Introduction
During the COVID 19 epidemic, the isolation helped virtual psychoterapy sessions, not to break up therapeutic relationship in critical moments.
Objectives
This paper points out the ...traditional setting modification and how the interpersonal relationship can affect the therapeutic dynamics.
Methods
The experience could support the possibility to design adequate plans to test possible relational potentiality/prospect to respond to the pandemic emergency. The computer screen represents a very important new and rich element as “Skype” seems to have been the most used remote support. The screen plays a filter and separation function but physically represents the related presence in a shared timeframe. It is also a “mutual mirror”, reflecting the exclusive duality and resending to “different” space and time where the therapeutic relationship acts.
Results
In this way the “analysis room” loses its physical feature to move towards a new dimension where the subjective experience are communicated/lived/re-elaborated by the mean of shared visual, modifyng the codified space of a traditional setting.
Conclusions
The screen is not only a mere vehicle of verbal communication, but fully gets in “hic et nunc” in space relationship assuming however an allegoric value, that, in the individual subjective, could go really beyond its “simple” and usual technological function.
Introduction
During COVID 19 epidemic it has been interesting to observe the gradual transformation of the daily routine into death, sorrow and pain. The moment of transition from life to death was ...really changed by distressing for survivors who had to face with unexpected ways to live their mourning.
Objectives
The paper would like to analyze the mounring ritual during COVID 19 epidemic.
Methods
During COVID 19 tragedy victims and survivors have been first associated by the infection and then dramatically separated by its effects. It has been necessary to re-relaborate new procedures of separation from deceased, as far for laws prohibitions it was no longer possible to use the traditional ones.
Results
So a leaving “ritual” re-emerged very similar to the “crying ritual” of the Southern Italy folkloric culture. The traditional wailers have been substitued by the windows flash mobs trying to replace the forced absence of “pietas”, with a moment of positive sharing of physical distance between life and death, using sounds, songs, tools that always, in farming culture help to exorcise and take away death.
Conclusions
The relevant starting powerlessness to face the fast disease diffusion, its intrinsic seriousness, inspired surprising capabilities of immediate reaction and active mobilization in response to the attack suffered by Koerper and Leib (in Heidegger sense) which actualized in the research of a new “separation” dimension. In the end, as psychiatrists, we have to notice how this collectivization practice is actually a big distress container and wonder where and how this distress will finally arrive
IntroductionIn the framework of the EU-Erasmus+, the European Alliance for Sport and Mental Health (EASMH) project has been funded, aiming to promote the improvement of good clinical practice for ...sport-based psychosocial interventions throughout Europe. A specific training programme tailoring professional sport coaches has been developed in order to improve their skills in engaging and involving patients with severe mental disorders in sport-based rehabilitation activities.Objectivesto evaluate the perceived quality and utility of the EASMH training programme by sport coaches from different European countries (including Italy, UK, Romania, and Finland).MethodsAs part of the EASMH project, the University of Campania “L. Vanvitelli” has coordinated the development of training materials for professional sport coaches. The training programme has been tested in a pilot training programme. An ad-hoc questionnaire has been developed and administered at the end of the training, during a meeting held in Brussels in July 2022.ResultsThe EASMH training programme consists of six modules, dealing with the following topics: definition of mental health/mental disorders; classification systems; essential clinical features of severe mental disorders; personal and social burden associated with severe mental disorders; how to build a therapeutic relationship with a patient with severe mental disorders; verbal and non-verbal communication; evaluation of patient’s preference in selecting sport activities; definition of a personalized plan; motivational interview/problem-solving strategy. A total of eight professional coaches involved in different sport coming from Italy, Romania, United Kingdom and Finland participated in the entire training, consisting of six 4hr training modules. Seven out the eight coaches compiled the questionnaire. The overall feedback has been extremely positive. Overall, coaches have judged the modules as very clear, useful and of high standing. Each question has been rated with an average of 4.35 related to the overall content.ConclusionsThe present survey confirms that a short online training programme focused on professional sport coaches is well received by participants and can provide them with useful information on how to engage patients with severe mental disorders. The next step of the EASMH project foresees the implementation of several local pilot actions with the active involvement of patients with severe mental disorders.Disclosure of InterestNone Declared
Introduction
Among psychosocial interventions, recent studies have highlighted that sport-based interventions can positively impact on the long-term outcomes of patients with severe mental disorders, ...in terms of improving their quality of life and promoting social inclusion. Although sport-based interventions should be considered an effective strategy for promoting patients’ recovery, few data are available on their dissemination in the clinical routine care in Europe.
