Psychiatric disorders in term-born children with marginally low birth weight: a population-based study.

BACKGROUND: Marginally low birth weight (MLBW) is defined as a birth weight of 2000 ~ 2499 g. Inconsistent findings have been reported on whether children with low birth weight had higher rates of neurological, attention, or cognitive symptoms. No studies have explored the occurrence of clinically diagnosed psychiatric disorders in term- born MLBW infants. We aimed to investigate the risk of subsequent psychiatric disorders in term-born children with MLBW. METHODS: This is a nationwide retrospective cohort study, by analysing the data from Taiwan's National Health Insurance Research Database from 2008 to 2018. The study population includes propensity-score-matched term-born infants with MLBW and those without MLBW (birth weight ≥ 2500 g). Cox proportional hazard analysis was used after adjustment for potential demographic and perinatal comorbidity confounders. Incidence rates and hazard ratios (HR) of 11 psychiatric clinical diagnoses were evaluated. RESULTS: A total of 53,276 term-born MLBW infants and 1,323,930 term-born infants without MLBW were included in the study. After propensity score matching for demographic variables and perinatal comorbidities, we determined that the term-born MLBW infants (n = 50,060) were more likely to have attention deficit and hyperactivity disorder (HR = 1.26, 95% confidence interval (CI) [1.20, 1.33]), autism spectrum disorder (HR = 1.26, 95% CI [1.14, 1.40]), conduct disorder (HR = 1.25, 95% CI [1.03, 1.51]), emotional disturbance (HR: = 1.13, 95% CI [1.02, 1.26]), or specific developmental delays (HR = 1.38, 95% CI [1.33, 1.43]) than term-born infants without MLBW (n = 50,060). CONCLUSION: MLBW was significantly associated with the risk of subsequent psychiatric disorder development among term-born infants. The study findings demonstrate that further attention to mental health and neurodevelopment issues may be necessary in term-born children with MLBW. However, possibilities of misclassification in exposures or outcomes, and risks of residual and unmeasured confounding should be concerned when interpreting our data.

The therapeutic effects of yoga in people with Parkinson's disease: a mini-review.

Parkinson's disease (PD) is one of the most common neurodegenerative diseases, second only to Alzheimer's disease. Drugs and deep brain stimulation (DBS) are the main treatments for PD. However, the long-term side effects of drugs and the risks of surgery cannot be ignored. It is therefore important to research safe and effective complementary and alternative therapies for PD. Yoga, an ancient mind-body exercise, has been widely used in health promotion. Although, yoga can address a range of health problems, little is known about its role in people with PD. This article reviews the evidence that yoga improves PD symptoms, including movement disorders, balance function and emotional disturbance. The authors analyze the role and shortcomings of the yoga intervention process, with the aim of providing a scientific basis for the application of yoga training to people with PD.

The risk associated with psychiatric disturbances in patients with diabetes in Indonesia (2018): a cross-sectional observational study.

BACKGROUND: The global prevalence of psychiatric disturbances is rising, detrimentally affecting the quality of care and treatment outcomes for individuals, particularly those with diabetes.This study investigated the association of risk factors for psychiatric disturbances among productive-age patients with diabetes (ages 30-59 years), considering sociodemographic characteristics and co-existing diseases. The risk factors considered included sociodemographic factors (e.g., residence, age, sex, marital status, education, and occupation) and co-existing diseases (e.g., hypertension, heart disease, stroke, renal failure, rheumatism, asthma, and cancer). METHODS: This cross-sectional study utilized data from the 2018 Indonesian National Health Survey (Riskesdas). The study population comprised respondents aged between 30 and 59 years who had diabetes and had completed the 20-question self-reporting questionnaire (SRQ-20). After the exclusion of incomplete SRQ-20 data, the sample included 8,917 respondents. Data were analyzed using logistic regression. RESULTS: Approximately 18.29% of individuals with diabetes displayed symptoms indicative of psychiatric disturbances. After adjusting for sociodemographic factors such as age, sex, education level, occupation, marital status, and place of residence, patients with diabetes who had co-existing conditions such as hypertension, heart diseases, rheumatic disorders, asthma, or cancer had a higher risk for developing psychiatric disturbances than those with diabetes alone (adjusted odds ratio, 6.67; 95% confidence interval, 4.481-9.928; p<0.001). CONCLUSION: The elevated risk of psychiatric disturbances among patients with diabetes who had comorbidities underscores the importance of addressing mental health issues in the management of diabetes, especially in patients with concurrent disease conditions.

