Detection of and response to gender-based violence: a quality improvement project across three secondary mental health services in London.

AIMS AND METHOD: Our team of core and higher psychiatry trainees aimed to improve secondary mental health service detection of and response to gender-based violence (GBV) in South East London. We audited home treatment team (HTT), drug and alcohol (D&A) service and in-patient ward clinical records (n = 90) for female and non-binary patients. We implemented brief, cost-neutral staff engagement and education interventions at service, borough and trust levels before re-auditing (n = 86), completing a plan-do-study-act cycle. RESULTS: Documented enquiry about exposure to GBV increased by 30% (HTT), 15% (ward) and 7% (D&A), post-intervention. We identified staff training needs and support for improving GBV care. Up to 56% of records identified psychiatric symptoms related to GBV exposure. CLINICAL IMPLICATIONS: Moves to make mental healthcare more trauma-informed rely on services first being supportive environments for enquiry, disclosure and response to traumatic stressors. Our collaborative approach across clinical services increased GBV enquiry and documentation. The quality of response is more difficult to measure and requires concerted attention.

No evidence of attentional bias toward threatening conspecific and allospecific faces in capuchin monkeys (Sapajus [Cebus] apella) using a dot-probe task.

The ability to quickly perceive and interpret threatening facial expressions from others is critical for successfully maintaining group cohesion in social nonhuman primate species. Rapid detection of threatening or negative stimuli in the environment compared to neutral stimuli, referred to as an attentional bias toward threat, is adaptive in that faster threat detection can lead to greater survival outcomes. However, the evolutionary roots of attentional bias formation toward social threat are not well understood. The present study investigated attentional biases toward social threat and the factors associated with them, including underlying hormonal mechanisms, in socially housed capuchin monkeys. Attentional biases were assessed using a dot-probe task that measured capuchins' latency to respond to a target using a joystick after viewing threatening or neutral conspecific or allospecific faces or nonface stimuli. In our first study, we examined how age, dominance status, sex, and cortisol level related to attentional biases. In our second study, we examined how manipulated oxytocin (OT) influenced attentional biases. Capuchin monkeys did not show attentional biases toward threatening faces or objects, but they showed attentional avoidance of scrambled familiar conspecific face stimuli. Cortisol and social rank were associated with attentional bias toward threat in the capuchin monkeys that participated in this study, which suggests that stress and dominance relate to attentional bias toward social threat. Manipulated OT increased attentional avoidance of scrambled familiar and unfamiliar face images, but not unscrambled faces or objects. Overall, we did not find compelling evidence of attentional biases toward social threat in capuchin monkeys. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association of white matter hyperintensities and clinical vascular burden with depressive symptoms in Black older adults.

OBJECTIVES: Black older adults have a higher vascular burden compared to non-Hispanic White (NHW) older adults, which may put them at risk for a form of depression known as vascular depression (VaDep). The literature examining VaDep in Black older adults is sparse. The current study addressed this important gap by examining whether vascular burden was associated with depressive symptoms in Black older adults. METHODS: Participants included 113 Black older adults from the Healthy Brain Project, a substudy of the Health, Aging, and Body Composition Study. In multiple regression analyses, clinical vascular burden (sum of vascular conditions) and white matter hyperintensity (WMH) volume predicted depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale, controlling for demographic variables. Follow-up analyses compared the associations in the Black subsample and in 179 NHW older adults. RESULTS: Higher total WMH volume, but not clinically-defined vascular burden, predicted higher concurrent depressive symptoms and higher average depressive symptoms over 4 years. Similar associations were found between uncinate fasciculus (UF) WMHs and concurrent depressive symptoms and between superior longitudinal fasciculus WMHs and average depressive symptoms. The association between depressive symptoms and UF WMH was stronger in Black compared to NHW individuals. CONCLUSION: This research is consistent with the VaDep hypothesis and extends it to Black older adults, a group that has historically been underrepresented in the literature. Results highlight WMH in the UF as particularly relevant to depressive symptoms in Black older adults and suggest this group may be particularly vulnerable to the negative effects of WMH.

