Electromyographic evidence of reduced emotion mimicry in individuals with a history of non-suicidal self-injury.

Engaging in facial emotion mimicry during social interactions encourages empathy and functions as a catalyst for interpersonal bonding. Decreased reflexive mirroring of facial expressions has been observed in individuals with different non-psychotic disorders, relative to healthy controls. Given reports of interpersonal relationship difficulties experienced by those who engage in non-suicidal self-injury (NSSI), it is of interest to explore facial emotion mimicry in individuals with a history of this behaviour (HNSSI). Among other things, this will enable us to better understand their emotion regulation and social interaction challenges. Surface facial electromyography (fEMG) was used to record the reflexive facial mimicry of 30 HNSSI and 30 controls while they passively observed a series of dynamic facial stimuli showing various facial expressions of emotion. Beginning with a neutral expression, the stimuli quickly morphed to one of 6 prototypic emotional expressions (anger, fear, surprise, disgust, happiness, or sadness). Mimicry was assessed by affixing surface electrodes to facial muscles known to exhibit a high degree of electrical activity in response to positive and negative emotions: the corrugator supercilii and the zygomaticus major. HNSSI participants, relative to controls, exhibited significantly less electrical activity in the corrugator muscle in response to viewing angry stimuli, and significantly less of an expected relaxation in muscle activity in response to viewing happy stimuli. Mirroring these results, greater endorsement of social influence as a motivator for engaging in NSSI was associated with less mimicry, and greater endorsement of emotion regulation as a motivator was associated with greater incongruent muscle response when viewing happy faces. These findings lend support to the theory that social interaction difficulties in HNSSI might be related to implicit violations of expected social rules exhibited through facial mimicry nonconformity.

Using an ideal observer analysis to investigate the visual perceptual efficiency of individuals with a history of non-suicidal self-injury when identifying emotional expressions.

Individuals who engage in non-suicidal self-injury (NSSI) often report significant interpersonal difficulties, with studies lending support to the idea of impaired social interactions. Perceptual processing deficits of facial expressions have also been associated with interpersonal difficulties, yet little research has assessed how individuals with a history of NSSI (HNSSI) process facial emotions. This study used an ideal observer analysis to assess emotion processing capabilities of these individuals. A total of 30 HNSSI and 31 controls were presented with static images of various facial expressions (fear, anger, disgust, happiness, sadness, surprise) at three intensity levels (50%, 75% and 100% emotion expressivity). Recognition of emotions were measured by signal-proportion thresholds, efficiency scores, and unbiased hit rate. Error responses were also recorded to investigate errors biases made by each group. No significant differences between HNSSI and controls were found in signal-proportion thresholds or efficiency scores. Decreased accuracy of HNSSI participants for recognizing fearful expressions was observed. An increased likelihood of mistaking angry for happy expressions and a decreased likelihood of mistaking sad for surprised expressions were recorded for the HNSSI group compared to controls. These findings provide support to the literature reporting deficits in accurate emotion identification for those engaged in NSSI behaviours.

Fostering excellence: roles, responsibilities, and expectations of new family physician clinician investigators.

PROBLEM ADDRESSED: A key priority in primary health care research is determining how to ensure the advancement of new family physician clinician investigators (FP-CIs). However, there is little consensus on what expectations should be implemented for new investigators to ensure the successful and timely acquisition of independent salary support. OBJECTIVE OF PROGRAM: Support new FP-CIs to maximize early career research success. PROGRAM DESCRIPTION: This program description aims to summarize the administrative and financial support provided by the C.T. Lamont Primary Health Care Research Centre in Ottawa, Ont, to early career FP-CIs; delineate career expectations; and describe the results in terms of research productivity on the part of new FP-CIs. CONCLUSION: Family physician CI's achieved a high level of research productivity during their first 5 years, but most did not secure external salary support. It might be unrealistic to expect new FP-CIs to be self-financing by the end of 5 years. This is a career-development program, and supporting new career FP-CIs requires a long-term investment. This understanding is critical to fostering and strengthening sustainable primary care research programs.

Difficulties encountered in collaborative care: logistics trumps desire.

INTRODUCTION: This study examines the development of collaborative relationships between family physicians (FPs) and Anticipatory And Preventative Team Care (APTCare) team members providing care to medically complex patients who have been identified as at-risk for negative health outcomes. METHODS: We undertook a qualitative study of a primary health care intervention in a family practice. Interviews were held with FPs and ATPCare intervention nurse practitioners (NPs) and pharmacists. Focus groups were conducted and a survey was administered to participating FPs, NPs, and pharmacists. NPs and pharmacists maintained a log recording their tasks and moments of collaboration. RESULTS: Scheduling demands rendered face-to-face collaboration difficult, leaving the team to rely on technological tools to keep in touch. Limited space meant the APTCare team had to work out of a downstairs office, limiting informal interactions with the practitioners on the main level. CONCLUSIONS: We demonstrate that the difficulties inherent in collaborative care are independent of the patient population being cared for. Regardless of the patient population and sector of health care, developing collaborative relationships and learning to work collaboratively is difficult and takes time. What many of these teams need is ongoing support and education about how to make these collaborative care practices work.

Interprofessional group intervention for parents of children age 3 and younger with feeding difficulties: pilot program evaluation.

BACKGROUND: Feeding difficulties are common with an estimated prevalence of 25%-45% in normally developing children. Clinicians and researchers emphasize the need for timely and effective treatment because a proportion of children develop failure to thrive with possible long-term impairments. Interprofessional assessment and treatment has emerged as an optimal approach to reduce parental anxiety and increase children's acceptance of a wider variety of foods. METHODS: Participants, including 30 children (mean age of 26 ± 8.2 months) meeting inclusion/exclusion criteria and their families, attended a program consisting of 4 sessions, and a 1-month follow-up. Parents completed the Behavioral Pediatrics Feeding Assessment Scale pre- and posttreatment and Goal Attainment Scaling (GAS). RESULTS: Paired t tests indicate that the composite scores for frequency of feeding difficulties were on average significantly less posttreatment compared with pretreatment, and composite scores for frequency of parental problems with feeding were also significantly less posttreatment. These results were reflected in the composite scores for both feeding difficulties and parental problems with feeding on child- and parent-related items. The median for the GAS was +2 (range, -2 to +2). Written parental responses in the GAS reflected 2 major themes: satisfaction with the program and a desire for more individualized attention. CONCLUSIONS: These results offer preliminary evidence suggesting that an interprofessionally led parent group, with contributions from clinical nutrition, occupational therapy, psychology, and speech-language pathology professionals, is effective in treating young children with feeding difficulties.