Creencias Irracionales y Sintomatología Depresiva en Estudiantes Universitarios de Psicología en Honduras

El objetivo de este estudio fue determinar la relación entre creencias irracionales y sintomatología depresiva en estudiantes universitarios de Psicología en Honduras. Se utilizó un enfoque cuantitativo, un alcance descriptivo-correlacional y un diseño no experimental transversal correlacional. La muestra fue de 257 estudiantes universitarios de Psicología de dos universidades hondureñas. Para la recolección de datos se aplicó el Test de Creencias Irracionales y el Inventario de Depresión de Beck-II. Las principales creencias irracionales manifiestas por los estudiantes son culpabilización, altas autoexpectativas, influencia del pasado y evitación de problemas, y alrededor de un tercio sufre sintomatología depresiva de moderada a severa. Los estudiantes varones, menores de 31 años, pertenecientes a una universidad privada y que se encuentran solteros son los que tienen más altas creencias irracionales y mayores niveles de depresión, pero solo hay diferencia estadísticamente significativa entre el grupo etario y la sintomatología depresiva. Además, existe relación significativa entre creencias irracionales y cuatro de sus dimensiones (necesidad de aprobación, altas autoexpectativas, culpabilización e influencia del pasado) con sintomatología depresiva. Es urgente que las autoridades universitarias elaboren programas y servicios institucionales que prevengan y promuevan la salud mental, para disminuir los procesos mentales patológicos que pueden desencadenar problemas como el suicidio.

The objective of this study was to determine the relationship between irrational beliefs and depressive symptoms in university students of Psychology in Honduras. A quantitative approach, a descriptive-correlational scope and a non-experimental correlational cross-sectional design was used. The sample was 257 university students of Psychology from two Honduran universities. For the collection of data, the Irrational Beliefs Test and the Beck-II Depression Inventory were applied. The main irrational beliefs manifested by the students are guilt, high self-expectations, influence of the past and avoidance of problems, and about a third of the students suffer from moderate to severe depressive symptoms. Male students, under 31 years, attending a private university and who are single are those who have the highest irrational beliefs and higher levels of depression, but there is only a statistically significant difference between the age group and depressive symptomatology. In addition, there is a statistically significant relationship between irrational beliefs and four of its dimensions (need for approval, high self-expectations, guilt and influence of the past) with depressive symptoms. It is urgent that university authorities develop programs and institutional services that prevent and promote mental health, to reduce pathological mental processes that can trigger problems such as suicide.

Prevalence of alexithymia among medical students in Nepal: A cross-sectional study based on a self-administered questionnaire.

Background and Aims: Alexithymia is a state in which one cannot comprehend and put their emotions or feelings into words. It is a disturbance that is common among general population as well as people with mental health disorders. Medical students are at higher risk of developing alexithymia due to the extensive nature of their course and clinical postings. The presence of alexithymia is negatively correlated with the self-efficacy of the students eventually affecting self-care and patient care in the future. The aim of this study is to find the prevalence of alexithymia among medical students in Nepal and know its associated factors. Methods: This cross-sectional study used convenient sampling for selecting responders and the TAS-20 tool for data collection. Data were analyzed by using SPSS 20. Frequency was calculated for all the variables. Prevalence with 95% confidence interval [CI] is reported and the χ 2 test is used to see the difference in alexithymia status among different categories of dichotomous independent variables. Results: Out of 386 students, 380 of them responded. The ratio of male and female was 1.8 with the mean age of 22.22 ± 1.77 years. The prevalence of alexithymia was found to be 22.89% (95% CI, 18.9-27.1). There was no statistically significant difference between the presence and absence of alexithymia among categories of sex, year of study, staying at hostel, involvement in extracurricular activities, involvement in daily exercise/yoga/outdoor sports, and smoking habit. Conclusion: The prevalence of alexithymia in our study was 22.89% with no association with known factors.

