Using a Videogame Intervention to Reduce Anxiety and Externalizing Problems among Youths in Residential Care: an Initial Randomized Controlled Trial

Residential care is among the most intensive forms of treatment in youth care. It serves youths with severe behavioral problems and is primarily focused on targeting externalizing problems. Despite best efforts, effect sizes remain moderate, which may be due to the disregarding of internalizing symptoms – in particular anxiety - and to limitations regarding the delivery model of interventions. This initial randomized controlled trial (n?=?37) aimed to examine the effectiveness of a biofeedback videogame intervention (Dojo) as an addition to treatment as usual for youths with and without intellectual disability (ID) in residential care with clinical levels of anxiety and externalizing problems. Dojo targets both anxiety and externalizing problems, and incorporates the principles of conventional treatment, while addressing its limitations. Youths were randomly assigned to play Dojo (eight 30-min gameplay sessions) or to treatment as usual (TAU). Measurements of anxiety and externalizing problems were conducted at baseline, posttreatment, and 4-months follow-up through youths’ self-report and mentor-report. Completers-only analyses revealed decreases in self-reported anxiety and externalizing problems, and mentor-reported anxiety at posttreatment for participants in the Dojo condition compared to the control condition. Only mentor-reported anxiety was maintained at follow-up. No effect was found for mentor-reported externalizing problems. These findings provided preliminary evidence that Dojo is a promising, innovative intervention that engages high-risk youths. Practical implications are discussed.     

Effects of stress management and relaxation training on the relationship between diabetes symptoms and affect among Latinos

Objective: Stress management and relaxation (SMR) interventions can reduce symptoms of chronic disease and associated distress. However, there is little evidence that such interventions disrupt associations between symptoms and affect. This study examined whether SMR dampened the link between symptoms of hyperglycemia and proximal levels of affect. We predicted that during periods of increased hyperglycemia, individuals receiving SMR training, relative to controls, would demonstrate smaller increases in negative affect.

Design: Fifty-five adult Latinos with type 2 diabetes were randomised to either one group session of diabetes education (DE-only; N = 23) or diabetes education plus eight group sessions of SMR (DE + SMR; N = 32). After treatment, participants reported five diabetes symptoms and four affective states twice daily for seven days using a bilingual telephonic system.

Results: Mean age = 57.8 years, mean A1c = 8.4%, and ¾ was female with less than a high school education. Individuals receiving DE + SMR, compared to DE-only, showed a weaker positive within-person association between daily diabetes symptoms and nervous affect. Groups also differed on the association between symptoms and enthusiasm. Age moderated these associations in most models with older individuals showing less affect reactivity to symptoms.

Conclusions: Findings provide partial support for theorised mechanisms of SMR.     

Differences in Unit Cohesion and Combat-Related Mental Health Problems Based on Attachment Styles in US Military Veterans

This study explored the differences in perceived unit cohesion, trauma symptoms, depression symptoms, and anxiety symptoms controlling for childhood trauma, based on attachment style in US military veterans. Previous studies have reported that higher levels of military unit cohesion, bonding through the social relationships between service members and their larger units, and secure attachment, are negatively associated with trauma symptoms, depression symptoms, and anxiety symptoms in veterans. This study examined mental health distress symptoms as well as military unit cohesion across attachment styles. Results suggest mean differences in trauma symptoms, depression symptoms, and anxiety symptoms across attachment styles. However, there was no difference in perceived unit cohesion across the four attachment styles. Those using fearful-avoidant attachment styles reported the highest mean trauma, depression, and anxiety symptoms followed by those using a dismissing-avoidant attachment style. Those using a secure attachment style reported the least mean trauma, depression, and anxiety symptoms. Implications for assessing and treating avoidant type attachment styles are discussed.     

