Feasibility and acceptability of a remotely delivered transdiagnostic CBT treatment for postnatal anxiety and related disorders: A pilot case series

Women in the postnatal period are at a high risk of developing clinically significant symptoms of anxiety. Cognitive behavioural therapy is effective in the treatment of postnatal anxiety; however, there are many barriers to accessing this treatment. This study examined the feasibility and acceptability of transdiagnostic cognitive behavioural therapy delivered remotely via Internet videoconferencing. Three women (Mage = 28.33 years; SD = 4.04) with a postnatal anxiety-related disorder were treated using the videoconference-delivered cognitive behavioural therapy. The treatment was delivered once per week over a 5-week period. All participants met criteria for clinically significant change in anxiety symptoms at post-treatment, and one participant met criteria for clinically significant change in depressive symptoms, which was maintained at 3-month follow-up. The intervention was also found to be acceptable by participants. The results provide preliminary feasibility evidence of the clinical utility and acceptability of remotely delivered transdiagnostic cognitive behavioural therapy as an intervention for postnatal anxiety disorders

Associations between defence-style, eating disorder symptoms, and quality of life in community sample of women : a longitudinal exploratory study

Background and Aim: Eating Disorders (EDs) impact an estimated 15% of the global population and are linked to maladaptive defence-styles (coping strategies) and poorer mental health outcomes. Defence-styles have been grouped into immature, neurotic, and mature behaviours. Studies have yet to examine all three defence-styles in ED symptomatic individuals over an extended period of time. The current study aimed to investigate using converse analysis the relationships between defence-style and ED outcomes over a 5-years period. Methods: Participants (n = 216, mean age 33 years) were recruited through the Women’s Eating and Health Literacy study, with the current study examining a 5-years period of two waves (year-4 and year-9). The current study tested associations over time between eating pathology (EDE-Q), psychological distress (K10), mental and physical health related quality of life (M/PHRQoL, SF-12), and defence-style (DSQ-40). Results: Mature, immature and neurotic defence-styles did not significantly change over 5 years. Over the same period, only PHRQoL significantly predicted mature defence-styles having positive effect. Both MHRQoL and PHRQoL significantly predicted immature defence-styles having positive and negative effects, respectively. Psychological distress, PHRQoL and weight concern significantly predicted neurotic defence-styles having positive effects except for psychological distress. PHRQoL, MHRQoL, restraint and eating concern significantly predicted overall eating pathology having positive effects except for PHRQoL and MHRQoL. Conversely, among the defence-style variables, over 5 years, both immature and neurotic defence-styles significantly predicted psychological distress having positive effects, immature and mature defence-styles significantly predicted MHRQoL having negative and positive effects, respectively, while only immature defence-styles significantly predicted overall eating pathology having positive effect. Conclusions: The results of the current study suggest that immaturity and neuroticism but not maturity were the defence-style variables predicting psychological distress over a 5-years period while conversely psychological distress predicted only neurotic defence styles. The findings of the current study may suggest that without intervention, mature, immature and neurotic defence-styles may largely remain immutable to significant shifts over time. Limitations in the current study included limited demographic representation. The current study is anticipated to generate considerations into treatments that could strengthen defence-styles in individuals with increased eating pathology

Role of community pharmacy professionals in child health service provision in Ethiopia: a cross-sectional survey in six cities of Amhara regional state

Background Community pharmacy professionals have great potential to deliver various public health services aimed at improving service access, particularly in countries with a shortage of health professionals. However, little is known about their involvement in child health service provision in Ethiopia. Objective The purpose of this study was to evaluate the level of involvement of community pharmacy professionals in child health service provision within Ethiopia. Methods A multi-center cross-sectional survey was conducted among 238 community pharmacy professionals from March to July 2020 in Amhara regional state of Ethiopia. Independent samples t-test and one way Analysis of Variance (ANOVA) was used to test the mean difference. Results Most community pharmacy professionals were 'involved' in providing child health services related to 'advice about vitamins/supplements' (46.6%), 'advice about infant milk/formulas' (47.1%) and 'responding to minor symptoms' (50.8%) for children. The survey revealed that, community pharmacy professionals were less frequently involved in providing childhood 'vaccination' services. Further, level of involvement of community pharmacy professionals differed according to participants' licensure level, setting type, responsibility in the facility and previous training experience in child health services. Conclusion Community pharmacy professionals have been delivering various levels of child health services, demonstrating ability and capacity in improving access to child health services in Ethiopia. However, there is a need for training and government support to optimize pharmacist engagement and contribution to service delivery

Feasibility and acceptability of a remotely delivered transdiagnostic CBT treatment for postnatal anxiety and related disorders: A pilot case series

