786 research outputs found
When all else fails, listen to the patient: A viewpoint on the use of ecological momentary assessment in clinical trials
Sports Performance Measures in Youth Wheelchair Basketball Athletes
https://louis.uah.edu/rceu-hcr/1268/thumbnail.jp
The spotlight effect and the illusion of transparency in social anxiety
[Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In: R. G. Heimberg, M. R.
Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: diagnosis, assessment, and treatment (pp.
69–93). New York: Guildford Press] cognitive model of social phobia suggests that both public and private
sources of information contribute to the construction of the self as a social object, which is thought to
maintain the disorder. This study used two concepts developed in social psychology that might help to
explain the processes that contribute to the development of this constructed self. These two concepts are the
spotlight effect [Gilovich, T., Medvec, V. H., & Savitsky, K. (2000). The spotlight effect in social judgment:
an egocentric bias in estimates of the salience of one’s own actions and appearance. Journal of Personality
and Social Psychology, 78(2), 211–222] and the illusion of transparency [Gilovich, T., Medvec, V. H., &
Savitsky, K. (1998). The Illusion of transparency: biased assessments of others’ ability to read one’s own
emotional states. Journal of personality and social psychology, 75(2), 332–346]. Participants performed a
memory task under either a low or a high social-evaluative condition. In the high social-evaluative
condition, participants reported higher levels of the spotlight effect and more negative evaluation of task
performance, compared to participants in the low social-evaluative condition. There were no differences
between the two conditions in levels of the illusion of transparency. Surprisingly, however, in the low socialevaluative
condition, participants reported higher levels of the illusion of transparency than the spotlight
effect, whereas, in the high social-evaluative condition, they reported the opposite. Results suggest that the
spotlight effect may be specific to social-evaluative concerns, whereas, the illusion of transparency may
represent more general features of social anxiety concerns. Implications of the results for Clark and Wells’
cognitive model of social phobia model are discussed
Perceptions of Nontraditional African American Baccalaureate Nursing Students of Their Persistence in or Departure From An Urban Nursing Program
The literature reflects that although more people of color are enrolling in higher education, graduation rates remain dismal. The purpose of this naturalistic qualitative inquiry was to determine perceptions of experiences of nontraditional African American nursing students regarding their persistence in or departure from a baccalaureate degree nursing program
December, 3 1886: To Lucinda L. Merriss Cornell
A piece of professional correspondence, written on stationary with company letterhead, from John Rodebaugh to Lucinda Cornell informing her that she might be entitled to pension after the death of her husband
D-cycloserine augmentation of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders: a systematic review and meta-analysis of individual participant data
Importance: Whether and under which conditions D-cycloserine (DCS) augments the effects of exposure-based cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders is unclear. Objective: To clarify whether DCS is superior to placebo in augmenting the effects of cognitive behavior therapy for anxiety, obsessive-compulsive, and posttraumatic stress disorders and to evaluate whether antidepressants interact with DCS and the effect of potential moderating variables. Data Sources: PubMed, EMBASE, and PsycINFO were searched from inception to February 10, 2016. Reference lists of previous reviews and meta-analyses and reports of randomized clinical trials were also checked. Study Selection: Studies were eligible for inclusion if they were (1) double-blind randomized clinical trials of DCS as an augmentation strategy for exposure-based cognitive behavior therapy and (2) conducted in humans diagnosed as having specific phobia, social anxiety disorder, panic disorder with or without agoraphobia, obsessive-compulsive disorder, or posttraumatic stress disorder. Data Extraction and Synthesis: Raw data were obtained from the authors and quality controlled. Data were ranked to ensure a consistent metric across studies (score range, 0-100). We used a 3-level multilevel model nesting repeated measures of outcomes within participants, who were nested within studies. Results: Individual participant data were obtained for 21 of 22 eligible trials, representing 1047 of 1073 eligible participants. When controlling for antidepressant use, participants receiving DCS showed greater improvement from pretreatment to posttreatment (mean difference, -3.62; 95% CI, -0.81 to -6.43; P = .01; d = -0.25) but not from pretreatment to midtreatment (mean difference, -1.66; 95% CI, -4.92 to 1.60; P = .32; d = -0.14) or from pretreatment to follow-up (mean difference, -2.98, 95% CI, -5.99 to 0.03; P = .05; d = -0.19). Additional analyses showed that participants assigned to DCS were associated with lower symptom severity than those assigned to placebo at posttreatment and at follow-up. Antidepressants did not moderate the effects of DCS. None of the prespecified patient-level or study-level moderators was associated with outcomes. Conclusions and Relevance: D-cycloserine is associated with a small augmentation effect on exposure-based therapy. This effect is not moderated by the concurrent use of antidepressants. Further research is needed to identify patient and/or therapy characteristics associated with DCS response.2018-05-0
The importance of mindfulness in psychosocial distress and quality of life in dermatology patients
Background: Mindfulness, defined as purposively and non-judgementally paying attention in the present moment, could be used within psychosocial interventions to reduce the distress associated with social anxiety and avoidance found in many skin conditions. However, little is known about the relationship between naturally occurring levels of mindfulness and distress in dermatology patients.
Objective: This study sought to examine the relationship between mindfulness and psychosocial distress in a dermatological sample. It was hypothesised that higher levels of mindfulness would be associated with lower levels of social anxiety, anxiety, depression, and skin shame, and with better quality of life.
Method: Adult dermatology outpatients (N=120) from one hospital completed items assessing subjective severity, skin shame, fear of negative evaluation (BFNE), anxiety and depression (HADS), quality of life (DLQI), and levels of mindfulness (FFMQ).
