The association between multiple sclerosis and early psychiatric background.

BACKGROUND: The exact cause of Multiple Sclerosis (MS) is unclear. Since its definition in the late 19th century, researchers have repeatedly suggested a connection between the disease and mental state. Studies have shown that mental symptoms tend to precede the initiation of the disease by up to ten years. However, the hypothesis that psychiatric issues might precede MS onset by longer periods has not been empirically established. This study seeks to fill this research gap. The current matched cohort study investigated the possibility that psychiatric conditions may precede the initiation of multiple sclerosis by 15 years or more METHODS: A retrospective analysis utilizing the electronic database of Clalit Health Services (CHS), Israel's largest HMO, compared a group of 9,533 MS-diagnosed female and male individuals with 28,599 non-MS matched controls RESULTS: Logistic regression analysis revealed a significant association (p < 0.001) between MS diagnosis and prior psychiatric conditions, indicating a 93% increased likelihood of psychiatric history among those later diagnosed with MS compared with those who were not CONCLUSIONS: The heightened probability of mental health issues preceding the onset of MS by extended durations suggests a potential etiological role in the development of MS, rather than solely representing a component of the prodromal stage of the disease. Limitations include the retrospective design and the need for prospective studies to validate these associations.

Mental health consequences of the COVID-19 pandemic: Results from a large-scale population-based study in Israel.

INTRODUCTION: Contemporary evidence notes the COVID-19 pandemic greatly impacted the utilization of physical and mental health services worldwide. The present study was therefore designed to evaluate the changes in the utilization of mental health services during the first year of the COVID-19 pandemic compared to previous years as well as to estimate the moderating role age had on these changes. MATERIALS AND METHODS: Psychiatric data was collected from n = 928,044 individuals living in Israel. Rates of receipt of psychiatric diagnoses and purchases of psychotropic medication were extracted for the first year of the COVID-19 pandemic and for two comparison years. The odds of receiving a diagnosis or of purchasing a psychotropic medication during the pandemic were compared to control years using uncontrolled logistic regression models and controlled and logistic regression that accounted for differences between ages. RESULTS: There was a general reduction of about 3-17% in the odds of receiving a psychiatric diagnosis or purchasing psychotropic medications during the pandemic year compared to control years. The bulk of tests conducted showed that reduction in the rates of receiving diagnoses and purchasing medications during the pandemic were evident or more profound in the older age groups. An analysis of a combined measure conclusive of all other measures revealed decreased rates of utilizing any service examined during 2020, with rates decreasing as age increases up to a decrease of 25% in the oldest age group (80-96). DISCUSSION AND CONCLUSION: Changes in utilization of mental health services reveal the interplay between psychological distress that has been documented to increase during the pandemic and people's reluctance to seek professional assistance. This appears to be especially prominent among the vulnerable elderly, who may have received even less professional help for their emerging distress. The results obtained in Israel are likely to be replicated in other countries as well, given the global impact of the pandemic on adults' mental health and individuals' readiness to utilize mental healthcare services. Future research on the long-term impact of the pandemic on utilization of mental healthcare services is warranted, with an emphasis on the response of different populations to emergency situations.

Children's Narrative Coherence in "Achieving Best Evidence" Forensic Interviews and Courtroom Testimony.

In the United Kingdom, Section 27 of the Youth Justice and Criminal Evidence Act permits "Achieving Best Evidence" (ABE) forensic interviews to replace the evidence-in-chief in cases involving children. It is therefore imperative that forensic interviewers elicit complete, reliable, and coherent narratives from children. The goal of the current research study was to assess the coherence of forensic interviews and whether the interviewers' emotional or cognitive support was associated with increases in the coherence of these interviews. Children's narrative coherence was examined in 80 transcripts of ABE investigative interviews with 7- to-15-year-olds who disclosed sexual abuse. Narrative coherence was assessed using the Narrative Coherence Coding Scheme, including three dimensions of narrative coherence: chronology, consistency, and theme (Reese et al., 2011). Findings revealed that first elicited events were more likely to be more coherent compared to subsequently elicited events, and child engagement was positively associated with all dimensions of narrative coherence. Interviewer support was positively associated with chronology, script accounts of abuse were associated with decreased consistency and chronology (but not theme), and cognitive support was not associated with any dimension of narrative coherence.

Discovering your presumed father is not your biological father: Psychiatric ramifications of independently uncovered non-paternity events resulting from direct-to-consumer DNA testing.

