Headache Specialists' Perceptions of the Role of Health Psychologists in Headache Management: A Qualitative Study.

Background Since headache specialists cannot treat all the patients with headache disorders, multidisciplinary teams that include health psychologists are becoming more prevalent. Health psychologists mainly use a form of cognitive-behavioral therapy (CBT), along with biofeedback on occasion, to effectively address patients' pain and headache disorders. The Veterans Health Administration (VHA) is one setting that routinely includes a health psychologist with advanced training in pain disorders in their pain care to its veterans. The VHA has established Headache Centers of Excellence (HCoE) around the country to provide multidisciplinary treatment for patients with headache disorders, which enables headache specialists to regularly interact with health psychologists. Objective The study's objective is to evaluate headache specialists' views of health psychologists in the treatment of patients with headache disorders. Method Semi-structured interviews were conducted with headache specialists in academic-based healthcare settings, the community, and VHA HCoE sites. The interviews were audio-recorded and de-identified so they could be transcribed and analyzed using content matrix analysis. Results Four themes emerged: headache specialists desired to work with health psychologists and included them as members of multidisciplinary teams; valued health psychologists because they provided non-pharmacological treatments, such as CBT and biofeedback; preferred in-person communication with health psychologists; and used multiple titles when referring to health psychologists. Conclusion Headache specialists valued health psychologists as providers of behavioral and non-pharmacological treatments and considered them essential members of multidisciplinary teams. Headache specialists should strive to work with a headache psychologist, not just a general health psychologist. By committing to this, headache specialists can foster changes in the quality of care, resource allocation, and training experiences related to health psychologists.

Folk psychological attributions of consciousness to large language models.

Technological advances raise new puzzles and challenges for cognitive science and the study of how humans think about and interact with artificial intelligence (AI). For example, the advent of large language models and their human-like linguistic abilities has raised substantial debate regarding whether or not AI could be conscious. Here, we consider the question of whether AI could have subjective experiences such as feelings and sensations ('phenomenal consciousness'). While experts from many fields have weighed in on this issue in academic and public discourse, it remains unknown whether and how the general population attributes phenomenal consciousness to AI. We surveyed a sample of US residents (n = 300) and found that a majority of participants were willing to attribute some possibility of phenomenal consciousness to large language models. These attributions were robust, as they predicted attributions of mental states typically associated with phenomenality-but also flexible, as they were sensitive to individual differences such as usage frequency. Overall, these results show how folk intuitions about AI consciousness can diverge from expert intuitions-with potential implications for the legal and ethical status of AI.

Silvia De Marchi (1929) on numerical estimation: A translation and commentary.

Vittorio Benussi (1878-1927) is known for numerous studies on optical illusions, visual and haptic perception, spatial and time perception. In Padova, he had a brilliant student who carefully worked on the topic of how people estimate numerosity, Silvia De Marchi (1897-1936). Her writings have never been translated into English before. Here we comment on her work and life, characterized also by the challenges faced by women in academia. The studies on perception of numerosity from her thesis were published as an article in 1929. We provide a translation from Italian, a redrawing of its 23 illustrations and of the graphs. It shows an original experimental approach and an anticipation of what later became known as magnitude estimation.

Engagement in GI Behavioral Health Is Associated with Reduced Portal Messages, Phone Calls, and ED Visits.

BACKGROUND AND AIMS: Chronic digestive disorders are associated with increased costs for healthcare systems and often require provision of both urgent care and non-face-to-face (non-F2F) care, such as responding to patient messages. Numerous benefits of integrated gastroenterology (GI) behavioral health have been identified; however, it is unclear if integrated care impacts healthcare utilization, including urgent care and non-F2F contact. We sought to investigate the association between patient engagement with GI behavioral health and healthcare utilization. METHODS: We performed a retrospective chart review study of adult patients who were referred for and completed at least one behavioral health appointment between January 1, 2019 and December 21, 2021 in the Gastroenterology and Hepatology department of a large academic medical center. Data on electronic medical record (EMR) messages, phone calls, and Emergency Department utilization were collected 6 months before and 9 months after patient engagement with GI behavioral health. RESULTS: 466 adult patients completed at least one behavioral health visit from 2019 to 2021. Overall, messages, phone calls, and ED visits all decreased significantly from the 6 months before behavioral health treatment to 6 months after (all P values < 0.001). CONCLUSION: Engagement with integrated GI behavioral health is associated with reduced non-F2F care and emergency department utilization in patients with chronic digestive disorders. Increasing access to GI behavioral health may result in reduced provider workload and healthcare system costs.