Objectives
to evaluate the availability of sport-based psychosocial interventions in European countries.
Methods
In the framework of the EU-Erasmus+, the European Alliance for Sport and Mental Health (EASMH) project has been funded. In order to evaluate the availability of sport-based interventions, an ad-hoc online survey, sent to national mental health centres, has been developed.
Results
103 responses were obtained (49 from Italy, 31 from UK, 17 from Finland and 12 from Romania). The respondents were mainly psychiatrists working in community mental health centers. Sport-based interventions were frequently provided by mental health services, in particular in Italy, UK and Finland. While in UK and Finland sport-based interventions are commonly offered to all patients, in the other countries these are provided only by patient’s request. The most frequent types of sport practised were: running, football, volleyball, tennis and table tennis and basketball. Almost all respondents reported to not use a dedicated monitoring tool for evaluating the efficacy of those interventions.
Conclusions
Sport-based interventions are not frequently provided in the routine clinical settings, although no monitoring tools are routinely adopted. The EASMHaims to fill this gap by disseminating good clinical practice related to sport-based interventions.
Disclosure
No significant relationships.
Introduction
Anorexia is a disorder associated with severe disturbances in eating behaviors and related thoughts and emotions (distorted weight perception, body dissatisfaction). Multidimensional ...integrative treatment approaches are needed to act both on intrapersonal (e.g. nutritional and psychological) and interpersonal (e.g. behavioral and affective) processes.
Objectives
Aim of this pilot project was to develop a 3-months horse-assisted intervention based on Equestrian Vaulting (EV) and tests its suitability and acceptability in patients with anorexia nervosa. Preliminary observations were carried out to assess the effectiveness of this program on body image, interpersonal relationships and communication and in managing anxiety.
Methods
Seven patients in charge of public service specialized in eating disorder participated in the study. EV activities were performed in an Equestrian Centre included horse grooming, gym exercises and horseback sessions.Clinical and psychological tests (SF 36, IPAQ, EDI3, STAI, SCL90) were administered at baseline and at the end of the program.
Results
Increases in body fat and decreases in lean muscle mass were observed. These were accompained by an improvement in participants’ anxiety and relational skills and in the specific disease related symptoms.
Conclusions
Results indicate the potential of EV to help patients with eating disorder regaining awareness of themselves and their body, a critical element for their future reintegration in the contexts of everyday life and society. Although this is a pilot, the protocol developed represents an initial step to promote the application of EV in persons with eating disorders, informing feasibility in the design of larger controlled studies and suggesting critical variables to be targeted.
Within-person variability in cognitive performance has emerged as a promising indicator of cognitive health with potential to distinguish normative and pathological cognitive aging. We use a ...smartphone-based digital health approach with ecological momentary assessments (EMA) to examine differences in variability in performance among older adults with mild cognitive impairment (MCI) and those who were cognitively unimpaired (CU).