Women in the postnatal period are at a high risk of developing clinically significant symptoms of anxiety. Cognitive behavioural therapy is effective in the treatment of postnatal anxiety" however, there are many barriers to accessing this treatment. This study examined the feasibility and acceptability of transdiagnostic cognitive behavioural therapy delivered remotely via Internet videoconferencing. Three women (Mage=28.33years; SD=4.04) with a postnatal anxiety-related disorder were treated using the videoconference-delivered cognitive behavioural therapy. The treatment was delivered once per week over a 5-week period. All participants met criteria for clinically significant change in anxiety symptoms at post-treatment, and one participant met criteria for clinically significant change in depressive symptoms, which was maintained at 3-month follow-up. The intervention was also found to be acceptable by participants. The results provide preliminary feasibility evidence of the clinical utility and acceptability of remotely delivered transdiagnostic cognitive behavioural therapy as an intervention for postnatal anxiety disorders

Classifying excessive exercise: Examining the relationship between compulsive exercise with obsessive‐compulsive disorder symptoms and disordered eating symptoms

Objective: There remains a lack of consensus around nosology for compulsive exercise (CE). Although widely observed in eating disorders (ED), CE shares theoretical overlap with obsessive‐compulsive disorder (OCD), where exercise compulsions occur in response to obsessions. Yet, there is limited and mixed evidence of a relationship between CE with OCD. This study aims to explore the appropriate diagnostic classification of CE through examination of CE in relation to OCD, obsessional thinking, and ED symptoms. Method: Two hundred and eighty one adults with mental health symptoms, dieting, and exercise behaviour completed measures of OCD, CE, and disordered eating symptoms. Regression and Receiver Operating Characteristic analyses examined relationships between dimensions of CE with OCD and ED symptoms, and the predictive ability of CE assessment for detecting threshold OCD and ED symptoms. Results: CE assessment was poor at predicting threshold OCD symptoms, probable Anorexia Nervosa, and Binge Eating Disorder and moderate at detecting probable disordered eating and Bulimia Nervosa. Associations between CE and OCD symptoms were not significant after adjustment for ED symptoms. Obsessional thinking was associated only with lack of exercise enjoyment. Conclusions: Results indicate that excessive exercise might represent a distinct disorder, with some shared traits across CE, OCD and ED symptoms. Findings question the utility of adaptation of OCD diagnostic criteria for CE. Assessment and treatment implications are considered

Assessing the relationship between early maladaptive schemas and interpersonal problems using interpersonal scenarios depicting rejection

Background Early maladaptive schemas (EMSs) have been theorised to contribute to reoccurring interpersonal problems. This study developed a novel experimental paradigm that aimed to assess if EMSs moderate the impact of interpersonal situations on interpersonal responses by manipulating the degree of rejection in a series of interpersonal vignettes depicting acceptance, ambiguous rejection and rejection. Method In a sample of 158 first-year psychology students (27.2% male; 72.2% female; 0.6% other) participant responses to interpersonal scenarios were measured including degree of perceived rejection, emotional distress, conviction in varying cognitive appraisals consistent with attribution theory and behavioural responses to scenarios. Qualitative data was analysed using inductive content analysis and statistical analyses were conducted using multi-level mixed effect linear and logistic regression models using the software Jamovi. Results People reporting higher EMSs reported increased emotional distress (F(1, 156) = 24.85, p < .001), perceptions of rejection (F(1, 156) = 34.33, p < .001), self-blame (F(1, 156) = 53.25, p < .001), other-blame (F(1, 156) = 13.16, p < .001) and more intentional (F(1, 156) = 9.24, p = .003), stable (F(1, 156) = 25.22, p < .001) and global (F(1, 156) = 19.55, p < .001) attributions but no differences in reported behavioural responses. The results also supported that EMSs moderate the relationship between interpersonal rejection and perceptions of rejection (F(2, 1252) = 18.43, p < .001), emotional distress (F(2, 1252) = 12.64, p < .001) and self-blame (F(2, 1252) = 14.00, p < .001). Conclusion Together these findings suggest that people with EMSs experience increased distress and select negative cognitions in situations where there are higher levels of rejection but that distress and negative cognitions are generally higher in people with EMSs irrespective of the situation

Australian Youth Mental Health and Climate Change Concern After the Black Summer Bushfires

Climate change and its effects present notable challenges for mental health, particularly for vul-nerable populations, including young people. Immediately following the unprecedented Black Summer bushfire season of 2019/2020, 746 Australians (aged 16–25 years) completed measures of mental health and perceptions of climate change. Results indicated greater presentations of depression, anxiety, stress, adjustment disorder symptoms, substance abuse, and climate change distress and concern, as well as lower psychological resilience and perceived distance to climate change, in participants with direct exposure to these bushfires. Findings highlight significant vulnerabilities of concern for youth mental health as climate change advances