Intercultural sensitivity as a mediator in the relationship between implicit intercultural identification and emotional disturbance-An exploratory study of international high school students.

Background: Intercultural adaptation is always associated with emotional disturbances. Intercultural communication competence, as an important competence of intercultural adaptation, involves implicit intercultural identification and intercultural sensitivity. Competence in these areas promotes the process of intercultural adaptation. Little is known about the relationship between intercultural communication competence and emotional disturbances in new students attending international high schools. The intercultural adaptation process of this population requires attention because of the increasing number of high school students attending international schools, and the fact that most of these teenagers are immersed in intercultural contexts for the first time. Objective: This study aimed to investigate the prevalence of emotional disturbance in new students in an international high school and confirm the relationship among implicit intercultural identification, intercultural sensitivity, and emotional disturbances. Methods: Study 1 was an investigation of the prevalence of emotional disturbance in 105 students in their 1st year at an international high school using the Self-rating Depression Scale and Self-rating Anxiety Scale. Of these students, 34 were invited to participate in Study 2 to further explore the relationship between intercultural sensitivity, implicit intercultural identification, and emotional disturbances using the Intercultural Sensitivity Scale and Single Category Implicit Association procedure. Results: Study 1 indicated that 15.24% of students were affected by apparent depression and 10.48% had anxiety symptoms. Study 2 revealed that emotional disturbances significantly correlated with intercultural sensitivity (p < 0.01) and implicit intercultural identification (p < 0.01). The openness factor from intercultural sensitivity mediated the relationship between implicit intercultural identification and depression (ratio of indirect effect = 41.04%, p < 0.05) and anxiety symptoms (ratio of indirect effect = 34.65%, p < 0.05). Conclusion: The study revealed that a significant proportion of students in the 1st year of international high school are affected by emotional difficulties. However, intercultural communication competence is a protective factor. Enhancing the international communication competence of senior students in international high schools is important to mitigate mental health challenges.

Emotional intelligence on job performance: A study on Malaysian employees.

BACKGROUND: The COVID-19 pandemic has affected the emotional intelligence of employees through the negative effects on their mental health, and led to poor workplace performance. OBJECTIVE: The purpose of this research is to examine the level of EI of Malaysian employees in various sectors affecting their job performance through the mediating influence of psychological capital by using the Schutte Self-Report Emotional Test (SSEIT), 24-item Psychological Capital Questionnaire (PCQ-24) and Role-Based Performance Scale (RBPS) theories. METHOD: A quantitative study was conducted. 350 sets of questionnaires were given out to Malaysian employees, of which 311 were returned. Data were analysed through regression analysis. RESULTS: The results showed that all emotional intelligence subscales, except for utilising emotions, have a significant relationship with job performance through the effect of psychological capital. CONCLUSION: This study offers valuable and insightful implications by combining the SSEIT, PCQ-24, and RBPS models to investigate the effect of emotional intelligence on job performance in Malaysia, which is an unusual combination model to analyse employees' job performance. It helps Malaysian companies, managers, employers, and other related parties to recognise the processes and elements that influence employees' work performance. This research also successfully developed an extended SSEIT model together with PCQ-24 and RBPS and verified their applicability on workplace performance.

Effect of Social Media Addiction on Executive Functioning Among Young Adults: The Mediating Roles of Emotional Disturbance and Sleep Quality.

Introduction: The increased research examining social media addiction with its negative consequences has raised concerns over the past decade. However, little research has investigated the association between social media addiction and executive functioning as well as the mechanisms underlying this relationship. Methods: Using a survey, the present study examined the association between social media addiction and executive functioning via emotional disturbance and sleep quality among 1051 Chinese young adults, aged 18 to 27 years old (M=21.02 years [SD=1.89]; 34.41% male). Results: The results showed that social media addiction had a significant negative association with executive functioning but positive associations with emotional disturbance and poor sleep quality. Structural equation modeling suggested that there was a significant direct effect between social media addiction and executive functioning. Indirect effects via two paths (ie, emotional disturbance alone, and both emotional disturbance and sleep quality) were also statistically significant. Discussion: The findings indicate that both emotional disturbance and poor sleep quality are risk-enhancing mediators in the relationship between social media addiction and executive functioning. Intervention programs (eg, emotional regulation strategies) should be considered to reduce the adverse effects of social media addiction on cognitive impairment among young adults.

