Large scale psychometric validation of two positive psychology outcome measures for people with dementia in Hong Kong

A systematic review was presented in Part one of this thesis, which aimed to identify measures of social support for caregivers of people with dementia (PwD) and to investigate their psychometric properties. Social support are resources perceived or provided by non-professionals in support groups or informal helping relationships. It was suggested that the availability of resources including social support could protect caregivers against stress and burden, which could be a protective factor for PwD and their carers. Having well-validated and standardised measures for this population is crucial for research and clinical use, especially for making meaningful comparisons between results across studies done across different time and places. Part two of the thesis involved an empirical paper that aimed to complete a large-scale psychometric validation of two positive psychology outcome measures for PwD in Hong Kong. Positive psychology in dementia shifts away from the traditional loss-oriented model to a non-pathologising approach that emphasises the strengths or capabilities used to achieve wellbeing despite difficulties. Due to unforeseeable challenges from COVID-19, it was not possible to recruit the sample size intended to complete in-depth analyses and draw conclusive results. Regardless, the preliminary results have provided valuable insight to the use of positive psychology approach and measures for PwD in Hong Kong. Part three involved a critical reflection and further discussion on findings while elaborating on the difficulties and challenges in the process, particularly in the face of COVID-19, as well as any dilemmas or scope for future research

Virtual individual cognitive stimulation therapy in Hong Kong: A mixed methods feasibility study

OBJECTIVES: We aimed to translate and culturally adapt Virtual Individual Cognitive Stimulation Therapy (V-iCST) for the Hong Kong (HK) Chinese population, and to evaluate its feasibility and acceptability. METHODS: A mixed methods case series (N=8) was used to assess the feasibility of V-iCST and changes in cognition, quality of life (QoL), mood, and communication pre and post-test. Data were analyzed with the reliable change index. Thematic analysis of post-therapy interviews and content analysis of session rating forms were used to evaluate the acceptability. RESULTS: V-iCST was feasible with low attrition (0%) and high attendance (100%). Participants had reliable improvements in all outcomes. Six had improved and stable cognition; four had clinically significant changes in depression. There were no reliable changes in QoL. Qualitative analyses indicated V-iCST as acceptable but required assistance. CONCLUSIONS: V-iCST can be adapted for HK Chinese with dementia and potentially improve cognition, QoL, mood, and communication

Bodily Expression of Social Initiation Behaviors in ASC and non-ASC children: Mixed Reality vs. LEGO Game Play

This study is part of a larger project that showed the potential of our mixed reality (MR) system in fostering social initiation behaviors in children with Autism Spectrum Condition (ASC). We compared it to a typical social intervention strategy based on construction tools, where both mediated a face-to-face dyadic play session between an ASC child and a non-ASC child. In this study, our first goal is to show that an MR platform can be utilized to alter the nonverbal body behavior between ASC and non-ASC during social interaction as much as a traditional therapy setting (LEGO). A second goal is to show how these body cues differ between ASC and non-ASC children during social initiation in these two platforms. We present our first analysis of the body cues generated under two conditions in a repeated-measures design. Body cue measurements were obtained through skeleton information and characterized in the form of spatio-temporal features from both subjects individually (e.g. distances between joints and velocities of joints), and interpersonally (e.g. proximity and visual focus of attention). We used machine learning techniques to analyze the visual data of eighteen trials of ASC and non-ASC dyads. Our experiments showed that: (i) there were differences between ASC and non-ASC bodily expressions, both at individual and interpersonal level, in LEGO and in the MR system during social initiation; (ii) the number of features indicating differences between ASC and non-ASC in terms of nonverbal behavior during initiation were higher in the MR system as compared to LEGO; and (iii) computational models evaluated with combination of these different features enabled the recognition of social initiation type (ASC or non-ASC) from body features in LEGO and in MR settings. We did not observe significant differences between the evaluated models in terms of performance for LEGO and MR environments. This might be interpreted as the MR system encouraging similar nonverbal behaviors in children, perhaps more similar than the LEGO environment, as the performance scores in the MR setting are lower as compared to the LEGO setting. These results demonstrate the potential benefits of full body interaction and MR settings for children with ASC.EPSR

Treatment engagement in specific psychological treatment vs. treatment as usual for adolescents with self-harm:Systematic review and meta-analysis

Background: Self-harm is a major public health problem. It is one of the best predictors of suicide in adolescents. Despite recent advances in the understanding of self-harm, poor treatment engagement remains a significant clinical obstacle.Objectives: The purpose of this meta-analysis is to update and extend previous research investigating treatment engagement with specific psychological treatments (SPT) vs. treatment as usual (TAU) in adolescents who self-harm.Methods: Data sources were identified by searching the Medline, PsychINFO, EMBASE, and PubMed databases as of October 2017. Randomized Controlled Trials (RCTs) comparing SPT and TAU in adolescents (through age 18 years) with self-harm were included.Results: The results show that 12 RCTs investigating 1,255 young people were included in the meta-analysis. The proportion of adolescents not completing four or more sessions in SPT was significantly lower (28.4%, 179/630) than TAU (45.9%, 287/625), RR = 0.64 (95% CI:0.51 −0.79), p < 0.0001. There were significantly more adolescents engaged with SPT than TAU.Conclusions: Specific psychological treatments should be offered to adolescents with self-harm to maximize treatment engagement. Engaging adolescents with psychological treatment is necessary although not sufficient to achieve treatment goals