Sexual minority status, social adversity and risk for psychotic disorders-results from the GROUP study

BACKGROUND: Lesbian, bisexual, or gay individuals (LBGs) have an increased risk for mental health problems compared to heterosexuals, but this association has sparsely been investigated for psychotic disorders. The aim of this study was: (1) to examine whether LBG sexual orientation is more prevalent in individuals with a non-affective psychotic disorder (NAPD) than in people without a psychotic disorder; and if so, (2) to explore possible mediating pathways.METHODS: Sexual orientation was assessed in the 6-year follow-up assessment of the Dutch Genetic Risk and Outcome of Psychosis study (GROUP), a case-control study with 1547 participants (582 patients with psychotic disorder, 604 siblings, and 361 controls). Binary logistic regression analyses were used to calculate the risk of patients with a psychotic disorder being LBG, compared to siblings and controls. Perceived discrimination, history of bullying, childhood trauma (CT), and sexual identity disclosure were investigated as potential mediating variables.RESULTS: The proportion of individuals with LBG orientation was 6.8% in patients (n = 40), 4.3% in siblings (n = 26), and 2.5% in controls (n = 10). The age- and gender-adjusted odds ratio of LBG for patients was 1.57 (95% CI 1.08-2.27; p = 0.019), compared to siblings and controls. Discrimination, bullying, and CT all partially mediated this association.CONCLUSIONS: Adverse social experiences related to sexual minority status may increase the risk for NAPD. Sexual identity, behavior, and difficulties need more attention in everyday clinical practice.</p

Virtual Reality Relaxation for Reducing Perceived Stress of Intensive Care Nurses During the COVID-19 Pandemic

During the COVID-19 pandemic ICU nurses endure high levels of stress. VR relaxation (VRelax, containing 360° immersive environments) provides an easy-to-use and effective means to induce positive affect and reduce perceived stress. We investigated feasibility and immediate effect on perceived stress of VRelax use by ICU nurses during work shifts. ICU nurses working with COVID-19 patients in an academic hospital could use VRelax as a 10-min break during their shift. Primary outcome was the difference between perceived stress immediately before and after VRelax use measured by a single-question VAS-stress scale. Statistically significant difference of the mean VAS-stress before and after use was determined using the paired t student test. A socio-demographic questionnaire, a questionnaire on perceived stress and stress resilience and VRelax user experiences were sent by email. Eighty-six (26%) nurses used VRelax at least once; 77% (N=66) of these filled out the VAS-stress scale before and after use of VRelax. Mean perceived stress lowered with 39.9% after use of VRelax (mean difference=14.0, SD=13.3, p<0.005). Mean score on the perceived stress scale-10 was 11.4 (SD=6.50), mean score on the Connor-Davidson Resilience Scale-10 was 29.0 (SD=5.51). Sixty-two percentage of the ICU nurses thought VRelax was helpful to reduce stress. Main barrier for use was a high workload. It is feasible for nurses to use VRelax in an ICU context. VRelax is an effective intervention to reduce immediate perceived stress and is of added value in stressful situations as during the COVID-19 pandemic, inducing a positive affective state and lowering perceived stress

How preference change induced by mere action versus inaction persists over time

Understanding how sustainable preference change can be achieved is of both scientific and practical importance. Recent work shows that merely responding or not responding to objects during go/no-go training can influence preferences for these objects right after the training, when people choose with a time limit. Here we examined whether and how such immediate preference change in fast choices can affect choices without time limit one week later. In two preregistered experiments, participants responded to go food items and withheld responses toward no-go food items during a go/no-go training. Immediately after the training, they made consumption choices for half of the items (with a time limit in Experiment 1; without time limit in Experiment 2). One week later, participants chose again (without time limit in both experiments). Half of the choices had been presented immediately after the training (repeated choices), while the other half had not (new choices). Participants preferred go over no-go items both immediately after the training and one week later. Furthermore, the effect was observed for both repeated and new choices after one week, revealing a direct effect of mere (non)responses on preferences one week later. Exploratory analyses revealed that the effect after one week is related to the memory of stimulus-response contingencies immediately after the training, and this memory is impaired by making choices. These findings show mere action versus inaction can directly induce preference change that lasts for at least one week, and memory of stimulus-response contingencies may play a crucial role in this effect

Priming to induce paranoid thought in a non clinical population.

