Outcomes for children with autism spectrum disorder and their families after two years of school based early intensive behavioural intervention.

The effectiveness of a school based Early Intensive Behavioural Intervention (EIBI) program was assessed over a two-year period for a cohort of 16 pre-school children with autism spectrum disorder (ASD) and their families. Children with a mean age of 40 months, were assessed prior to intervention, after 1 year of intervention, and again after 2 years. Significant improvements were observed on measures of adaptive behaviour, communication ability and challenging behaviour. Parents of children attending the program also reported increased familial quality of life, specifically improved emotional and physical well-being and increased parenting capacity over the duration of the program. The current study suggests that EIBI for young children with ASD can be effective in facilitating improvements in communication ability, reducing challenging behaviours and improving quality of life for families. Children's pre-intervention adaptive skills appeared to be the strongest predictor of post intervention gains as initial level of adaptive ability was positively related to improved post-intervention outcomes.

The Mental States Task (MST): Correlates and New Perspectives on Mentalizing in a Lebanese Student Sample.

Mentalizing is defined as one's capacity to think in terms of mental states underlying one's own and others' behaviors. It has been posited to develop within the context of a secure attachment relationship and has been linked to a myriad of psychological adjustment variables. Given the scarcity of research on mentalizing in Lebanon, this study aimed to investigate mentalizing in a sample of 293 Lebanese undergraduate students using a novel tool, the Mental State Task (MST). Higher mentalizing scores were found to be positively correlated with self-esteem, neurotic defenses, authenticity and adaptive emotion regulation strategies, as well as negatively correlated with psychological symptomatology. This study also provided descriptions of the six mental states measured by the MST continuum based on their correlations with related constructs. Findings diverge with the literature in relation to the association between defense styles and MST scores, which were posited to reflect cultural specificities of this sample.

Parental satisfaction with early intensive behavioral intervention.

Research related to parental satisfaction with early intensive behavioral intervention (EIBI) remains limited. A 35-item questionnaire called the parental satisfaction scale-EIBI (PSS-EIBI) was developed with four subdomains (child outcomes, family outcomes, quality of the model, and relationship with the team). Study 1 assessed levels of satisfaction for 48 parents with their child's EIBI program after approximately 1 year of intervention. Study 2 examined the relationship between parental satisfaction, length of child participation in EIBI, and the relationship between parental satisfaction and actual outcomes for their child as assessed by the Verbal Behavior Milestones Assessment and Placement Program after approximately 2 years. Results indicate that parental satisfaction with EIBI was consistently high in all four domains of the PSS-EIBI in both studies. Parental satisfaction was found to be associated with gains in child functioning after 1 year of intervention.

An evaluation of positive behavioural support for children with challenging behaviour in community settings.

This study employs a multiple baseline across individual design to describe the implementation of positive behavioural supports for seven children and adolescents in residential community settings over a period of 24 months. These individuals with intellectual disability are residing in one county with long-standing challenging behaviour resulting in home breakdown and serious physical injury. Four types of outcome are presented: rates of behaviour, rates of medication, psychiatric symptomatology and quality of life (QoL). Behaviours reduced to lower levels for the majority of participants following the implementation of positive behavioural supports, and improvements were largely sustained. The use of psychotropic medications reduced or stabilized for the majority of individuals over the same period. QoL Questionnaire scores improved substantially for four participants. The results are discussed in the context of a framework for supporting children with severe challenging behaviours in the community.

Religious coping and levels of posttraumatic stress disorder symptomatology after the Beirut explosion.

OBJECTIVE: Religious coping has implications for the development of psychopathology in the aftermath of traumatic events. This study explored the relationship between religious coping (positive and negative) and posttraumatic stress disorder (PTSD) symptomology among survivors of a large industrial explosion that devastated parts of Beirut in August of 2020. METHOD: Three months after the disaster, 996 residents of Beirut and Lebanon completed validated measures of religious coping (RCOPE) and PTSD symptomatology (Impact of Events Scale-Revised) in either English or Arabic. The majority of participants were young adults aged between 18 and 25 years. RESULTS: Results indicated that higher levels of negative religious coping were a significant predictor of higher levels of PTSD symptomatology and were associated with a two-fold risk of meeting the criteria for probable PTSD. Other significant predictors included female gender, being a resident of Beirut at the time of the explosion, having personally sustained an injury, or knowing a person injured in the explosion. Effects sizes ranged from .34 to .68. CONCLUSIONS: Higher scores on measures of negative religious coping were associated with higher levels of PTSD symptomatology. However, negative religious coping may be better construed as a set of religious-based appraisals of event causality and may represent a form of peritraumatic appraisal in the wake of traumatic events. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Exploring attachment security in a sample of Lebanese adolescents: The validation of the Arabic IPPA-R.

