The current study examined whether youth perceptions of school racial messages that acknowledged the reality of racism (critical consciousness CC messages) or denied racism (color‐blind messages) ...predicted youth anti‐racism action through interpersonal and communal/political means. We further tested whether youths’ critical reflection of perceived inequality and anger toward social injustice—psychological aspects of CC development—mediated relations between school messages and youth actions. These questions were explored using structural equation modeling with 372 racially/ethnically diverse adolescents (Mage = 17.00; standard deviation = 1.29; female = 51.0%). Results indicated that youth perceptions of CC messages predicted their involvement in both interpersonal and communal/political anti‐racism action. Youths’ anger toward social injustice mediated links between school racial messages and anti‐racism action, albeit in unique ways. These findings underscore the power of schools in prompting youth anti‐racism action. Implications of the importance of partnerships between schools and youth community organizing groups to stimulate youth anti‐racism action were discussed.
In this manuscript, we explore the promise and challenges of youth participatory action research (YPAR), paying particular attention to ethical issues and power dynamics that emerge in the context of ...research partnerships between youth and adults. We begin by reviewing the key tenets of YPAR and then go on to discuss how these tenets are often at odds with dominant approaches to research. We describe the tension between the values of YPAR and the systems and structures embedded in the academy. Further, we elucidate how adultism and the capitalist nature of the academy intersect with white supremacy culture, posing significant barriers to meaningful youth participation in community research partnerships. We then describe ways in which participatory scholars can disrupt these systems as well as larger paradigm shifts in the culture of academia that will be required to elevate youth voices and to amplify their efforts for equity.
Highlights
A recent surge in youth activism may provide opportunities for youth‐focused scholars to engage.
Youth Participatory Action Research (YPAR) may be a useful vehicle for amplifying youth voice.
Adultism and incompatible structures in academia pose barriers to youth engagement in research.
An emphasis on systems‐level change will be necessary to move YPAR forward.
Objective
First Episode Rapid Early Intervention for Eating Disorders (FREED) is a service model and care pathway which aims to provide timely, well‐coordinated, developmentally informed and ...evidence‐based care for young people with eating disorders (EDs). This article investigates the impact of the COVID‐19 pandemic on FREED patient presentations and service provision in England.
Method
Data from three services spanning the pre‐ to post‐pandemic period were included (January 2019–September 2021; n = 502 patients). Run charts were created to analyze changes in monthly baseline patient data (e.g., referral numbers, duration of an untreated ED, diagnostic mix, and average body mass index for patients with anorexia nervosa AN).
Results
Significant increases in referral numbers were found from September 2020 onward, coinciding with the end of the first UK national lockdown. The percentage of AN presentations significantly increased after the onset of the first national lockdown (April 2020–December 2020). No other significant change patterns were identified.
Discussion
There have been substantial increases in referral numbers and presentations of AN to FREED services whereas illness severity seems largely unchanged. Together, this suggests that increased referrals cannot be attributed to milder presentations being seen. Implications for the implementation, funding, and sustainability of the model are discussed.
Public Significance
Our research suggests that early intervention eating disorder services across England faced significant increases in patient referrals and presentations of anorexia nervosa over the COVID‐19 pandemic. This increase in referrals is not due to a rise in milder eating disorder cases, as baseline symptom severity remained stable across the pandemic. Investment in early intervention for eating disorders must therefore match increased referral trends.
Deficits in visual statistical learning and predictive processing could in principle explain the key characteristics of inattention and distractibility in attention deficit hyperactivity disorder ...(ADHD). Specifically, from a Bayesian perspective, ADHD may be associated with flatter likelihoods (increased sensory processing noise), and/or difficulties in generating or using predictions. To our knowledge, such hypotheses have never been directly tested.
We here test these hypotheses by evaluating whether adults diagnosed with ADHD (n = 17) differed from a control group (n = 30) in implicitly learning and using low-level perceptual priors to guide sensory processing. We used a visual statistical learning task in which participants had to estimate the direction of a cloud of coherently moving dots. Unbeknown to the participants, two of the directions were more frequently presented than the others, creating an implicit bias (prior) towards those directions. This task had previously revealed differences in other neurodevelopmental disorders, such as autistic spectrum disorder and schizophrenia.