Brief Coping Scale TCS-9: Optimising the Assessment of Coping Strategies. The case of Health Care Workers.

Background: The COVID-19 pandemic has intensified the focus on mental health, particularly on the coping strategies of healthcare workers who have faced unparalleled stress due to their pivotal role in addressing health disparities and determinants of health. Constantly operating in high-risk environments and managing the surge of critically ill patients, these professionals' psychological resilience has been sternly tested, necessitating robust assessment tools. Aim: This study aims to refine the extensive 54-item Toulouse Coping Scale into a more pragmatic and less time-consuming instrument while preserving its statistical integrity, to support the mental well-being of healthcare workers. Setting: The setting for this study was amongst healthcare workers in Greece, during the COVID-19 pandemic, a period marked by significant psychological demands on medical staff. Methods: We conducted an unbiased exploratory factor analysis on the Toulouse Coping Scale's 54 items, drawing from a sample of 144 healthcare workers, adhering to strict methodological criteria. Results: Data completeness was achieved across the sample, which comprised 40 (28%) males and 104 (72%) females, predominantly aged between 31 and 50 years. The final instrument, encapsulating two domains with a total of nine questions, demonstrated strong internal consistency, with an eigenvalue of 3.438 for the first domain and 1.478 for the second, validated by a scree plot. Conclusion: The streamlined TCS-9 scale facilitates a more rapid assessment of coping strategies while reducing redundancy. The two-domain structure ensures that the revised scale retains the original's thoroughness in a more concise form. Contribution: By enabling quicker and more efficient evaluations, the TCS-9 enhances the practicality of assessing coping mechanisms in healthcare settings, thereby contributing to the sustenance of health systems and the promotion of health equity.

Activating values intervention: an integrative pathway to well-being.

Introduction: The present study expands the existing knowledge base regarding positive psychology interventions (PPIs), by employing an integrative approach to explore the potential benefits of translating values into action. Methods: Participants (n = 476) were randomly assigned to the Activating Values intervention, the affirmation-only, or the control (no treatment) group. The intervention involved participants choosing a life area they valued, affirming its importance, identifying a specific action related to that valued area, and then planning and carrying out that chosen action within the following week. Data was collected at baseline and three follow-up points: one, two, and three weeks after the intervention. Results: Results suggest that the intervention contributes to the participants' well-being, including increased self-insight, sense of coherence, and prioritizing meaning, and decreased symptoms of psychopathology. Exploratory content analyses provide a deeper understanding of the content and frequency of activities chosen and the enabling conditions. Discussion: The discussion explores the findings within this intersection as well as ramifications for brief, scalable interventions to support and promote well-being.

Potential categories of employment stress among rural college students and their relationship to employment psychology.

Background: Psychological problems related to employment are among the most common psychological problems faced by rural college students. Employment stress is an important factor affecting the development of psychological health in employees; thus, reducing employment stress can improve the psychological state of employment. Objective: This study aimed to understand the potential profiles of employment stress among rural college students to determine the relationship between different profiles and employment psychology. Methods: This study was conducted in a higher education institution in Qingdao, Shandong Province, China between June and December 2023, and 249 rural college students participated. The Employment Stress Scale and Employment Psychology Scale were used to collect the data. Data were analyzed using latent profile analysis, independent sample t-tests, and binary logistic regression analysis. Results: The results showed that rural university students were categorized into low-level (49.80%) and high-level (50.21%) employment stress groups. There was a statistically significant difference between the employment psychology of rural college students in the low- and high-level groups (p < 0.001). Juniors/seniors were more likely to be classified in the high-level group (OR = 0.477, p = 0.011). Conclusion: Intervention programs should be developed and implemented to address the characteristics of employment stress among rural college students with different profiles to promote the healthy development of their attitudes toward employment.

Psychometric Properties of the Principal Instructional Leadership Scale (PILS) in Saudi Arabia.