Disparities in Youth and Family Experiences of System-of-Care Principles by Level of Youth Need.

The extent to which mental health services for youths embody system-of-care (SOC) principles is an important quality indicator. This study tested whether youth and family experiences of SOC principles varied depending on youths' level of need after adjusting for sociodemographic and treatment factors. The relationship to caregiver-reported clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1124 caregivers of youths ages 5-20 within a statewide system, adjusted analyses indicated caregivers of youths with the most intensive needs were significantly less likely to report receiving care that embodied SOC principles, with deficits on six of nine items. Youths whose services embodied SOC principles experienced significantly greater improvement in caregiver-reported functioning even after adjusting for level of need. Results highlight disparities in SOC principles for youths with intensive needs and the need for policy and intervention development to improve care for this population.

Emotional disturbance and risk factors among COVID-19 confirmed cases in isolation hotels.

Patients with coronavirus disease 2019 (COVID-19) has been isolated in hospital-managed isolation hotels under a policy of the Taiwan government. Centrally isolation patients are more likely to experience psychological symptoms. The purpose of the study was to investigate emotional disturbance during their isolation period and then pinpoint the factors during their isolation period associated with the emotional disturbance. We retrospectively analysed the medical charts of the patients confined to a Banqiao isolation hotel between May 28 and July 3, 2021. The 5-item brief symptom rating scale (BSRS-5) was used to evaluate emotional disturbance levels. Descriptive and logistic regression was used for the data analysis. In total, 197 complete medical records were reviewed, and of these 84 (42.6%) showed emotional disturbance. The majority of them reported only minor disturbance (n = 49, 58.3%). After controlling for confounding factors, being satisfied about medical information was the only protective factor associated with emotional disturbance (OR = 0.2, P = 0.018). Being a male patient (OR = 3.0, P = 0.005), worrying about stigmatization (OR = 2.2, P = 0.041) and being unable to contact family members (OR = 2.9, P = 0.018) increased the risk of experiencing emotional disturbance. Patients with clinical symptoms, namely sore throat (OR = 3.4, P = 0.013) and muscle aches (OR = 6.3, P = 0.005), were also found to be more likely to report emotional disturbance. Mental disturbance commonly occurs among patient with COVID-19 who are isolated in a hospital-managed hotel. Being a male patient, having symptoms, namely a sore throat and muscle pain, being unable to contact family and/or a failure to receive sufficient medical information were found to be associated with emotional disturbance. In order to help isolated patients, government officials should provide a clear rationale for isolation and recognize the patients' efforts to follow the government's policy, which will help to minimize social stigma.

A Multi-Stakeholder Perspective on Factors Affecting Successful Transition to Adulthood for Youth with Severe Emotional Disturbances.

This study elicited the perspectives of youth, caregivers, service providers and researchers to explore how communities can best support the transition to adulthood for youth ages 16-21 with mental health and functional impairments, who are at risk of disconnecting from health and human services. Framed by Relational Systems Evaluation (RSE) and Positive Youth Development (PYD), our study demonstrates the importance of engagement with youth experts. Group Concept Mapping (GCM), a collaborative multiphase mixed-methods approach, was used as a systematic process for participants to make meaning of qualitative data using multidimensional scaling and hierarchical cluster analysis (Kane and Trochim in Concept mapping for planning and evaluation, Sage Publications Inc., Thousand Oaks, 2007). Across all participant groups, Life Skills were perceived as highly important and highly feasible for a successful transition to adulthood. However, Positive Social Support & Connectedness were viewed as less important and less feasible by all groups. When examined closely, youth perspectives differed from caregiver and provider perspectives in the factors they prioritized and deemed feasible. Our findings have implications for community mental health services and positive youth development program practitioners.

Extreme emotional disturbance: Legal frameworks and considerations for forensic evaluation.