Age and Gender Differences in the Borrowing of Personal Stories.

BACKGROUND: In prior research, about half of undergraduate students claimed to have "borrowed" a story, by telling someone else's autobiographical memory as if it was their own. Given that borrowing stories often involves intentional fabrication, and given that there are age-related declines in lying, we hypothesized that reports of intentionally borrowing stories should decline with age. METHODS: We recruited participants who ranged in age from 18 to 86 and asked them to complete an online retrospective survey about borrowing stories. RESULTS: Consistent with our hypothesis, older age was associated with lower reports of borrowing stories. Furthermore, among people who did report borrowing a story, older age was associated with less frequent story borrowing and less recent story borrowing. CONCLUSION: These findings highlight the importance of using age-diverse samples when examining social memory phenomena. Findings based upon undergraduate students do not always replicate in other age groups.

Younger and older adults' memory of past feelings surrounding an election.

People often misremember their past feelings, especially when recalling their prior mood as opposed to their specific emotions in response to events. A previous study also found that the direction of memory errors varies based on feeling type; younger adults overestimated the intensity of prior moods but underestimated the intensity of prior event-specific emotions. This study aimed to replicate these patterns and test whether they vary with age. In doing so, we also tested whether an age-related positivity effect would emerge, such that older adults would be relatively more likely to overestimate past positive feelings and underestimate past negative feelings. Using a sample of American voters, who reported their feelings following the 2020 United States presidential election, we found that both younger and older adults subsequently overestimated the intensity of their past mood in the week following the election but were relatively accurate in recalling the intensity of their prior emotions about the election result. Unexpectedly, among election losers, we also observed an age-related negativity effect in recall for prior mood. When faced with negative real-world events, older adults may not show the same positivity biases that are observed in lab studies.

The illusory truth effect: A review of how repetition increases belief in misinformation.

Repetition increases belief in information, a phenomenon known as the illusory truth effect. In laboratory experiments, the illusory truth effect has often been examined using general trivia statements as stimuli, but repetition also increases belief in misinformation, such as fake news headlines and conspiracy beliefs. Repetition even increases belief in claims that are implausible or that contradict prior knowledge. Repetition also has broader impacts beyond belief, such as increasing sharing intentions of news headlines and decreasing how unethical an act is perceived to be. Although the illusory truth effect is robust, some interventions reduce its magnitude, including instruction to focus on accuracy and awareness of the illusory truth effect. These strategies may be effective for reducing belief in misinformation.

Correlates of adverse childhood experiences and secondary traumatic stress in school personnel.

While previous research has noted the large numbers of school personnel with exposure to potentially traumatic experiences and its relation to secondary traumatic stress, it is unclear how different patterns of adverse childhood experiences influence secondary traumatic stress. As such, the present study employed latent profile analysis to examine natural groups of adverse childhood experience (ACE) history in 218 school mental health professionals (65% female; 55% White, 17.9% Black; 39% early career, 34% midcareer, and 28% late career; Mage = 32.91) and 348 teachers (80% female; 80.5% White, 6.3% Black; 16% early career, 14% midcareer, and 70% late career; Mage = 41.03) to examine the magnitude of secondary traumatic stress. The present study also examined the moderating effect of trauma-informed practice efficacy on the relationship between ACE history latent profiles and secondary traumatic stress. Four latent profiles were revealed among school personnel: (a) low ACEs, (b) average ACEs (c) neglected, and (d) high ACEs. Additionally, trauma-informed practice efficacy did not moderate the relationship between ACEs history profiles and secondary traumatic stress. Implications include targeted approaches for helping school personnel decrease secondary traumatic stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The illusory truth effect requires semantic coherence across repetitions.

