The impact of COVID-19 on home,social, and productivity integration of people with chronic traumatic brain injury or stroke living in the community

Compare community integration of people with stroke or traumatic brain injury (TBI) living in the community before and during the coronavirus severe acute respiratory syndrome coronavirus 2 disease (COVID-19) when stratifying by injury: participants with stroke (G1) and with TBI (G2); by functional independence in activities of daily living: independent (G3) and dependent (G4); by age: participants younger than 54 (G5) and older than 54 (G6); and by gender: female (G7) and male (G8) participants.Prospective observational cohort studyIn-person follow-up visits (before COVID-19 outbreak) to a rehabilitation hospital in Spain and on-line during COVID-19.Community dwelling adults (≥18 years) with chronic stroke or TBI.Community integration questionnaire (CIQ) the total-CIQ as well as the subscale domains (ie, home-CIQ, social-CIQ, productivity CIQ) were compared before and during COVID-19 using the Wilcoxon ranked test or paired t test when appropriate reporting Cohen effect sizes (d). The functional independence measure was used to assess functional independence in activities of daily living.Two hundred four participants, 51.4% with stroke and 48.6% with TBI assessed on-line between June 2020 and April 2021 were compared to their own in-person assessments performed before COVID-19.When analyzing total-CIQ, G1 (d = −0.231), G2 (d = −0.240), G3 (d = −0.285), G5 (d = −0.276), G6 (d = −0.199), G7 (d = −0.245), and G8 (d = −0.210) significantly decreased their scores during COVID-19, meanwhile G4 was the only group with no significant differences before and during COVID-19.In productivity-CIQ, G1 (d = −0.197), G4 (d = −0.215), G6 (d = −0.300), and G8 (d = −0.210) significantly increased their scores, meanwhile no significant differences were observed in G2, G3, G5, and G7.In social-CIQ, all groups significantly decreased their scores: G1 (d = −0.348), G2 (d = −0.372), G3 (d = −0.437), G4 (d = −0.253), G5 (d = −0.394), G6 (d = −0.319), G7 (d = −0.355), and G8 (d = −0.365).In home-CIQ only G6 (d = −0.229) significantly decreased, no significant differences were observed in any of the other groups.The largest effect sizes were observed in total-CIQ for G3, in productivity-CIQ for G6, in social-CIQ for G3 and in home-CIQ for G6 (medium effect sizes).Stratifying participants by injury, functionality, age or gender allowed identifying specific CIQ subtotals where remote support may be provided addressing them.     

Treatment of Trauma- and Abuse-Related Dissociative Symptom Disorders in Children and Adolescents

TOPIC:  Dissociation is believed to be one of the most common underlying psychological processes among children and adolescents receiving mental health treatment, but most of the dissemination of information about dissociation has occurred among psychiatrists and psychologists.
PURPOSE:  Modes of treatment for dissociation as it affects children and adolescents are described.
SOURCES USED:  Current research and practice scholarly articles on treatment of children and adolescents for dissociation and dissociative symptom disorders were accessed and critically reviewed.
CONCLUSIONS:  Prognosis in children and adolescents can vary widely among patients and between the specific types of dissociation disorder; however, expert clinicians and researchers agree that early, intense treatment offers the greatest possibility of full recovery.     

Coordination of fingertip forces during precision grip in premanifest Huntington's disease