International society of sport psychology position stand: mental health through occupational health and safety in high performance sport

There is considerable attention devoted to athlete mental health in high-performance sport. The International Society of Sport Psychology seeks to extend this discourse by expanding the discussion through a lens of occupational health and safety (OHS). Drawing upon knowledge from OHS, the authors have considered existing mental health challenges as well as proactive and reactive strategies conducive of athlete safety. This Position Stand is structured into four sections. The authors introduce OHS and its relevance to high-performance sport in section one. Section two focuses on athlete mental health and the need for an OHS approach within sport organisations. Section three is focused particularly on athlete safety in relation to high-performance youth athletes. The fourth and final section is a broader ideological discussion of how OHS might vary in approach based on national sport systems and cultural orientation

Clinical decision making and mental health service use in people with severe mental illness across Europe

Objective: This study aims to explore relationships between preferred and experienced clinical decision making with service use, and associated costs, by people with severe mental illness. Methods: Prospective observational study of mental healthcare in six European countries: Germany, UK, Italy Hungary, Denmark and Switzerland. Patients (N = 588) and treating clinicians (N = 213) reported preferred and experienced decision making at baseline using the Clinical Decision Making Style Scale (CDMS) and the Clinical Decision Involvement and Satisfaction Scale (CDIS). Retrospective service use was assessed with the Client Socio-Demographic and Service Receipt Inventory (CSSRI-EU) at baseline and 12-month follow-up. Negative binomial regression analyses examined the effects of CDMS and CDIS on service use and inpatient costs at baseline and multilevel models examined these relationships over time. Results: At baseline, staff and patient preferences for active decision making and low patient satisfaction with experienced decisions were associated with longer hospital admissions and higher costs. Patient preferences for active decision making predicted increases in hospital admissions (b = .236, p =.043) over 12 months and cost increases were predicted by low patient satisfaction (b = 4803, p =.005). Decision making was unrelated to medication, outpatient, or community service use. Conclusions: Decision making is related to inpatient service use and associated costs by people with severe mental illness. A preference for shared decision making may reduce healthcare costs via a reduction in inpatient admissions. Patient satisfaction with decisions is a crucial predictor of healthcare costs; therefore, clinicians should maximize patient satisfaction with decision making

Commentary: An Extension of the Australian Postgraduate Psychology Education Simulation Working Group Guidelines: Simulated Learning Activities Within Professional Psychology Placements

A Commentary on The use of simulated patients in medical education: AMEE Guide No 42 by Cleland, J. A., Abe, K., and Rethans, J. J. (2009). Med. Teach. 31, 477–486. doi: 10.1080/01421590903002821 Simulation based education by Cleland, J. A. (2017). Psychologist 30, 36–40. Building Academic Staff Capacity for Using eSimulations in Professional Education for Experience Transfer by Cybulski, J., Holt, D., Segrave, S., O'Brien, D., Munro, J., Corbitt, B., et al. (2010). Sydney, NSW: Australian Learning and Teaching Council. Student and staff views of psychology OSCEs by Sheen, J., McGillivray, J., Gurtman, C. and Boyd, L. (2015). Aust. Psychol. 50, 51–59. doi: 10.1111/ap.12086 The Australian Postgraduate Psychology Education Simulation Working Group (APPESWG) recently published guidelines titled "A new reality: The role of simulated learning activities in postgraduate psychology training programs" (Paparo et al., 2021). The document was developed in the context of COVID 19-related disruption to practica within professional psychology training. As a consequence, many training providers adopted simulated training activities as a way to support course progression during the pandemic. Paparo and colleagues' stated aims were to provide comprehensive guidance for the use of simulation as a competency-based training tool and in the interests of public and student safety, both during and after COVID 19. The guidelines included nine criteria for best practice in simulated learning activities in training, for example, that activities should be competency-based, should mirror real-life practice situations and should provide opportunities for active participation and trainee reflection (see Paparo et al. for detail). The document provided helpful guidance on the use of simulated learning activities (SLA) as part of course content within an Australian professional psychology training context, however the guidelines did not cover simulated placement experiences. Considerations especially around supervision and the development of professional and ethical practice within a simulated learning environment need to be made to effectively apply the APPESWG Guidelines within a placement context. Here, we extend these guidelines for provision of simulated professional psychology placements based on our successful development and implementation of large-scale simulated placements at an Australian University (2020-current). Previously, all professional psychology placements in Australia were limited to in-vivo options, however the latest version of the Accreditation Standards for Psychology Programs (Australian Psychology Accreditation Council, 2019) now make provision for simulated learning within required placement experiences at Level 3, Professional Competencies. This extension of the Paparo et al. (2021) article provides guidelines specifically for the use of simulation with professional psychology placements, with a focus on the Australian context