Does treatment method matter? A meta-analysis of the past 20 years of research on therapeutic interventions for self-harm and suicidal ideation in adolescents

Background: Self-harm is a clinically relevant and prevalent behaviour which peaks in adolescence. Given the high prevalence of self-harm, the high levels of psychiatric comorbidity, and its role as a risk factor for suicide, delivering evidence-based care is critical. Methods: We conducted a systematic review and meta-analysis of the literature on treating self-harm in adolescents (12-19 years) published in the last 20 years, identifying 25 randomised controlled trials. We calculated the effect of treatment interventions relative to active control conditions in reducing self-harm, suicidal ideation and depressive symptoms. Results: Overall, treatment interventions fared slightly better than active controls in decreasing self-harm (d = 0.13, 95% CI 0.04-0.22, p =.004), suicidal ideation (d = 0.31, 95% CI 0.12-0.50, p =.001) and depressive symptoms (d = 0.22, 95% CI 0.07-0.38, p =.006). Subgroup analysis of specific therapies revealed moderate effects of DBT-A in reducing self-harm (d = 0.51, 95% CI 0.18-0.85, p =.002) and suicidal ideation (d = 0.48, 95% CI 0.17-0.80, p =.003), as well as moderate effects of family-centred therapy in the treating suicidal ideation (d = 0.58, 95% CI 0.01-1.15, p =.049). Conclusions: The findings of our meta-analysis indicate that, overall, currently available treatments are effective in treating self-harm, suicidal ideation, and depressive symptoms in adolescence. Although the treatment intervention conditions showed only small to moderate effects in comparison to active controls, these differences were statistically significant and are clinically important. Further research is needed to understand the reduction in self-harm within active controls, which may arise due to the natural course of self-harm, or the potential efficacy of treatment as usual and enhanced usual care. Given the significant reduction of self-harm in active control conditions, delivering effective care to a large number of adolescents with self-harm may require developing stepped-care models in clinical practice. Expensive and poorly available treatments should be targeted at young people who most need them.fals

Applicability of Immersive Analytics in Mixed Reality: Usability Study

Nowadays, visual analytics is mainly performed by programming approaches and viewing the results on a desktop monitor. However, due to the capabilities of smart glasses, new user interactions and representation possibilities become possible. This refers especially to 3D visualizations in the medical field, as well as, the industry domain, as valuable depth information can be related to the complex real-world structures and related data, which is also denoted as immersive analytics. However, the applicability of immersive analytics and its drawbacks, especially in the context of mixed reality, are quite unexplored. In order to validate the feasibility of immersive analytics for the aforementioned purposes, we designed and conducted a usability study with 60 participants. More specifically, we evaluated the effects of spatial sounds, performance changes from one analytics task to another, expert status, and compared an immersive analytics approach (i.e., a mixed-reality application) with a desktop-based solution. Participants had to solve several data analytics tasks (outlier’s detection and cluster recognition) with the developed mixed-reality application. Thereby, the performance measures regarding time, errors, and movement patterns were evaluated. The separation into groups (low performer vs. high performer) was performed using a mental rotation pretest. When solving analytic tasks in mixed reality, participants changed their movement patterns in the mixed reality setting significantly, while the use of spatial sounds reduced the handling time significantly, but did not affect the movement patterns. Furthermore, the usage of mixed reality for cluster recognition is significantly faster than the desktop-based solution (i.e., a 2D approach). Moreover, the results obtained with self-developed questionnaires indicate 1) that wearing smart glasses are perceived as a potential stressor and 2) that the utilization of sounds is perceived very differently by the participants. Altogether, industry and researchers should consider immersive analytics as a suitable alternative compared to the traditional approaches

Impact of social media on triggering nonsuicidal self‑injury in adolescents: a comparative ambulatory assessment study

