Functional movement disorders during the COVID-19 pandemic

Functional movement disorders (FMDs) are a heterogenous group of movement abnormalities that greatly affect the quality of life of patients. They usually manifest as a result of underlying psychological or psychiatric illnesses without any known structural or neurochemical diseases. Various neurological disorders such as encephalitis, stroke, demyelination, seizures, and neuropathy have been reported by otherwise healthy individuals during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Here, we describe the case of a 27-year-old woman who presented to our outpatient department with episodes of deviation of angle of mouth with variability and distractibility. Following thorough clinical evaluation and appropriate investigation, the underlying etiology was identified as FMD secondary to the restrictions imposed during the COVID-19 pandemic to contain the transmission of the virus. The lockdown, isolation, financial strain, and other pandemic-related issues are stressors that may contribute to psychogenic disorders in people.Copyright © 2021 Annals of Movement Disorders Published by Wolters Kluwer - Medknow.

Acceptabilité et faisabilité d'un module TCD-A multi-familles « tolérance à la détresse » proposé à des adolescents ayant un trouble de la personnalité borderline ou des troubles de la régulation émotionnelle

Le trouble de la personnalité borderline est un trouble psychiatrique fréquent qui apparaît à l'adolescence. La thérapie comportementale dialectique adaptée aux adolescents (TCD-A) a montré son efficacité dans la prise en charge psychothérapeutique des adolescents souffrant de conduites suicidaires ou d'auto-agressivité associées au trouble de la personnalité borderline. Au travers de notre étude nous avons souhaité explorer la faisabilité et l'acceptabilité, pour des adolescents présentant un TPL diagnostiqué ou des troubles de la régulation des émotions, d'un module TCD intitulé « tolérance à la détresse » proposé sur le mode d'un groupe multi-familles. Pour ce faire nous avons mis en place un groupe multi-familles de six adolescents et de leurs parents. L'acceptabilité et la faisabilité du protocole étaient excellentes. Les témoignages des adolescents et de leurs parents nous apportent des informations précieuses sur l'intérêt d'un tel groupe et sur les améliorations à introduire. La mise en place d'un tel groupe est une première en France et nous souhaitions montrer par notre étude pilote, sa faisabilité, son acceptabilité et ses effets afin de promouvoir son développement et son implémentation dans le contexte pédopsychiatrique français. Borderline personality disorder is a common psychiatric disorder emerging in adolescence. Dialectical Behavioral Therapy adapted to adolescents (DBT-A) has proven to be effective as a psychotherapeutic treatment for adolescents suffering from borderline-related behaviors, such as suicidal or self-aggressive behaviors. In our study, we were interested in exploring the feasibility and acceptability of a DBT-A module entitled "distress tolerance", which reduces borderline-related behaviors in borderline adolescents or undiagnosed adolescents who experience difficulties in regulating their emotions. To do this, we set up a pilot study with one multi-family treatment group of six adolescents and their parents. The treatment was fully accepted by all adolescents and parents with an excellent acceptability. Comments from adolescents and parents gave us valuable information about the great interest of a multi-family treatment group and potential improvements for its implementation. This is the first study exploring a DBT-A multi-family treatment group in France. It highlights its feasibility, acceptability and potential positive effects. Further studies are needed to promote the implementation and development of such interventions in the context of child and adolescent psychiatry in France. [ FROM AUTHOR] Copyright of Neuropsychiatrie de l'enfance & de l'Adolescence is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Psychoeducation and emotional regulation in times of confinement: Feasibility and interest of YouTube videos of dialectical behavioral therapy

Introduction: Dialectical Behavior Therapy (DBT) aims to decrease emotional dysregulation, particularly through psychoeducation groups targeting skills learning. In March 2020, the confinement due to COVID-19 abruptly interrupted these groups. We continued skills training through YouTube videos. Our objective is to evaluate the feasibility of this format during the confinement. Method(s): All the participants in the DBT skills group carried out in Strasbourg were included (n = 37). The psychoeducational videos were published biweekly during the confinement on the YouTube channel "GREMO HUS". Participants were encouraged to view these videos by calls/messages. One month after the end of the confinement, an online questionnaire assessed satisfaction. Result(s): In total, 92% of patients responded. Of the 34 respondents, 28 (82%) had watched at least one video, and 32% had watched more than 6 videos. A very large majority of users were satisfied with the videos. Seventy-nine percent said they were very helpful in understanding the skills, and 77% thought they had used the DBT skills more frequently. All but one said that the skills helped them to overcome difficulties in times of confinement. Discussion(s): Our study is the first to interview patients directly regarding DBT YouTube videos. These videos were considered relevant by participants during the confinement period. Their use could compliment DBT skills training groups, and serve as a training support for therapists.Copyright © 2021 Elsevier Masson SAS

Psychological Treatment of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia Using an Integrative Approach.