A Feasibility Trial of Mental Health First Aid First Nations: Acceptability,Cultural Adaptation,and Preliminary Outcomes

The Mental Health First Aid First Nations course was adapted from Mental Health First Aid Basic to create a community‐based, culturally safe and relevant approach to promoting mental health literacy in First Nations contexts. Over 2.5 days, the course aims to build community capacity by teaching individuals to recognize and respond to mental health crises. This feasibility trial utilized mixed methods to evaluate the acceptability, cultural adaptation, and preliminary effectiveness of MHFAFN. Our approach was grounded in community‐based participatory research principles, emphasizing relationship‐driven procedures to collecting data and choice for how participants shared their voices. Data included participant interviews (n = 89), and surveys (n = 91) from 10 groups in four provinces. Surveys contained open‐ended questions, retrospective pre‐post ratings, and a scenario. We utilized data from nine facilitator interviews and 24 facilitator implementation surveys. The different lines of evidence converged to highlight strong acceptability, mixed reactions to the cultural adaptation, and gains in participants’ knowledge, mental health first aid skill application, awareness, and self‐efficacy, and reductions in stigma beliefs. Beyond promoting individual gains, the course served as a community‐wide prevention approach by situating mental health in a colonial context and highlighting local resources and cultural strengths for promoting mental well‐being.     

Assessment of Current Genetic Counselor Practices in Post-Visit Written Communications to Patients

Providing patients with post-visit written communication (PVWC) is a long-standing component of genetic counseling. However the depiction of this practice in today’s clinical landscape is limited. To better describe this practice, we surveyed practicing clinical genetic counselors to ask if they send post-visit communications to patients and if so, what are the types, the average length, and the average time spent writing. They were also asked the perceived purpose of providing PVWC, if/how the practice has changed over time, and factors influencing the practice. Eighty three percent (233/280) of participants reported sending patients PVWC. Of those, 93% sent at least one communication written in patient-friendly language. The type of communication varied by specialty. Prenatal genetic counselors were less likely to send patient-specific letters and hybrid letters (defined as letters with content intended for both a physician and a patient) than those in cancer genetics (p = 0.010, p = 0.001, respectively) or pediatric genetics (p = 0.001, p = 0.004, respectively). Prenatal genetic counselors spent less time on average writing post-visit communications (19.0 min) relative to those in cancer and pediatric genetics (30.6 min, p = 0.027 and 37.7 min, p = 0.001, respectively). The most commonly cited purpose for sending PVWC was to provide patients a formal account of what happened during the appointment. These data suggest PWVC are still regularly sent to patients but the practice is variable and is influenced by numerous factors including specialty, years of experience, and time constraints.     

Associations between Stress,Psychosomatic Complaints,and Parental Criticism among Affluent Adolescent Girls

A growing body of research has shown that adolescent girls in the context of affluence face a series of unique pressures that may increase social-emotional problems. Little research, however, has examined associations between perceived stress and psychosomatic complaints among privileged youth. In the present study, we investigated the relationships between stress, psychosomatic complaints, and parental criticism in a sample of preadolescent and adolescent girls (n?=?218) from selective, private schools. Using OLS regression analyses, cross-sectional and longitudinal associations were evident between perceived stress and psychosomatic complaints, with increases in stress associated with increases in psychosomatic problems. Parental criticism was also examined as a predictor of girls’ psychosomatic complaints and stress levels. Results indicated that parental criticism was significantly and positively associated with psychosomatic problems in cross-sectional models and that perceived stress levels mediated this association. Additional analyses demonstrated that the relationship between psychosomatic complaints and stress may be bidirectional. Taken together, results from this exploratory study suggest that girls in the context of affluence may also experience psychosomatic complaints, in addition to social-emotional problems.     