We found that both groups acquired the prior expectation for the most frequent directions and that these expectations substantially influenced task performance. Overall, there were no group differences in how much the priors influenced performance. However, subtle group differences were found in the influence of the prior over time.
Our findings suggest that the symptoms of inattention and hyperactivity in ADHD do not stem from broad difficulties in developing and/or using low-level perceptual priors.
Sociopolitical development (SPD) is the process by which individuals become aware of social inequality, recognize the status of their social identities, and engage in activism. For racially ...marginalized youth, race is an important aspect of their SPD. Yet few studies have considered the connections between racial factors and youth's SPD. In this article, we introduce an integrative model situating racial sociocultural processes (i.e., racial identity, racial socialization, and experiences of racial discrimination) within current SPD theory. In particular, we look at African American youth as a case study to discuss how sociocultural factors can contribute to youth's awareness of structures of social inequality (i.e., critical social analysis) and engagement in action against social inequality (i.e., sociopolitical action). We conclude with suggestions for research.
Eating disorders (EDs) during the transition to adulthood can derail social, psychological, and vocational development. Effective treatment is of paramount importance, yet young adults' treatment ...needs are typically less well met than those of adolescents. In recent years, there has been a considerable shift in how developmental psychologists understand the transition to adulthood, with this life-phase reconceptualized as "emerging adulthood" (EA) (~18-25 years). Engagement with burgeoning developmental research is likely key to providing more effective care for young people experiencing EDs.
To review ED research which has utilized the concept of EA, and to assess the usefulness of this concept for ED research and practice.
A systematic scoping review was conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. Three databases (Psychinfo, PubMed, Embase) were searched for papers which explicitly focused on EDs during EA. No restrictions as to publication type, language, study design, or participants were applied. Included studies were assessed for developmental "informedness," and findings were qualitatively synthesized.
Thirty-six studies (
= 25,475) were included in the review. Most studies used quantitative methodologies, were cross-sectional in design and focused on identifying psychological and social factors which contribute to etiology of EDs. Many studies (
= 22) used well-defined samples of emerging adults (EAs); few studies (
= 8) included developmental measures relevant to EAs. Findings indicate that whilst factors implicated in EDs in adolescence and adulthood are relevant to EAs, EA-specific factors (e.g., identity exploration) may also contribute. Conventional ED services and treatments present difficulties for EAs, whilst those adapted to EAs' needs are feasible, acceptable, and more effective than treatment-as-usual. Directions for future research and clinical implications are discussed.
Existing research indicates that the EA concept is relevant for understanding EDs during the transition to adulthood, and ED services should implement adaptations which exploit the opportunities and overcome the challenges of this developmental stage. EA is currently an underused concept in ED research, and future engagement with the developmental literature by both researchers and clinicians may be key to understanding and treating EDs during transition to adulthood.
Prominent theories suggest that symptoms of schizophrenia stem from learning deficiencies resulting in distorted internal models of the world. To test these theories further, we used a visual ...statistical learning task known to induce rapid implicit learning of the stimulus statistics. In this task, participants are presented with a field of coherently moving dots and are asked to report the presented direction of the dots (estimation task), and whether they saw any dots or not (detection task). Two of the directions were more frequently presented than the others. In controls, the implicit acquisition of the stimuli statistics influences their perception in two ways: (i) motion directions are perceived as being more similar to the most frequently presented directions than they really are (estimation biases); and (ii) in the absence of stimuli, participants sometimes report perceiving the most frequently presented directions (a form of hallucinations). Such behaviour is consistent with probabilistic inference, i.e. combining learnt perceptual priors with sensory evidence. We investigated whether patients with chronic, stable, treated schizophrenia (n = 20) differ from controls (n = 23) in the acquisition of the perceptual priors and/or their influence on perception. We found that although patients were slower than controls, they showed comparable acquisition of perceptual priors, approximating the stimulus statistics. This suggests that patients have no statistical learning deficits in our task. This may reflect our patients' relative wellbeing on antipsychotic medication. Intriguingly, however, patients experienced significantly fewer (P = 0.016) hallucinations of the most frequently presented directions than controls when the stimulus was absent or when it was very weak (prior-based lapse estimations). This suggests that prior expectations had less influence on patients' perception than on controls when stimuli were absent or below perceptual threshold.