BACKGROUNDS: The principal instructional leadership describes how school principals oversee the curriculum, instruction, and assessment. The main aims of the current study were translation and evaluation of the psychometric properties of the Principal Instructional Leadership Scale (PILS) in a Saudi Arabian population. METHODS: The translation and cross-cultural adaptation process has been conducted in five stages, including forward translation, translation synthesis, backward translation, expert committee, and pilot testing. Face, content, construct, and convergent validity were used to establish validity. Cronbach's alpha coefficient and McDonald's omega (Ω) were used for internal consistency. RESULTS: To validate the PILS structure, the total sample (N = 724) was randomly split into two subgroups, each comprising 362 individuals, for Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA). Five factors obtained from EFA explain 71.07 % of the variance in PILS. The PILS encompasses domains of improving curriculum quality, teaching, and enhancing the effectiveness of adaptive learning, adding to the dimensions covered by previous instructional leadership measures. The five components show strong internal consistency (0.93 to 0.97). Both first-order and second-order CFAs confirmed the 5-factor model, meeting criteria (CFI > 0.91, GFI > 0.9, IFI > 0.9, RMSEA<0.05). All 21 items displayed suitable internal consistency (Cronbach's α > 0.8, McDonald's omega >0.7). Second-order average variance extracted validity (0.50) indicated PILS validity. Gender invariance analysis revealed no significant differences (∆CFI < 0.01, ΔRMSEA<0.01) in PILS structure between genders. CONCLUSION: The reliability and validity of the Arabic rendition of PILS are commendable, making it suitable for evaluating principal instructional leadership in Saudi Arabia.

A qualitative study on experiences of stigma among postoperative oral cancer patients.

AIM: This study aimed to explore the characteristics of stigma in postoperative oral cancer patients to provide a reference for the formulation of targeted intervention measures. METHODS: A qualitative study was conducted on 25 postoperative oral cancer patients in a tertiary A hospital in Hunan, China, from March to July 2021. Semi-structured face-to-face interviews focused on experiences of stigma were performed. The interview data was analyzed using the NVivo V.12 software based on the reflexive intuitive thematic analysis method. The paper complies with the COREQ. RESULTS: The stigma experience of postoperative oral cancer patients can be divided into 3 themes: (1) triggers (impaired appearance and oral function and psycho-social pressure); (2) forms (overall isolation, unpleasant feeling of inferiority, and unpleasant social discrimination); (3) coping strategies (positive psychological adjustment, seeking social support and coming out of the unpleasant shadows). CONCLUSION: Postoperative oral cancer patients clearly articulated that stigma was present in their lives and they experienced multiple forms of stigma. Further work is needed to increase education and awareness about oral cancer to guide them to take positive coping and reduce stigma.

Robotic assisted and exoskeleton gait training effect in mental health and fatigue of multiple sclerosis patients. A systematic review and a meta-analysis.

PURPOSE: Robotic and Exoskeleton Assisted Gait Training (REAGT) has become the mainstream gait training module. Studies are investigating the psychosocial effects of REAGT mostly as secondary outcomes. Our systematic review and meta-analysis aims to investigate the effects of REAGT in MS patients' mental health and fatigue. MATERIALS AND METHODS: We searched the electronic databases (Scopus, PubMed, Pedro, Cochrane Trials, Dare) for RCT studies fulfilling our inclusion criteria. A meta-analysis of available assessment tools was conducted calculating the summary mean differences in two different timepoints, before and after the intervention using random-effects models. RESULTS: The systematic search of the electronic databases identified 302 studies. Seven RCT studies were considered eligible for data extraction and meta-analysis, according to our eligibility criteria. We were able to obtain adequate data to proceed with a quantitative synthesis for QoL SF36-MC (Mental Component), QoL SF-36 mental and psychosocial subscales, Multiple Sclerosis Quality of Life-54-Mental Health Composite (MSQoL-54-MHC), Patient's Health Questionnaire (PHQ-9) and Fatigue Severity Scale (FSS). CONCLUSIONS: Overall, REAGT seems to have a positive effect to Quality of Life, especially in MS patients' perspective of General and Mental Health and a slight positive effect in depression as measured by PHQ-9.Implications for rehabilitationMultiple Sclerosis (MS) decreases physical and non-physical aspects of patients' quality of life perspective.Rehabilitation strategy must take into consideration the non-physical effects of a training intervention.Robotic and Exoskeleton Gait Training has a positive effect in MS patients' non-physical quality of life and a slight positive effect in depression.