Despite growing evidence supporting the importance of the quality of attachment during adolescence, no studies have been conducted to date in the Arab world due to an absence of valid and reliable tools to measure this construct in Arabic. The Inventory of Parent and Peer Attachment-Revised (IPPA-R) was devised as a self-report questionnaire in English to assess the quality of adolescent attachment to mother, father, and peers, each scale consisting of 25 items. The current study sets out to determine the psychometric properties of the Arabic IPPA-R and to explore attachment styles in Lebanon in a sample of 765 Lebanese adolescents. Results suggested a modified three-factor structure to reach satisfactory reliability of the Arabic IPPA-R, resulting in a modified questionnaire consisting of 19 items for each of mother (α = .82) and father (α = .85), and 21 items for peers (α = .89). Strict measurement invariance across gender was achieved for the IPPA-R parental forms, while only scalar invariance was achieved for the IPPA-R peers form. Overall, there were significant differences in attachment scores to mother and father, with adolescents scoring higher on attachment to mother, with both scores being significantly lower than attachment to peers. Gender differences were found on the peer scale with girls scoring significantly higher than boys. Results are interpreted from a cultural lens, emphasizing the importance of accounting for cultural, religious, and socio-economic factors in understanding adolescent attachment. This study is the first conducted in the Arab region and provides a road map to understanding gender-roles, parental expectations and adolescent perceived parenting, and their impact on adolescent attachment scores.

In situ synchrotron diffraction studies on the formation kinetics of jarosites.

This paper reports the results of time-resolved synchrotron powder diffraction experiments where jarosites with different K/H(3)O, K/Na and Na/H(3)O ratios were synthesized in situ at temperatures of 353, 368 and 393 K in order to observe the effect on kinetics and species produced. The Na/H(3)O sample formed monoclinic jarosite at all three temperatures, whereas the K/H(3)O and K/Na samples formed as rhombohedral jarosites at 353 K, and as mixtures of rhombohedral and monoclinic jarosites at the higher temperatures. The relative amount of the monoclinic phase increased with increase in temperature. Unit-cell parameter changes with reaction time could be explained by changes in iron stoichiometry (samples become more stoichiometric with time) together with changes in K/H(3)O and Na/H(3)O ratios. The reaction kinetics have been fitted using a two-stage Avrami model, with two different Avrami exponents corresponding to initial two-dimensional growth followed by one-dimensional diffusion-controlled growth. Activation energies for the initial growth stage were calculated to be in the range 90-126 kJ mol(-1).

In situ SAXS studies of the formation of sodium jarosite.

This paper reports the results of time-resolved synchrotron small-angle scattering and powder diffraction experiments where natrojarosites were synthesized in situ in order to observe the species produced at the earliest stages of nucleation. The sample temperatures were 333, 353 and 368 K. These compounds were synthesized by co-precipitation from solution on the Small and Wide Angle Scattering and Powder Diffraction beamlines at the Australian Synchrotron. Scattering data were collected continuously throughout the syntheses. The results presented here show that the first particles to form in solution appear to be amorphous and nucleate on the walls of the reaction vessel. Crucially, there is a single nucleation event which forms particles with an elliptical disc morphology which then grow uniformly before natrojarosite crystallization is observed in complementary powder diffraction data. This nucleation event may represent the key to controlling the growth of jarosites in industrial and environmental settings.

Generalized Anxiety Mediates the Relationship Between Loneliness and Sleep Quality Amongst Young Adults During the COVID-19 Pandemic.

Since the outbreak of COVID-19, restrictions to minimize its spread have had a profound effect. Government instigated restrictions, such as social isolation, have affected millions worldwide, and the downstream consequences of perceived loneliness upon mental health and sleep are largely unknown. A total of 1662 individuals participated in an online survey. Loneliness, anxiety, and sleep quality were assessed using the UCLA Loneliness Scale, the Generalized Anxiety Disorders scale, and the Pittsburgh Sleep Quality Index, respectively. Higher levels of perceived loneliness, as well as each one-unit increase in anxiety, were independent predictors of poor sleep quality, where OR = 1.16 (95% CI: 1.03-1.31) and 1.16 (1.11-1.21), respectively, and after adjustment. In our path analysis, we revealed significant direct effects between loneliness and sleep quality (ß = 0.25, p < .001), as well as generalized anxiety and sleep quality (ß = 0.28, p < .001), and generalized anxiety mediated the relationship between loneliness and sleep quality (ß = 0.33, p < .001). Heightened anxiety and perceived loneliness appear to be significant drivers of poor sleep quality during the COVID-19 pandemic. Digital media platforms that encourage support groups for those experiencing social isolation are encouraged, along with self-help and meditative practices, which may minimize an increase of mental health and sleep disorder diagnoses post COVID-19.

