Characteristics of patients in routine psycho-oncological care,and changes in outcome variables during and after their treatment

Objective: The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions.

Design: During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later.

Results and conclusions: Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.     

Cardiac-somatic integration: An index of visual attention

Eighteen 15-week-old, normal full-term infants were presented with photographic slides of a human facial expression. The infant's heart rate, body movement, and visual attention were recorded simultaneously. The results showed that heart rate and body movement were significantly correlated during visual attention but not during inattention. Both heart rate and body movement decelerated significantly when the infants visually attended to the target stimulus. The results are discussed with reference to cardiac-somatic integration in early infancy and its implication as a possible index of attention.     

Examining the initial usability,acceptability and feasibility of a digital mental health intervention for college students in India

Generalised anxiety disorder (GAD) is prevalent among college students in India; however, barriers like stigma, treatment accessibility and cost prevent engagement in treatment. Web- and mobile-based, or digital, mental health interventions have been proposed as a potential solution to increasing treatment access. With the ultimate goal of developing an engaging digital mental health intervention for university students in India, the current study sought to understand students' reactions to a culturally and digitally adapted evidence-based cognitive behavioural therapy (CBT) for GAD intervention. Specifically, through theatre testing and focus groups with a non-clinical sample of 15 college students in India, the present study examined initial usability, acceptability and feasibility of the “Mana Maali Digital Anxiety Program.” Secondary objectives comprised identifying students' perceived barriers to using the program and eliciting recommendations. Results indicated high usability, with the average usability rating ranking in the top 10% of general usability scores. Participants offered actionable changes to improve usability and perceived acceptability among peers struggling with mental health issues. Findings highlight the benefits of offering digital resources that circumvent barriers associated with accessing traditional services. Results build on existing evidence that digital interventions can be a viable means of delivering mental healthcare to large, defined populations.     

Running as a way fat women re-story their bodies and construct a runner identity in a North American sociocultural context

AimThis research sought to identify the process by which women who identify as fat or as not having a typical athletic body construct an athletic identity and persist in their running and other athletic endeavors despite body size-related barriers.MethodsFrom an online recruitment effort, 19 North American women runners in larger bodies completed interviews in which they told the story of how they had become runners. A narrative analysis with a feminist, constructivist approach was conducted to identify story types.ResultsFour narrative types were identified: reclaiming the body, reclaiming health, space-making, and future-imagining. Through finding a size- and pace-inclusive running community, running persistently, and completing races, women relinquished the stories they’d believed that their bodies were not athletic since childhood and constructed an identity of runner in a fat body.ConclusionsThese women’s engagement in running is a personal form of resistance against those who define athletic and healthy as “thin” or “fit.” They have found a welcoming athletic community and have moved on to leadership where they are working to make running accessible to other women in bodies like theirs. Those reading these narratives should consider ways in which fat bodies have been excluded from athletics, as well as ways to support the work being done by women runners in fat bodies to redefine health and athleticism.     

Beyond the FN: A spatio-temporal analysis of the neural correlates of feedback processing in a virtual Blackjack game

Studies using event-related brain potentials (ERPs) to examine feedback processing in gambling tasks have focused almost exclusively on components elicited between 200 and 500 ms after feedback over the frontal-central region of the scalp (i.e., P2, feedback negativity (FN), and P3a). In contrast, studies examining the functional neuroanatomy of feedback processing reveal activation in a distributed network that includes the anterior and posterior cingulate, the lateral and medial orbitofrontal cortex, the occipital cortex, and the basal ganglia. In the current study, we used ERPs in combination with spatial principal components-massive univariate analysis and distributed source analysis to examine the time course, topography, and neural generators of ERPs elicited in a virtual Blackjack game from 0 to 2000 ms after feedback was delivered. The ERP data revealed the P2–FN–P3a complex, as well as, broadly distributed transient and slow wave activity that was sensitive to the magnitude and valence of an outcome. The ERPs reflected activation in the anterior and posterior cingulate, in addition to the occipital, temporal and medial frontal cortices. These data demonstrate that ERPs can provide valuable insight into the timing of neural recruitment within a distributed cortical network during the first two seconds of feedback processing.     