Persistent genital arousal disorder/genitopelvic dysesthesia (PGAD/GPD) is characterized by persistent, unwanted physiological genital arousal (i.e., sensitivity, fullness, and/or swelling) in the absence of sexual excitement or desire which can persist for hours to days and causes significant impairment in psychosocial well-being (e.g., distress) and daily functioning. The etiology and course of PGAD/GPD is still relatively unknown and, unsurprisingly, there are not yet clear evidence-based treatment recommendations for those suffering from PGAD/GPD. We present the case of a 58-year-old woman with acquired persistent genital arousal disorder, which began in March 2020; she believed she developed PGAD/GPD due to a period of significant distress and anxiety related to the COVID-19 pandemic. After seeking medical diagnosis and treatment from multiple healthcare providers and trying a combination of pharmacological and medical treatment modalities, she presented for psychological treatment. An integrative therapy approach (3 assessment sessions, 11 treatment sessions), which included cognitive behavior therapy, distress tolerance and emotion regulation skills from dialectical behavior therapy, and mindfulness practice, was utilized. The patient reported improvements anecdotally (e.g., decreased impact on occupational and social functioning, greater self-compassion, less frequent and shorter duration of PGAD/GPD flare-ups, improved ability to cope with PGAD/GPD symptoms, and decreased need for sleeping medication) and on self-report measures (e.g., lower PGAD/GPD catastrophizing, lower anxiety and depression, and greater overall quality of life).We report the use of an integrative (i.e., psychoeducational, cognitive behavioral, dialectical behavioral, and mindfulness-based) intervention, which may be an effective psychological treatment for PGAD/GPD.

Somatic Cough Syndrome, Is COVID-19 Guilty: Case Reports and Literature Review

Introduction: Somatic cough syndrome (formerly known as Psychogenic Cough) is an uncommon and sometimes underestimated cause of persistent cough that is generally found after a series of rigorous testing and therapies. There is a peak incidence between 8 and 14 years;both sexes are affected similarly. Case presentation: The current article describes three cases of somatic cough disorder observed at our institution during the COVID-19 pandemic. The patients were diagnosed after 2-3 months and were successfully managed with suggestive and behavioral therapy. Conclusion(s): Lack of knowledge regarding somatic cough syndrome exists among frontline health care personnel. The relevance of reporting such cases emphasizes the need for health care professionals to be aware of the need to avoid unneeded medical management. Whether or not COVID-19 is linked to an increased incidence of somatic cough syndrome is yet to be established. Still, multidisciplinary collaboration, patient participation, and public education are essential, along with a clear case definition or working diagnosis.Copyright © 2023, Bahrain Medical Bulletin. All rights reserved.

Making Lemonade out of Lemons: Dialectical Behavior Therapy via Telehealth During a Pandemic

The COVID-19 pandemic has created a burden on healthcare systems and increased demand for mental healthcare at a time when in-person services are limited. Many programs offering dialectical behavior therapy (DBT) for complex clients have pivoted to telehealth in order to increase access to critical mental healthcare. There is, however, limited research on the provision of telehealth treatment for clients with complex psychopathology more broadly, or the telehealth implementation of DBT more specifically. The aim of this study was to examine the use of telehealth services and related clinician attitudes and experiences in the context of DBT. We examined the degree of telehealth platform adoption among DBT clinicians, as well as changes in stress and self-care strategies. A supplemental aim was to gather clinicians' recommendations for providing DBT via telehealth. Participants included N=99 DBT practitioners (79.8% female;20.2% male). Qualitative and quantitative methods were used for data analysis. Findings show that telehealth DBT has been widely adopted among DBT clinicians, and that clinicians' attitudes to telehealth DBT are cautiously optimistic. Participants described three main areas of stress associated with DBT via telehealth provision, as well as lost and novel self-care strategies.