The Influence of Multiple Community Level Traumatic Event Types on Mental Health Outcomes.

Lebanon witnessed three large-scale negative community level events in 2020; a severe economic crisis, the COVID-19 pandemic, and an explosion in the port of the capital city, Beirut, which resulted in the deaths of 218 individuals and several thousand injured. The current study examined the relationship between the number of community level events individuals identified as personally impactful and corresponding levels of anxiety, depression, and symptoms of PTSD. The study also examined the roles of specific protective factors including perceived social support, resilience, and religious coping. A total of 406 participants aged between 18 to 64 years completed validated self-report measures online in February 2021. Results indicated elevated levels of mental health difficulties within the sample with over half of the participants reporting moderate to severe anxiety and moderate to severe depression and meeting the cut-off for probable PTSD. Females had significantly higher scores on measures of depression, anxiety, and PTSD. Individuals reporting all three events as negatively impactful were 47% more likely to meet the cut-off for PTSD than individuals identifying a single event. Resilience appeared to be the strongest protective factor against elevated scores on all three mental health outcomes. Higher scores on negative religious coping were also associated with elevated PTSD scores. Low levels of resilience, higher negative religious coping, and being a female were identified as significant predictors of reaching the PTSD cut-off using binary logistic regression analysis.

An evaluation of an intervention sequence outline in positive behaviour support for people with autism and severe escape-motivated challenging behaviour.

BACKGROUND: Positive behaviour support emphasises the impact of contextual variables to enhance participation, choice, and quality of life. This study evaluates a sequence for implementing changes to key contextual variables for 4 individuals. Interventions were maintained and data collection continued over a 3-year period. METHOD: Functional assessments were conducted with 4 individuals with exceptionally severe challenging behaviours. Interventions were based on the multi-element model of behavioural support (LaVigna & Willis, 2005a). Dependent variables were behavioural ratings of (1) frequency, (2) episodic severity, (3) episodic management difficulty, and measures of (4) mental health status, and (5) quality of life. The intervention sequence was low arousal environment, rapport building, predictability, functionally equivalent skills teaching, and differential reinforcement strategies. RESULTS: Substantial reductions in target behaviours were observed, along with incremental improvement in mental health scores and quality-of-life scores. CONCLUSION: The study demonstrates the efficacy of positive behaviour support for people with exceptionally severe behaviour in individually designed services.

A component analysis of positive behaviour support plans.

BACKGROUND: Positive behaviour support (PBS) emphasises multi-component interventions by natural intervention agents to help people overcome challenging behaviours. This paper investigates which components are most effective and which factors might mediate effectiveness. METHOD: Sixty-one staff working with individuals with intellectual disability and challenging behaviours completed longitudinal competency-based training in PBS. Each staff participant conducted a functional assessment and developed and implemented a PBS plan for one prioritised individual. A total of 1,272 interventions were available for analysis. Measures of challenging behaviour were taken at baseline, after 6 months, and at an average of 26 months follow-up. RESULTS: There was a significant reduction in the frequency, management difficulty, and episodic severity of challenging behaviour over the duration of the study. Escape was identified by staff as the most common function, accounting for 77% of challenging behaviours. The most commonly implemented components of intervention were setting event changes and quality-of-life-based interventions. CONCLUSION: Only treatment acceptability was found to be related to decreases in behavioural frequency. No single intervention component was found to have a greater association with reductions in challenging behaviour.

The prevalence of psychological consequences of COVID-19: A systematic review and meta-analysis of observational studies.

A systematic review and a meta-analysis were conducted to examine the overall prevalence of psychological health outcomes during COVID-19. Seven databases were systematically searched to include studies reporting on at least one psychological outcome. The pooled prevalence of primary psychological outcomes was 26% (95%CI: 21-32). Pooled prevalence for symptoms of PTSD was 33% (0-86), anxiety 28% (21-36), stress 27% (14-43), and depression 22% (13-33). The prevalence of psychological outcomes was similar in healthcare workers and in the general population (34% [24-44] and 33% [27-40] respectively). High prevalence figures support the importance of ensuring adequate provision of resources for mental health.

