A qualitative exploration of how people with bipolar disorder consider risk-taking in everyday decisions

Background: Difficulties with decision making and risk taking in individual with Bipolar Disorder (BD) have been associated with mood episodes. However, there is limited information about these experiences during euthymia, the mood state where people with BD spent the majority of their time. Aims: To examine how individuals with BD consider risk in everyday decisions during their euthymic phase. Method: We conducted a qualitative study that used semi-structured audio recorded interviews. Eight euthymic participants with confirmed BD were interviewed, and we used Interpretative Phenomenological Analysis to analyse the data. Results: We identified four themes. The first theme, “Who I Really Am”, involves the relationship between individual identity and risks taken. The second theme, “Taking Back Control of my Life”, explored the relationship between risks taken as participants strove to keep control of their lives. The third theme, “Fear of the ‘What Ifs’”, represents how the fear of negative consequences from taking risks impacts risk decisions. Finally, the fourth theme, “The Role of Family and Friends”, highlights the important role that a supporting network can have in their lives in the context of taking risks. Conclusions: The study highlights aspects that can impact on an individual with BD’s consideration of risk during euthymia. Identity, control, fear and support all play a role when a person considers risk in their decision-making process, and they should be taken into consideration when exploring risk with individuals with BD in clinical settings, and inform the design of future interventions

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

Examining the Association Between Mentalizing and Parental Mental Health in a Sample of Caregivers of Children with Asthma

Background: Caregivers of children with asthma are at higher risk of experiencing mental health difficulties and lower quality of life than caregivers of healthy children. Mentalizing is a psychological construct that defines the ability of understanding one’s own and others’ states of mind. Poor levels of mentalizing are strongly associated with a wide range of mental health difficulties such as depression, anxiety or emotional dysregulation. This cross-sectional study is the first to examine the associations between mentalizing and mental health in a sample of caregivers of children with asthma. Method: Caregivers of children (mean age=6.53, SD=3.72, ages 1 to 17) with asthma were recruited from social media support groups and the Asthma UK charity research bulletin. Participants completed self report measures of mentalizing, family functioning, mood and anxiety difficulties. Results: A total of 88 caregivers completed the full survey. Results indicated that poorer mentalizing capacity was significantly associated with poorer family functioning and increased mood and anxiety symptomatology. Poor mentalizing was significantly associated with increased levels of depression, hypomania and anxiety, explaining 16% of variance in depression and 10% of variance in anxiety. Family functioning was not a significant predictor after controlling for the effect of mentalizing. Conclusions: These findings suggest that mentalizing capacity might be a valued new treatment target to improve the mental health of caregivers of children with asthma. The results suggest that mentalizing could complement previously identified factors such as family functioning or asthma symptom severity in understanding caregivers’ mental health. Further investigation into the role of mentalizing in the mental health of this population is warranted

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

What is the relationship between people with dementia and their caregiver’s illness perceptions post diagnosis and the impact on help seeking behaviour?:A systematic review

Background: As the number of people with dementia increases, more families will be affected by the daily challenges of providing effective support, given its current incurable status. Once individuals are diagnosed with dementia, the earlier they access support the more effective the outcome. However once people receive a diagnosis, how they make sense of their dementia can impact on their help seeking intentions. Exploring the illness beliefs of people with dementia and their caregivers and this relationship to help seeking may identify how best to facilitate early support. Aims: To systematically obtain and critically review relevant studies on the relationship between illness perceptions and help seeking of people with dementia and their caregivers. Method: A systematic search was conducted and included both quantitative and qualitative studies. The Initial search was conducted in October 2018, with an adjacent search conducted in April 2020. Findings: A total of 14 articles met the inclusion criteria. Conceptually the studies examined the association of illness perceptions and help seeking post diagnosis and revealed that people living with dementia and their caregivers sought help when symptoms became severe. Components of Illness perceptions revealed that lack of knowledge, cultural beliefs, complexity of the health care system, threat to independence and acceptance were identified as major factors for delaying help seeking. Conclusion: Although research interest in the area of illness perceptions and their impact on help seeking for dementia is increasing, further work is needed to understand this area, particularly regarding the influence of the relationship between the person with dementia and their caregiver

