Long-Term Effects of an Internet-Based Treatment for Posttraumatic Stress

Advances in communication technology offer additional strategies for providing psychological treatment. Previous trials of Internet-based treatment approaches reported significant reductions in posttraumatic stress and related symptoms in response to Internet-based treatments relative to control groups. However, empirical data on the long-term effects of those approaches are sparse. In order to evaluate the long-term effect of an Internet-based intervention, the authors conducted an 18-month follow-up of an Internet-based cognitive behavioural therapy for posttraumatic stress. Severity of posttraumatic stress symptoms was the primary outcome. Additional measures were depression, anxiety, mental and physical health, and health care utilization during the follow-up period. Treatment group participants (n ¼ 34) were assessed 1.5 years after completing treatment. Results indicated that reductions in symptoms of posttraumatic stress symptoms, depression, and anxiety found at posttreatment were sustained during the 18-month follow-up period. Preliminary evidence on long-term effects of Internet-based health care as shown in this study is promising. However, research with larger and clinically more diverse samples is needed to fully assess the clinical impact and potential of Internet-based health care provision. Key words: online therapy; Internet; randomized controlled trial; long-term effects; cognitive behavioural treatment; PTS

Efficacy of internet-based interventions for common mental disorder symptoms and psychosocial problems in older adults: A systematic review and meta-analysis.

Although a high proportion of older adults suffer from common mental disorder symptoms and psychosocial problems, only a small number of older individuals seek psychological treatment. Internet-based interventions have the potential to bridge this treatment gap. However, while there is extensive literature on internet-based treatments in younger to middle-aged adults, research on older individuals is lacking. We aimed to summarize narratively and empirically the existing literature on the efficacy of internet-based interventions for the treatment of common mental disorder symptoms and psychosocial problems (loneliness, stress) in older individuals. This systematic review and meta-analysis was registered in PROSPERO (registration number: CRD42021235129). Systematic literature searches were conducted in PsycInfo, Ageline, Medline, CINHAL, and Psyndex. Studies were eligible for inclusion if they a) focused on older adults, b) assessed the efficacy of an internet-delivered psychological intervention, c) included a control condition and d) assessed common mental disorder symptoms or psychosocial problems as outcomes. Meta-analyses were conducted based on studies that included a passive, minimally active or placebo control condition to estimate pooled effects on overall symptom severity as well as on specific psychological outcomes. 11 Studies met inclusion criteria, with the majority of interventions focusing on depression or anxiety symptoms and being based on CBT principles. Significant large effect of internet-based interventions for older adults were found for overall symptom severity (depression, anxiety, PTSD, stress) as well as for depression symptom severity. No significant effects were found for anxiety symptom severity. Our findings provide preliminary support that internet-based interventions might be a feasible and effective intervention method for the treatment of common mental disorder symptoms and stress in older adults. However, research in this area is still at an early stage. More studies are needed to shed light on the role of various treatment and patient characteristics in the efficacy of internet-delivered treatments

An Infrared Study of the Circumstellar Material Associated with the Carbon Star R Sculptoris

The asymptotic giant branch (AGB) star R Sculptoris (R Scl) is one of the most extensively studied stars on the AGB. R Scl is a carbon star with a massive circumstellar shell ($M_{shell}\sim 7.3\times10^{-3}~M_{\odot}$) which is thought to have been produced during a thermal pulse event $\sim2200$ years ago. To study the thermal dust emission associated with its circumstellar material, observations were taken with the Faint Object InfraRed CAMera for the SOFIA Telescope (FORCAST) at 19.7, 25.2, 31.5, 34.8, and 37.1 $\mu$m. Maps of the infrared emission at these wavelengths were used to study the morphology and temperature structure of the spatially extended dust emission. Using the radiative transfer code DUSTY and fitting the spatial profile of the emission, we find that a geometrically thin dust shell cannot reproduce the observed spatially resolved emission. Instead, a second dust component in addition to the shell is needed to reproduce the observed emission. This component, which lies interior to the dust shell, traces the circumstellar envelope of R Scl. It is best fit by a density profile with $n \propto r^{\alpha}$ where $\alpha=0.75^{+0.45}_{-0.25}$ and dust mass of $M_d=9.0^{+2.3}_{-4.1}\times10^{-6}~M_{\odot}$. The strong departure from an $r^{-2}$ law indicates that the mass-loss rate of R Scl has not been constant. This result is consistent with a slow decline in the post-pulse mass-loss which has been inferred from observations of the molecular gas.Comment: 10 pages, 10 figures, accepted to Ap

