A Holistic Self-learning Approach for Young Adult Depression and Anxiety Compared to Medication-Based Treatment-As-Usual.

A package of biopsychosocial services for young adults experiencing psychological distress was evaluated and compared to usual outpatient psychiatric care. Young adults (18-25) with moderate-to-severe symptoms of depression and/or anxiety (n = 26) were enrolled in a 13-week intervention consisting of nutritional coaching and multi-vitamin supplements, weekly educational and peer support groups, and a modest financial stipend to engage with physical or expressive activities. A comparison group (n = 13) continued with their usual medication-based outpatient care. Program participants reported significantly improved depression, anxiety, severity of distress, overall quality of life, and empowerment over 4 months, with progress maintained or further improved at 2-month follow-up. No evidence of change on any outcome was observed for comparison group participants. Although long-term impacts on mental health trajectories and reliance on psychotropic medications remain unknown, a holistic self-learning approach is a viable alternative to standard outpatient psychiatric care for young adults.

Assessing disorganized attachment representations: a systematic psychometric review and meta-analysis of the Manchester Child Attachment Story Task.

Narrative story stem measures are increasingly popular for the assessment of attachment representations among early school-age children. Given their clinical and theoretical importance, disorganized representations are typically a focus of assessment procedures. The Manchester Child Attachment Story Task (MCAST) is one such measure. A systematic literature review and meta-analysis was conducted to evaluate the documented reliability and validity of the MCAST with a focus on assessing disorganized representations. Twenty-five studies were included in the review encompassing 1,876 children from nine countries. Results suggest that inter-rater reliability for the MCAST is acceptable and the prevalence of disorganization identified on the MCAST among various subgroups (e.g. community, clinical, adopted/maltreated) is comparable to prevalence estimates from other developmental periods using other assessment methods. In addition, prevalence of disorganization on the MCAST differed in hypothesized ways between the various subgroups. However, MCAST disorganization did not correlate in predictable ways with many constructs when relationships were examined within samples. Few studies examined the relationship of disorganization on the MCAST with parenting variables, aspects of adoption and maltreatment, and emotion regulation skills. Recommendations for further study of the MCAST and for how the tool might be integrated into clinical and developmental research are provided.

The association between Disruptive Mood Dysregulation Disorder symptoms and sleep problems in children with and without ADHD.

BACKGROUND: Many youth experience persistent irritability and recurrent temper outbursts, conceptualized by DSM-5 as Disruptive Mood Dysregulation Disorder (DMDD). Sleep deprivation impairs emotion regulation which could increase rates of DMDD symptoms, especially in those with preexisting regulatory impairments, as seen with ADHD. However, there has been little examination of the relationship between chronic sleep problems and DMDD symptoms. METHODS: Associations between DMDD symptoms and sleep parameters in children were assessed using parent-report and objective measures of sleep in a general population sample (N = 665) and an ADHD sample (N = 784). Irritability, temper outbursts, sleep problems and other psychological problems were assessed with the Pediatric Behavior Scale. The general population study also completed overnight polysomnography (PSG). RESULTS: DMDD symptoms were reported in 9.2% of the community sample and 31.4% of the ADHD sample. In both samples, children with DMDD symptoms had significantly higher parent-reported sleep problems than children without DMDD symptoms. Children with sleep problems had significantly higher DMDD scores than children without sleep problems. However, DMDD symptoms were most strongly associated with oppositional behavior. Sleep problems were not a significant contributor. Hyperactivity-impulsivity was most strongly associated with sleep problems, and DMDD was not a significant contributor. Children with and without DMDD symptoms did not differ significantly on any PSG parameter. CONCLUSIONS: Associations between parent-reported sleep problems and DMDD symptoms were due to their shared relationship with other behavioral problems. Therefore, chronic sleep problems do not appear to be a primary source of DMDD symptoms in children with or without ADHD.