The role of human support and online depression prevention for adolescents

Depression is a mental health disorder that is impacting youth within the United States at high rates. It is estimated that 3.2 million youth in the United States have experienced at least one major depressive episode. The rate of depression in youth is increasing over time. Depression poses a high risk to youth for general poorer life outcomes such as worse academic performance, suicidal behavior, physical health problems, and comorbid mental health problems. Depression presents a significant burden to society with adverse financial implications and substantial costs to the public health sector. It is imperative to direct resources and research into depression prevention efforts. Some prevention efforts have included online programs. CATCH-IT (Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training) is an internet-based depression prevention program for adolescents that has shown to reduce depression in subsyndromal youth (Van Voorhees, Ellis, et al., 2005;Van Voorhees, Paunesku, et al., 2008). Coupled with the Internet program, participants received human support measures (e.g., contacts, motivational interviews) to supplement the online depression prevention program. However, research on the effect of human support on engagement and depressive clinical outcomes in youth has produced mixed results when looking at the effects over time. This study is a secondary analysis that seeks to understand how human support impacts the relationship between the efficacy of CATCH-IT on overall level of engagement with the intervention and clinical depression scores. Given the emerging utilization of telemental health and digital tools to provide treatment in the context of COVID-19, behavioral intervention technologies (BITs) targeting adolescent depression may become a therapeutic forefront to the peri- and post-pandemic period. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The effectiveness of the cognitive-behavioral treatment on the experience of grief, depression and anxiety by Bereft families of Covid-19 victims

The present research was conducted with the aim of investigating the effectiveness of cognitive-behavioral intervention on the grief experience, depression and anxiety of relatives of Covid-19 victims. In terms of objective, the research was an applied one and used the mixed methodology (quantitative and qualitative). The statistical population included men and women over 18 years old in the city of Shiraz. The research used the non-random sampling technique. The people whose grief experience lasted over 4 months and scored above 68 were selected as samples. Following the interview and qualitative analysis, the control and experimental groups were compared using Beck's depression questionnaire and Good's existential anxiety questionnaire. The results of Mann-Whitney U test and Wilcoxon test showed that cognitive-behavioral therapy had a significant effect on the grief experience, depression and anxiety of the relatives of the victims of Covid-19. According to the results, the cognitive-behavioral therapy had an effect on the experience of grief, depression and anxiety by the families of the Covid-19 victims. This method can be used individually and in groups to deal with problems and can promote mental health and cause effective and adaptive reactions by people to traumatic life events. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

iCOPE With COVID-19: A Brief Telemental Health Intervention for Children and Adolescents During the COVID-19 Pandemic.

The COVID-19 pandemic has prompted unprecedented disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase of anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care has been affected causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.

Evaluating the acceptability of a technology-enhanced version of the good behavior game

The Good Behavior Game (GBG) is an evidence-based interdependent group contingency originally designed to decrease inappropriate student behavior. Despite the dearth of research on the GBG, few studies have assessed the acceptability of technology-enhanced versions of the GBG. The purpose of this study was to analyze the acceptability of a version of the Good Behavior Game (GBG) in which university students used a novel website application to simulate intervention implementation. Due to COVID-19-related school closures, participants practiced implementing the GBG while watching an animated implementation video. This study used a within-subjects quasi-experimental pretest-posttest design. The dependent variable was participants' ratings of acceptability on the Technology Acceptance Model Instrument-Fast Form (FF-TAM) before and after the simulated intervention implementation. Results indicated moderate acceptability levels prior to the simulation and significantly higher (t = 7.904;p < .001) acceptability levels following the simulation. Overall, the simulated implementation had a large effect on acceptability scores (Cohen's d = .89). Implications for practice and research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Compassion fatigue, compassion satisfaction, and self-care among child trauma

