ask, the participants we include (and exclude), and the ways in which the system creates unnecessary barriers for researchers who try to mitigate or address these biases in our work. We recommend implementing strategies for institutional progress that benefit diverse early-career faculty including mentoring programs, developing funding opportunities, changing faculty evaluation practices, and creating equitable workloads.

"Learning with each other, about each other": Interdisciplinary learning among genetic counseling students and clinical health psychology residents.

Interprofessional collaborative healthcare is known to improve provider satisfaction and retention, as well as patient safety and quality of care. The specific knowledge, skills, and attitudes required to work in these environments are best taught interprofessionally. Despite having considerable overlap in training, orientation, and populations served, it is rare for trainees from genetic counseling and clinical health psychology to interact and learn together. In 2017, we developed an innovative week-long clinical health psychology rotation for students in the University of Manitoba MSc in Genetic Counselling Program, which aims to enrich psychotherapeutic/counseling knowledge and skills, as well as gain familiarity with the work of clinical psychologists. This rotation incorporates didactic teaching, observation, and structured reflection. Didactic teaching includes topics such as psychological assessment, adaptation to life-altering news, skills for managing intense emotional responses, and counseling for change. Observations of clinical health psychologists and clinical health psychology residents occur in a range of health settings. Structured reflection is practiced in both oral and written formats. Finally, both groups of trainees participate in an interprofessional case seminar series. Feedback from this experience has been very promising, and it was identified as a strength in the program's accreditation review. Adaptations over time include refining the clinical exposures to increase breadth and relevance, increasing the contact between the trainees from the two professions and enhancing the case seminar series to be more learner-driven and to focus on explicit interprofessional skills and themes. In addition to expected results, this rotation has led to some unanticipated findings, including an emergent emphasis on the social determinants of health and the need to work collaboratively for systemic change. Further, psychology residents have identified that it benefits them to learn more about genetic counseling and expressed interest in potential reciprocal learning opportunities in genetics clinics.

Ethical, legal, and social implications of digital health: A needs assessment from the Society of Behavioral Medicine to inform capacity building for behavioral scientists.

The ethical, legal, and social implications (ELSIs) of digital health are important when researchers and practitioners are using technology to collect, process, or store personal health data. Evidence underscores a strong need for digital health ELSI training, yet little is known about the specific ELSI topic areas that researchers and practitioners would most benefit from learning. To identify ELSI educational needs, a needs assessment survey was administered to the members of the Society of Behavioral Medicine (SBM). We sought to identify areas of ELSI proficiency and training need, and also evaluate interest and expertise in ELSI topics by career level and prior ELSI training history. The 14-item survey distributed to SBM members utilized the Digital Health Checklist tool (see recode.health/tools) and included items drawn from the four-domain framework: data management, access and usability, privacy and risk to benefit assessment. Respondents (N = 66) were majority faculty (74.2%) from psychology or public health. Only 39.4% reported receiving "formal" ELSI training. ELSI topics of greatest interest included practices that supported participant engagement, and dissemination and implementation of digital tools beyond the research setting. Respondents were least experienced in managing "bystander" data, having discussions about ELSIs, and reviewing terms of service agreements and privacy policies with participants and patients. There is opportunity for formalized ELSI training across career levels. Findings serve as an evidence base for continuous and ongoing evaluation of ELSI training needs to support scientists in conducting ethical and impactful digital health research.

New technologies are increasingly used in research and practice, which introduce new ethical, legal, and social implications (ELSIs). While there are scholars who study ELSIs in research, it is important that behavioral scientists have ELSI training in order to identify and mitigate possible harms and maximize benefits among their patients/participants, particularly when using technologies that collect personal health information. ELSI training opportunities are limited and, because ELSI is a broad complicated field, we know very little about the specific topics that researchers/practitioners would benefit from learning. To understand ELSI training needs specific to the field of digital health, we asked the members of the Society of Behavioral Medicine, a multidisciplinary nonprofit organization, to tell us about which ELSI areas they are most interested in. We found that 39.4% of members received formal ELSI training. Members were most interested in using technology to help patients/participants stay engaged in their treatments, and developing technologies that can be used outside of research (in the "real world"). Members were least experienced in reviewing terms of service/privacy policies and handling information collected from non-patient/participants (people in the backgrounds of voice recordings/videos). Training interests differed by career level (faculty vs. students), and so future ELSI trainings could be more beneficial if they were mindful of prior experiences.

Leveraging the adolescent brain cognitive development study to advance and promote adolescent health: Introduction to the special issue.