Repeated exposure to information increases its' perceived truth, and this illusory truth effect is often explained by two theoretical frameworks: the fluency account and the referential theory of truth. Whereas the fluency account suggests that prior activation of a single referent within a statement should increase its perceived truth, the referential theory makes no such predictions. The referential theory instead proposes that when a statement is processed, it activates the corresponding memory referents within that statement and strengthens the connection between these referents in the semantic memory network. Because repeated statements will have more coherent corresponding referents than new statements, they are perceived as relatively truer. Experiments 1 and 2 focused on testing the fluency account, with participants exposed to one or two of a statement's referents before evaluating that statement's truth. Experiments 3 and 4 focused on the referential theory by exposing participants to non-critical facts that linked together two of a critical statements' referents before evaluating the truth of the critical statements. We consistently observed a standard illusory truth effect, such that facts that repeated verbatim were rated as truer than new facts. However, perceived truth was not affected by prior exposure to the critical statement's topic (Experiment 1) or by prior exposure to non-critical facts related to the same topic(s) as the critical statement (Experiment 2). There was also no boost in perceived truth following prior exposure to non-critical facts that linked together two of the primary referents of the critical statement but did so in a semantically distinct manner from how those same referents were linked in the critical statement itself (Experiments 3 and 4). However, Experiment 4 demonstrated that perceived truth significantly increased if there was prior exposure to non-critical facts that linked two of the critical statement primary referents in a way that was semantically coherent with how those same referents were linked within the critical statement. Together, these results are consistent with the referential theory, and suggest that semantic consistency across repetitions plays a crucial role in leading to repetition-based illusory truth effects.

Rostral anterior cingulate connectivity in older adults with subthreshold depressive symptoms: A preliminary study.

Subthreshold depressive symptoms are highly prevalent among older adults and are associated with numerous health risks including cognitive decline and decreased physical health. One brain region central to neuroanatomical models of depressive disorders is the anterior cingulate cortex (ACC). The rostral portion of the ACC-comprised of the pregenual ACC and subgenual ACC-is implicated in emotion control and reward processing. The goal of the current study was to examine how functional connectivity in subregions of the rostral ACC relate to depressive symptoms, measured by the Beck Depression Inventory-Second Edition, in an ethnically diverse sample of 28 community-dwelling older adults. Based on meta-analyses of previous studies in primarily young adults with clinical depression, we hypothesized that greater depressive symptoms would be associated with primarily increased resting-state functional connectivity from both the subgenual ACC and pregenual ACC to default mode network regions and the dorsolateral PFC. We instead found that higher depressive symptoms were associated with lower functional connectivity of the ACC to the dorsolateral PFC and regions within the default mode network, including from the subgenual ACC to the dorsolateral PFC and anterior cingulate and from the pregenual ACC to the middle cingulate gyrus. This preliminary study highlights brain alterations at subthreshold levels of depressive symptoms in older adults, which could serve as targets for interventions.

Age differences in affective forecasting accuracy.

Affective forecasts are people's predictions of their future feelings in response to future events. In this study, we examined whether younger and older adults differ in their affective forecasting accuracy. To do so, we recruited younger and older American voters and asked them to predict how they would feel following the 2020 U.S. presidential election. In the general feelings condition, participants predicted how they would feel, in general, following an election victory or loss. In the event-related feelings condition, participants predicted their future feelings specifically about an election victory and about an election loss. Later, these same participants reported their experienced feelings (either in general or about the election outcome). In the general feelings condition, age differences in affective forecasting accuracy varied as a function of whether participants' preferred candidate won or lost the election. Among election victors, there were age-related improvements in affective forecasting accuracy of negative feelings. In contrast, among election losers there were age-related declines in affective forecasting accuracy of both negative and positive feelings. A different pattern emerged for participants in the event-related feelings condition. These participants were highly accurate in their affective forecasts, and there were minimal age differences in forecasting accuracy. Together, these results show that age differences in affective forecasting accuracy depend upon both the type of future event, and the type of future feeling being predicted. When considered together, these results also suggest that the focusing illusion plays a key role in modulating age differences in affective forecasting accuracy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Impact of cardiovascular risk factors on the relationships of physical activity with mood and cognitive function in a diverse sample.