Prevalence and correlates of mental health difficulties following the beirut port explosion: The roles of mentalizing and resilience.

OBJECTIVE: Research has consistently highlighted an increased prevalence of mental health problems, such posttraumatic stress disorder (PTSD), depression, and anxiety, following both man-made and natural disasters. Mentalizing and resilience have been previously identified as potential protective factors against the onset of mental health difficulties following such events. METHOD: This study first identified the prevalence of PTSD symptoms, depression, anxiety, and stress and subsequently assessed mentalizing abilities and resilience as predictors of PTSD symptomatology in a sample of 521 Lebanese participants following the Beirut Port explosion on August 4, 2020. RESULTS: Findings were consistent with existing literature highlighting elevated rates of PTSD, depression, and anxiety subsequent to man-made disasters, with higher rates of mental health symptoms observed among women, those with a preexisting diagnosis of psychiatric disorder (1.5 times more likely to meet the PTSD Checklist for DSM-5 [PCL-5] cutoff score), and those who had to move houses (over 2 times more likely to meet PCL-5 cutoff) as a consequence of the explosion. Higher mentalizing capacities were positively correlated with higher resilience scores and lower indices of mental health difficulties. Each unit increase in resilience scores was associated with a 3% reduction in meeting PCL-5 cutoff, and poorer mentalizing abilities was associated with a 2-fold increase in the risk of meeting PCL-5 cutoff. CONCLUSIONS: Presence of a previous psychiatric diagnosis, having to move houses, lower mentalizing capacities, and lower resilience scores were found to predict elevated PCL-5 scores. Findings are discussed within the framework of recommendations for interventions targeting people affected by traumatic events. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A systematic review and meta-analysis to assess the relationship between sleep duration/quality, mental toughness and resilience amongst healthy individuals.

The majority of sleep research has focused on deleterious health outcomes, with little attention to positive sequels. A systematic review of the literature regarding sleep duration and/or sleep quality in relation to mental toughness and resilience amongst non-clinical, healthy populations was completed. Eight databases and selected sources for grey literature were searched from their inception to April 2021. A total of 1925 unique records (1898 from the database search and 27 from grey sources) were identified and screened against the pre-set inclusion and exclusion criteria. Of these, 68 studies were eligible and 63 were included in the meta-analysis. Pooled results indicated a weak, positive correlation between sleep duration and resilience (r = 0.11, p < 0.001), and sleep quality (r = 0.27, p < 0.001). The pooled correlation was slightly attenuated for prospective studies pertaining to sleep quality and resilience (r = 0.18, p < 0.001). We found evidence of high publication bias for studies that explored the relationship between sleep quality and resilience. Sleep and resilience are positively correlated but additional research is needed to verify the direct relationship through carefully designed, prospective studies that capture both subjective and objective sleep estimates. For a more comprehensive understanding, complementary reviews that explore the sleep-resilience association are needed for clinical populations, and those who have suffered extreme hardship.

Early screening for post-stroke depression, and the effect on functional outcomes, quality of life and mortality: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Post-stroke depression (PSD) is a severe complication of cerebrovascular stroke affecting about one-third of stroke survivors. Moreover, PSD is associated with functional recovery and quality of life (QOL) in stroke survivors. Screening for PSD is recommended. There are, however, differences in the literature on the impact of early screening on functional outcomes. In this systematic review, we synthesise the currently available literature regarding the associations between timing and setting of PSD screening and mortality, QOL and functional outcomes in stroke survivors. METHODS AND ANALYSIS: We will systematically search electronic databases including PubMed, Embase, APA PsycINFO, Web of Science, Scopus and CINAHL from inception to August 2021. Four reviewers will screen the title and abstract and full-text level records identified in the search in a blinded fashion to determine the study eligibility. Any selection disagreements between the reviewers will be resolved by the study investigator. Data extraction of eligible studies will be conducted by two reviewers using a predefined template. We will complete the quality assessment of included articles independently by two reviewers using the Newcastle Ottawa Scale. Eventual discrepancies will be resolved by the principal investigator. ETHICS AND DISSEMINATION: Due to the nature of the study design, ethical approval is not required. The systematic review and meta-analysis findings will be published and disseminated in a peer-reviewed journal. Our results will also be disseminated through posters and presentations at appropriate scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42021235993.

Health behaviour changes during COVID-19 and the potential consequences: A mini-review.