Child trauma counselors are at elevated risk for burnout, posing a legitimate concern for society as routine exposure to the trauma of others has been linked to clinical error, so finding ways to sustain counselor well-being is vital. The current study used the compassion fatigue-compassion satisfaction theory integrated with positivistic psychology constructs. The quantitative associative-correlational method explored relationships between the Professional Quality of Life-V (burnout, secondary traumatic stress, and compassion satisfaction) and self-care. In September of 2021, during the COVID-19 pandemic, Qualtrics collected response data from volunteer participants recruited from certified Trauma-Focused Cognitive Behavioral therapists (N = 295). The data was analyzed using a Spearman rank-order correlation. There was a statistically significant negative correlation between self-care and burnout (p < .01;correlation coefficient r = -.60) and between self-care and secondary traumatic stress (p < .01;correlation coefficient r = -0.21) while a significant positive correlation between self-care and compassion satisfaction (p < .01;correlation coefficient r = 0.50) was found. The results suggest that self-care enhances compassion satisfaction, serving as a buffer to burnout and secondary traumatic stress, affording worker resiliency. The study model recognized adjunctive factors related to positive outcomes encompassing personal resiliency, self-efficacy, individual empowerment, and intrinsic motivation for peak performance fueling the restorative, proactive self-care practice. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Trauma-informed workshop for healing couples

This dissertation aims to develop a workshop curriculum focused on resiliency and post-trauma growth in couples. Significant shifts have been seen in work with trauma and couples, from a primary focus on solution-focused conflict reduction to a higher priority on post-traumatic growth and resiliency. In a randomized controlled trial of cognitive behavioral conjoint therapy, Wagner et al. (2016) note the importance of future research focusing on post-traumatic growth in treatment due to its positive impacts on relationships. As the world has seen significant levels of stress from the Coronavirus pandemic and, most recently, the war in Ukraine, the need for support for families is high. This project aims to integrate new constructs of couples counseling with trauma-informed approaches. Keywords: workshop, couples, trauma, post-traumatic growth. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Evaluating the effectiveness of telehealth to teach functional communication skills

Individuals living with autism and other developmental disabilities do not always have access to effective behavior analytic intervention services due to the lack of geographical proximity to resources. The novel coronavirus (COVID-19) pandemic further posed unprecedented challenges to not only obtain access to resources and treatment, but unique challenges to the delivery of applied behavior analysis (ABA). Recent research and advances in telecommunication technologies have made it possible to provide behavioral healthcare services remotely. In this study, a concurrent multiple-baseline design across behaviors was used to evaluate the effectiveness of utilizing telehealth to teach functional communication. Four child-research assistant dyads participated. All dyads received training through telehealth. Results showed that telehealth was an effective modality for teaching mands and tacts to individuals diagnosed with autism spectrum disorder (ASD). (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Wellness center impact on classroom attendance at a New Jersey High School

In 2013, The Center for Disease Control and Prevention reported 13 - 20% of youth living in the United States experiencing a mental health disorder. Research indicated that mental health disorders can negatively affect an individual's cognitive, social, and emotional functions (National Institute of Mental Health, 2018). As a result, students experiencing mental health related stress have high rates of absenteeism (Sahin, Arseven, & Kihc, 2016). Schools have the unparalleled capacity to reach students and offer cognitive, social, and emotional support. This research study worked to answer the question: Can mental health support offered to high school students increase classroom attendance rates? Implementation of a wellness center took place at Cherokee High School in September 2020. The wellness center sign-in data and classroom attendance data were collected and analyzed for 44 days between March 1, 2021, and May 18, 2021, to determine if classroom attendance would increase for wellness center users ten days after a wellness center visit. This ten-day period was known as the enrollment period. The research found that seven of the eight students with a 504-plan associated with mental health related stress increased class attendance 5% or greater during the enrollment period. This study was implemented during the COVID 19 pandemic. The pandemic impeded the remote students' ability to attend the Cherokee Wellness Center. The attendance data collected included full-time in-person students and eliminated the remote students. The research is significant in that classroom attendance data can be increased with the correct student support for mental health related stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Perceived Stress and Association with Sociodemographic, Interpersonal Relationship and COVID-19 Lockdown Related Stress in South Africa