Physical activity has well-known benefits for older adults' mood and cognitive functioning; however, it is not clear whether risk factors for cardiovascular disease (CVD) affect the relationships of physical activity with these health outcomes among diverse older adults. This study investigated the impact of CVD risk burden on the relationships among self-reported physical activity, mood, and cognitive functioning in a diverse sample of 62 adults age 45 and older. We found that higher physical activity was associated with better attention and verbal working memory at lower CVD risk, but with worse attention and verbal working memory at higher CVD risk levels. Thus, higher CVD risk might limit the effectiveness of exercise interventions for mood and cognitive functioning. Future studies are needed to further clarify individual differences that impact the relationships among physical activity, CVD risk, and cognitive outcomes.

Can healthy ageing moderate the effects of population ageing on economic growth and health spending trends in Mongolia? A modelling study.

BACKGROUND:  Population ageing will accelerate rapidly in Mongolia in the coming decades. We explore whether this is likely to have deleterious effects on economic growth and health spending trends and whether any adverse consequences might be moderated by ensuring better health among the older population. METHODS:  Fixed-effects models are used to estimate the relationship between the size of the older working-age population (55-69 years) and economic growth from 2020 to 2100 and to simulate how growth is modified by better health among the older working-age population, as measured by a 5% improvement in years lived with disability. We next use 2017 data on per capita health spending by age from the National Health Insurance Fund to project how population ageing will influence public health spending from 2020 to 2060 and how this relationship may change if the older population (≥ 60 years) ages in better or worse health than currently. RESULTS:  The projected increase in the share of the population aged 55-69 years is associated with a 4.1% slowdown in per-person gross domestic product (GDP) growth between 2020 and 2050 and a 5.2% slowdown from 2020 to 2100. However, a 5% reduction in disability rates among the older population offsets these effects and adds around 0.2% to annual per-person GDP growth in 2020, rising to nearly 0.4% per year by 2080. Baseline projections indicate that population ageing will increase public health spending as a share of GDP by 1.35 percentage points from 2020 to 2060; this will occur slowly, adding approximately 0.03 percentage points to the share of GDP annually. Poorer health among the older population (aged ≥ 60 years) would see population ageing add an additional 0.17 percentage points above baseline estimates, but healthy ageing would lower baseline projections by 0.18 percentage points, corresponding to potential savings of just over US$ 46 million per year by 2060. CONCLUSIONS:  Good health at older ages could moderate the potentially negative effects of population ageing on economic growth and health spending trends in Mongolia. Continued investment in the health of older people will improve quality of life, while also enhancing the sustainability of public budgets.

Research to inform health systems' responses to rapid population ageing: a collection of studies funded by the WHO Centre for Health Development in Kobe, Japan.

Population ageing is a global phenomenon that has profound implications for all aspects of health systems development. Research is needed to understand and improve the health system response to this demographic shift, especially in low- and middle-income countries where the change is happening rapidly. This Supplement was organized by the WHO Centre for Health Development in Kobe, Japan (WHO Kobe Centre) whose mission is to promote innovation and research for equitable and sustainable universal health coverage considering the impacts of population ageing. The Supplement features 10 papers all based on studies that were funded by the WHO Kobe Centre in recent years. The studies involve a diverse set of 10 countries in the Asia Pacific (Cambodia, Japan, the Lao People's Democratic Republic, Malaysia, Mongolia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam); address various aspects of the health system including service delivery, workforce development and financing; and utilize a wide range of research methods, including economic modelling, household surveys and intervention evaluations. This introductory article offers a brief description of each study's methods, key findings and implications. Collectively, the studies demonstrate the potential contribution that health systems research can make toward addressing the challenges of ensuring sustainable universal health coverage even while countries undergo rapid population ageing.

Pricing Services: An Underutilized Policy Instrument for Access and Quality.

