Retrospective descriptive analysis of an urban pediatric collaborative care program.

OBJECTIVE: The prevalence of mental health conditions in pediatric patients in the United States is approximately 15%. Concerningly, nearly half go untreated, with lower treatment rates among children of color. Collaborative care can increase access to care and has an emerging evidence base for pediatrics. We present retrospective results from a collaborative care program that accepted referrals for a variety of conditions. METHODS: Pediatric patients seen in an academic, urban collaborative care program from July 2019 to December 2021 were tracked in a registry. Demographics, presenting problem(s), symptoms, treatment, and discharge dispositions were examined. Descriptive data were analyzed, including changes in reported symptoms via paired t-tests. RESULTS: Three hundred nineteen patients were seen. Racial and ethnic diversity in our clinic's population was similar to that of the surrounding community, with half belonging to a minoritized racial or ethnic group. Symptom comparisons demonstrated clinically and statistically significant improvements from intake to discharge. CONCLUSION: Collaborative care can improve access to care and outcomes for a diverse pediatric population. Our clinic served racial and ethnic patient populations that were representative of the demographics of the metropolitan area. Further study is necessary to determine if collaborative care increases access for these underserved groups.

On the relation between oral contraceptive use and self-control.

In two studies we examined the relation between oral contraceptive (OC) use and self-reported levels of self-control in undergraduate women using OCs (Study 1: OC group N = 399, Study 2: OC group N = 288) and naturally cycling women not using any form of hormonal contraceptives (Study 1: Non-OC group N = 964, Study 2: Non-OC group N = 997). We assessed the self-overriding aspect of self-control using the Brief Self-Control Scale (BSCS) and strategies for self-regulation using the Regulatory Mode Scale (RMS), which separately measures the tendency to assess one's progress towards a goal (assessment), and the tendency to engage in activities that move one towards an end goal (locomotion). In Study 1, we found no significant differences between OC and non-OC groups in their levels of self-overriding or self-regulatory assessment. However, we found that those in the OC group reported significantly greater levels of self-regulatory locomotion compared to those in the non-OC group, even after controlling for depression symptoms and the semester of data collection. The findings from Study 2 replicated the findings from Study 1 in a different sample of participants, with the exception that OC use was also related to higher levels of assessment in Study 2. These results indicate that OC use is related to increases in self-regulatory actions in service of goal pursuit and perhaps the tendency to evaluate progress towards goals.

Evaluation of US Medical Student Bias Toward Mental Health Before and After First-Year Pre-clinical Psychiatry Education.

OBJECTIVE: Much of mental health care is provided by non-psychiatric providers, and unfortunately, bias toward patients with mental health conditions leads to worsened outcomes. The authors endeavored to determine if pre-clinical medical student psychiatry education had an impact on these perceptions. METHODS: All 366 first-year medical students at Indiana University were invited to participate in a survey that consisted of the Mental Illness: Clinician's Attitudes version 2 (MICA-2) and six supplemental questions, pre- and post-course. RESULTS: One hundred seventeen students completed both surveys. The pre- and post-course means were 36.6 and 33.6, a change of - 2.9 (paired t-test p-value < 0.001), indicating a reduction in bias. CONCLUSIONS: These results suggest that pre-clinical education can lead to a measurable decrease in bias in medical students early in training. Unfortunately, individual question results and free responses continue to highlight significant bias in US medical students against mental illness and the field of psychiatry. Health care educators should be aware of these biases and their potential impact on patient outcomes so that these harmful perceptions can be targeted.

Examining the relation between oral contraceptive use and attentional engagement in everyday life.

Oral contraceptives (OCs) used by women worldwide include artificial estradiol and progesterone, which can attach to receptors in the brain and potentially influence cognition. In the present studies, we examined the relation between OC use and self-reported everyday attention. We collected trait-level measures of mind wandering, attention-related errors, and attention lapses in undergraduate women using OCs (Study 1: OC group N = 471, Study 2: OC group N = 246) and naturally cycling women not using any form of hormonal contraceptives (Study 1: Non-OC group N = 1,330, Study 2: Non-OC group N = 929). In Study 1, we found that women using OCs reported significantly less spontaneous and deliberate mind wandering than naturally cycling women and no differences between groups on attention-related errors and attention lapses. In Study 2, our findings indicated no significant differences between groups on any of our attention measures. Regression analyses controlling for depression symptoms and semester of data collection found that OC use did predict unique additional variance on some attention measures, but these effects were small and unreliable across the two studies. Taken together, our data suggests there is little evidence that OC use is related to differences in attentional engagement in everyday life.