Background: COVID-19 pandemic was declared a global public health emergency in March 2020. South Africa, like many countries, was not spared from this pandemic. In March 2020, the president announced a nationwide lockdown with social restrictions aimed to curb the spread of the virus. Such lockdown restrictions disrupted the normal day to day life for South Africans, leading to personal stress. Objective: The current study aimed to explore perceived stress and lockdown related stress among South African adults during the first wave of COVID 19. Methods: This study was cross-sectional in nature, using a sample of 203 adult males and females who were selected using a convenience sampling method on online social media platforms such as WhatsApp and Facebook. Participants completed an online survey that assessed socio-demographic information, perceived stress and lockdown related stress. Results and Discussion: A significant statical difference between males and females regarding their experience of lockdown related stress t (281) = 1.35, p < .004 was found. Relationship status was also significant for lockdown related stress t (281) =-2.02, p< .001 and perceived stress t= (281) =-.08, p< .000. No significant statistical difference between young and older adults in their experience of lockdown related stress and perceived stress was found. Conclusion: Male participants reported more lockdown related stress, while female participants reported more perceived stress. There were no age differences in lockdown related stress and perceived stress. People without intimate relationships reported more lockdown related stress and perceived stress than people with intimate relationships. © 2023 Maepa et al.

The impact of intensive, group-format parent-child interaction therapy on positive parenting skills and oppositional behavior of young children

Disruptive behavior disorders affect 10.75% of children and cause significant problems throughout life (Alizadeh et al., 2019;APA, 2013;Azeredo et al., 2018;Frick & Loney, 1999;Kofler et al., 2015;Leadbeater & Ames, 2016;Liu et al., 2017). The defiant behavior that is a common symptom of these disorders has shown to occur at higher rates when the child's parent uses a more harsh, negative, or neglectful parenting style (Brown et al., 2017;Giannotta & Rydell, 2016;Ghosh et al., 2017;Lavigne et al., 2016;Lin et al., 2019;Tung & Lee, 2014). To treat children's defiant behavior, Parent-Child Interaction Therapy (PCIT) addresses ineffective parenting styles by teaching parents positive parenting skills (Eyberg & Funderburk, 2011). While PCIT has been shown to be effective in reducing oppositional behavior for children between the ages of three and seven years old, many families are unable to access individual PCIT due to its resource-heavy nature (i.e. price, time commitment, technology requirement) (Barkley, 1986;Chen & Fortson, 2015;Kazdin, 2008;Kazdin et al., 1997;Lanier et al., 2011;Lyon & Budd, 2010;Matos et al., 2006). Alternative forms of PCIT like group PCIT, intensive PCIT and brief group PCIT have addressed some of these limitations of individual PCIT but no alternative form has addressed each limitation. The current study sought to address prior limitations by exploring whether an alternative form of remote PCIT, Intensive Group-Format PCIT (IG-PCIT), would be as effective in addressing children's oppositional behavior and parents' positive parenting skill acquisition as remote standard, individual PCIT and remote group PCIT. The current study consisted of 36 child-parent dyads. Participants were quasirandomly placed in the remote IG-PCIT condition (16 participants), the remote individual PCIT condition (10 participants), or the remote group PCIT condition (nine participants). The individual PCIT condition offered PCIT remotely and individually over a 12-week span. The group PCIT condition offered PCIT in a remote group format over the span of 12 weeks. The IG-PCIT condition consisted of four remote weekly group sessions. Due to the COVID-19 pandemic, all conditions were held virtually. The researcher of the current study found that remote IG-PCIT, remote group PCIT, and remote individual PCIT significantly reduced child externalizing behavior and parenting stress from pre- to post-treatment overall, but both areas did not significantly reduce for each individual dyad. The reductions were also maintained at the three months follow up. It was found that all three treatment conditions did significantly improve positive parenting skills (i.e. reflections, labelled praises, and behavior descriptions) and directive parenting skills (i.e. questions, commands, and negative talk) and these improvements were maintained at the three months follow up. The current researcher found that the remote IG-PCIT condition was as effective in improving child externalizing behaviors, parenting stress, and parenting skill use as the remote group PCIT and the remote individual PCIT conditions. No significant relationships between change in positive parenting skills and change in parenting stress or child externalizing behavior were found. The highest attrition rates were found in the remote individual PCIT condition. Lastly, high levels of treatment satisfaction for all three treatment conditions were reported. The researcher of the current study interpreted these results to suggest that all three remote conditions, IG-PCIT, group PCIT, and individual PCIT, can effectively improve child externalizing behavior, parenting stress, and parenting skill use. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Helping students C.O.P.E.: Effects of a mental health program on adolescents with challenging behaviors