Abstract
Background
Due to scarce resources and high demand, priority setting in mental health services is necessary and inevitable. To date, no study has examined priority setting in eating disorder ...(ED) services specifically. Here, we evaluate the level of consensus and perceived relative importance of factors used to determine patient prioritisation in ED services, amongst clinicians and individuals with lived experience (LE) of an ED.
Methods
A three round Delphi study and a ranking task were used to determine the level of consensus and importance. Consensus was defined as > 80% agreement or disagreement. Items that reached consensus for agreement were ranked in order of importance from most to least important. Participants were 50 ED clinicians and 60 LE individuals. Participant retention across rounds 2, 3, and 4 were 92%, 85%, and 79%, respectively.
Results
Over three iterative rounds, a total of 87 statements about patient prioritisation were rated on a 5-point Likert-scale of agreement. Twenty-three items reached consensus in the clinician panel and 20 items reached consensus in the LE panel. The pattern of responding was broadly similar across the panels. The three most important items in both panels were medical risk, overall severity, and physical health deteriorating quickly. Clinicians tended to place greater emphasis on physical risk and early intervention whereas the LE panel focused more on mental health and quality of life.
Conclusions
Eating disorder services tend to prioritise patients based upon medical risk and severity, and then by the order in which patients are referred. Our findings align in some respects with what is observed in services, but diverge in others (e.g., prioritising on quality of life), providing important novel insights into clinician and LE opinions on waiting list prioritisation in EDs. More research is warranted to validate these findings using multi-criterion decision techniques and observational methods. We hope these findings provide a foundation for future research and encourage evidence-based conversations around priority setting in ED services.
The following article explores how the curricular adaptation of seminal and contemporary definitions of and approaches to transformative justice frameworks can foster student's critical reflection ...from identity awareness toward critical action informed by collectivist perspectives of social change. Applications in the social work curriculum are presented.
The First Episode Rapid Early Intervention for Eating Disorders (FREED) service has been shown to reduce the wait for care and improve clinical outcomes in initial evaluations. These findings led to ...the national scaling of FREED in England. To support this scaling, we conducted a mixed method evaluation of the perceptions and experiences of clinicians in the early phases of scaling. The Normalisation Process Theory (NPT) was used as a conceptual lens to understand if and how FREED becomes embedded in routine practice.
The convergent mixed method evaluation included 21 semi-structured interviews with clinicians from early adopter sites and 211 surveys administered to clinicians before, immediately after and 3 months after the FREED training. The interview guide and survey included questions evaluating attitudes towards early intervention for eating disorders (EDs) and NPT mechanisms. Interview data were analysed using an inductive thematic analysis. The NPT was applied to the inductively derived themes to evaluate if and how NPT domains impacted the implementation. Survey data were analysed using multilevel growth models.
Six themes and 15 subthemes captured barriers and facilitators to implementation at the patient, clinician, service, intervention, implementation and wider system levels. These interacted with the NPT mechanisms to facilitate or hinder the embedding of FREED. Overall, clinicians were enthusiastic and positive towards early intervention for EDs and FREED, largely because of the expectation of improved patient outcomes. This was a considerable driver in the uptake and implementation of FREED. Clinicians also had reservations about capacity and the potential impact on other patients, which, at times, was a barrier for its use. The FREED training led to significant improvements in positive attitudes and NPT mechanisms that were largely maintained at the 3-month follow-up. However, negative attitudes did not significantly improve following training.
Positive attitudes towards early intervention for EDs increased enthusiasm and engagement with the model. Features of the model and its implementation were effective at developing adopter commitment and capabilities. However, there were aspects of the model and its implementation which require attention in the future (e.g., capacity and the potential impact on the wider service).
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