A significant minority of jurisdictions in the United States offer extreme emotional disturbance (EED) as a partial defense to murder. The form of this defense, as established by statute and case law, varies widely among jurisdictions. Empirical research on EED is scant with little guidance to forensic mental health professionals on how to approach and conceptualize potential EED cases. This paper addresses these issues by being the first known published work to (1) set forth a contemporary map of the varying definitions and scope of EED across the United States, (2) translate legal terminology into constructs accessible to forensic evaluators, and (3) provide legal and clinical analyses of sample EED cases to highlight key differences in the form of the defense and the admissibility of evidence between jurisdictions.

Depresión, desregulación emocional y estrategias de afrontamiento en adolescentes con conductas de autolesión / Depression, emotional dysregulation and coping strategies in adolescents with self-injurious behaviors

Resumen En México, el estudio de la autolesión cuenta con pocas investigaciones, y menos si se trata de estudios que conformen posibles modelos explicativos. Teniendo esto en cuenta, en el presente trabajo se planteó como objetivo conocer la relación de la autolesión con la depresión, la desregulación emocional y los estilos de afrontamiento, con el fin de generar un modelo explicativo de la problemática. El estudio se realizó a partir de un diseño cuantitativo, transversal y con alcance explicativo, y se contó con una muestra de 5835 adolescentes (M edad = 11-15 años) inscritos en 62 secundarias públicas del estado de Sonora. Se realizaron regresiones logísticas para el análisis de los datos, y como resultado se encontró que, para los estudiantes con autolesión severa (3.54 %), el modelo explica el 61 % de la varianza en los datos (R1 de Nagelkerke = .61) y clasifica correctamente al 84.1 % de los participantes; mientras que, en la autolesión leve (5.29 %), el modelo explica el 72 % de la varianza en los datos (R2 de Nagelkerke = .72) y clasifica correctamente al 88.2 % de los estudiantes. Asimismo, las dimensiones de depresión mostraron el mayor nivel explicativo (cognitiva-afectiva, somática) y correlaciones positivas con la desregulación emocional y el estilo de afrontamiento de evitación, así como correlaciones negativas con el estilo de afrontamiento de aproximación. Al final se discute respecto a la importancia de las variables independientes para futuras investigaciones, y sobre los resultados anómalos y otros datos de interés.

Abstract In Mexico, there is little research on the study of self-injury and even less on possible explanatory models. With this in mind, this study aimed to determine the relationship between self-injury and depression, emotional dysregulation, and coping styles, to generate an explanatory model of the problem. The study was carried out using a quantitative, cross-sectional, explanatory scope, design and a sample of 5835 adolescents (Mage = 11-15 years) enrolled in 62 public high schools in the state of Sonora. Logistic regressions were performed for data analysis, and as a result it was found that, for students with severe self-injury (3.54 %), the model explains 61 % of the variance in the data (Nagelkerke's R2 = .61) and correctly classifies 84.1 % of the participants; whereas, in mild self-injury (5.29 %), the model explains 72 % of the variance in the data (Nagelkerke's R2 = .72) and correctly classifies 88.2 % of the students. Likewise, the depression dimensions showed the highest explanatory level (cognitive-affective, somatic) and positive correlations with emotional dysregulation and avoidance coping style, as well as negative correlations with approach coping style. At the end, the importance of the independent variables for future research is discussed, as well as anomalous results and other data of interest.

Degenerative temporomandibular joint diseases and their relation with sleep and emotional disturbance.

OBJECTIVE: The relation of degenerative temporomandibular joint (TMJ) diseases (DJDs) with sleep and emotional disturbance were investigated. METHODS: CBCT examination of patients (n = 358) with DC/TMD-defined intra-articular temporomandibular disorders was performed and stratified into NN: no DJD and no arthralgia; NA: no DJD with arthralgia; TO: osteoarthrosis; and TR: osteoarthritis. Sleep and emotional disturbance were assessed with the Pittsburgh Sleep Quality Index (PSQI) and Depression Anxiety Stress Scale-21 (DASS-21). Data were evaluated using non-parametric and multivariate logistic regression analyses (α = 0.05). RESULTS: Distributions of NN, NA, TO, and TR groups were 23.2%, 27.1%,19.0%, and 30.7%, respectively. No significant differences in total-PSQI/DASS scores were detected among the four groups. The presence of pain and stress predicted poor quality sleep with odds ratios of 10.75 and 1.07, accordingly. CONCLUSION: Sleep quality was affected more by arthralgia and stress than the presence of TMJ DJDs.