Precision grip control is important for accurate object manipulation and requires coordination between horizontal (grip) and vertical (load) fingertip forces. Manifest Huntington's disease (HD) subjects demonstrate excessive and highly variable grip force and delayed coordination between grip and load forces. Because the onset of these impairments is unknown, we examined precision grip control in premanifest HD (pre‐HD) subjects. Fifteen pre‐HD and 15 age‐ and sex‐matched controls performed the precision grip task in a seated position. Subjects grasped and lifted an object instrumented with a force transducer that measured horizontal grip and vertical load forces. Outcomes were preload time, loading time, maximum grip force, mean static grip force, and variability for all measures. We compared outcomes across groups and correlated grip measures with the Unified Huntington's Disease Rating Scale and predicted age of onset. Variability of maximum grip force (P < .0001) and variability of static grip force (P < .00001) were higher for pre‐HD subjects. Preload time (P < .007) and variability of preload time (P < .006) were higher in pre‐HD subjects. No differences were seen in loading time across groups. Variability of static grip force (r² = 0.23) and variability of preload time (r² = 0.59) increased with predicted onset and were correlated with tests of cognitive function. Our results indicate that pre‐HD patients have poor regulation of the transition between reach and grasp and higher variability in force application and temporal coordination during the precision grip task. Force and temporal variability may be good markers of disease severity because they were correlated with predicted onset of disease. © 2011 Movement Disorder Society     

Trait anger,anger expression,stress, and health status of American and Turkish midlife women

In a cross‐cultural study, we investigated the relationships of trait anger, anger expression modes, and stress to physical and mental health in Turkish and American midlife women. Zero‐order correlations and multiple regression analyses indicated that regardless of cultural origin, stress was a strong predictor of health status. Stress was negatively related to physical health and positively related to depression. Trait anger, the angry temperament dimension of trait anger, and anger‐out were positively related to depression in both American and Turkish women. The negative relationship between somatic mode of anger expression and health was also consistent for both groups. However, anger‐in was positively correlated with depression only in American women; suppression of anger was unrelated to health status in Turkish women. Cross‐cultural comparisons indicated that Turkish midlife women were higher in trait anger, somatic anger symptoms, perceived stress, and depression than American women. American women, on the other hand, had higher scores on physical health status. These findings are discussed with regard to theory, previous research, and sociocultural context.     

Do persons with schizophrenia who have better metacognitive capacity also have a stronger subjective experience of recovery?

Research suggests that persons with schizophrenia experience deficits in the ability to synthesize complex and integrated representations of themselves and others. While impairments in these metacognitive capacities are hypothetically related to the ability to make sense of the challenges of schizophrenia, little is known about their relationship with the subjective experience of recovery from mental illness. To examine this question, this study investigated whether persons with stronger self-reported recovery had better metacognitive capacity, after controlling for severity of psychiatric symptoms. Forty-six outpatients with schizophrenia spectrum disorders who were taking part in a study of the Illness Management and Recovery program were concurrently administered the Recovery Assessment Scale, the Positive and Negative Syndrome Scale, and the Indiana Psychiatric Illness Interview which was scored using the Abbreviated Metacognitive Assessment Scale. Analysis of covariance revealed that metacognitive capabilities reflecting self-reflectivity and decentration were differentially related to several components of recovery beyond the effects of psychiatric symptoms. The metacognitive abilities to think about oneself in a sophisticated way and form integrated ideas about oneself and others within the larger world, understanding that none are the metaphorical center are present in individuals holding strong perceptions of recovery.     

Depressive Illness in Teens and Preteens and Effectiveness of the RADS-2 as a First-Stage Assessment. Part 1: Descriptive Paper

PROBLEM:  Measurement of the characteristics and severity of depression in adolescence is an emerging science. During patient assessment, or if using first-stage screening measures in practice, nurses must be confident that these instruments demonstrate high levels of accuracy in capturing the specific features of depressive symptoms expressed in diverse individuals.
METHODS:  A review of the scientific literature of depressive illness and its assessment in teens and preteens is presented. The Reynolds Adolescent Depression Scale–Revised (RADS-2) measure is introduced and evaluated from a nursing practice standpoint.
FINDINGS:  The RADS-2 is easy to use and demonstrates good reliability, validity, and construct features, providing evidence for nurses that the measure can be used with confidence in assessment of depressive symptoms in adolescents.
CONCLUSIONS:  The RADS-2 is an effective first-stage assessment of depressive mood in teens and preteens.