An Investigation of the Information Provided to the Parents of Young People with Mental Health Needs on an Internet Forum

Background: Access to Children and Adolescent Mental Health Services (CAMHS) can be difficult, with lengthy wait times. Many of the young people and their parents are not signposted to any form of support during their wait for initial assessment or treatment and people are increasingly turning towards web-based resources for help and advice. However, there are some concerns about the quality of the information shared online. Research on the use and quality of information shared on online platforms for mental health inquiries is limited. Aims: We aimed to investigate the content and quality of the responses shared by forum users on an online forum for parents of young people with mental health needs (Mumsnet ‘Talk’). Forum users were primarily parents, but 8 posts were written by posters identifying as a healthcare worker, teacher, or autism spectrum specialist. Methods: Qualitative methodology was adopted for this study. Forum content from Mumsnet was extracted in an anonymised form and thematic analysis was conducted to explore the content. Information shared in the online forum was assessed for quality by comparing the responses with clinical guidelines. Results: Thread topics related to 16 mental health problems. “Autistic Traits/Autism Spectrum Disorder”, “Obsessions and Intrusive Thoughts/ Obsessive Compulsive Disorder” and “Comorbid Anxiety and Depression” were the most prevalent thread topics, consisting 38.3% of the extracted content. The investigation focused on “Information Offered” as the general dimension. Based on the thematic analysis, there were four second-order themes regarding the information offered by forum users; referral, advice, anecdotal information and opinion on case. The quantitative assessment of responses found that 58.3% of the knowledge exchange on Mumsnet was congruent with evidence-based clinical guidelines. Conclusions: Themes indicate that parents of children and young people with mental health needs seem to use online fora for informational support. It is promising that a significant proportion of the information shared within the extracted forum content is congruent with evidence-based knowledge. However, further investigation is needed to generate better understanding of the overall quality of mental health information available on online platforms

The Efficacy of Parent Training Interventions for Disruptive Behavior Disorders in Treating Untargeted Comorbid Internalizing Symptoms in Children and Adolescents: A Systematic Review

Disruptive behavior disorders (DBDs) are among the primary reasons for child and youth referrals to mental health services and are linked to poor adult outcomes including antisocial behavior disorder. Research indicates a high incidence of internalizing problems in those with DBDs and those who have DBDs with cooccurring internalizing problems may have more severe later outcomes. Interventions targeted at internalizing symptoms have been found to also reduce comorbid externalizing problems. The impact of treatments for DBDs on comorbid internalizing disorders is not known. Databases PsycINFO, EMBASE and MEDLINE were systematically searched based on the Cochrane guidelines for systematic reviews. Records were independently reviewed by two reviewers. 12 papers were deemed eligible. A quality assessment of the selected studies was conducted independently by both reviewers. The 12 studies included 1334 young people with a mean age of 5 years. The parent training interventions assessed were the Incredible Years (6/12 studies), Triple-P (5/12) and Tuning In To Kids (1/12). 11 of the 12 studies reported significant reductions in primary externalizing behavior problems and DBDs. 7 studies reported significant reductions in internalizing symptoms. Mechanisms of change, clinical implications and directions for future research are discussed

Cognitive-behavior therapy for compulsive checking in OCD

There is substantial evidence for the effectiveness of psychological treatments for OCD, and various approaches have been widely recommended. These approaches tend to be characterized by exposure and response prevention (ERP) and also tend to be applied equally to all forms of OCD. Patients/clients (and some therapists) often find ERP to be a difficult treatment, and both dropout and refusal rates are unacceptably high. Based on specific cognitive conceptualizations of different manifestations of OCD, new and refined cognitive treatment methods are now available. The present article describes a specific cognitively based approach to the treatment of compulsive checking

Mental contamination in obsessive–compulsive disorder

It was recently proposed that feelings of contamination can arise in the absence of physical contact with a contaminant. Currently, there are limited data regarding this construct of ‘mental contamination’ although it is hypothesised to be relevant to obsessive compulsive disorder(OCD) where compulsive washing in response to contamination fear is a common presentation (Rachman,2006). This research examined the presence of mental contamination in OCD. Participants (N=177) with obsessive compulsive symptoms completed questionnaires to assess mental contamination, OCD symptoms and thought-action fusion (TAF). Findings indicated that 46% of participants experienced mental contamination, and severity was associated with severity of OCD symptoms and TAF. Mental contamination in the absence of contact contamination was reported by 10.2% of participants. Similar findings were reported in a sub-sample of participants who had received a formal diagnosis of OCD (N=54). These findings suggest that mental contamination is a distinct construct that overlaps with, but is separate from, contact contamination, and provide preliminary empirical support for the construct

