EMPOWER: Toward the Global Dissemination of Psychosocial Interventions.

Even before the COVID-19 pandemic, the needs for care of persons with mental illness remained largely unmet worldwide, testifying to the inadequacy of current approaches to mental health care and their unsuitability for the rising demand. One hurdle to improved access to quality care is the reliance on expensive specialist providers, particularly for the delivery of psychosocial interventions. This article describes EMPOWER, a not-for-profit program that builds on the clinical science demonstrating the effectiveness of brief psychosocial interventions for a range of psychiatric conditions; implementation science demonstrating the effectiveness of delivery of these interventions by non-specialist providers (NSPs); and pedagogical science demonstrating the effectiveness of digital approaches for training and quality assurance. The EMPOWER program leverages digital tools for training and supervising NSPs, designing competency-based curricula, assessing treatment-specific competencies, implementing measurement-based peer supervision for support and quality assurance, and evaluating impacts to enhance the effectiveness of the delivery system.

Temporal orienting in Parkinson's disease.

Temporal orienting of attention can affect multiple stages of processing to guide adaptive behaviour. We tested whether temporal expectation in different task contexts is compromised in individuals with Parkinson's disease (PD). In Experiment 1 two temporal-orienting tasks were used: a speeded task emphasizing motor preparation and a non-speeded task emphasizing perceptual discrimination using rapid serial visual presentation. In both tasks, auditory cues indicated the likelihood of a target appearing after a short or long interval. In the speeded-response task, participants used the cues to anticipate an easily detectable target stimulus. In the non-speeded perceptual-discrimination task, participants used the cues to help discriminate a target letter embedded in a stream of letters. Relative to healthy participants, participants with PD did not show altered temporal orienting effects in the speeded-response task. However, they were impaired in using temporal cues to improve perceptual discrimination. In Experiment 2, we tested whether the temporal-orienting deficits in the perceptual-discrimination task depended on the requirement to ignore temporally distracting stimuli. We replicated the impaired temporal orienting for perceptual discrimination in an independent group of individuals with PD, and showed the impairment was abolished when individuals were on their dopaminergic medication. In a task without any distracting letters, however, patients off or on medication benefited normally from temporal orienting cues. Our findings suggest that deficits in temporal orienting in individuals with PD interact with specific task demands, such as the requirement to select target from temporally competing distractors.

Anticipatory neural dynamics of spatial-temporal orienting of attention in younger and older adults.

Spatial and temporal expectations act synergistically to facilitate visual perception. In the current study, we sought to investigate the anticipatory oscillatory markers of combined spatial-temporal orienting and to test whether these decline with ageing. We examined anticipatory neural dynamics associated with joint spatial-temporal orienting of attention using magnetoencephalography (MEG) in both younger and older adults. Participants performed a cued covert spatial-temporal orienting task requiring the discrimination of a visual target. Cues indicated both where and when targets would appear. In both age groups, valid spatial-temporal cues significantly enhanced perceptual sensitivity and reduced reaction times. In the MEG data, the main effect of spatial orienting was the lateralised anticipatory modulation of posterior alpha and beta oscillations. In contrast to previous reports, this modulation was not attenuated in older adults; instead it was even more pronounced. The main effect of temporal orienting was a bilateral suppression of posterior alpha and beta oscillations. This effect was restricted to younger adults. Our results also revealed a striking interaction between anticipatory spatial and temporal orienting in the gamma-band (60-75 Hz). When considering both age groups separately, this effect was only clearly evident and only survived statistical evaluation in the older adults. Together, these observations provide several new insights into the neural dynamics supporting separate as well as combined effects of spatial and temporal orienting of attention, and suggest that different neural dynamics associated with attentional orienting appear differentially sensitive to ageing.

Building the Thermometer for Mental Health.

Millions of people suffer from serious mental illness, but very few receive consistent coordinated care. Since leaving his post in 2015 after 13 years as director of the National Institute of Mental Health, co-author Tom Insel has been on a mission to use technology (such as mining your smartphone) to better understand your state of mind and treat depression, schizophrenia, and other disorders. Insel and co-author Joshua Chauvin, part of the team at a healthcare innovation company, examine the potential and pitfalls of this next digital frontier.

Temporal orienting of attention can be preserved in normal aging.

Being able to orient our attention to moments in time is crucial for optimizing behavioral performance. In young adults, flexible cue-based temporal expectations have been shown to modulate perceptual functions and enhance behavioral performance. Recent studies with older individuals have reported significant deficits in cued temporal orienting. To investigate the extent of these deficits, the authors conducted 3 studies in healthy old and young adults. For each study, participants completed 2 tasks: a reaction time (RT) task that emphasized speeded responding and a nonspeeded rapid-serial-visual-presentation task that emphasized visual discrimination. Auditory cues indicated the likelihood of a target item occurring after a short or long temporal interval (foreperiod; 75% validity). In the first study, cues indicating a short or a long foreperiod were manipulated across blocks. The second study was designed to replicate and extend the first study by manipulating the predictive temporal cues on a trial-by-trial basis. The third study extended the findings by including neutral cues so that it was possible to separate cueing validity benefits and invalidity costs. In all 3 studies, cued temporal expectation conferred significant performance advantages for target stimuli occurring after the short foreperiod for both old and young participants. Contrary to previous findings, these results suggest that the ability to allocate attention to moments in time can be preserved in healthy aging. Further research is needed to ascertain whether similar neural networks are used to orient attention in time as we age, and/or whether compensatory mechanisms are at work in older individuals. (PsycINFO Database Record