Using activity schedules to promote varied application use in children with autism

We evaluated the effects of an activity schedule embedded within an iPad on varied play across applications. After establishing a pattern of repetitive gameplay, we taught three children with autism to follow the activity schedule using physical guidance. All participants increased their varied play to four applications per session and demonstrated independent and accurate activity schedule usage. The activity schedule was removed, and responding decreased to baseline levels, demonstrating the activity schedule's control over varied responding. The activity schedule was reintroduced and participant responding maintained when engaging with novel applications.     

Guided Recovery: An Interpretative Phenomenological Analysis of Service Users’ Experiences of Guided Self-Help for Bulimic and Binge Eating Disorders

The efficacy of Cognitive Behavioral Therapy–based Guided Self-Help for mild to moderate bulimia and binge eating disorders has been well supported. However, limited research has explored in-depth individual experiences of this treatment approach. In-depth semi-structured interviews were conducted with 4 individuals who had completed Cognitive Behavioral Therapy–based Guided Self-Help (CBT-GSH) for bulimic or binge eating disorders. The interviews were transcribed verbatim and subsequently analyzed using Interpretative Phenomenological Analysis (IPA). Three superordinate themes emerged: Autonomy and volition; A dynamic relationship: the guided and the guide; and The unwanted friend. The reciprocal nature of the guide/guided relationship was identified as integral to the success of the therapeutic approach. However, participants expressed initial uncertainty towards the therapeutic process, and experienced an uncomfortable dissonance between a lack of volition in therapy seeking and the need to continually self-prescribe CBT-GSH. The findings affirm the central role of the guide in promoting motivation to engage with therapy and highlight the potential benefits of in-session weighing. However, it may be necessary to provide additional support on commencing CBT-GSH to address concerns about the therapeutic approach in this group.     

Early Eye Movement Desensitisation and Reprocessing (EMDR) intervention in a disaster mental health care context

‘Early psychological intervention’ is defined as commencing treatment within three months of the traumatic event, with the aim to prevent or treat posttraumatic stress disorder, ongoing distress or acute stress disorder. In natural disaster situations, specific issues may limit the amount of time available for treatment and the possibility of interventions. Eye Movement Desensitisation and Reprocessing (EMDR) can be used without regard to these limits. The aim of the study is to evaluate the effects of EMDR, Recent Traumatic Episode Protocol (R-TEP) provided within three months of the traumatic event to a large sample of individuals exposed to the earthquake that hit Emilia Romagna Region (Northern Italy) in 2012. This study is based on a retrospective review of medical records collected during the activities of psychological and psychosocial unit in the immediate aftermath of earthquake. In total, 529 participants completed the Impact of Event Scale Revised (IES-R) (pre e post treatment). In order to provide a comparison similar to a waitlist-like control group, a method of cohort analysis was applied. In addition, possible time dependent effect was tested. ET (early-treated sample, participants treated within one month after the earthquake) and LT (late-treated sample, participants treated after the first month from the earthquake) reported at post-treatment an improvement to a level below the IES-R cutoff (65.8% of the ET sample and 64.02% of the LT sample). Control group analogue and time-outcome correlation suggest that positive changes in symptoms were likely due to the treatment provided and not merely to the time lapse from the traumatic event. The results of this study suggest that EMDR is a viable treatment option in response to a disaster crisis and in reducing psychological distress of acutely traumatized individuals within the context of a natural disaster.     

Predictors of adherence to aerobic exercise in rectal cancer patients during and after neoadjuvant chemoradiotherapy

This pilot study explored predictors of adherence to exercise during and after neoadjuvant chemoradiotherapy (NACRT) in rectal cancer patients. Eighteen rectal cancer patients were prescribed three supervised aerobic exercise sessions/week during NACRT followed by ≥150 min/week of unsupervised aerobic exercise after NACRT. Although not statistically significant, adherence to supervised exercise during NACRT was meaningfully better for patients who were women (d = .82; P = .12), younger (d = ?.62; P = .30), married (d = .62; P = .42), with better mental health (r = .32; P = .21), fewer diarrhea symptoms (r = .48; P = .052), and higher anticipated enjoyment (r = .31; P = .23), support (r = .32; P = .22), and motivation (r = .31; P = .23). After NACRT, adherence was significantly better for patients who reported worse mental health (r = ?.56; P = .046) and meaningfully better for patients who were women (d = .54; P = .38), better educated (d = .77; P = .22), had no comorbidities (d = ?.63; P = .17), and exercised at baseline (d = 1.05; P = .12). Demographics, tumor side effects, and motivational variables may predict adherence to exercise during and after NACRT.