The relationship between online social networking and depression:a systematic review of quantitative studies

Online social networking sites (SNSs) such as Facebook, Twitter, and MySpace are used by billions of people every day to communicate and interact with others. There has been increasing interest in the potential impact of online social networking on wellbeing, with a broadening body of new research into factors associated with both positive and negative mental health outcomes such as depression. This systematic review of empirical studies (n=30) adds to existing research in this field by examining current quantitative studies focused on the relationship between online social networking and symptoms of depression. The academic databases PsycINFO, Web of Science, CINAHL, MEDLINE, and EMBASE were searched systematically using terms related to online social networking and depression. Reporting quality was critically appraised and the findings discussed with reference to their wider implications. The findings suggest that the relationship between online social networking and symptoms of depression may be complex and associated with multiple psychological, social, behavioral, and individual factors. Furthermore, the impact of online social networking on wellbeing may be both positive and negative, highlighting the need for future research to determine the impact of candidate mediators and moderators underlying these heterogeneous outcomes across evolving networks

Diagnostic efficiency of the SDQ for parents to identify ADHD in the UK:a ROC analysis

BackgroundEarly, accurate identification of ADHD would improve outcomes while avoiding unnecessary medication exposure for non-ADHD youths, but is challenging, especially in primary care.The aim of this paper is to test the Strengths and Difficulties Questionnaire (SDQ) using a nationally representative sample to develop scoring weights for clinical use. MethodThe British Child and Adolescent Mental Health Survey (N=18,232 youths 5 to 15 years old) included semi-structured interview DSM-IV diagnoses and parent-rated SDQ scores. ResultsAreas Under the Curve (AUCs) for SDQ subscales were good (0.81) to excellent (0.96) across sex and age groups. Hyperactive/Impulsive scores of 10+ increased odds of ADHD by 21.3x. For discriminating ADHD from other diagnoses, accuracy was fair (<0.70) to good (0.88); Hyperactive/Impulsive scores of 10+ increased odds of ADHD by 4.47x. ConclusionsThe SDQ is free, easy to score, and provides clinically meaningful changes in odds of ADHD that can guide clinical decision-making in an evidence based medicine framework

Decision‐making and risk in bipolar disorder:A quantitative study using fuzzy trace theory

Objectives: This study characterizes risk-taking behaviours in a group of people with a self-reported diagnosis of BD using fuzzy trace theory (FTT). FTT hypothesizes that risk-taking is a ‘reasoned’ (but sometimes faulty) action, rather than an impulsive act associated with mood fluctuations. Design: We tested whether measures of FTT (verbatim and gist-based thinking) were predictive of risk-taking intentions in BD, after controlling for mood and impulsivity. We hypothesized that FTT scales would be significant predictors of risk-taking intentions even after accounting for mood and impulsivity. Methods: Fifty-eight participants with BD (age range 21–78, 68% female) completed a series of online questionnaires assessing risk intentions, mood, impulsivity, and FTT. Results: Fuzzy trace theory scales significantly predicted risk-taking intentions (medium effect sizes), after controlling for mood and impulsivity consistent with FTT (part range.26 to.49). Participants with BD did not show any statistically significant tendency towards verbatim-based thinking. Conclusions: Fuzzy trace theory gist and verbatim representations were both independent predictors of risk-taking intentions, even after controlling for mood and impulsivity. The results offer an innovative conceptualization of the mechanisms behind risk-taking in BD. Practitioner points: Risk-taking behaviour in bipolar disorder is not just a consequence of impulsivity. Measures of fuzzy trace theory help to understand risk-taking in bipolar disorder. FTT measures predict risk-taking intentions, after controlling for mood and impulsivity

Nonparametric Time Series Summary Statistics for High-Frequency Accelerometry Data from Individuals with Advanced Dementia

Accelerometry data has been widely used to measure activity and the circadian rhythm of individuals across the health sciences, in particular with people with advanced dementia. Modern accelerometers can record continuous observations on a single individual for several days at a sampling frequency of the order of one hertz. Such rich and lengthy data sets provide new opportunities for statistical insight, but also pose challenges in selecting from a wide range of possible summary statistics, and how the calculation of such statistics should be optimally tuned and implemented. In this paper, we build on existing approaches, as well as propose new summary statistics, and detail how these should be implemented with high frequency accelerometry data. We test and validate our methods on an observed data set from 26 recordings from individuals with advanced dementia and 14 recordings from individuals without dementia. We study four metrics: Interdaily stability (IS), intradaily variability (IV), the scaling exponent from detrended fluctuation analysis (DFA), and a novel nonparametric estimator which we call the proportion of variance (PoV), which calculates the strength of the circadian rhythm using spectral density estimation. We perform a detailed analysis indicating how the time series should be optimally subsampled to calculate IV, and recommend a subsampling rate of approximately 5 minutes for the dataset that has been studied. In addition, we propose the use of the DFA scaling exponent separately for daytime and nighttime, to further separate effects between individuals. We compare the relationships between all these methods and show that they effectively capture different features of the time series