The Development of a Multi-Modal Cancer Rehabilitation (Including Prehabilitation) Service in Sheffield, UK: Designing the Active Together Service.

Cancer patients undergoing major interventions face numerous challenges, including the adverse effects of cancer and the side effects of treatment. Cancer rehabilitation is vital in ensuring cancer patients have the support they need to maximise treatment outcomes and minimise treatment-related side effects and symptoms. The Active Together service is a multi-modal rehabilitation service designed to address critical support gaps for cancer patients. The service is located and provided in Sheffield, UK, an area with higher cancer incidence and mortality rates than the national average. The service aligns with local and regional cancer care objectives and aims to improve the clinical and quality-of-life outcomes of cancer patients by using lifestyle behaviour-change techniques to address their physical, nutritional, and psychological needs. This paper describes the design and initial implementation of the Active Together service, highlighting its potential to support and benefit cancer patients.

Understanding and optimising gratitude interventions: the right methods for the right people at the right time.

OBJECTIVE: Gratitude has consistently been associated with various beneficial health-related outcomes, including subjective wellbeing, positive mental health, and positive physical health. In light of such effects, positive psychology researchers and practitioners have often implemented gratitude interventions in an attempt to build individuals' orientations toward appreciation and thankfulness. Recent meta-analyses and reviews have revealed, however, that these interventions often have mixed effects on gratitude or other health outcomes. With this issue in mind, we aimed to identify (a) contextual considerations that may impact the effectiveness of these approaches, and (b) recommendations for the optimisation of gratitude interventions. METHODS AND MEASURES: Seventeen mental health professionals or experienced health psychology researchers engaged in semi-structured interviews to address the research questions. RESULTS: Thematic analysis of the data resulted in three contextual themes-cultural considerations, personal characteristics, and life experience-that were discussed as factors likely to influence intervention effectiveness. With respect to recommendations, participants highlighted the importance of encouraging deep engagement in gratitude tasks, consistent repetition of those tasks, and the value of interpersonal expressions of gratitude. CONCLUSION: Discussion is centred on suggestions for future research on gratitude and on implications for the implementation of gratitude interventions.

Using unsupervised clustering approaches to identify common mental health profiles and associated mental healthcare service use patterns in Ontario, Canada.

Mental health is a complex, multidimensional concept that goes beyond clinical diagnoses, including psychological distress, life stress and well-being. This study aims to use unsupervised clustering approaches to identify multidimensional mental health profiles that exist in the population, and their associated service use patterns. The data source for this study is the 2012 Canadian Community Health Survey- Mental Health linked to administrative healthcare data holdings, included were all Ontario adult respondents. We used a Partioning Around Medoids clustering algorithm with Gower's proximity to identify groups with distinct combinations of mental health indicators and described them by their sociodemographic and service use characteristics. We identified four groups with distinct mental health profiles, including one group who met the clinical threshold for a depressive diagnosis, with the remaining three groups expressing differences in positive mental health, life stress and self-rated mental health. The four groups had different age, employment and income profiles and exhibited differential access to mental healthcare services. This study represents the first step in identifying complex profiles of mental health at the population level in Ontario, Canada. Further research is required to better understand the potential causes and consequences of belonging to each of the mental health profiles identified.

Mindfulness-based psychosocial interventions and psychological wellbeing in cancer survivorship: a meta-analysis.