We aim to introduce the readers of this special collection to the importance of pricing health and long-term care services, a topic covered in 2 recent joint World Health Organization/Organization for Economic Co-operation and Development (WHO/OECD) publications. The special issue will focus on country experiences in pricing setting and regulation, best practices, and areas for future research.

Preliminary User Evaluation of a Physical Activity Smartphone App for Older Adults.

Objectives: Mobile health (mHealth) delivered through smartphone apps is a viable means of improving health behaviors. Technologies can be strengthened and made more age-inclusive by involving older adults as co-designers, resulting in more accessible and effective products. This study's purpose is to describe preliminary acceptability and feasibility of a physical activity (PA) app tailored to underactive older people. Methods: Moving Up is a multi-feature app designed to increase PA and reduce sedentary behaviors in underactive older adults. The suite houses a core activity tracker and three add-on features that target correlates of inactivity: sedentary behavior, stereotypes about aging, and PA knowledge and routines. Three groups of 4-5 older adult smartphone owners were provided with and oriented to the Moving Up app activity tracker and one add-on feature. Participants beta-tested the app for two weeks, after which each cohort reconvened to discuss experiences, make recommendations for app improvements, and complete a usability questionnaire on their assigned feature. Results: Thirteen participants (median age, 71 years; iOS users, n=8; females, n=12) completed the beta-testing period and returned for follow-up. Reported usability was moderate across the features. Sentiments about app content and general impressions were mainly positive, although users made several recommendations for app improvements such as more individualized messaging and timely notifications. Conclusions: A PA app for older adults demonstrated generally good usability and acceptability. Integrating the impressions and recommendations from older adults into the design of mHealth tools will enhance overall usability and likelihood to positively influence PA behaviors long-term.

Population ageing and health financing: A method for forecasting two sides of the same coin.

There is a perception that population ageing will have deleterious effects on future health financing sustainability. We propose a new method-the Population Ageing financial Sustainability gap for Health systems (or alternatively, the PASH)-to explore how changes in the population age mix will affect health expenditures and revenues. Using a set of six anonymized country scenarios that are based on data from countries in Europe and the Western Pacific representing a diverse range of health financing systems, we forecast the size of the ageing-attributable gap between health revenues and expenditures from 2020 to 2100 under current health financing arrangements. In the country with the largest financing gap in 2100 (country S6) the majority (87.1%) is caused by growth in health expenditures. However in countries that are heavily reliant on labour-market related social contributions to finance health care, a sizeable share of the financing gap is due to reductions in health revenues. We argue that analyses giving equal attention to both health expenditures and revenues steers decision makers towards a more balanced set of policy options to address the challenges of population ageing, ranging from targeting expenditures and utilization of services to diversifying revenue.

The effects of repetition spacing on the illusory truth effect.

The illusory truth effect refers to the fact that repetition increases perceptions of truth. In these experiments, we examined whether the magnitude of the illusory truth effect varies based upon repetition spacing. In Experiment 1, participants read facts that repeated twice, with a lag of 0, 1, 2, 4, 8, 16, or 32 intervening facts. Participants later rated the truthfulness of these facts in addition to new facts. Here, we observed a spacing effect: Truth ratings were higher when repetitions were spaced (i.e., lags of 1 through 32) rather than massed (i.e., lag of 0). We also observed a lag effect that followed a quadratic pattern: Truth ratings increased up to a lag of 16, after which they decreased. In Experiment 2 we tested whether the spacing effect in truth ratings depends upon the number of repetitions. In Experiment 2a we used a small number of repetitions (2, 3, or 4) and short lag lengths (0, 1, or 2). In Experiment 2b, we increased the number of repetitions (2 or 10) and the lag lengths (0 or 10). In Experiment 2a there was an illusory truth effect, but its magnitude did not depend upon lag length or repetition number. However, in Experiment 2b the magnitude of the illusory truth effect increased as lag length and repetition number increased, but there was no interaction between these two factors. Together, these findings show that repetition is most likely to increase perceived truth when repetitions are spaced with a moderate number of intervening items.