The empirical reports in this special issue of Health Psychology showcase the work of a diverse array of accomplished early-stage investigators who are members of the Adolescent Brain Cognitive Development (ABCD) study consortium and who are drawn from the community of female and underrepresented scientists. Their studies focus primarily on youth assessed during preadolescence and early adolescence, and they are based on the ABCD data that were available to the scientific community at the time this special issue was being prepared (e.g., baseline, Years 1 and 2 assessments). They address a variety of questions about adolescent health behavior, such as the effects of screen time and caffeine on sleep; individual lifestyle, neighborhood, and environmental factors associated with physical health conditions and brain development; and the antecedents and consequences of prenatal and adolescent substance exposure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adolescent health behavior research.

The Adolescent Brain Cognitive Development (ABCD) Study is the largest, long-term study of brain development and child and adolescent health that has ever been conducted in the United States. The ABCD Research Consortium is supported by the National Institutes of Health and includes a central coordinating center, a data analysis and informatics core, and 21 research sites across the country. This special issue of Health Psychology presents some important findings on adolescent health behavior that have recently emerged from the ABCD Study (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Health equity is not possible without addressing disparities.

Health equity is the aspirational assurance of optimal health for all. Synonymous with fair and just opportunities for physical and mental health, equity work reflects intentional efforts to remove access barriers and allocate high-quality, need-based resources. Health equity is not possible without meaningful reductions in disparities-and evaluating progress goes further to describe, assess, and continuously evaluate fairness and social justice within structures, community contexts, and healthcare. The National Institute on Minority Health and Health Disparities (NIMHD) has a longstanding and deep commitment to advancing health equity. This article describes efforts in two specific areas: workforce diversity, equity, and inclusion (DEI) and scientific initiatives. We also summarize five actionable strategies for health equity promotion in health psychology-relevant research and practice, including increasing workforce DEI, inclusive research participation, cultural competence and humility, applying community-engaged research principles, and going beyond "do no harm." Meaningful equity work often requires major shifts in approaches, dedicated resources, and targeted efforts toward social justice. The current emphasis on addressing health disparities and understanding the structural factors underlying them presents unequivocal opportunities for changes in clinical practice and research. NIMHD seeks to support innovative health psychology and behavioral medicine research with the potential to transform health via effective and equitable interventions/treatments, systems changes, and policies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Advocacy efforts of the Society of Behavioral Medicine: a 6-year update.

Six years ago, we published a paper describing the Society of Behavioral Medicine's (SBM) health policy organizational leadership structure and policy initiatives. The purpose of the current paper is to provide an update on changes in the infrastructure and new policy initiatives that have been developed since 2017. We review each of the policy leadership arms of SBM including details of the work of each and goals for the future. The SBM engages in several health policy advocacy efforts through their Advocacy Council and Position Statements Committee. The Advocacy Council launched the Health Policy Ambassador Program in 2020. The Ambassador Program serves to train members to develop longer-term relationships with legislative staff around key policy priority areas. The Position Statements Committee is responsible for overseeing the development and dissemination of health policy position statements. Both groups work together and with partner organizations to increase the impact of our science. Over the last 6 years, developing a stronger infrastructure and implementing metrics for progress such as tracking social media engagement has helped to move SBM's policy agenda forward. The work of the policy-related leadership teams can serve as a model for other organizations who are interested in further developing their policy advocacy efforts.

The Society of Behavioral Medicine (SBM) engages in several health policy advocacy efforts through their Advocacy Council and Position Statements Committee. The Advocacy Council launch the Health Policy Ambassador Program in 2020. The Ambassador Program serves to train members to develop longer-term relationships with legislative staff around key policy priority areas. The Position Statements Committee is responsible for overseeing the development and dissemination of health policy position statements. Both groups work together and with partner organizations to increase the impact of our science. Over the last 6 years, developing a stronger infrastructure and implementing metrics for progress has helped to move SBM's policy agenda forward. The work of the policy-related leadership teams can serve as a model for other organizations who are interested in further developing their policy advocacy efforts.

Introduction to the special issue on vaccine hesitancy and refusal.

This is an introduction to the special issue "Vaccine Hesitancy and Refusal." This special issue of Health Psychology examines various aspects of vaccine hesitancy using a health psychology lens. The timing of this issue, following a call for papers issued in the summer of 2021, in the midst of the COVID-19 pandemic, is reflected in the focus on COVID-19 vaccine hesitancy in the papers included here. This is important, as the field of vaccine hesitancy research has expanded greatly in response to the COVID-19 pandemic. As of March 2, 2023, a search of PubMed for "vaccine hesitancy" yielded 5,635 papers, dating back to 1968. A similar search for "COVID vaccine hesitancy" yielded 3,851 papers, starting in 2020. This highlights the need for new and novel theory-based interventions that can be broadly applicable to hesitancy to other routine vaccinations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Tutorial on causal mediation analysis with binary variables: An application to health psychology research.