Mental health concerns are rising among adolescents and have intensified since the COVID-19 pandemic (APA, 2020). Specifically, externalizing behavior challenges perceived by adults as 'aggressive' place adolescents at an increased risk for negative outcomes, including poor academic achievement and involvement with the juvenile justice system (Skiba et al., 2014). Schools have a responsibility to respond to the mental health needs of adolescent students through the implementation of evidence-based intervention (Domitrovich et al., 2010). One program that has demonstrated effectiveness towards improving these outcomes is the seven-session Creating Opportunities for Personal Empowerment (COPE) Teen program, a cognitive-behavioral skills-building intervention. In this study, the COPE program was delivered virtually, through a culturally responsive lens, to three high school students with ongoing aggressive behavior during the COVID-19 pandemic. It was hypothesized that the frequency and intensity of the aggressive behavior would decrease for each participant as a function of the COPE program. The behavior was operationally defined for each student and measured through direct observation by parents in the home setting. A single case multiple-baseline design was implemented. Visual analysis of data suggest that the frequency and intensity of aggressive behavior did not decrease as a function of the COPE program, indicating no intervention effect. Supplementary statistical analyses (e.g., log-response ratios) found varied intervention effects among students, ranging from no effects to small effects. Further, participants reported the COPE program as a helpful way to manage stress and would recommend it to their peers. The study results, limitations, and implications for future research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The psychological experience and intervention in post-acute COVID-19 inpatients

Purpose: COVID-19 patients faced first-hand the life-threatening consequences of the disease, oftentimes involving prolonged hospitalization in isolation from family and friends. This study aimed at describing the psychological intervention to address the psychological difficulties and issues encountered by the hospitalized post-acute COVID-19 patients in a rehabilitation setting. Patients and Methods: Patients' demographics, medical diagnosis, and neuropsychological information were collected from March 2nd to May 12th, 2020. The main psychological issues and intervention strategies were collected. Results: A total of 181 patients were hospitalized during this period. Among them, the 47.5% underwent psychological assessment (N = 86;age: 74.58 +/- 13.39;54.7% females). The most common psychological issues were acute stress disorders (18.6%), anxious and demoralization symptoms (26.7%), depression (10.5%%), and troublesome grief (8.1%). Once recovered from COVID-19, many patients were discharged home (38.4%), some received further rehabilitation in non-COVID-19 wards (41.9%), mostly due to pre-existent diseases (72.2%) rather than to COVID-19 complications (27.8%). Conclusion: A great number of the hospitalized post-acute COVID-19 patients showed psychological issues requiring psychological intervention, the most common were anxiety, demoralization, acute stress, depression, and grief. The proposed psychological treatment for hospitalized COVID-19 patients was conducted in a Cognitive Behavioral framework. In particular, during the COVID-19 pandemic, psychological intervention is an important part of rehabilitation in the post-acute phase of the illness to reduce distress symptoms and improve psychological health. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Biopsychosocial therapy of generalized anxiety disorder. Integrative treatment concept

