Digital bibliotherapy as a scalable intervention for suicidal thoughts: A randomized controlled trial.

OBJECTIVE: Suicide is a major public health concern in the United States, but few effective and scalable interventions exist to help those with suicidal thoughts. We hypothesized that reading first-person narratives about working through suicidal thoughts would reduce the desire to die among adults and that this effect would be mediated by increased perceived shared experience and optimism. METHOD: Using a randomized waitlist-controlled trial, we tested the effect of digital narrative-based bibliotherapy among 528 adults visiting a social media platform dedicated to providing mental health support. Participants were randomized to either a treatment condition (n = 266), in which they read one suicide narrative per day for 14 days or to a waitlist control condition (n = 262). The primary outcome was a measure of desire to die assessed daily for the 14-day trial period and at 2-week follow-up. RESULTS: Participants in the treatment condition reported lower desire to die than participants in the control condition during the 14-day trial period (ß = -0.26, p = .001) and at 2-week follow-up (t = -2.82, p = .005). Increased perceived shared experience (indirect effect b = -0.55, p < .001) and optimism (indirect effect b = -0.85, p < .001) mediated the effect of treatment on desire to die. CONCLUSIONS: Digital narrative-based bibliotherapy may be an effective intervention for those at risk for suicide, and may work in part by increasing feelings of perceived shared experience and optimism. Future research is needed to test the generalizability of these results to other platforms, groups, and conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

From Monsters to Malformations: Anatomical Preparations as Objects of Evidence for a Developmental Paradigm of Embryology, 1770-1850.

A common object found within medical museums is the developmental series: an arrangement of embryos depicting the transformation of an unremarkable blob into an anatomically organized and recognizable organism. The developmental series depicts a normative process, one where bodies emerge in reliable sequential stages to reveal anatomically perfect beings. Yet a century before the developmental series would become a visual model of embryological development, the very process of development itself was discerned through the comparative study of preserved human fetuses-specifically, those deemed "monstrous" or characterized as "malformations." This article examines how anatomically diverse fetal bodies were reformulated from singular curiosities into alternative developmental pathways whose characteristics testified to the laws of nature and to the primordial, physical relationship between humans and other species. In early nineteenth century Amsterdam, the father-son team of physicians Gerard and Willem Vrolik built up an internationally renowned anatomical museum famous especially for Willem's collection of fetal malformations. Physical preparations of fetal malformations play a central role in Willem's monumental handbook on developmental embryology: comparing human embryos against one another and the embryos of other species, Willem plots out a sequence of embryological development in which a body's form marks its place within the ever-unfolding natural order. In conversation with the literature on model organisms, this article explores how the "monstrous" gets standardized and, in doing so, contributes to the scientific production of a normative physiological process.

Assessment of public and patient online comments in social media and food and drug administration archival data.

OBJECTIVES: To refine a method of collecting the data from various patient generated data sources to explore themes with high repeatability. FDA will acquire new insight into understanding the perspectives of patients and caregivers through analyses of multiple sources. DESIGN: Qualitative analysis of FDA archival data and social media data. SETTING: Two pilot studies assessing methodologies on differing unstructured data sources. Study 1: Opioid Use Disorder (OUD), analyzing OUD public docket comments and social media data. STUDY 2: Pulmonary Arterial Hypertension (PAH), utilizing FDA's PAH PFDD meeting transcripts and 1813 Online User Generated Content (UGC) posts. RESULTS: Through triangulation of data, FDA identified data overlaps (thus increasing confidence of data) and located information found only in certain sources. CONCLUSIONS: and Relevance: For research to be patient centric, leveraging technological advances and multiple patient experience data sources captures the patient perspective beyond clinical delivery and provides additional information and aids in understanding the picture of medical product functioning beyond controlled randomized clinical trials.

Patient-Reported Outcomes in Online Communications on Statins, Memory, and Cognition: Qualitative Analysis Using Online Communities.

BACKGROUND: In drug development clinical trials, there is a need for balance between restricting variables by setting eligibility criteria and representing the broader patient population that may use a product once it is approved. Similarly, although recent policy initiatives focusing on the inclusion of historically underrepresented groups are being implemented, barriers still remain. These limitations of clinical trials may mask potential product benefits and side effects. To bridge these gaps, online communication in health communities may serve as an additional population signal for drug side effects. OBJECTIVE: The aim of this study was to employ a nontraditional dataset to identify drug side-effect signals. The study was designed to apply both natural language processing (NLP) technology and hands-on linguistic analysis to a set of online posts from known statin users to (1) identify any underlying crossover between the use of statins and impairment of memory or cognition and (2) obtain patient lexicon in their descriptions of experiences with statin medications and memory changes. METHODS: Researchers utilized user-generated content on Inspire, looking at over 11 million posts across Inspire. Posts were written by patients and caregivers belonging to a variety of communities on Inspire. After identifying these posts, researchers used NLP and hands-on linguistic analysis to draw and expand upon correlations among statin use, memory, and cognition. RESULTS: NLP analysis of posts identified statistical correlations between statin users and the discussion of memory impairment, which were not observed in control groups. NLP found that, out of all members on Inspire, 3.1% had posted about memory or cognition. In a control group of those who had posted about TNF inhibitors, 6.2% had also posted about memory and cognition. In comparison, of all those who had posted about a statin medication, 22.6% (P<.001) also posted about memory and cognition. Furthermore, linguistic analysis of a sample of posts provided themes and context to these statistical findings. By looking at posts from statin users about memory, four key themes were found and described in detail in the data: memory loss, aphasia, cognitive impairment, and emotional change. CONCLUSIONS: Correlations from this study point to a need for further research on the impact of statins on memory and cognition. Furthermore, when using nontraditional datasets, such as online communities, NLP and linguistic methodologies broaden the population for identifying side-effect signals. For side effects such as those on memory and cognition, where self-reporting may be unreliable, these methods can provide another avenue to inform patients, providers, and the Food and Drug Administration.