PURPOSE: Among cancer survivors, mindfulness-based interventions appear promising in decreasing distress for cancer patients, but little attention has been paid to the ultimate mindfulness goal of increasing psychological wellbeing. This meta-analysis aims to summarise and synthesise available evidence concerning the effectiveness of MBIs on positive psychological outcomes reflecting key aspects of psychological wellbeing in heterogeneous cancer patients. METHODS: A literature search of mindfulness-based randomised clinical trials in cancer survivors was conducted across six electronic databases. Two reviewers independently screened studies and extracted data. Meta-analyses were conducted using R; standardised mean difference (SMD) was used to determine intervention effect. Moderators examined included therapeutic orientation, control group type, treatment modality, treatment target, heterogeneous vs. homogeneous cancer type, and facet of wellbeing. RESULTS: Thirty-one studies were included (N = 2651). Those who received mindfulness-based interventions reported significantly higher eudaimonic, hedonic, and social wellbeing than respondents in control groups (SMD = 0.599). Interventions were equally effective across therapeutic orientation, control group type, treatment modality and treatment target. There were trend level differences favouring homogeneous cancer diagnosis groups over heterogeneous diagnosis groups. CONCLUSION: MBIs provide an effective treatment for increasing psychological wellbeing in cancer survivors. This finding has important implications for clinical practice.

Understanding How Contingency Staffing Programs Can Support Mental Health Services in the Veterans Health Administration.

Introduction: Beginning in 2019, the Department of Veterans Affairs (VA) prioritized improving access to care nationally to deliver virtual care and implemented 18 regionally based Clinical Resource Hubs (CRHs) to meet this priority. This observational study describes the quantity and types of care delivered by CRH Mental Health teams, and the professions of those hired to deliver it. Methods: A retrospective cohort study, based on national VA CRH mental health care utilization data and CRH staffing data for CRH's first 3 years, was conducted. Results: CRH Mental Health teams primarily used Telemental Health (TMH) to provide care (98.1% of all CRH MH encounters). The most common disorders treated included depression, post-traumatic stress disorder, and anxiety disorders. The amount of care delivered overtime steadily increased as did the racial and ethnic diversity of Veterans served. Psychologists accounted for the largest share of CRH staffing, followed by psychiatrists. Conclusions: CRH TMH delivered from a regional hub appears to be a feasible and acceptable visit modality, based on the continuously increasing CRH TMH visit rates. Our results showed that CRH TMH was predominantly used to address common mental health diagnoses, rather than serious mental illnesses. Traditionally marginalized patient populations increased over the 3-year window, suggesting that CRH TMH resources were accessible to many of these patients. Future research should assess barriers and facilitators for accessing CRH TMH, especially for difficult-to-service patient populations, and should consider whether similar results to ours occur when regional TMH is delivered to non-VA patient populations.

A hierarchy of visual processing deficits in body dysmorphic disorder: a conceptual review and empirical investigation.

OBJECTIVE: Abnormal visual processing has been proposed as a mechanism underlying excessive focus on minor appearance flaws in body dysmorphic disorder (BDD). Existing BDD research has not differentiated the various stages of face processing (featural, first-order configural, holistic and second-order configural) that are required for higher-order processes such as emotion recognition. This study investigated a hierarchical visual processing model to examine the nature of abnormalities in face processing in BDD. METHOD: Thirty BDD participants and 27 healthy controls completed the Navon task, a featural and configural face processing task and a facial emotion labelling task. RESULTS: BDD participants performed similarly to controls when processing global and local non-face stimuli on the Navon task, when detecting subtle changes in the features and spacing of a target face, and when labelling emotional faces. However, BDD participants displayed poorer performance when viewing inverted faces, indicating difficulties in configural processing. CONCLUSIONS: The findings only partially support prior work. However, synthesis of results with previous findings indicates that heterogenous task methodologies may contribute to inconsistent findings. Recommendations are provided regarding the task parameters that appear most sensitive to abnormalities in BDD.

Institutional design and moral conflict in health care priority-setting.

Priority-setting policy-makers often face moral and political pressure to balance the conflicting motivations of efficiency and rescue/non-abandonment. Using the conflict between these motivations as a case study can enrich the understanding of institutional design in developed democracies. This essay presents a cognitive-psychological account of the conflict between efficiency and rescue/non-abandonment in health care priority-setting. It then describes three sets of institutional arrangements-in Australia, England/Wales, and Germany, respectively-that contend with this conflict in interestingly different ways. The analysis yields at least three implications for institutional design in developed democracies: (1) indeterminacy at the level of moral psychology can increase the probability of indeterminacy at the level of institutional design; (2) situational constraints in effect require priority-setting policy-makers to adopt normative-moral pluralism; and (3) the U.S. health care system may be in an anti-priority-setting equilibrium.