A systematic review of the association of diet quality with the mental health of university students:implications in health education practice

University students are at risk of experiencing mental health problems during the transition from home to university. This transition can also adversely affect their diet quality. This review aims to examine bidirectional associations from observational studies regarding the influence of diet quality on the mental health of university students, and vice versa. The databases PubMed, CINAHL, EMBASE, PsycINFO, The Cochrane Library and Web of Science were searched using relevant search terms. The searches were last updated on 15 July 2022. Majority of studies (36 out of 45) found that good diet quality of students was associated with better mental health in terms of depression, anxiety, stress and overall general mental well-being. Moreover, majority of studies (19 out of 23) found that stress and anxiety of students were associated with poorer diet quality. The effect sizes observed were generally small–moderate. Healthy diets of students have been associated with better mental health in terms of depression, anxiety, stress or other mental health issues. Stress experienced by university students has been associated with unhealthy diets. There are implications for health education research, as interventions to improve diet quality at the university level could reduce mental health issues; additionally, interventions to support students under stress may lead to healthier dietary habits when living on campuses. Randomized controlled trials and intervention studies are needed to further investigate these implications

Predictors and Moderators in the Randomized Trial of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders

OBJECTIVE: This study investigated predictors and moderators of mood symptoms in the randomized controlled trial (RCT) of Multi-Family Psychoeducational Psychotherapy (MF-PEP) for childhood mood disorders. METHOD: Based on predictors and moderators in RCTs of psychosocial interventions for adolescent mood disorders, we hypothesized that children’s greater functional impairment would predict worse outcome, while children’s stress/trauma history and parental expressed emotion and psychopathology would moderate outcome. Exploratory analyses examined other demographic, functioning, and diagnostic variables. Logistic regression and linear mixed effects modeling were used in this secondary analysis of the MF-PEP RCT of 165 children, ages 8–12, with mood disorders, a majority of whom were male (73%) and White, non-Hispanic (90%). RESULTS: Treatment nonresponse was significantly associated with higher baseline levels of global functioning (i.e., less impairment; Cohen’s d = 0.51) and lower levels of stress/trauma history (d = 0.56) in children and Cluster B personality disorder symptoms in parents (d = 0.49). Regarding moderators, children with moderately impaired functioning who received MF-PEP had significantly decreased mood symptoms (t = 2.10, d = 0.33) compared with waitlist control. MF-PEP had the strongest effect on severely impaired children (t = 3.03, d = 0.47). CONCLUSIONS: Comprehensive assessment of demographic, youth, parent, and familial variables should precede intervention. Treatment of mood disorders in high functioning youth without stress/trauma histories and with parents with elevated Cluster B symptoms may require extra therapeutic effort, while severely impaired children may benefit most from MF-PEP

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

Is the finding too good to be true?:Moving from “more is better” to thinking in terms of simple predictions and credibility

In 2018, De Los Reyes and Langer expanded the scope of the Evidence Base Updates series to include reviews of psychological assessment techniques. In keeping with the goal of offering clear "take-home messages" about the evidence underlying the technique, experts have proposed a rubric for evaluating the reliability and validity support. Changes in the research environment and pressures in the peer review process, as well as a lack of familiarity with some statistical methods, have created a situation where many findings that appear “excellent” in the rubric are likely to be “too good to be true,” in the sense that they are unlikely to generalize to clinical settings or are unlikely to be reproduced in independent samples. We describe several common scenarios where published results are often too good to be true, including internal consistency, inter-rater reliability, correlation, standardized mean differences, diagnostic accuracy, and global model fit statistics. Simple practices could go a long way towards improving design, reporting, and interpretation of findings. When effect sizes are in the “excellent” range for issues that have been challenging, scrutinize before celebrating. When benchmarks are available base on theory or meta-analyses, results that are moderately better than expected in the favorable direction (i.e., Cohen’s q≥+.30) also invite critical appraisal and replication before application. If readers and reviewers pull for transparency and do not unduly penalize authors who provide it, then change in research quality will be faster and both generalizability and reproducibility are likely to benefit