The corona pandemic has led many people to experience an existential threat and has triggered different forms of coping with this persistent stress situation. The risk for the development of a generalized anxiety disorder (GAD) in particular has significantly increased. The established concepts of cognitive behavioral therapy (CBT) are only moderately effective in the treatment of GAD. Therefore, an integrative therapy concept is developed with reference to the biopsychosocial approach. This mediates a reference to early influences in the primary family (insecure ambivalent attachment, suppression of curiosity behavior) even during the psychoeducation as the cause of a permanent worrying and the underlying intolerance of uncertainty. The initial priority is on establishing a sustainable therapeutic relationship (alliance) in which the patient's autonomy and self-efficacy are promoted. Of central importance to therapeutic progress is the promotion of experiences that enhance self-efficacy and the reduction of avoidance behavior through exposure and behavioral experiments. The reduction of maladaptive anxiety coping through worry chains and reassurance behavior occurs through the development of an increasingly greater tolerance of uncertainty in actual daily life. Essential for the prognosis are the consideration of metacognitions and dysfunctional relationship patterns in the couple relationship as well as carrying out relaxation procedures and correctly dosed exercises. Finally, it is a matter of the processing of dysfunctional coping strategies, which promote chronification. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (German) Die Coronapandemie hat bei vielen Menschen zum Erleben einer existenziellen Bedrohung gefuhrt und unterschiedliche Formen der Bewaltigung dieser anhaltenden Stresssituation ausgelost. Besonders stark gestiegen ist das Risiko fur die Entwicklung einer generalisierten Angsterkrankung (generalized anxiety disorder", GAD). Die etablierten Konzepte der kognitiven Verhaltenstherapie (cognitive behavioral therapy", CBT) sind in der Behandlung einer GAD nur masig wirksam. Daher wird unter Bezugnahme auf den biopsychosozialen Ansatz ein integratives Therapiekonzept entwickelt. Dieses vermittelt bereits im Rahmen der Psychoedukation einen Bezug zu fruhen Pragungen in der Primarfamilie (unsicher-ambivalente Bindung, Unterdruckung von Neugierverhalten) als Ursache eines permanenten Sichsorgens und der dahinter stehenden Intoleranz fur Ungewissheit. Zunachst steht der Aufbau einer tragfahigen therapeutischen Beziehung (alliance") im Vordergrund, bei der die Autonomie und Selbstwirksamkeit des Patienten gefordert werden. Eine zentrale Bedeutung fur den therapeutischen Fortschritt haben die Forderung von Erfahrungen, die die Selbstwirksamkeit erhohen, sowie die Reduktion von Vermeidungsverhalten durch Exposition und Verhaltensexperimente. Der Abbau der maladaptiven Angstbewaltigung durch Sorgenketten und Ruckversicherungsverhalten geschieht durch die Entwicklung einer wachsenden Toleranz von Ungewissheit im jeweils aktuellen Lebensalltag. Prognostisch wesentlich sind die Berucksichtigung von Metakognitionen und dysfunktionalen Beziehungsmustern in der Paarbeziehung sowie die Durchfuhrung von Entspannungsverfahren und richtig dosierter Sporttherapie. Schlieslich geht es um die Bearbeitung dysfunktionaler Coping-Strategien, die die Chronifizierung fordern. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

If you build it, will they come? Acceptability, feasibility, and uptake of TMS-based treatment for pediatric Tourette Syndrome

Background: Transcranial magnetic stimulation (TMS) treatment holds promise for pediatric neurological and psychiatric illnesses, but little is known about the acceptability, feasibility, and uptake of experimental TMS intervention in pediatric populations. The current study aimed to identify successful recruitment strategies and participation barriers in the CBIT+TMS Trial, an ongoing clinical trial testing TMS augmentation of behavior therapy for Tourette Syndrome in 12-21 year olds. Method(s): Participation involves 10 daily treatment sessions over two weeks plus pre/post neuroimaging and clinical assessments through 3-month follow-up. Recruitment data from November 2020 - August 2022 were examined for recruitment status, recruitment source, and reason for ineligibility or non-participation. Result(s): N = 171 individuals expressed interest in participation. Of these, 53% declined or passively declined participation, 45% completed phone screening, 19% were deemed ineligible, and 18% enrolled. The most successful recruitment strategies were community flyering, sharing information through a patient support organization, and provider referrals. The most commonly stated reasons for declining participation were related to time commitment and the need to travel to in-person appointments. Notably, participation was greatest during summer months. All enrolled participants have been retained through follow-up visits. Conclusion(s): TMS treatment is of interest to youth and parents in the TS community. As a comparison, a prior TS therapy trial screened =6 youth/month across three sites (Piacentini et al., 2010), whereas our single site is screening =4 youth/month. Stated reasons for declining participation related to schedule and travel feasibility rather than concerns about TMS. This recruitment period overlapped with the COVID-19 pandemic, which likely heightened these particular barriers. Future pediatric TMS research should include efforts to maximize efficacy within protocol schedules that are feasible for youth. Continued examination of factors contributing to pediatric TMS interest and uptake can help inform developmentally sensitive intervention and clinical trial protocols. Research Category and Technology and Methods Clinical Research: 10. Transcranial Magnetic Stimulation (TMS) Keywords: Tourette, Clinical Trial, Pediatric, FeasibilityCopyright © 2023