The relation between trait flow and engagement, understanding, and grades in undergraduate lectures.

BACKGROUND: Much work has focused on inattention in the classroom, examining how episodes of task-unrelated thought (i.e., mind wandering) and engagement with various forms of media (e.g., media multitasking, smartphone use) influence retention of lecture material. However, considerably less work has examined factors that may positively influence attentiveness in lectures. AIMS: We aimed to explore whether the trait-level tendency to experience 'flow'-defined here as the subjective experience of deep and effortless concentration-is related to in-class reports of engagement and understanding during undergraduate lectures, as well as academic performance. SAMPLE: Participants were undergraduate students in Psychology at a University in Ontario, Canada. METHODS: We measured trait flow (i.e., deep, effortless concentration) at the beginning of each semester, and assessed engagement and understanding during lectures via experience sampling probes throughout two semesters in several university courses. Experience sampling probes were presented intermittently using a laptop application. We also measured students' trait mind wandering and grit, and collected students' course grades. RESULTS: The general tendency to experience deep, effortless concentration predicted engagement and understanding in lectures throughout the term, as well as final course grades, over and above students' grittiness and tendency to mind wander. CONCLUSIONS: These findings suggest that the everyday tendency to experience flow extends to a classroom environment and has implications for academic success.

Catatonia: A Narrative Review for Hospitalists.

Background: Catatonia is a complex psychomotor syndrome commonly associated with psychiatric disorders. However, hospitalists encounter this condition on medical floors, where it is typically due to an underlying medical, especially neurological, etiology. Delays in the diagnosis of catatonia are common and lead to worsened outcomes for patients, including a multitude of medical complications, such as venous thromboembolism and stasis ulcers. Catatonia due to a medical condition is less likely to respond to benzodiazepine therapy; identification and treatment of the underlying cause is crucial. Methods: This article provides a practical review of the catatonia literature, with a focus on diagnosis, workup, and management of catatonia for patients admitted to medical hospitals. Conclusions: With greater knowledge about catatonia, internists are uniquely positioned to recognize and initiate treatment.

On the relation between mind wandering, PTSD symptomology, and self-control.

Here we examined the association between mind wandering, post-traumatic stress disorder (PTSD) symptomology, and self-control. In a large undergraduate sample (N = 5,387), we assessed trait-levels of spontaneous and deliberate mind wandering, self-control, and PTSD symptomology. Results indicated that, while PTSD symptomology was uniquely positively associated with spontaneous mind wandering, it was negatively associated with deliberate mind wandering and self-control. These findings suggest that the mechanism(s) underlying everyday mind wandering may also underlie PTSD symptomology and traumatic intrusions. Moreover, the unique negative association between PTSD symptomatology and self-control suggests that PTSD is characterized not only by impairments in inhibiting unwanted thoughts (as indexed by mind wandering), but also by impairments in inhibiting other unwanted behaviors.

Re-examining the effect of motivation on intentional and unintentional task-unrelated thought: accounting for thought constraint produces novel results.

It has been proposed that motivating participants to perform well on a cognitive task ought to lead to decreases in rates of intentional, but not unintentional, task-unrelated thought (TUT; a commonly studied variety of mind wandering). However, at odds with this prediction, research has found that increasing motivation results in decreases in both intentional and unintentional TUTs. One possible explanation for this surprising finding is that standard assessments of TUT may inadvertently conflate TUTs with another variety of mind wandering: unconstrained thought. If so, then deconfounding task-unrelated and unconstrained varieties of mind wandering might produce the predicted effect of a decrease in intentional, but not unintentional, TUT when motivation is increased. To explore this possibility, in the present study, participants completed a sustained-attention task after receiving standard instructions (normal-motivation condition) or instructions informing them that they could leave the study early if they achieved a certain level of performance (motivated condition). Throughout the task, we assessed rates of TUT (both intentional and unintentional) and unconstrained thoughts. Consistent with prior work, the results indicated that motivated participants reported being on-task significantly more frequently than non-motivated participants. However, unlike previous work, we found that when deconfounding TUTs and unconstrained thoughts, participants in the motivation condition reported significantly fewer bouts of intentional TUT than those in the non-motivation condition, but no differences in rates of unintentional TUT were observed between groups. These results suggest that (a) motivation specifically targets intentional TUT and (b) standard assessments of TUT conflate task-relatedness and thought constraint.

Attention spreads between students in a learning environment.