The COVID-19 pandemic has brought about profound changes to social behaviour. While calls to identify mental health effects that may stem from these changes should be heeded, there is also a need to examine potential changes with respect to health behaviours. Media reports have signalled dramatic shifts in sleep, substance use, physical activity and diet, which may have subsequent downstream mental health consequences. We briefly discuss the interplay between health behaviours and mental health, and the possible changes in these areas resulting from anti-pandemic measures. We also highlight a call for greater research efforts to address the short and long-term consequences of changes to health behaviours.

Poor sleep efficiency and daytime napping are risk factors of depersonalization disorder in female university students.

OBJECTIVES: Depersonalization is characterized by feelings of detachment from reality and has been associated with anxiety and depression, both of which have a bi-directional relationship with sleep. To date, few studies have directly examined the potential relationship between sleep and depersonalization, which was the primary objective of our study. DESIGN/METHODS: A cross-sectional study of female, Emirati, university students (n = 100) was conducted. Participants completed the Pittsburgh Sleep Quality Index (PSQI), the Cambridge Depersonalization Scale (CDS) and the Hospital Anxiety and Depression Scale (HADS). Additionally, 36 of the 100 participants wore wrist actigraphy for two consecutive weekdays. Average sleep duration, and average sleep efficiency (SE; %) across the two nocturnal sleep episodes were calculated. Total number of sleep episodes were obtained from wrist actigraphy and sleep logs. RESULTS: A significant, positive relationship was observed between PSQI global score and CDS total score (r = 0.21, p = 0.04). Actigraphy-estimated average nocturnal sleep duration was not significantly associated with the CDS. Compared to nocturnal sleepers only, those who undertook daytime naps had almost three times the risk of meeting the criteria for depersonalization disorder (OR = 2.95, 95% CI: 1.04-8.41), after adjustment. For each 1% increase in SE a 23% decreased risk of depersonalization was observed (OR = 0.77, 95% CI: 0.61-0.96), after adjustment. CONCLUSIONS: Sleep screening in young adults may help to ensure better detection and management of psychological health outcomes. Our findings need to be confirmed prospectively in larger samples and amongst different populations but reiterate the importance of sleep habits pertaining to mental health.

The role of perceived social support on depression and sleep during the COVID-19 pandemic.

The aim of the present study was to examine the role of perceived social support pertaining to a range of psychological health outcomes amongst individuals undergoing social isolation and social distancing during COVID-19. A total of 2,020 participants provided responses to an online cross-sectional survey comprised of validated instruments including the Multidimensional Scale of Perceived Social Support (MSPSS), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-9), the Brief Irritability Test (BITe) and the UCLA Loneliness Scale (UCLA-LS). Individuals experiencing self-isolation had significantly higher rates of depression, irritability and loneliness compared to those who were not. The risk for elevated levels of depression symptoms was 63% lower in individuals who reported higher levels of social support compared to those with low perceived social support. Similarly, those with high social support had a 52% lower risk of poor sleep quality compared to those with low social support. Social support was found to be significantly associated with elevated risk for depression and poorer sleep quality. The results contribute to our understanding of differential psychological outcomes for individuals experiencing anti-pandemic measures.

Perceived Risk and Protection From Infection and Depressive Symptoms Among Healthcare Workers in Mainland China and Hong Kong During COVID-19.

Psychological health among healthcare workers (HCWs) has become a major concern since the COVID-19 outbreak. HCWs perceived risks of contracting COVID-19, in relation to depression were investigated. It was hypothesized that perceived high risk of contracting COVID-19 (close contact with cases, inadequate provision of personal protective equipment, insufficient infection control training, and presence of symptoms) would be significant predictors of depression. Our cross-sectional survey was completed by HCWs across three regions (Hubei, Guangdong, Hong Kong) between March 9 to April 9 2020 using convenience sampling. Depression was assessed using the 9-item Patient Health Questionnaire (PHQ-9). Prevalence of depression was 50.4% (95% CI: 44.5-56.2), 15.1% (10.1-21.9) and 12.9% (10.3-16.2) for HCWs in Hong Kong, Hubei and Guangdong, respectively. The strongest significant risk factors for depression, after adjustment, were HCWs who reported the greatest extent of feeling susceptible to contracting COVID-19 and those who reported the greatest difficulty obtaining face masks. HCWs whose family/peers greatly encouraged face mask use had lower prevalence of depression. Access to adequate supplies of personal protective equipment is essential for the psychological health of HCWs working in stressful environments, through potentially easing their perceptions of vulnerability to COVID-19.