MUX-PLMs: Data Multiplexing for High-throughput Language Models

The widespread adoption of large language models such as ChatGPT and Bard has led to unprecedented demand for these technologies. The burgeoning cost of inference for ever-increasing model sizes coupled with hardware shortages has limited affordable access and poses a pressing need for efficiency approaches geared towards high throughput and performance. Multi-input multi-output (MIMO) algorithms such as data multiplexing, offer a promising solution with a many-fold increase in throughput by performing inference for multiple inputs at the cost of a single input. Yet these approaches are not currently performant enough to be deployed in modern systems. We change that by developing MUX-PLMs, a class of high throughput pre-trained language models (PLMs) trained with data multiplexing, that can be fine-tuned for any downstream task to yield high-throughput high-performance. Our novel multiplexing and demultiplexing modules proficiently entangle and disentangle inputs, and enable high-performance high throughput \muxplms{} that are competitive with vanilla PLMs while achieving 2x/5x inference speedup with only a $1-4\%$ drop on a broad suite of tasks

Cognitive or behavioural interventions (or both) to prevent or mitigate loneliness in adolescents, adults, and older adults

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To examine the effects of structured psychological interventions, based on cognitive behavioural therapy (CBT) techniques, compared to all comparators on loneliness in adolescents, adults, and older adults with diagnoses of common mental disorders, or at risk of loneliness. To examine the effects of structured psychological interventions, based on CBT techniques, compared to all comparators on depression severity, anxiety severity, social connectedness, or quality of life in adolescents, adults, and older adults, with diagnoses of common mental disorders, or at risk of loneliness

Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19

OBJECTIVE: Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. METHOD: For this rapid review, we searched MEDLINE, PSYCHINFO, and Web of Science for articles published between 01/01/1946 and 03/29/2020. 20% of articles were double screened using pre-defined criteria and 20% of data was double extracted for quality assurance. RESULTS: 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n=51,576; mean age 15.3) 61 studies were observational; 18 were longitudinal and 43 cross sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time loneliness was measured and between 0.25 to 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness. CONCLUSION: Children and adolescents are probably more likely to experience high rates of depression and probably anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventative support and early intervention where possible and be prepared for an increase in mental health problems

Loneliness and mental health in children and adolescents with pre-existing mental health problems: A rapid systematic review

Objectives: Periods of social isolation are associated with loneliness in children and young people, and loneliness is associated with poor mental and physical health. Children and young people with pre-existing mental health difficulties may be prone to loneliness. Containment of COVID-19 has necessitated widespread social isolation, with unprecedented school closures and restrictions imposed on social interactions. This rapid review aimed to establish what is known about the relationship between loneliness and mental health problems in children and young people with pre-existing mental health problems. Methods: We sought to identify all primary research that examined the cross-sectional and longitudinal associations between loneliness/perceived social isolation and mental health in children and young people with pre-existing mental health problems. We also aimed to identify effective interventions that reduce the adverse impact of loneliness. A rapid systematic search was conducted using MEDLINE, PsycINFO, and Web of Science. Results: Of 4,531 papers screened, 15 included children and young people with pre-existing mental health conditions. These 15 studies included 1,536 children and young people aged between 6 and 23 years with social phobia, anxiety and/or depression, and neurodevelopmental disorders. Loneliness was associated with anxiety and depression both cross-sectionally and prospectively in children and young people with mental health problems and neurodevelopmental conditions. We found preliminary evidence that psychological treatments can help to reduce feelings of loneliness in this population. Conclusions: Loneliness is associated with depression and anxiety in children and young people with pre-existing mental health conditions, and this relationship may be bidirectional. Existing interventions to address loneliness and/or mental health difficulties in other contexts may be applied to this population, although they may need adaptation and testing in younger children and adolescents. Practitioner points: Loneliness is common in children and young people, and during periods of enforced social isolation such as during COVID-19, children and young people report high levels of loneliness (or increased rates of loneliness). The review showed that loneliness is associated, both cross-sectionally and prospectively, in children and young people with mental health problems and also in children and young people with neurodevelopmental conditions, such as autism spectrum disorder. Thus, loneliness is a possible risk factor of which mental health providers should be aware. Maintaining social contact both by direct and by indirect means, especially through the Internet, could be important in mitigating loneliness. Interventions to address loneliness should be further developed and tested to help children and young people with pre-existing mental health problems who are lonely by preventing exacerbation of their mental health difficulties, in particular anxiety and depression

Abnormal and Normal Mental Contamination

Mental contamination is defined and the main features of the phenomenon are set out. In addition to the familiar form of abnormal mental contamination, as evident in psychological disorders, notably Obsessive-compulsive Disorder, the phenomenon of non-clinical mental contamination is common. The clinical form is distressing, uncontrollable, constant and dysfunctional. The normal phenomenon can be disturbing but it is usually dormant, evoked intermittently, transient, tolerable, manageable, not dysfunctional and psychologically fascinating. The cognitive theory of mental contamination encompasses the causes of mental contamination, its persistence, and individual vulnerability. The field would benefit greatly from additional work, such as that reported elsewhere in this Special Issue, to incorporate the unusual manifestations of visual contamination, morphing and self-contamination, and to account for the experience of mental contamination in nonclinical and other clinical manifestations