L-band (3.5 micron) IR-excess in massive star formation, II. RCW 57/NGC 3576

We present a JHKL survey of the massive star forming region RCW 57 (NGC 3576) based on L-band data at 3.5 micron taken with SPIREX (South Pole Infrared Explorer), and 2MASS JHK data at 1.25-2.2 micron. This is the second of two papers, the first one concerning a similar JHKL survey of 30 Doradus. Colour-colour and colour-magnitude diagrams are used to detect sources with infrared excess. This excess emission is interpreted as coming from circumstellar disks, and hence gives the cluster disk fraction (CDF). Based on the CDF and the age of RCW 57, it is possible to draw conclusions on the formation and early evolution of massive stars. The infrared excess is detected by comparing the locations of sources in JHKL colour-colour and L vs. (K-L) colour-magnitude diagrams to the reddening band due to interstellar extinction. A total of 251 sources were detected. More than 50% of the 209 sources included in the diagrams have an infrared excess. Comparison with other JHKL surveys, including the results on 30 Doradus from the first paper, support a very high initial disk fraction (>80%) even for massive stars, although there is an indication of a possible faster evolution of circumstellar disks around high mass stars. 33 sources only found in the L-band indicate the presence of heavily embedded, massive Class I protostars. We also report the detection of diffuse PAHs emission throughout the RCW 57 region.Comment: 15 pages, 13 figure

Study of the inner dust envelope and stellar photosphere of the AGB star R Doradus using SPHERE/ZIMPOL

We use high-angular-resolution images obtained with SPHERE/ZIMPOL to study the photosphere, the warm molecular layer, and the inner wind of the close-by oxygen-rich AGB star R Doradus. We present observations in filters V, cntH$\alpha$, and cnt820 and investigate the surface brightness distribution of the star and of the polarised light produced in the inner envelope. Thanks to second-epoch observations in cntH$\alpha$, we are able to see variability on the stellar photosphere. We find that in the first epoch the surface brightness of R Dor is asymmetric in V and cntH$\alpha$, the filters where molecular opacity is stronger, while in cnt820 the surface brightness is closer to being axisymmetric. The second-epoch observations in cntH$\alpha$ show that the morphology of R Dor changes completely in a timespan of 48 days to a more axisymmetric and compact configuration. The polarised intensity is asymmetric in all epochs and varies by between a factor of 2.3 and 3.7 with azimuth for the different images. We fit the radial profile of the polarised intensity using a spherically symmetric model and a parametric description of the dust density profile, $\rho(r)=\rho_\circ r^{-n}$. On average, we find exponents of $- 4.5 \pm 0.5$ that correspond to a much steeper density profile than that of a wind expanding at constant velocity. The dust densities we derive imply an upper limit for the dust-to-gas ratio of $\sim 2\times10^{-4}$ at 5.0 $R_\star$. Given the uncertainties in observations and models, this value is consistent with the minimum values required by wind-driving models for the onset of a wind, of $\sim 3.3\times10^{-4}$. However, if the steep density profile we find extends to larger distances from the star, the dust-to-gas ratio will quickly become too small for the wind of R Dor to be driven by the grains that produce the scattered light.Comment: 10 pages, 8 figures, 4 table

Unexpectedly large mass loss during the thermal pulse cycle of the red giant R Sculptoris!

The asymptotic giant branch star R Sculptoris is surrounded by a detached shell of dust and gas. The shell originates from a thermal pulse during which the star undergoes a brief period of increased mass loss. It has hitherto been impossible to constrain observationally the timescales and mass-loss properties during and after a thermal pulse - parameters that determine the lifetime on the asymptotic giant branch and the amount of elements returned by the star. Here we report observations of CO emission from the circumstellar envelope and shell around R Sculptoris with an angular resolution of 1.3 arcsec. What was hitherto thought to be only a thin, spherical shell with a clumpy structure, is revealed to contain a spiral structure. Spiral structures associated with circumstellar envelopes have been seen previously, from which it was concluded that the systems must be binaries. Using the data, combined with hydrodynamic simulations, we conclude that R Sculptoris is a binary system that underwent a thermal pulse approximately 1800 years ago, lasting approximately 200 years. About 0.003 Msun of mass was ejected at a velocity of 14.3 km s-1 and at a rate approximately 30 times higher than the prepulse mass-loss rate. This shows that approximately 3 times more mass is returned to the interstellar medium during and immediately after a pulse than previously thought.Comment: Accepted by Natur