Accuracy of Achenbach Scales in the Screening of ADHD in a Community Mental Health Clinic

Objective To use receiver-operating characteristics analysis to identify multilevel diagnostic likelihood ratios and provide a framework for the diagnosis of attention-deficit/hyperactivity disorder (ADHD) in children (5–10 years old) and adolescents (11–18 years old) in an outpatient setting. Method Caregiver, teacher, and youth reports from the Achenbach System of Empirically Based Assessment (ASEBA) were obtained for 299 children and 321 adolescents with multiple imputation of missing data. The reference standard was diagnosis of ADHD based on case history and a semistructured diagnostic interview masked to the ASEBA measurements. Results In children, caregiver-reported Attention Problems (area under the curve [AUC] = 0.74) outperformed all other subscales of the caregiver and teacher measures (AUCs ≤ 0.72). In the older sample, caregiver- and teacher-reported Attention Problems (caregiver AUC = 0.73; teacher AUC = 0.61) were best at identifying ADHD. Inclusion of caregiver and teacher reports significantly (p < .001 for all comparisons) increased prediction of ADHD diagnosis, whereas youth self-report did not. Conclusion Caregiver-reported Attention Problems were more useful than teacher-reports and self-report in identifying ADHD. Combining caregiver and teacher reports improved identification. Multilevel likelihood ratios are provided to facilitate routine clinical use

'To wait or not to wait':lessons from running a wait-list controlled trial (ELSA) of a volunteer befriending service at the end of life within NHS, hospice and voluntary sectors

Background: Many innovations in palliative care are implemented without robust understanding of their effect. Trials are underused as they can be considered ethically and pragmatically challenging. Wait-list designs show promise as they enable all participants to receive the intervention, but with the rigour of a controlled trial. Aim: To provide recommendations on running wait-list trials in partnership with lay researchers within the hospice and voluntary sectors. Methods: A wait-list controlled trial testing volunteer delivered social action befriending services across 11 hospice, charity and NHS sites. Many non-clinical staff are responsible for site trial management and informed consent procedures, prepared with innovative face to face role play workshops. Participants are estimated to be in their last year of life, randomly allocated to receive the befriending intervention immediately or after a four week wait. Data collection at baseline, 4, 8 weeks: WHO QOL BREF, Loneliness scale, mMOS-SS, social networks. Intention to treat analysis includes fitting a linear mixed effect model to each outcome variable at 4, 8 and 12 weeks. ISRCTN 12929812 Results: Participants (currently n=117, recruitment commenced 6/15, completes 12/15) are currently at all trial stages. Methodological challenges centre on ‘the wait’. Initiation issues include acknowledging site staff design concerns and involving them in developing the protocol and documentation. Ongoing ‘wait’ issues involve providing support to address informed consent concerns and understanding trial procedures, addressing disappointment of ‘the wait’ allocation, allocating volunteers in a timely fashion, and the impact this has on understanding effect for this design. Conclusions: It is possible to run a rigorous and ethical wait-list trial in partnership with non-clinical site staff and volunteers. Key considerations include assessment of the wait period and data collection timing, understanding providing a service in the context of a trial, and clear responsive communications to support staff

Quality of life trends in people with and without cancer referred to volunteer provided palliative care services (ELSA):A longitudinal study

Context Trends in symptoms and functional ability are known towards the end of life, but less is understood about quality of life, particularly prospectively following service referral. Objectives This study compares quality of life trajectories of people with and without cancer, referred to volunteer provided palliative care services. Methods A secondary analysis of the ELSA trial (n = 85 people with cancer and n = 72 without cancer). Quality of life data (WHOQOL-BREF) were collected at baseline (referral), 4, 8 and 12 weeks. Socio-demographic data were collected at baseline. We specified a series of joint models to estimate differences on quality of life trajectories between groups adjusting for participants who die earlier in the study. Results People with cancer had a significantly better quality of life at referral to the volunteer provided palliative care services than those with non-malignant disease despite similar demographic characteristics (Cohen d’s=.37 to .45). More people with cancer died during the period of the study. We observed significant differences in quality of life physical and environmental domain trajectories between groups (b = -2.35, CI -4.49, -0.21, and b = -4.11, CI -6.45, -1.76). People with cancer experienced a greater decline in quality of life than those with non-malignant disease. Conclusion Referral triggers for those with and without cancer may be different. People with cancer can be expected to have a more rapid decline in quality of life from the point of service referral. This may indicate greater support needs, including from volunteer provided palliative care services