Direct-to-consumer DNA tests provide information on ancestry and family relations. Their increased use in recent years has led many to discover that their presumed father is not their biological father, a non-paternity event (NPE). We aimed to explore and quantify the psychiatric effects of discovering one's father's identity was misattributed. We distributed questionnaires in a private online community of individuals who learned they were NPEs. Questionnaires included clinical scales assessing depressive, anxiety, and panic symptomatology as well as background and personal details regarding participants' NPE discovery and demography. A total of 731 people participated. Results demonstrated increased levels of depression, anxiety, and panic symptoms relative to controls. Multiple factors influenced such effects, including demographics, background information, family members' reactions, and personal reactions. We identified a worsening relationship or attitude toward the mother as a risk factor for worse mental health. The ability to openly discuss the discovery and acceptance of it were identified as protective factors. This is the first paper to explore the psychiatric sequelae of discovering misattributed paternity in a large cohort. This unique psychosocial stressor is likely to become more common as direct-to-consumer DNA tests gain popularity, requiring the attention of mental health professionals.

Nonverbal Emotions While Disclosing Child Abuse: The Role of Interviewer Support.

Statements by alleged victims are important when child abuse is prosecuted; triers-of-fact often attend to nonverbal emotional expressions when evaluating those statements. This study examined the associations among interviewer supportiveness, children's nonverbal emotions, and informativeness during 100 forensic interviews with alleged victims of child abuse. Raters coded the silent videotapes for children's nonverbal emotional expressions while other raters coded the transcripts for interviewer support, children's verbal emotions, and informativeness. Results showed that children's nonverbal signals were more common than and preceded the verbal signs. Interviewer support was associated with children's expressivity. When children expressed more nonverbal emotions, they were more responsive during the pre-substantive phases and more informative about the abuse. Nonverbal emotions partially mediated the association between support and informativeness. The findings underline the value of nonverbal emotional expression during forensic interviews and demonstrate how the interviewers' supportive demeanor can facilitate children's emotional displays and increase informativeness.

Risk factors for postpartum depression among sexual minority and heterosexual parents.

OBJECTIVE: Postpartum depression (PPD), a major depressive episode with postpartum onset, develops in 15% of mothers. Although findings suggest sexual minority parents may be at risk for PPD, research among this population is scarce. We evaluated risk factors for PPD in a sample of sexual minority and heterosexual parents. METHOD: Four hundred and twenty seven heterosexual and one hundred and eleven sexual minority parents responded to a questionnaire distributed via social media that included demographics, the Edinburgh Postnatal Depression Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS: Sexual minority identity was not associated with increased risk for PPD. Pregnancy had no significant effect on the likelihood for PPD. Social support was negatively and significantly associated with probability for PPD. CONCLUSIONS: Our data suggest that sexual minority parents are not at increased risk for PPD, contrary to previous findings. The parental role, a psychosocial factor, is a more dominant risk factor than pregnancy itself, in the development of PPD.

Emotional valence and the types of information provided by children in forensic interviews.

BACKGROUND: Emotions can powerfully affect memory retrieval although this effect has seldom been studied in everyday contexts. OBJECTIVE: This study aimed to explore the association between children's verbal emotional expressions and the type of information reported during forensic interviews. PARTICIPANTS AND SETTING: The sample included 198 interviews with 4- to 14-year-old (M = 9.36, SD = 2.37) alleged victims of repeated physical abuse perpetrated by family members conducted using the Revised NICHD Protocol which emphasizes a supportive interviewing style. METHODS: Interview videos were transcribed and each conversational turn was coded to reflect the amount and type of children's verbal emotional expressions, forensic information provided, interviewers' demeanor, and type of question asked. RESULTS: The verbal expression of negative emotions was positively associated with the production of more central details (ß = 0.29, SE = 0.05, p < 0.001) and peripheral details (ß = 0.66, SE = 0.07, p < 0.001), while the verbal expression of positive emotions was correlated with peripheral details (ß = 0.29, SE = 0.15, p = 0.047). The verbal expression of negative emotions was associated with the production of more specific details (ß = 0.73, SE = 0.06, p < 0.001]) and less generic information (ß = -0.39, SE = 0.18, p = 0.029) whereas positive emotions were associated only with increased specific information (ß = 0.28, SE = 0.12, p = 0.025). CONCLUSIONS: These findings highlight how emotional expression, especially of negative emotions, enhances the quantity and quality of children's reports in forensic contexts.