Freeman et al. reported that a substantial minority of the general population has paranoid thoughts while exposed in a virtual environment. This suggested that in a development phase of a virtual reality exposure system for paranoid patients initially a non-clinical sample could be used to evaluate the system's ability to induce paranoid thoughts. To increase the efficiency of such an evaluation, this paper takes the position that when appropriately primed a larger group of a non-clinical sample will display paranoid thoughts. A 2-by-2 experiment was conducted with priming for insecurity and vigilance as a withinsubject factor and prior-paranoid thoughts (low or high) as a between-subjects factor. Before exposure into the virtual world, participants (n = 24) were shown a video and read a text about violence or about mountain animals. While exposed, participants were asked to comment freely on their virtual environment. The results of the experiment confirmed that exposure in a virtual environment could induce paranoid thought. In addition, priming with an aim to create a feeling of insecurity and vigilance increased paranoid comments in the non-clinical group that otherwise would less often exhibit ideas of persecutio

Traditional and faith-based healthcare in the management of psychotic disorders in Africa:in search for synergy

PURPOSE OF REVIEW: This review summarizes the current literature on the role of traditional and faith-based healthcare in the management of psychotic disorders in Africa.RECENT FINDINGS: In contemporary Africa, individuals with psychosis and traditional and faith healers (TFH) are pluralistic towards their understanding of psychosis and their help-seeking behaviour. Traditional healing is perceived to be helpful to patients with psychotic disorders and their family members and may have a positive influence on the course of psychosis in some selected individuals. Studies show that potentially harmful practices are commonly used by African TFH, but that these are associated with a lack of resources and are susceptible to training. Although various TFH and biomedical practitioners are open to collaboration, the many identified obstacles hinder actual partnerships. However, the few studies that have been conducted on collaborative care for patients with psychotic disorders on the continent, show positive outcomes.SUMMARY: Rather than harmonizing the two healing paradigms, synergistic collaboration between traditional/faith-based and biomedical mental healthcare in the management of individuals with psychosis seems to be possible within certain limits. Synergistic collaboration is more culturally syntonic and may actually contribute to bridging the treatment gap for mental disorders in present-day Africa.</p

Advances in immersive virtual reality interventions for mental disorders:A new reality?

Immersive virtual reality (VR) has been identified as a potentially revolutionary tool for psychological interventions. This study reviews current advances in immersive VR-based therapies for mental disorders. VR has the potential to make psychiatric treatments better and more cost-effective and to make them available to a larger group of patients. However, this may require a new generation of VR therapeutic techniques that use the full potential of VR, such as embodiment, and self-led interventions. VR-based interventions are promising, but further well-designed studies are needed that use novel techniques and investigate efficacy, efficiency, and cost-effectiveness of VR interventions compared with current treatments. This will be crucial for implementation and dissemination of VR in regular clinical practice

Risk homeostasis theory - A study of intrinsic compensation

Risk homeostasis theory (RHT) suggests that changes made to the intrinsic risk of environments are negated in one of three ways: behavioural adjustments within the environment, mode migration, and avoidance of the physical risk. To date, this three-way model of RHT has little empirical support, whilst research findings on RHT have at times been diametrically opposed. A reconciliation of apparently opposing findings might be possible by suggesting that extrinsic compensation fails to restore previously existing levels of actual risk in cases where behavioural adjustments within the environment are incapable of negating intrinsic risk changes. This paper reports a study in which behavioural adjustments within the physical risk-taking environment are capable of reconciling target with actual risk. The results provide positive support for RHT in the form of overcompensation for the intrinsic risk change on specific driver behaviours