High-resolution observations of gas and dust around Mira using ALMA and SPHERE/ZIMPOL

The outflows of oxygen-rich asymptotic giant branch (AGB) stars are thought to be driven by radiation pressure due to the scattering of photons on relatively large grains, with sizes of tenths of microns. The details of the formation of dust in the extended atmospheres of these stars and, therefore, the mass-loss process, is still not well understood. Aims. We aim to constrain the distribution of the gas and the composition and properties of the dust grains that form in the inner circumstellar environment of the archetypal Mira variable o Cet. Methods. We obtained quasi-simultaneous observations using ALMA and SPHERE/ZIMPOL on the Very Large Telescope (VLT) to probe the distribution of gas and large dust grains, respectively. Results. The polarized light images show dust grains around Mira A, but also around the companion, Mira B, and a dust trail that connects the two sources. The ALMA observations show that dust around Mira A is contained in a high-gas-density region with a significant fraction of the grains that produce the polarized light located at the edge of this region. Hydrodynamical and wind-driving models show that dust grains form efficiently behind shock fronts caused by stellar pulsation or convective motions. The distance at which we observe the density decline (a few tens of au) is, however, significantly larger than expected for stellar-pulsation-induced shocks. Other possibilities for creating the high-gas-density region are a recent change in the mass-loss rate of Mira A or interactions with Mira B. We are not able to determine which of these scenarios is correct. We constrained the gas density, temperature, and velocity within a few stellar radii from the star by modelling the CO v = 1, J = 3-2 line. We find a mass (~3.8 \ub1 1.3) 7 104 M to be contained between the stellar millimetre photosphere, R338 GHz, and 4 R338 GHz. Our best-fit models with lower masses also reproduce the 13CO v = 0, J = 3-2 line emission from this region well. We find TiO2 and AlO abundances corresponding to 4.5% and <0.1% of the total titanium and aluminium expected for a gas with solar composition. The low abundance of AlO allows for a scenario in which Al depletion into dust happens already very close to the star, as expected from thermal dust emission observations and theoretical calculations of Mira variables. The relatively large abundance of aluminium for a gas with solar composition allows us to constrain the presence of aluminium oxide grains based on the scattered light observations and on the gas densities we obtain. These models imply that aluminium oxide grains could account for a significant fraction of the total aluminium atoms in this region only if the grains have sizes 0.02 μm. This is an order of magnitude smaller than the maximum sizes predicted by dust-formation and wind-driving models. Conclusions. The study we present highlights the importance of coordinated observations using different instruments to advance our understanding of dust nucleation, dust growth, and wind driving in AGB stars

Validation of the French ADNM-20 in the assessment of emotional difficulties resulting from COVID-19 quarantine and outbreak

Background: Multiple psychological consequences of the COVID-19 outbreak and quarantine have been described. However, there is a lack of global conceptualization. We argue that the stressful aspects of the situation, the multiple environmental consequences of the outbreak, and the diversity of symptoms observed in such a situation, suggest that Adjustment disorder (AD) is a promising way to conceptualize the psychological consequences of the outbreak and quarantine. The first aim of the study was to validate the French version of the ADNM. The second aim was to set out adjustment difficulties resulting from COVID-19 outbreak and quarantine. Method: We recruited 1010 (840 women, 170 men) who consented online to participate. They filled out the French ADNM, visual analogic scales, HADS, IES, and the COPE, to evaluate coping strategies. Results: We confirmed the factor structure of the ADNM and we found good psychometric properties. We found that 61.3% of participants presented an adjustment disorder related to COVID-19 outbreak. We found multiple risk factors and protective factors to AD due to quarantine and outbreak. We also identified the coping strategies negatively and positively associated with AD. Conclusion: Adjustment disorder is a relevant concept to understand psychological manifestations caused by quarantine and outbreak. The French ANDM has good psychometric properties to evaluate such manifestations. The association between coping strategies and AD symptoms suggest that CBT may be the best intervention to help people suffering from AD