The dynamics of two-session interviews with suspected victims of abuse who are reluctant to make allegations.

Supportive forensic interviews conducted in accordance with the National Institute of Child Health and Human Development Revised Protocol (RP) help many alleged victims describe abusive experiences. When children remain reluctant to make allegations, the RP guides interviewers to (a) focus on rapport building and nonsuggestive support in a first interview, and (b) plan a second interview to allow continued rapport building before exploring for possible abuse. We explored the dynamics of such two-session RP interviews. Of 204 children who remained reluctant in an initial interview, we focused on 104 who made allegations when re-interviewed a few days later. A structural equation model revealed that interviewer support during the first session predicted children's cooperation during the rapport-building phase of the second session, which, in turn, predicted more spontaneous allegations, which were associated with the interviewers' enhanced use of open-ended questions. Together, these factors mediated the effects of support on children's free recall of forensically important information. This highlighted the importance of emphasizing rapport with reluctant children, confirming that some children may need more time to build rapport even with supportive interviewers.

Facilitating the Expression of Emotions by Alleged Victims of Child Abuse During Investigative Interviews Using the Revised NICHD Protocol.

Children's testimony is often critical to the initiation of legal proceedings in abuse cases. In forensic interviews, the expression of emotions can powerfully enhance both the quality of children's statements and perceptions that their statements are coherent and credible. However, children rarely express their emotions when reporting abusive events. The Revised The National Institute of Child Health and Human Development (NICHD) Protocol (RP) was designed to emphasize socioemotional communication during forensic interviews and thus should be associated with more extensive and diverse expressions of emotions by alleged victims of abuse. The present study focused on forensic interviews (178 using the Revised and 100 using the Standard NICHD Protocol) with victims of physical child abuse whose allegations were corroborated using independent evidence. Detailed content coding showed that the RP was associated with the expression of more different emotions, more expression of abuse-related emotions, and more expression of emotions related to the interview context. Emotional expressiveness was associated with increased informativeness, and the association between the type of protocol and informativeness was fully mediated by emotional expressiveness. These results suggest that the Revised Protocol facilitates the expression of emotions by alleged victims of abuse in a way that enhances the value of children's testimony in multiple ways.

Is interviewer support associated with the reduced reluctance and enhanced informativeness of alleged child abuse victims?

Child maltreatment victims are often reluctant to report abuse when formally interviewed. Evidence-based guidelines like the National Institute of Child Health and Human Development Standard Investigative Interview Protocol do not adequately address such reluctance because they are focused on cognitive rather than socioemotional strategies. The present study was designed to determine whether the Revised National Institute of Child Health and Human Development Protocol, which emphasizes supportive interviewing more than the standard protocol does, might predict increases in the overall informativeness and reductions in the reluctance of alleged victims. A total of 254 interviews, 166 using the revised protocol and 88 using the standard protocol, were conducted with 4.06- to 13.98-year-old children (M = 9.20, SD = 2.49) who disclosed multiple incidents of physical abuse by their parents and were thus expected to be more reluctant than victims of extrafamilial abuse. We coded indices of interviewer support and question types, children's reluctance, and informativeness in each utterance during the substantive phases of the interviews. The Revised Protocol was associated with better interviewer support and questioning as well as reduced reluctance and increased informativeness on the part of the children. These findings document the value of training interviewers to attend to the socioemotional needs of suspected abuse victims during investigative interviews. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Support and reluctance in the pre-substantive phase of alleged child abuse victim investigative interviews: revised versus standard NICHD protocols.

Children's unwillingness to report abuse places them at risk for re-victimization, and interviewers who do not respond sensitively to that unwillingness may increase the likelihood that victims will not disclose abuse. Interviewer support and children's reluctance were examined on a turn-by-turn basis using sequential analyses in 199 forensic interviews of 3- to 13-year-olds who alleged maltreatment. Half of the children were interviewed using the Revised Protocol that emphasized rapport-building (RP), the others using the Standard National Institute of Child Health and Human Development Protocol (SP). When using the RP, interviewers provided proportionally more support than when using the SP, but even when using the RP they did not specifically provide support when children expressed reluctance. The RP promoted immediate cooperation when reluctant utterances were met with support, however, suggesting that supportive statements were valuable. The findings enhance our understanding of children's willingness to participate in investigative interviews and the means through which interviewers can foster the comfort and well-being of young witnesses.