Exploring the Relationship Between Child Maltreatment,Intimate Partner Violence Victimization,and Self-Injurious Thoughts and Behaviors

Child maltreatment is considered a significant risk factor for young adult self-injury; however, the mechanisms that underlie this relationship are not yet understood. To elucidate this association, the mediating role of intimate partner violence victimization in the relationship between child maltreatment and self-injurious thoughts and behaviors was investigated. The sample consisted of 406 young adults (346 females; M_age = 19.87 years; SD = 1.72) involved in a couple relationship. Results of bootstrapping procedures demonstrated that intimate partner violence victimization mediated the relationship between child maltreatment and self-injurious behaviors but did not mediate the association between child maltreatment and self-injurious thoughts. Results suggest that young adults with a history of child maltreatment may be more likely to be exposed to IPV victimization, which, in turn, is associated with the use of self-injurious behaviors, but not the use of self-injurious thoughts. Findings highlight the utility of examining models that incorporate distal and proximal factors contributing to self-injury, and provide direction toward better understanding the relationship experiences of self-injuring young adults.     

A Cross-cultural Study of Biological,Psychological, and Social Antecedents of Self-objectification in Italy and Romania

Although there is extensive documentation of the damaging psychological consequences of self-objectification, more research is needed to explain its antecedents. With the present study we (a) investigated the correlates of self-objectification by analyzing biological (age and body-mass index), psychological (self-esteem), and sociocultural dimensions (influence of mass media and significant others) in women and men; (b) examined the role of culture in self-objectification processes; and (c) tested the effect of gender as a moderator in the relationship between both psychological and sociocultural dimensions and self-objectification. A total of 770 heterosexual adults residing in Italy and Romania completed a self-reported questionnaire. Self-objectification was operationalized as Body Surveillance (BS) and Body Shame (BSH); however, because the the BS subscale was not satisfactorily reliable, our focus was restricted to BSH. The correlates of self-objectification for BSH were analyzed separately by nationality in regression models. Overall, BSH emerged as a process influenced by agents rooted in biological and psychological domains, as well as in social and cultural domains. High educational level and high self-esteem (this last particularly in men) correlated with reduced body shame for the Romanian sample, whereas within the Italian sample, the internalization of media standards and influence of significant others emerged as risk factors for body shame. Taken together, these findings underline the need to identify cross-cultural constants of self-objectification, as well as differences across contexts, in order to better understand self-objectification and to promote protective factors in specific culturally situated interventions.     

Cross-cultural differences in item and background memory: examining the influence of emotional intensity and scene congruency

After viewing a scene, individuals differ in what they prioritise and remember. Culture may be one factor that influences scene memory, as Westerners have been shown to be more item-focused than Easterners (see Masuda, T., & Nisbett, R. E. (2001). Attending holistically versus analytically: Comparing the context sensitivity of Japanese and Americans. Journal of Personality and Social Psychology, 81, 922–934). However, cultures may differ in their sensitivity to scene incongruences and emotion processing, which may account for cross-cultural differences in scene memory. The current study uses hierarchical linear modeling (HLM) to examine scene memory while controlling for scene congruency and the perceived emotional intensity of the images. American and East Asian participants encoded pictures that included a positive, negative, or neutral item placed on a neutral background. After a 20-min delay, participants were shown the item and background separately along with similar and new items and backgrounds to assess memory specificity. Results indicated that even when congruency and emotional intensity were controlled, there was evidence that Americans had better item memory than East Asians. Incongruent scenes were better remembered than congruent scenes. However, this effect did not differ by culture. This suggests that Americans’ item focus may result in memory changes that are robust despite variations in scene congruency and perceived emotion.     

Effect of a spiritual retreat on perceived stress of Nigerian Catholic immigrant sisters in the United States

Stress among immigrants may be due to loss of familiar environment and experience of discrimination. Spiritual retreats may be one way to manage stressful life situations. The present study examined whether participation in a six-day spiritual retreat results in changes in perceived stress and whether changes in perceived stress depend on participant’s demographic characteristics. A total of 88 Nigerian Catholic immigrant sisters completed the Perceived Stress questionnaire pre-retreat, day three, and immediately after a spiritual retreat. Friedman Two-way ANOVA by rank was used to determine if there are mean changes in perceived stress over the three-time period, while Kruskal–Wallis ANOVA was used to determine if there were demographic differences in perceived stress. There were no differences in perceived stress at baseline, but there was a significant reduction in perceived stress at Time 2 and 3. There were no differences in perceived stress for the demographic variables except age.