Depression and Anxiety: Considerations for Interpretation of the SNOT-22 (22-Item Sinonasal Outcome Test).

OBJECTIVE: The objective of this study was to determine whether depression and anxiety symptoms affect and confound scoring on the 22-item Sinonasal Outcome Test (SNOT-22), a commonly used outcome measure for chronic rhinosinusitis. STUDY DESIGN: Prospective cross-sectional. SETTING: Tertiary care academic center. METHODS: 240 participants completed the SNOT-22, from which nasal, sleep, ear/facial pain, and emotional subdomain scores were calculated. They also completed the 8-item Patient Health Questionnaire (PHQ-8) as a reflection of depression symptoms and 7-item Generalized Anxiety Disorder (GAD-7) questionnaire as a reflection of anxiety symptoms. Correlations were calculated between the 4 SNOT-22 subdomains and the PHQ-8 and GAD-7. Additionally, the predictive ability of subdomains and individual items of the SNOT-22 to predict depression and anxiety was calculated. RESULTS: The SNOT-22 sleep and emotional subdomains most strongly correlated with the PHQ-8 and the GAD-7. The emotional and sleep subdomain scores were predictive of having depression or anxiety. An emotional subdomain score ≥4 had 62.5% sensitivity and 90.1% specificity for detecting depression and 78.8% sensitivity and 88.9% specificity for detecting anxiety. A sleep subdomain score ≥21 had 81.2% sensitivity and 71.4% specificity for detecting depression and 87.9% sensitivity and 68.6% specificity for detecting anxiety. The emotional subdomain item related to sadness and the sleep subdomain items related to functional impairment were most predictive of depression and anxiety. CONCLUSION: The SNOT-22 emotional and sleep subdomain scores may be used to predict active depression and anxiety symptoms, especially when items related to sadness or functional impairment are scored with moderate burden.

The Relationship Between Children's Exposure to Intimate Partner Violence and an Emotional-Behavioral Disability: A Scoping Review.

Children's exposure to intimate partner violence (IPV) is an adverse childhood experience that often results in academic, behavior, and mental health difficulties. This study reviewed the empirical studies examining the relationship between children's exposure to IPV and an emotional-behavioral disability (EBD). Studies were included in the review if they examined the relationship between exposure to IPV and EBD among children under 18. This research identified three empirical studies that analyzed the relationship between exposure to IPV and EBD. The review demonstrated that few studies had been conducted that explored the relationship between children's exposure to IPV and EBD and that most of the extant studies are dated. Findings from this review showed that children exposed to IPV were more likely to have EBD compared to other disabilities such as a learning disability, hearing disability, speech and language disability, and an intellectual disability. Higher frequency of violence exposure was associated with EBD. Practice implications include assessing children's functioning at school and discussing with families or caregivers the option of requesting an evaluation for EBD for children with severe emotional or behavioral difficulties. Special education evaluators assessing children for EBD should consider screening for children's exposure to IPV and providing resources for IPV. Future research should conceptualize the full range of IPV experiences and collect exposure data from children directly using a validated measure.

The effect of a group cognitive behavioral therapy on the quality of life and emotional disturbance of women with breast cancer.

PURPOSE: While the rate of survival has increased in the past decade, the diagnosis of breast cancer is an extremely stressful experience for patients and it is associated with the manifestation of several psychological problems. To examine the effect of a group cognitive behavioral therapy (CBT) on the quality of life and emotional disturbance of women with breast cancer. METHODS: The study was a randomized controlled clinical trial. Samples were 48 women who had been diagnosed with breast cancer and had undergone mastectomy and chemotherapy. Study variables were measured before and after the intervention and 1 month after the end of the intervention as a follow-up. Controls received nothing and were just followed-up. Repeated measure ANOVAs were used to compare the effectiveness of the intervention on the study variables. RESULTS: The results of 32 women were analyzed. The increase in quality of life scores was significantly higher in the intervention group compared to the control group (P < 0.05). There were also significantly lower changes in the depression, anxiety, and stress scores of the intervention group (P < 0.05). However, the changes in the score of death anxiety were not significantly lower in the intervention group in comparison to controls (P > 0.05). CONCLUSION: Group cognitive behavioral therapy was effective in the improvement of quality of life and decreases some aspects of emotional disturbance. Findings of this study suggest that women with breast cancer can benefit from group CBT. Yet, some aspects of the mental health of these women may need more attention and individualized methods. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: IRCT20100911004728N4.