A sample of 311 systematically recruited, community-dwelling older adults from the Einstein Aging Study (Mean age = 77.46 years, SD = 4.86, Range = 70-90; 67% Female; 45% Non-Hispanic White, 40% Non-Hispanic Black) completed neuropsychological testing, neurological assessments, and self-reported questionnaires. One hundred individuals met Jak/Bondi criteria for MCI. All participants performed mobile cognitive tests of processing speed, visual short-term memory binding, and spatial working memory on a smartphone device up to six times daily for 16 days, yielding up to 96 assessments per person. We employed heterogeneous variance multilevel models using log-linear prediction of residual variance to simultaneously assess cognitive status differences in mean performance, within-day variability, and day-to-day variability. We further tested whether these differences were robust to the influence of environmental contexts under which assessments were performed.
Individuals with MCI exhibited greater within-day variability than those who were CU on ambulatory assessments that measure processing speed (
< 0.001) and visual short-term memory binding (
< 0.001) performance but not spatial working memory. Cognitive status differences in day-to-day variability were present only for the measure of processing speed. Associations between cognitive status and within-day variability in performance were robust to adjustment for sociodemographic and contextual variables.
Our smartphone-based digital health approach facilitates the ambulatory assessment of cognitive performance in older adults and the capacity to differentiate individuals with MCI from those who were CU. Results suggest variability in mobile cognitive performance is sensitive to MCI and exhibits dissociative patterns by timescale and cognitive domain. Variability in processing speed and visual short-term memory binding performance may provide specific detection of MCI. The 16-day smartphone-based EMA measurement burst offers novel opportunity to leverage digital technology to measure performance variability across frequent assessments for studying cognitive health and identifying early clinical manifestations of cognitive impairment.
Despite the potential of mobile health (mHealth) to address high rates of depression and anxiety in underserved rural communities, most mHealth interventions do not explicitly consider the realities ...of rural life. The aim of this scoping review is to identify and examine the available literature on mHealth interventions that consider the needs of rural populations in order to gauge their feasibility and utility for addressing depression and anxiety. Additionally, we provide an overview of rural users' perceptions about and preferences for mHealth-delivered mental health screening and intervention systems. Out of 169 articles identified, 16 met inclusion criteria. Studies were conducted across a wide range of countries, age groups, and rural subpopulations including individuals with bipolar disorder, anxiety, perinatal depression, PTSD, and chronic pain, as well as refugees, veterans, and transgender and LGBTQ+ individuals. All interventions were in the feasibility/acceptability testing stage for rural users. Identified strengths included their simplicity, accessibility, convenience, availability of support between sessions with providers, and remote access to a care team. Weaknesses included problems with charging phone batteries and exceeding data limits, privacy concerns, and general lack of comfort with app-based support. Based upon this review, we provide recommendations for future mHealth intervention development including the value of developer-user coproduction methods, the need to consider user variation in access to and comfort with smartphones, and potential data or connectivity limitations, mental health stigma, and confidentiality concerns in rural communities.
The development of mobile technology with substantial computing power (ie, smartphones) has enabled the adaptation of performance-based cognitive assessments to remote administration and novel ...intensive longitudinal study designs (eg, measurement burst designs). Although an "ambulatory" cognitive assessment paradigm may provide new research opportunities, the adaptation of conventional measures to a mobile format conducive to intensive repeated measurement involves balancing measurement precision, administration time, and procedural consistency.
Across 3 studies, we adapted "complex span" tests of working memory capacity (WMC) for ultra-brief, smartphone-based administration and examined their reliability, sufficiency, and associations with full-length, laboratory-based computerized administrations.
In a laboratory-based setting, study 1 examined associations between ultra-brief smartphone adaptations of the operation span, symmetry span, and rotation span tasks and full-length computerized versions. In study 2, we conducted a 4-day ecological momentary assessment (EMA) study (4 assessments per day), where we examined the reliability of ultra-brief, ambulatory administrations of each task. In study 3, we conducted a 7-day EMA study (5 assessments per day) involving the ultra-brief rotation span task, where we examined reliability in the absence of extensive onboarding and training.