Results: Considering depression, 14% reported mild, 5% moderate and 2.5% severe symptoms. For anxiety, 22% reported mild, 23% moderate and 6% severe symptoms. In addition, 33.4% reported clinically significant social anxiety. After controlling for subjective severity, mindfulness explained an additional 19% of the variance in depression, 39% in anxiety, 41% in social anxiety, 13% in skin shame, and 6% in dermatological quality of life. One specific facet of mindfulness (acting with awareness) was found to be the most consistent predictor of distress.
Conclusions: The findings indicate that higher levels of mindfulness are associated with lower distress. This suggests that facilitating mindfulness may be helpful in reducing distress in dermatology patients and the use of mindfulness techniques warrants further investigation
Foot Stress and Blood Flow Sensing Under High-Loading during Hip Surgery
The PolyHIPS team was tasked with integrating sensors into Stryker’s hip arthroscopy boot that monitor blood flow and heel slip during hip surgery. During hip arthroscopy, the femur head is distracted from the acetabulum to create space in the joint for the surgeon to operate. This requires the use of up to 200 lbf. In order to maintain this space, the foot is held tightly in the boot. Complications can result from the foot being held too tightly in the boot during the procedure. The most common complication is neuropraxia, or temporary nerve damage. PolyHIPS proposes a solution that utilizes three types of sensors to monitor for nerve damage and heel slip. The final design includes three pressure sensors and a distance sensor that are all wired to a microcontroller. The microcontroller displays the sensor data on an LCD screen and transmits the data via Bluetooth to an app
Social anxiety, negative affect, and hearing difficulties in adults
Subjective ratings of communication function reflect both auditory sensitivity and the situational, social, and emotional consequences of communication difficulties. Listeners interact with people and their environment differently, have various ways of handling stressful situations, and have diverse communication needs. Therefore, understanding the relationship between auditory and mental health factors is crucial for the holistic diagnosis and treatment of communication difficulty, particularly as mental health and communication function may have bidirectional effects. The goal of this study was to evaluate the degree to which social anxiety and negative affect (encompassing generalized anxiety, depression, and anger) contributed to subjective communication function (hearing handicap) in adult listeners. A cross-sectional online survey was administered via REDCap. Primary measures were brief assessments of social anxiety, negative affect, and subjective communication function measures. Participants were 628 adults (408 women, 220 men), ages 19 to 87 years (mean = 43) living in the United States. Results indicated that individuals reporting higher social anxiety and higher negative affect also reported poorer communication function. Multiple linear regression analysis revealed that both negative affect and social anxiety were significant and unique predictors of subjective communication function. Social anxiety and negative affect both significantly, and uniquely, contribute to how much someone feels a hearing loss impacts their daily communication function. Further examination of social anxiety and negative affect in older adults with hearing loss may help researchers and clinicians understand the complex interactions between mental health and sensory function during everyday communication, in this rapidly growing clinical population
Mindfulness training for depressed older adults using smartphone technology: Protocol for a fully remote precision clinical trial
BACKGROUND: Precision medicine, optimized interventions, and access to care are catchphrases for the future of behavioral treatments. Progress has been slow due to the dearth of clinical trials that optimize interventions\u27 benefits, individually tailor interventions to meet individual needs and preferences, and lead to rapid implementation after effectiveness is demonstrated. Two innovations have emerged to meet these challenges: fully remote trials and precision clinical trials.
OBJECTIVE: This paper provides a detailed description of Mindful MyWay, a study designed to test online mindfulness training in older adults with depression. Consistent with the concept of fully remote trials using a smartphone app, the study requires no in-person contact and can be conducted with participants anywhere in the United States. Based upon the precision medicine framework, the study assesses participants using high-frequency assessments of symptoms, cognitive performance, and patient preferences to both understand the individualized nature of treatment response and help individually tailor the intervention.
METHODS: Mindful MyWay is an open-label early-phase clinical trial for individuals 65 years and older with current depression. A smartphone app was developed to help coordinate the study, deliver the intervention, and evaluate the acceptability of the intervention, as well as predictors and outcomes of it. The curriculum for the fully remote intervention parallels the mindfulness-based stress reduction curriculum, a protocolized group-based mindfulness training that is typically provided in person. After consent and screening, participants download The Healthy Mind Lab mobile health smartphone app from the Apple App Store, allowing them to complete brief smartphone-based assessments of depressive symptoms and cognitive performance 4 times each day for 4 weeks prior to and after completing the intervention. The intervention consists of an introduction video and 10 weekly mindfulness training sessions, with the expectation to practice mindfulness at home daily. The app collects participant preference data throughout the 10-week intervention period; these high-frequency assessments identify participants\u27 individually dynamic preferences toward the goal of optimizing the intervention in future iterations.
RESULTS: Participant recruitment and data collection began in March 2019. Final end point assessments will be collected in May 2022. The paper describes lessons learned regarding the critical role of early-phase testing prior to moving to a randomized trial.
CONCLUSIONS: The Mindful MyWay study is an exemplar of innovative clinical trial designs that use smartphone technology in behavioral and neuropsychiatric conditions. These include fully remote studies that can recruit throughout the United States, including hard-to-access areas, and collect high-frequency data, which is ideal for idiographic assessment and individualized intervention optimization. Our findings will be used to modify our methods and inform future randomized controlled trials within a precision medicine framework.
TRIAL REGISTRATION: ClinicalTrials.gov NCT03922217; https://clinicaltrials.gov/ct2/show/NCT03922217.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39233
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