Examining community mental health providers' delivery of structured weight loss intervention to youth with serious emotional disturbance: An application of the theory of planned behaviour.

BACKGROUND: Rates of overweight and obesity are disproportionately high among youth with serious emotional disturbance (SED). Little is known about community mental health providers' delivery of weight loss interventions to this vulnerable population. OBJECTIVE: This study examined attitudinal predictors of their providers' intentions to deliver weight loss interventions to youth with SED using the theory of planned behaviour. DESIGN: This study used a cross-sectional, single-time-point design to examine the relationship of the theory of planned behaviour constructs with behavioural intention. SETTING AND PARTICIPANTS: Community mental health providers (n = 101) serving youth with SED in the United States completed online clinical practice and theory of planned behaviour surveys. MAIN VARIABLES STUDIED: We examined the relationship of direct attitude constructs (i.e., attitude towards the behaviour, social norms and perceived behavioural control), role beliefs and moral norms with behavioural intention. Analyses included a confirmatory factor analysis and two-step linear regression. RESULTS: The structure of the model and the reliability of the questionnaire were supported. Direct attitude constructs, role beliefs and moral norms predicted behavioural intention to deliver weight loss interventions. DISCUSSION: While there is debate about the usefulness of the theory of planned behaviour, our results showed that traditional and newer attitudinal constructs appear to influence provider intentions to deliver weight loss interventions to youth with SED. Findings suggest preliminary strategies to increase provider intentions. PUBLIC CONTRIBUTION: This study was designed and the results were interpreted as part of a larger, community-based participatory research effort that included input from youth, families, providers, administrators and researchers. Collaborative discussions with community mental health providers and administrators particularly contributed to the study question asked as well as interpretation of results.

Medicaid Waivers for Youth with Severe Emotional Disturbance: Associations with Public Health Coverage, Unmet Mental Health Needs & Adequacy of Health Coverage.

Home and Community-Based Services (HCBS) Medicaid waivers for Serious Emotional Disturbance (SED) extend Medicaid eligibility to youth who otherwise would be financially ineligible and finance a broad array of highly specialized mental health services specific to the needs of youth with SED. This study examines whether these policies are associated with greater public health insurance coverage among youth with severe mental health diagnoses. It also assesses, among youth with severe mental health diagnoses who have public health coverage, whether waiver policies are associated with reduced reports of unmet mental health treatment need and increased reports of adequate mental health coverage. Analysis uses CMS reported data on state HCBS Medicaid waivers in conjunction with data from the National Survey of Children's Health for the years 2016 through 2018. Multi-level, fixed-effects logistic regression models demonstrate that living in a state with an HCBS Medicaid waiver is associated with significantly increased odds of having public insurance among children with concurrent private health coverage (OR 1.89), reduced odds of unmet mental health needs among youth with public coverage (OR 0.45), but not significantly associated with reported adequacy of mental health insurance coverage.

Reading Instruction for Students with Emotional Disturbance: A Mixed-Methods Investigation.

Although there is a substantial body of observation research investigating the manner in which reading instruction is provided to students with learning disabilities, there is little research in this area involving students with and at risk for emotional disturbance. The purpose of this investigation was to contribute to the limited corpus of observation studies investigating school-based practice in reading for this student population. In this investigation, 11 teachers from two states were systematically observed while providing reading instruction over the course of the 2017-2018 school year. Participating students were also observed over the course of the year and completed two standardized reading assessments at the beginning and end of this investigation. Teachers were also interviewed to identify contextual factors that promote or impede the provision of high quality reading instruction to this student population. Study findings suggest that teachers are in need of additional training, support, and resources to maximize instructional time. Students in this sample tended to make no or minimal progress in reading and were frequently observed displaying low levels of academic engagement across settings. Implications for school practice and areas for future research are discussed.