A pilot study of a brief and scalable psychosocial intervention for children and adolescents following disasters.

OBJECTIVES: Following disaster exposure, a significant proportion of children/adolescents will develop levels of post-traumatic stress symptoms (PTSS) that do not meet diagnostic threshold for PTSD, but which cause ongoing distress. This paper describes the development and pilot testing of a brief, scalable, psychosocial intervention. SOLAR-Kids/Teens has been designed to be delivered by non-mental health professionals ('coaches') to children/adolescents experiencing moderate levels of PTSS following disasters. METHODS: An international collaboration of experts developed The Skills fOr Life Adjustment and Resilience (SOLAR) for Kids and Teens programs. The programs were piloted-using a pre-post mixed methods design-with 10 children and adolescents (8-18 years), with the aims of examining the feasibility of the program's delivery model as well as the program's potential usefulness. RESULTS: The pilot data indicated that after 1 day of training and with ongoing supervision, the SOLAR program was safe and feasible for coaches to deliver to children/adolescents experiencing PTSS. Coaches reported increased knowledge (p = .001), confidence (p = .001) and skills (p = .006). The programs were acceptable to coaches, children/adolescents and parents. Parents and children/adolescents reported reductions in trauma and anxiety symptoms from pre- to post-treatment, with moderate to large effect sizes. CONCLUSIONS: The preliminary findings demonstrate that the SOLAR-Kids/Teens program is feasible, acceptable and safe to be delivered by trained non-mental health professionals to children and adolescents experiencing PTSS and anxiety following disaster exposure. Randomized controlled trials are required to evaluate the efficacy of the SOLAR-Kids/Teens programs.

Best Practice Injury Compensation Processes Following Intentional Vehicular Assaults and Other Large Scale Transport Incidents: A Delphi Review.

OBJECTIVE: Intentional vehicular assaults on civilians have become more frequent worldwide, with some resulting in mass casualties, injuries, and traumatized witnesses. Health care costs associated with these vehicular assaults usually fall to compensation agencies. There is, however, little guidance around how compensation agencies should respond to mental and physical injury claims arising from large-scale transport incidents. METHODS: A Delphi review methodology was used to establish expert consensus recommendations on the major components of "no fault" injury claim processes for mental and physical injury. RESULTS: Thirty-three international experts participated in a 3-round online survey to rate their agreement on key statements generated from the literature. Consensus was achieved for 45 of 60 (75%) statements, which were synthesized into 36 recommendations falling within the domains of (1) facilitating claims, (2) eligibility rules, (3) payments and benefits for clients, (4) claims management procedures, (5) making and explaining decisions, (6) support and information resources for clients, (7) managing scheme staff and organizational response, (8) clients with special circumstances, and (9) scheme values and integrity. CONCLUSIONS: The recommendations present an opportunity for agencies to review their existing claims management systems and procedures. They also provide the basis for the development of best practice guidelines, which may be adapted for application to compensation schemes in different contexts worldwide.

Age Differences in Emotion Regulation and Facial Muscle Reactivity to Emotional Films.

BACKGROUND: Age-related declines in many cognitive abilities are common in healthy aging. However, the ability to effectively regulate emotions is preserved, and possibly even enhanced, in late adulthood. This capacity has been examined most commonly in relation to low-intensity emotional stimuli that typically involve static pictures. Evidence is suggesting that older adults may become overwhelmed when exposed to emotional cues of heightened intensity. OBJECTIVE: In the current study, we assessed whether older adults retain the ability to regulate emotions successfully when exposed to more emotionally evocative (e.g., dynamic) stimuli. METHODS: Young and older adults were instructed to regulate, using expressive suppression, their outward behavioral expression of emotions while viewing dynamic stimuli involving amusing and sad films. Facial reactivity, as indexed using electromyography, self-rated emotional experience, and memory for the stimuli were assessed. RESULTS: The results showed that, relative to young adults, older adults were unable to suppress zygomaticus (cheek) activity to amusing films or corrugator (brow) reactivity to sad films, which is likely due to their relatively reduced facial muscle reactivity. Expressive suppression did not affect young or older adults' subjective feelings or memory for the stimuli. CONCLUSION: Our findings suggest that there are age differences in facial muscle reactivity to amusing and sad cues of heightened intensity. These findings suggest that older adults' ability to effectively regulate emotions may be limited, at least with expressive suppression, in the context of high-intensity emotional cues. Further research is needed to investigate possible exceptions the preservation of emotion regulation in older adults.

Reduced facial reactivity as a contributor to preserved emotion regulation in older adults.

This study investigated whether differences in the type of strategy used, or age-related differences in intensity of facial reactivity, might contribute to preserved emotion regulation ability in older adults. Young (n = 35) and older (n = 33) adults were instructed to regulate their emotion to positive and negative pictures under 3 conditions (watch, expressive suppression, cognitive 'detached' reappraisal). Participants were objectively monitored using facial electromyography (EMG) and assessed on memory performance. Both age groups were effectively, and equivalently, able to reduce their facial expressions. In relation to facial reactivity, the percentage increase of older adults' facial muscle EMG activity in the watch condition was significantly reduced relative to young adults. Recall of pictures following regulation was similar to the watch condition, and there was no difference in memory performance between the 2 regulation strategies for both groups. These findings do not support the proposal that the type of strategy used explains preserved emotion regulation ability in older adults. Coupled with the lack of memory costs following regulation, these data instead are more consistent with the suggestion that older adults may retain emotion regulation capacity partly because they exhibit less facial reactivity to begin with.

Don't grin when you win: the social costs of positive emotion expression in performance situations.

People who express positive emotion usually have better social outcomes than people who do not, and suppressing the expression of emotions can have interpersonal costs. Nevertheless, social convention suggests that there are situations in which people should suppress the expression of positive emotions, such as when trying to appear humble in victory. The present research tested whether there are interpersonal costs to expressing positive emotions when winning. In Experiment 1, inexpressive winners were evaluated more positively and rated as lower in hubristic-but not authentic-pride compared with expressive winners. Experiment 2 confirmed that inexpressive winners were perceived as using expressive suppression to downregulate their positive emotion expression. Experiment 3 replicated the findings of Experiment 1, and also found that people were more interested in forming a friendship with inexpressive winners than expressive winners. The effects were mediated by the perception that the inexpressive winner tried to protect the loser's feelings. This research is the first to identify social costs of expressing positive emotion, and highlights the importance of understanding the situational context when determining optimal emotion regulation strategies.