Effects of a Family Caregiver-Delivered MultiSensory Cognitive Stimulation Intervention for Older People With Dementia During Coronavirus 2019: A Randomized Controlled Trial.

BACKGROUND AND OBJECTIVES: Many community dementia services such as home-visiting services and center-based activities were suspended during the coronavirus 2019 pandemic. This study investigated the efficacy of a caregiver-delivered cognitive stimulation therapy (CDCST) on people with dementia during the pandemic. RESEARCH DESIGN AND METHODS: This was a 2-arm randomized controlled trial involving 241 patient-caregiver dyads assigned to a 15-week CDCST or control group (usual care). We hypothesized that CDCST would facilitate significant improvements among people with dementia (cognition, behavioral/psychiatric symptoms, and quality of life) and their caregivers (caregiving appraisal, attitudes, and psychological well-being) at postintervention (T1) and at the 12-week follow-up (T2). Generalized estimating equations evaluated the study outcomes. RESULTS: A total of 230 dyads completed the study, with good program adherence (93%). Participants in the CDCST showed significant improvements in cognition (p < .001), behavioral and psychiatric symptoms (p =. 027), and quality of life (p =.001) at the 3-month follow-up period. Family caregivers had improved positive aspects of caregiving (p = .008; p = .049) and decreased negative attitudes toward people with dementia (p =. 013; p < .001) at both T1 and T2. There were nonsignificant changes in the caregivers' perceived burden, distress, and psychological well-being. DISCUSSION AND IMPLICATIONS: Family caregivers could be trained to provide cognitive stimulation at home for people with dementia, which could benefit both parties. CDCST could manage to improve the cognition, neuropsychiatric symptoms, and quality of life of people with dementia, while also improving caregiving appraisal and negative attitudes among family caregivers. CLINICAL TRIAL REGISTRATION NUMBER: NCT03803592.

Reaching hidden youth in Singapore through the Hidden Youth Intervention Program: A biopsychosocial approach integrating mental health and social work interventions.

Hidden youth are youth who withdraw from society for at least 6 months, physically isolating within their homes or rooms. There has been a steady rise in this phenomenon across many developed countries, and this trend is expected to continue. As hidden youths often present with complex psychopathology and psychosocial issues, multi-factorial intervention approaches are recommended. To reach this isolated population and address gaps in services, a community mental health service and a youth social work team collaborated to develop the first specialized intervention for hidden youth in Singapore. This pilot intervention combines components from Hikikomori treatment models from Japan and Hong Kong, and a treatment program for isolated individuals diagnosed with Internet Gaming Disorder. This paper describes the development of the pilot intervention model- a four-stage biopsychosocial intervention targeting the complex needs of hidden youth and their families- and illustrates its implementation and challenges faced through a case study. Based on 2 years of service delivery to 25 youths, good practices such as utilizing novel outreach strategies and the importance of involving and caring for caregivers are also highlighted. Preliminary outcomes of this ongoing pilot intervention indicate reductions in social withdrawal behavior and increased engagement in school or work, especially for youth at the final stage of intervention. Strengths of the program include its multi-disciplinary and flexible nature, and the whole-family approach. Limitations of this program included a lack of information on Singaporean hidden youth and the lack of quantitative outcome data of this pilot program. In future, we aim to further enhance program elements through collaboration with international and local partners, and to develop an evaluative framework to determine program effectiveness.

Perceptions of Child Maltreatment Among Professionals and the Public in Singapore.

Child maltreatment is associated with significant negative long-term outcomes. Behaviors considered to be more serious and abusive are more likely identified as maltreatment and reported. Therefore, studying child maltreatment perceptions among professionals and the public who regularly work with children could inform practice. Existing studies examining professionals' and the public's perceptions of maltreatment have reported mixed findings, motivating a more comprehensive study of maltreatment perceptions. Our study compared perceived abusiveness and seriousness of behaviors (a) across professional groups (educators, counselors/social workers, nurses, doctors, and police officers), and (b) between professional groups and the public. We surveyed 1,022 professionals and 500 members of the public. Respondents completed an 18-item measure on their perceived abusiveness of potential maltreatment behaviors, and rated the seriousness of 21 vignettes depicting maltreatment behaviors. We found that educators surveyed in our study perceived all child maltreatment behaviors as more serious, and emotional maltreatment behaviors as more abusive, than other professional groups. Conversely, police officers in our sample perceived neglect/emotional maltreatment behaviors as less serious than other professionals. Police officers also perceived physical abuse and emotional maltreatment behaviors as less abusive than other professionals. In our sample, professionals perceived maltreatment behaviors as less serious than the public, while the public was more hesitant to label behaviors as constituting abuse than professionals. These findings highlight the need to address inconsistencies in maltreatment perceptions across professionals and the public, to ensure the provision of appropriate intervention in suspected maltreatment cases.

Multiple trauma exposure and psychosocial functioning in Singaporean children in out-of-home care.

OBJECTIVE: Children in out-of-home care are often exposed to chronic, interpersonal traumas such as abuse and domestic violence. Exposure to more than 1 interpersonal trauma is associated with functional impairments, mental health symptoms, and risk behaviors. Despite the importance of studying trauma in this vulnerable population, very few studies have investigated trauma exposure among children and youth in out-of-home care in Asia. This is the first study to examine the effects of multiple interpersonal trauma exposure in a large sample of children in out-of-home care in Singapore. METHOD: A cross-sectional study of 721 children between the ages of 5 and 17 years residing in foster care and voluntary children's homes in Singapore was conducted to determine the proportion of children with interpersonal trauma exposure and the effect of trauma exposure on psychosocial functioning. RESULTS: Results indicated that 63% of the sample experienced at least 1 interpersonal trauma, with neglect (34%) and physical abuse (31%) the most prevalent. Girls were more likely to be emotionally and sexually abused than boys. Children with multiple interpersonal trauma exposure (35% of the sample) were significantly older, more likely to be female, and had a higher number of life functioning, behavioral, and emotional, as well as risk behavior needs compared with children with no previous trauma. CONCLUSION: Findings highlight the importance of conducting comprehensive assessments of children in out-of-home care to provide specialized interventions for children with interpersonal trauma exposure. (PsycINFO Database Record

Enhanced selective memory consolidation following post-learning pleasant and aversive arousal.

It is well established that emotions modulate memory, typically enhancing consolidation through post-learning arousal. However, many aspects of this phenomenon have yet to be delineated. For example, it remains unclear whether or not the type of arousal is relevant (pleasant vs. aversive), whether arousal enhances memory selectively for some stimuli but not others (emotional vs. neutral), which specific aspects of the stimulus representation (gist vs. detail) are affected, and whether these mechanisms are sexually dimorphic. In order to explore these issues, 178 undergraduate participants viewed a series of negative, positive and neutral pictures. They were then subjected to a post-learning arousal manipulation in the form of a pleasantly arousing-, aversively arousing-, or neutral video. Free recall tests one week later indicated that both pleasant and aversive post-learning arousal enhanced memory consolidation for positive and negative but not neutral stimuli, independent of the participants' sex. Further analysis for gist and detail aspects suggests that post-learning arousal enhances memory for the gist of the stimuli. The study has implications for the understanding of healthy and pathological cognitive-affective processes in humans.