Psychotic symptoms in ADHD:an analysis of the MTA database

Objective: To assess the prevalence of psychotic symptoms among youths (age 14-25 years) with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) combined type. Method: The participants in the Multimodal Treatment Study of Children with ADHD (MTA) and a local normative comparison group (LNCG) were systematically assessed 6, 8, 10, 12, 14, and 16 years after the original enrollment at a mean age of 8.5 years. Trained research assistants administered a psychosis screener, and positive screens were referred to study clinicians to confirm or exclude psychosis. Possible associations between screening positive and alcohol or substance use were assessed. Results: Data were available from 509 MTA participants (88% of the original MTA sample) and 276 LNCG subjects (96% of the original sample), with a mean age of 25.1 and 24.6 years, respectively, at Year 16. Twenty-six MTA subjects (5%, 95% CI: 3, 7) and 11 LNCG (4%, 95% CI: 2, 6) screened positive for at least one psychotic symptom (p=0.60). Most psychotic symptoms were transient. The prevalence of clinician-confirmed psychotic symptoms was 1.1% (95% C.I. 0.2, 2.1) in the MTA and 0.7% (0, 1.7) in the LNCG (p=0.72). Greater cannabis use was reported by those who screened (p<0.05) and were confirmed positive (p<0.01). Conclusions: There was no evidence that ADHD increased the risk for psychotic symptoms. In both the ADHD and normative comparison groups, more frequent cannabis use was associated with greater likelihood of experiencing psychotic symptoms, thus supporting the recommendation that youth should not use cannabis

Blue Blocking Glasses Worn at Night in First Year Higher Education Students with Sleep Complaints:A Feasibility Study

Background: Late adolescence and early adulthood is a period of highest incidence for onset of mental health problems. Transition to college environment has been associated with many risk factors such as the initial disruption - and subsequent irregularity - of the student's sleep and activity schedule. We tested the feasibility of using blue blocking glasses (BBG) at night in first year higher education students with sleep complaints, to obtain preliminary evidence for the impact of BBG on sleep, activity and mood. Methods: Participants were thirteen first year undergraduates (from 10 different academic courses) living on campus for first time with sleep complaints/disorders confirmed at screening via the Duke Structured Interview Schedule for Sleep Disorders. We used a two-week, balanced crossover design (BBG vs placebo glasses; participants were unaware which was the active intervention) with computer-generated random allocation. Exploratory analyses provided descriptive and frequency summaries to evaluate feasibility of the intervention. Results: Preliminary evidence supports the feasibility and acceptability of the trial; almost all screened participants consented and completed the protocol with high adherence, missing data were negligible. Additionally, the effectiveness of BBGs to enhance sleep, mood and activity levels in young adults was supported. Conclusions: The results of this feasibility trial suggest that BBG have potential as an inexpensive and feasible intervention for reducing sleep and circadian dysregulation in young adult students. A larger trial, following this successfully-implemented protocol, is necessary to fully test the efficacy of BBG

Assessing for Suicidal Behavior in Youth Using the Achenbach System of Empirically Based Assessment

Objective: This study investigated the clinical utility of the Achenbach System of Empirically Based Assessment (ASEBA) for identifying youth at risk for suicide. Specifically, we investigated how well the Total Problems scores and the sum of two suicide-related items (#18 “Deliberately harms self or attempts suicide” and #91 “Talks about killing self”) were able to distinguish youth with a history of suicidal behavior. Method: Youth (N=1117) aged 5 to 18 were recruited for two studies of mental illness. History of suicidal behavior was assessed by semi-structured interviews (KSADS) with youth and caregivers. Youth, caregivers, and a primary teacher each completed the appropriate form (YSR, CBCL, TRF, respectively) of the ASEBA. Areas under the curve (AUCs) from ROC analyses and diagnostic likelihood ratios (DLRs) were used to measure the ability of both Total Problems T-scores, as well as the summed score of two suicide-related items, to identify youth with a history of suicidal behavior. Results: The Suicide Items from the CBCL and YSR performed well (AUCs=.85 and .70, respectively). The TRF Suicide Items did not perform better than chance, AUC=.45. The AUCs for the Total Problems scores were poor-to-fair (.33-.65). The CBCL Suicide Items outperformed all other scores (ps=.04 to <.0005). Combining the CBCL and YSR items did not lead to incremental improvement in prediction over the CBCL alone. Conclusion: The sum of two questions from a commonly used assessment tool can offer important information about a youth’s risk for suicidal behavior The low burden of this approach could facilitate wide-spread screening for suicide in an increasingly at-risk population