We propose a novel phenomenon, attention contagion, defined as the spread of attentive (or inattentive) states among members of a group. We examined attention contagion in a learning environment in which pairs of undergraduate students watched a lecture video. Each pair consisted of a participant and a confederate trained to exhibit attentive behaviors (e.g., leaning forward) or inattentive behaviors (e.g., slouching). In Experiment 1, confederates sat in front of participants and could be seen. Relative to participants who watched the lecture with an inattentive confederate, participants with an attentive confederate: (a) self-reported higher levels of attentiveness, (b) behaved more attentively (e.g., took more notes), and (c) had better memory for lecture content. In Experiment 2, confederates sat behind participants. Despite confederates not being visible, participants were still aware of whether confederates were acting attentively or inattentively, and participants were still susceptible to attention contagion. Our findings suggest that distraction is one factor that contributes to the spread of inattentiveness (Experiment 1), but this phenomenon apparently can still occur in the absence of distraction (Experiment 2). We propose an account of how (in)attentiveness spreads across students and discuss practical implications regarding how learning is affected in the classroom. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The relation between task-unrelated media multitasking and task-related motivation.

In two experiments, we explored the relation between participants' (a) levels of motivation to complete a task and (b) task-unrelated media multitasking. In Experiment 1, we examined the extent to which participants' levels of motivation to complete a task influenced their tendency to engage in task-unrelated media multitasking. Participants completed a 1-back task, while having the opportunity to turn on and off an unrelated, optional video. Results showed that participants who were told they would finish the experiment early if they achieved a sufficient level of performance (the motivated group) were significantly less likely to play the optional video during the 1-back task than those who were not given the opportunity to finish early (control condition). In Experiment 2, we examined the extent to which engaging in task-unrelated media multitasking affected task-related motivation. Three groups of participants completed a 1-back task, while (a) no video was presented, (b) a video was continuously played, or (c) participants could turn on and off a video at their leisure (as in Experiment 1). At both the beginning and the end of Experiment 2, participants were asked to indicate their level of motivation to complete the task. Interestingly, results revealed that continuously having the video playing helped sustain task-related motivation. Thus, although greater motivation to perform a task reduces the likelihood of engaging in task-unrelated media multitasking, such media multitasking also appears to increase levels of motivation.

Yearning for distraction: Evidence for a trade-off between media multitasking and mind wandering.

We examined whether providing participants with the opportunity to media multitask influenced their tendency to be 'off-task.' More specifically, we were interested in whether providing participants with the opportunity to engage with an external media stream during a required (researcher-imposed) cognitive task might lead to a trade-off between mind wandering and engagement with external distractions (such as the media). We also examined the extent to which intentionality plays a role in these associations. Participants completed 2 phases of a cognitive task (1-back). During 1 phase, participants were provided the opportunity to concurrently watch a video while they performed the cognitive task; during the other, no such opportunity was provided. Throughout both phases, thought probes asked participants if they were (a) focused on the task, (b) attending to external distractions, or (c) mind wandering. If options 2 or 3 were selected, participants were further asked to report whether these forms of distraction were engaged intentionally or unintentionally. Our findings indicated that, although the opportunity to media multitask increased overall reports of being off-task, the tendency to mind-wander was significantly reduced in favour of attending to external distractions (such as the video). Of interest to the authors, overall reports of being unintentionally off-task were equivalent, irrespective of whether participants had the opportunity to media multitask or not, which suggests that the increased tendency to have an off-task locus of attention was because of intentionally shifting attention away from the primary task. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Loading loading The influence of download time on information search.

When browsing online, there is considerable variation in the amount of time that one has to wait for content to appear once the link to that content has been activated (i.e., clicked). In two experiments we examined how 'download time'-a potential barrier to information access-influences search behaviour. In both experiments, participants completed a video-watching task in which they were presented with a screen containing six clickable icons, each of which represented a unique video. When participants clicked an icon, a video would begin to load and then play. The participants' task was to gain as much information from the videos as possible for a later memory test. Critically, however, the 'download time' (i.e., the time between the click on the icon and the video beginning to play) of the available videos in a given search session varied. In Experiment 1, these download times were 0 (instant), 2, or 30 seconds, and in Experiment 2, they were 5, 15, or 30 seconds. In general, we found that participants terminated and avoided videos with longer download times than videos with shorter download times. Interestingly, this effect was attenuated when the experienced download times were more similar to each other (Experiment 2) than when they were more different from each other (Experiment 1).