Cognitive and Affective Empathy as Indirect Paths Between Heterogeneous Depression Symptoms on Default Mode and Salience Network Connectivity in Adolescents.

Depression amongst adolescents is a prevalent disorder consisting of heterogeneous emotional and functional symptoms-often involving impairments in social domains such as empathy. Cognitive and affective components of empathy as well as their associated neural networks (default mode network for cognitive empathy and salience network for affective empathy) are affected by depression. Depression commonly onsets during adolescence, a critical period for brain development underlying empathy. However, the available research in this area conceptualizes depression as a homogenous construct, and thereby miss to represent the full spectrum of symptoms. The present study aims to extend previous literature by testing whether cognitive and affective empathy indirectly account for associations between brain network connectivity and heterogeneous depression symptoms in adolescents. Heterogeneous functional and emotional symptoms of depression were measured using the child depression inventory. Our results indicate that cognitive empathy mediates the association between default mode network functional connectivity and emotional symptoms of depression. More specifically, that adolescents with a stronger positive association between the default mode network and cognitive empathy show lower emotional depression symptoms. This finding highlights the importance of cognitive empathy in the relationship between brain function and depression symptoms, which may be an important consideration for existing models of depression in adolescents.

Network functional connectivity underlying dissociable cognitive and affective components of empathy in adolescence.

Empathy, the capacity to understand and share others' emotions, can occur through cognitive and affective components. These components are different conceptually, behaviorally, and in the brain. Neuroimaging task-based research in adolescents and adults document that cognitive empathy associates with the default mode and frontoparietal networks, whereas regions of the salience network underlie affective empathy. However, cognitive empathy is slower to mature than affective empathy and the extant literature reveals considerable developmental differences between adolescent and adult brains within and between these three networks. We extend previous work by examining empathy's association with functional connectivity within and between these networks in adolescents. Participants (n = 84, aged 13-17; 46.4% female) underwent resting state fMRI and completed self-report measures (Interpersonal Reactivity Index) for empathy as part of a larger Nathan-Kline Institute study. Regression analyses revealed adolescents reporting higher cognitive empathy had higher within DMN connectivity. Post hoc analysis revealed cognitive empathy's association within DMN connectivity is independent of affective empathy or empathy in general; and this association is driven by positive pairwise connections between the bilateral angular gyri and medial prefrontal cortex. These results suggest introspective cognitive processes related to the DMN are specifically important for cognitive empathy in adolescence.

Training future clinicians: An interprofessional approach to treating tobacco use and dependence.

The high prevalence of smoking among persons with mental illness and co-occurring substance use disorders has not changed in the past decade despite a decline in smoking among the general population. Interprofessional collaborative care offers clinicians the opportunity to engage their patients in tobacco cessation treatment that is coordinated and comprehensive. Investigators applied a 1-group, pre/post-test design with qualitative and quantitative descriptive analyses to estimate the impact of an interprofessional tobacco education program on perceived self-efficacy and self-reported counseling abilities of graduate nursing, social work, and pharmacy (PharmD) students (N = 36; nursing, n = 13, n = 9 PharmD, n = 14 social work) to treat tobacco dependence among this subpopulation of smokers, and to assess their perceptions of interprofessional education. All participants completed a 2-h web-based module, a 3-h classroom training, a simulation with a standardized patient, and a group audio-recorded debriefing session with faculty. Emergent themes from qualitative analyses were valuing simulations, demystifying disciplines, reflecting on and critiquing practice, and lessons learned. Participants' perceived self-efficacy, self-rated counseling ability, intention to ask about tobacco use, and intention to provide counseling for tobacco cessation increased significantly. Teaching students an interprofessional team approach appears to be effective in enhancing counseling abilities and self-efficacy and may positively influence health professions students' perceptions of interprofessional education. Larger studies are recommended to validate the results of this pilot study.

Students' Perceptions of a Tobacco Education Intervention.

Persons living with a mental illness represent an especially vulnerable and disadvantaged subgroup of smokers. Compared to those in the general population, they smoke more, die younger, and suffer disproportionately from cardiovascular disease, diabetes, stroke, and cancer, all diseases and conditions directly associated with, and exacerbated by, smoking. Despite strong evidence that tobacco cessation counseling by a health professional can approximately double patients' odds of quitting, clinicians across disciplines are reluctant to offer these individuals effective means by which to quit smoking. This disinclination is due, at least in part, to inadequate tobacco cessation training during degree education. The purpose of this qualitative study was to assess undergraduate nursing students' perceptions of a tobacco education intervention. Findings support the integration of tobacco education into undergraduate nursing curricula.

If You Teach It, They Will Screen: Advanced Practice Nursing Students' Use of Screening and Brief Intervention in the Clinical Setting.

BACKGROUND: In the United States, approximately 30% of adults drink at risky levels or meet the criteria for harmful or dependent alcohol use. Screening, brief intervention, and referral to treatment (SBIRT) in primary care settings is indicated. This study assessed whether knowledge, attitudes, and beliefs about SBIRT, evaluated after a three-part, mixed-methods training, predicted whether 21 family nurse practitioner (FNP) students screened for alcohol use during clinical patient encounters. METHOD: After training, students completed a survey and documented implementation of SBIRT during their clinical practice-specific management courses. RESULTS: FNP students who reported higher levels of perceived competence in their posttraining surveys were more likely to screen for alcohol in the clinical setting. CONCLUSION: Screening for alcohol misuse and identifying patients engaged in hazardous drinking meet important nurse practitioner competencies. Further research is needed to explore training programs that specifically emphasize activities to increase perceived competence, knowledge, and comfort regarding SBIRT.

Female circumcision: toward an inclusive practice of care.

Female circumcision is a cultural tradition that includes cutting of female genitals without medical necessity. Over 130 million girls and women have been circumcised globally. This article reports on partial findings from a qualitative study that examined the lives of Somali Muslim women who were circumcised. A reoccurring theme of resentment toward North American health care practitioners who condemn the women for having experienced the practice of circumcision in their birth country was found. Discussion will include the physical and social stigma, the complex legal aspects, and ways to deal with female circumcision in a culturally competent manner.