Background Nonsuicidal self-injury (NSSI) is a prevalent and concerning behavior among adolescents, often triggered by negative interpersonal events. As social media is essential in the daily life of adolescents, gaining a better understanding of the impact of negative online events on NSSI urges and behaviors, distinct from that of real-life events, is warranted. Methods We recruited 25 adolescents with a history of NSSI and 25 healthy controls. Participants reported on their stress, affect, and NSSI urges four times daily over seven days using ambulatory assessment. We examined the immediate effects of negative events in real-life and on social media on these psychological outcomes. Results In adolescents who engage in NSSI, negative events on social media were positively associated with perceived stress, negative affect, and NSSI urges to a greater extent than real-life negative events. However, NSSI events during the sampling period were mostly triggered by real-life events. While the frequency of social media use was generally similar between groups, those with NSSI reported experiencing more negative events on social media. Conclusions Our findings highlight the significant impact of social media on the mental health of adolescents who engage in NSSI, possibly exacerbating stress and negative affect more than real life events. These results underscore the need for targeted interventions addressing online interactions to mitigate NSSI behaviors and improve adolescent mental health

Barriers to adopting therapeutic virtual reality: the perspective of clinical psychologists and psychotherapists

Background and objectiveDespite evidence supporting the effectiveness of Virtual Reality (VR) for mental disorders, VR adoption in therapy remains low. As VR-technology continues to advance, it is crucial to examine individual and contextual barriers preventing implementation of therapeutic VR.MethodsAn online survey with closed and open-ended questions regarding knowledge of VR, VR-usage and barriers to VR adoption was conducted among clinical psychologists and psychotherapists in Austria (Mage=51.71 years, 76% women).ResultsOf 694 participants, only 10 reported using therapeutic VR. Chi-square tests revealed significant differences regarding interest in therapeutic VR based on prior experience, employment status, professional training, and therapeutic cluster. Besides a small age effect, no effects of gender or professional experience were found. Participants interested in VR (interest group, IG) frequently cited barriers and other reasons (see thematic analysis) for not having used VR yet. Those not interested in VR (no interest group, NIG) indicated a lack of relevance, no perceived advantage, or disinterest as reasons for not using VR. Thematic analysis identified four themes shared by both IG and NIG, each encompassing group-specific sub-themes: professional barriers (lack of knowledge, training, time, personal reasons), financial barriers (costs, cost-benefit-ratio), therapeutic barriers (clinical applicability, concerns about “real” therapeutic relationship), and technological barriers (immature technology, cybersickness, no equipment).ConclusionsSignificant barriers to the adoption of therapeutic VR among clinical psychologists and psychotherapists are gaps in knowledge and training, financial constraints, and lack of motivation, all of which highlight the need for training and financial support to enhance VR implementation

Early Detection, Diagnosis and Intervention Services for Young Children with Autism Spectrum Disorder in the European Union (ASDEU): Family and Professional Perspectives

Early services for ASD need to canvas the opinions of both parents and professionals. These opinions are seldom compared in the same research study. This study aims to ascertain the views of families and professionals on early detection, diagnosis and intervention services for young children with ASD. An online survey compiled and analysed data from 2032 respondents across 14 European countries (60.9% were parents; 39.1% professionals). Using an ordinal scale from 1 to 7, parents’ opinions were more negative (mean = 4.6; SD 2.2) compared to those of professionals (mean = 4.9; SD 1.5) when reporting satisfaction with services. The results suggest services should take into account child’s age, delays in accessing services, and active stakeholders’ participation when looking to improve services

Psychological and physiological human responses to simulated and real environments: A comparison between Photographs, 360° Panoramas, and Virtual Reality

[EN] Psychological research into human factors frequently uses simulations to study the relationship between human behaviour and the environment. Their validity depends on their similarity with the physical environments. This paper aims to validate three environmental-simulation display formats: photographs, 360° panoramas, and virtual reality. To do this we compared the psychological and physiological responses evoked by simulated environments set-ups to those from a physical environment setup; we also assessed the users' sense of presence. Analysis show that 360° panoramas offer the closest to reality results according to the participants' psychological responses, and virtual reality according to the physiological responses. Correlations between the feeling of presence and physiological and other psychological responses were also observed. These results may be of interest to researchers using environmental-simulation technologies currently available in order to replicate the experience of physical environments.This work was supported by the Ministerio de Economia y Competitividad. Spain (Project TIN2013-45736-R).Higuera-Trujillo, JL.; López-Tarruella Maldonado, J.; Llinares Millán, MDC. (2017). Psychological and physiological human responses to simulated and real environments: A comparison between Photographs, 360° Panoramas, and Virtual Reality. Applied Ergonomics. 65:398-409. https://doi.org/10.1016/j.apergo.2017.05.006S3984096

Distance Learning: Pitfalls and Possibilities

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