Measurement models in study 1 suggest that comparable estimates of latent WMC can be recovered from ultra-brief complex span task performance on smartphones. Significant correlations between the ultra-brief tasks and respective full-length versions were observed in study 1 and 2, ranging from r=0.4 to r=0.57. Results of study 2 and study 3 suggest that reliable between-person estimates of operation span, symmetry span, rotation span, and latent WMC can be obtained in 2-3 ultra-brief administrations (equivalent to <1 day of testing in an EMA study design). The results of study 3 replicated our findings, showing that reliable between-person estimates of rotation span may be obtained in as few as 2 ultra-brief administrations in the absence of extensive onboarding and training. In addition, the modification of task parameterization for study 3 improved the estimates of reliability of within-person change.
Ultra-brief administration of complex span tasks on smartphones in a measurement burst design can generate highly reliable cross-sectional estimates of WMC. Considerations for future mobile cognitive assessment designs and parameterizations are discussed.
The present study examines change in reports of daily, weekly, and monthly psychological distress over 20 years, and of negative and positive affect over 10 years, using data from the Midlife in the ...United States study. The study includes three waves of data collection on adults ranging from 22 to 95 years old. Cross-sectional findings reveal that older age is related to lower levels of psychological distress and negative affect and to higher levels of positive affect across each successive age group. Yet, longitudinal findings vary across younger, middle-aged, and older adults. Psychological distress decreases over time among younger adults (although only until age 33 for weekly reports), remains stable in midlife, and is stable (monthly) or slightly increases (daily and weekly) among older adults. For negative affect, levels decrease over time for younger and middle-aged adults, and only increase for the oldest adults for daily and monthly affect. Positive affect is stable over time among younger adults, but decreases in midlife starting in the mid-fifties. In conclusion, overall patterns of findings suggest that being old (assessed cross-sectionally) is related to higher levels of emotional well-being. Growing old (assessed longitudinally) is related to improvements in emotional well-being across younger and early middle adulthood, which mirrors cross-sectional findings. There is relative stability in later midlife, however, and continued stability or slight declines across older age.
: Increased intraindividual variability (IIV) in function has been linked to various age-related outcomes including cognitive decline and dementia. Most studies have operationalized IIV as ...fluctuations across trials (e.g., response latencies) for a single task, with comparatively few studies examining variability across multiple tasks for a given individual. In the present study, we derive a multivariable operationalization of dispersion across a broad profile of neuropsychological measures and use this index along with degree of engaged lifestyle to predict risk of cognitive impairment.
: Participants (
= 60) were community-dwelling older adults aged 65+ years (M = 74.1, SD = 6.5) participating in a cross-sectional investigation of risk factors for amnestic mild cognitive impairment (a-MCI) and probable Alzheimer's Disease (AD). Participants were classified into three subgroups based on test performance and clinical judgement. Healthy controls (
= 30) scored better than -1 SD relative to existing norms on all classification measures, in the absence of memory complaints or functional impairments. The a-MCI group (
= 23) had self- or informant-reported memory complaints and scored 1 SD or more below the mean for at least one memory task while scoring better than 1 SD below the mean for all other cognitive domains, in the absence of functional impairments. The AD group (
= 7) scored at least 2 SD below the mean for two cognitive domains (including memory) with impairments in functioning. Measures spanned a range of cognitive domains (episodic memory, executive function, language), with the derived dispersion estimates reflecting variability across an individual's neuropsychological profile relative to the group average. Further, an Activities Lifestyle Questionnaire, indexing social, cognitive, and physical behaviors, was administered to assess the protective benefits of engaged lifestyle.
: Multinomial logistic regression models examined the risk of being classified as a-MCI or AD as a function of increased dispersion, (dis)engaged lifestyle, and their interaction. Greater dispersion was associated with an increased likelihood of being classified with AD, with protective engaged-lifestyle benefits apparent for a-MCI individuals only.
: As a measure of IIV, dispersion across neuropsychological profiles holds promise for the detection of cognitive impairment.
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