Mediation analysis has been widely applied to explain why and assess the extent to which an exposure or treatment has an impact on the outcome in health psychology studies. Identifying a mediator or assessing the impact of a mediator has been the focus of many scientific investigations. This tutorial aims to introduce causal mediation analysis with binary exposure, mediator, and outcome variables, with a focus on the resampling and weighting methods, under the potential outcomes framework for estimating natural direct and indirect effects. We emphasize the importance of the temporal order of the study variables and the elimination of confounding. We define the causal effects in a hypothesized causal mediation chain in the context of one exposure, one mediator, and one outcome variable, all of which are binary variables. Two commonly used and actively maintained R packages, mediation and medflex, were used to analyze a motivating example. R code examples for implementing these methods are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Behavioural Medicine: Strengthening approaches to address co-morbid chronic physical and mental disorders.

South Africa is confronted with multi-morbid chronic physical and mental disorders. The relationships between these conditions are often multidirectional and result in a variety of adverse mental and physical health outcomes. The risk factors and perpetuating conditions in multi-morbidity are potentially modifiable through effective behaviour change. However, in South Africa, interventions and clinical care that address these co-occurring factors have traditionally functioned in a vacuum, created by a lack of formalised multidisciplinary collaboration. In high-income settings, the field of Behavioural Medicine was established in recognition of the importance of psychosocial factors in illness and assumes that the presence of physical concerns can be influenced by psychological and behavioural factors. The large body of evidence supporting Behavioural Medicine has afforded the field global recognition. Yet, it remains an emerging field in South Africa and on the African continent. The purpose of this paper is to contextualise the field of Behavioural Medicine in South Africa and present a way forward to establish the field in our context.

Effects of a health psychology-based intervention for patients with asplenia on psychological determinants of preventive behaviour: A propensity score analysis.

OBJECTIVE: Patients with asplenia have an increased lifelong risk of severe infections especially post splenectomy sepsis with hospital mortality rates of 30-50%. Adherence to existing guidelines for preventive measures is low. Objective of the study is the evaluation of a novel intervention to increase health psychological outcomes in patients with asplenia resulting in better adherence to preventive measures. METHODS: The intervention was evaluated by conducting a prospective, two-armed historical control group design via propensity score analysis. Focus are health-psychological outcomes: self-efficacy, intention, risk perception, behaviour planning, self-management, health literacy, patient involvement and disease-knowledge. RESULTS: Patients in the intervention group (N = 110) showed a higher increase in almost all outcomes compared to a historical control group (N = 115). The strongest increase was observed in "asplenia-specific self-management" (average treatment effect: ATE 1.14 [95% CI 0.91-1.36] p < .001) and "asplenia-specific health-literacy" (ATE 1.42 [95% CI 1.18-1.65] p < .001). Significant intervention effects were also found in behaviour planning, perceived involvement and disease-knowledge. CONCLUSION: The patient-focused intervention is effective in improving health-psychological outcomes in patients with asplenia. PRACTICE IMPLICATIONS: The implementation of the intervention can make an important contribution to care and lead to an improvement of health-psychological outcomes that may result in a higher adherence to prevention measures.

A Theoretically Informed Critical Review of Research Applying the Concept of Liminality to Understand Experiences with Cancer: Implications for a New Oncological Agenda in Health Psychology.

Liminality was described more than 20 years ago as a major category explaining how cancer is experienced. Since then, it has been widely used in the field of oncology research, particularly by those using qualitative methods to study patient experience. This body of work has great potential to illuminate the subjective dimensions of life and death with cancer. However, the review also reveals a tendency for sporadic and opportunistic applications of the concept of liminality. Rather than being developed in a systematic way, liminality theory is being recurrently 're-discovered' in relatively isolated studies, mostly within the realm of qualitative studies of 'patient experience'. This limits the capacity of this approach to influence oncological theory and practice. In providing a theoretically informed critical review of liminality literature in the field of oncology, this paper proposes ways of systematizing liminality research in line with a processual ontology. In so doing, it argues for a closer engagement with the source theory and data, and with more recent liminality theory, and it sketches the broad epistemological consequences and applications.