Familial factors related to suicidal ideation of Latina adolescents in the United States.

The purpose of this study was to examine whether a Latina adolescent's perception of mother connectedness, father connectedness, parental caring, autonomy granting from parents, and parental interest in their child's school life predicts suicidal ideation above and beyond known risk factors of adolescent depression and acculturation. Using the National Longitudinal Study of Adolescent Health (Add Health) Wave 1, 2 secondary logistic regression data analyses were conducted on a sample of 345 Latina adolescents. Results of correlational analyses indicated that perceived mother connectedness, father connectedness, parental caring, and academic interest were positively related; depression and nativity were negatively related to reports of suicidal ideation. Additionally, in a model with adolescents who reported having both a mother and father figure present in their life, depression and academic interest were significant predictors of suicidal ideation. In a second model, which included all Latinas regardless of the presence of both parents, depression, nativity, perceived academic interest, and caring were significant predictors. Implications are discussed for suicide prevention and intervention with Latina adolescents.

Probing the dependence of long-range, four-atom interactions on intermolecular orientation. 1. Molecular hydrogen and iodine monochloride.

The dependence of the long-range interactions between molecular hydrogen and iodine monochloride on the geometry between the molecules is investigated. Laser-induced fluorescence and action spectroscopy experiments have identified multiple conformers of the o,p-H2...I35,37Cl(X,v' '=0) van der Waals complexes. A conformer with the hydrogen molecule localized at the iodine end of the dihalogen, most likely with C2v symmetry, is significantly more stable than an asymmetric conformer with the hydrogen localized in the well oriented orthogonally to the I-Cl bond axis, D0' ' = 186.4(3) cm-1 versus 82.8(3)

Experimental and theoretical investigations of the He...I2 rovibronic spectra in the I2 B-X, 20-0 region.

The laser-induced fluorescence and action spectra of I2 in a helium supersonic expansion have been recorded in the I2 B-X, 20-0 region. Two features are identified within the spectra. The lower-energy feature arises from transitions between states that are localized in a T-shaped conformation on both the X- and B-state potentials. The higher-energy feature reflects transitions from states that are localized in a linear conformation on the X state to states that have energies that are larger than the barrier for free rotation of the rare gas atom about the I2 molecule on the B-state potential. Ground-state binding energies of 16.6(6) and 16.3(6) cm-1 were determined for the T-shaped and linear conformers, respectively. These spectra are compared to those calculated using the experimentally determined rotational temperatures. Based on the agreement between the experimental and calculated spectra, the binding energies of the J'=0 states with 0 and 2-6 quanta of excitation in the He...I2 bending mode on the B state were determined. Several models for the B-state potential were used to investigate the origins of the shape of the contour of the higher-energy feature in the spectra for He...I2 and He...Br2. The shape of the contours was found to be relatively insensitive to the choice of potential. This leads us to believe that the spectra of these systems are relatively insensitive to the parameters of the B-state potential energy surface and are more sensitive to properties of the halogen molecule.

Stabilization and rovibronic spectra of the T-shaped and linear ground-state conformers of a weakly bound rare-gas-homonuclear dihalogen complex: He...Br2.

Laser-induced fluorescence spectra of Br(2) entrained in a He supersonic expansion have been recorded in the Br(2) B-X, 8-0, 12-0, and 21-0 spectral regions at varying downstream distances, and thus different temperature regimes. Features associated with transitions of the T-shaped and linear He...Br(2)(X,nu(") = 0) complexes are identified. The changes in the relative intensities of the T-shaped and linear features with cooling in the expansion indicate that the linear conformer is energetically more stable than the T-shaped conformer. A He + Br(2)(X,nu(") = 0) ab initio potential-energy surface, computed at the coupled cluster level of theory with a large, flexible basis set, is used to calculate the binding energies of the two conformers, 15.8 and 16.5 cm(-1) for the T-shaped and linear complexes, respectively. This potential and an excited-state potential [M. P. de Lara-Castells, A. A. Buchachenko, G. Delgado-Barrio, and P. Villareal, J. Chem. Phys. 120, 2182 (2004)] are used to calculate the excitation spectra of He...(79)Br(2)(X,nu(") = 0) in the Br(2) B-X, 12-0 region. The calculated spectra are used to make spectral assignments and to determine the energies of the excited-state intermolecular vibrational levels accessed in the observed transitions. Temperature-dependent laser-induced fluorescence spectra and a simple thermodynamic model [D. S. Boucher, J. P. Darr, M. D. Bradke, R. A. Loomis, and A. B. McCoy, Phys. Chem. Chem. Phys. 6, 5275 (2004)] are used to estimate that the linear conformer is 0.4(2) cm(-1) more strongly bound than the T-shaped conformer. Two-laser action spectroscopy experiments reveal that the binding energy of the linear He...(79)Br(2)(X,nu(") = 0) conformer is 17.0(8) cm(-1), and that of the T-shaped He...(79)Br(2)(X,nu(") = 0) conformer is then 16.6(8) cm(-1), in good agreement with the calculated values.