Psychosocial Adjustment of Adolescent Cancer Survivors: Time Perspective and Positive Emotions as Mediators to Quality of Life and Benefit Finding

Adolescents with cancer are surviving at improved rates with levels of psychopathology in line with their healthy peers. Thus, recent psycho-oncology research is focusing on finding significant predictors to their positive adjustment and psychosocial functioning. The author examined adolescent cancer survivors (n = 50; diagnosis age = 10 21; 2 10 years post-diagnosis) to test the mediation effects of positive emotionns (satisfaction with life, subjective happiness, and optimism) and time perspective on the outcome variables quality of life and benefit finding with demographic/medical variables (gender, number of treatments received for cancer, and previous psychotherapy) as independent variables. Results indicated that positive emotions fully mediated the relationship between the number of treatments received for cancer and quality of life and partially mediated the relationship between having engaged in psychotherapy and quality of life with adolescent cancer survivors. Importantly, results indicated that patients\u27 with a relapse diagnosis scored significantly different than those with no relapse diagnosis on quality of life. Although positive emotions were significantly associated with scores on benefit finding in a positive direction, benefit finding did not fit two of the four criteria for mediation. Time perspective indices did not meet full criteria for significant mediation with the relationships between independent and outcome variables. Regarding time perspective indices, significant associations included: prior participating in psychotherapy was associated with higher scores on a Past-Negative time perspective, the more treatments received for cancer was associated with higher scores on a Present-Focused time perspective, and higher scores on the Past-Negative time perspective was associated with lower scores on benefit finding. Discussion centers on the use of evidence-based interventions that cultivate positive emotions with adolescent cancer survivors and the utility of implementing quality of life assessment in pediatric medical settings. Continued emphasis is placed on larger sample sizes via multi-center cooperation that may better illustrate adjustment difficulties within subgroups of this population (i.e. relapse diagnosis). Future research considerations are provided for the constructs of time perspective and benefit finding

Treatment Use Among Children with Tourette Syndrome Living in The United States, 2014

Treatment of Tourette syndrome (TS) can be complicated by changes over time in tic expression, severity, and co-occurring disorders. Using the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, this study provides descriptive estimates of the use of behavioral interventions and medication among children living with TS. Parent-reported data on 115 children aged 5–17 years ever diagnosed with TS were analyzed to provide descriptive, unweighted results. Overall, 77.4% of children had current or past use of any TS treatment; 59.1% ever used behavioral interventions and 56.1% had ever taken TS medication. Children with moderate” or “severe” versus “mild” TS, ≥1 co-occurring disorders, and tics that interfered with functioning were significantly more likely to have used one or more TS treatments. Side effects were reported for 84.4% of children who took TS medication. Most parents of children with current TS (87.2%) were satisfied with the management of their child\u27s TS. However, parents of children with “moderate” or “severe” current TS were significantly more dissatisfied compared to parents of children with “mild” TS. Findings from this study could be used to inform efforts to support children living with TS and their families

Anxiety Detection Leveraging Mobile Passive Sensing

Anxiety disorders are the most common class of psychiatric problems affecting both children and adults. However, tools to effectively monitor and manage anxiety are lacking, and comparatively limited research has been applied to addressing the unique challenges around anxiety. Leveraging passive and unobtrusive data collection from smartphones could be a viable alternative to classical methods, allowing for real-time mental health surveillance and disease management. This paper presents eWellness, an experimental mobile application designed to track a full-suite of sensor and user-log data off an individual's device in a continuous and passive manner. We report on an initial pilot study tracking ten people over the course of a month that showed a nearly 76% success rate at predicting daily anxiety and depression levels based solely on the passively monitored features

Depressive and anxiety disorders and antidepressant prescriptions among insured children and young adults with congenital adrenal hyperplasia in the United States

BackgroundDysfunction in the hypothalamic-pituitary-adrenal axis has been associated with depressive and anxiety disorders. Little is known about the risk for these disorders among individuals with congenital adrenal hyperplasia (CAH), a form of primary adrenal insufficiency.ObjectiveWe investigated the prevalence of depressive and anxiety disorders and antidepressant prescriptions in two large healthcare databases of insured children, adolescents, and young adults with CAH in the United States.MethodsWe conducted a retrospective cohort study using administrative data from October 2015 through December 2019 for individuals aged 4–25 years enrolled in employer-sponsored or Medicaid health plans.ResultsAdjusting for age, the prevalence of depressive disorders [adjusted prevalence ratio (aPR) = 1.7, 95% confidence interval (CI): 1.4-2.0, p<0.001], anxiety disorders [aPR = 1.7, 95% CI: 1.4-1.9, p<0.001], and filled antidepressant prescriptions [aPR = 1.7, 95% CI: 1.4-2.0, p<0.001] was higher among privately insured youth with CAH as compared to their non-CAH peers. Prevalence estimates were also higher among publicly insured youth with CAH for depressive disorders [aPR = 2.3, 95% CI: 1.9-2.9, p<0.001], anxiety disorders [aPR = 2.0, 95% CI: 1.6-2.5, p<0.001], and filled antidepressant prescriptions [aPR = 2.5, 95% CI: 1.9-3.1, p<0.001] as compared to their non-CAH peers.ConclusionsThe elevated prevalence of depressive and anxiety disorders and antidepressant prescriptions among youth with CAH suggests that screening for symptoms of depression and anxiety among this population might be warranted

Developing a theory-based multimedia intervention for schools to improve young people's asthma: my asthma in school (MAIS).

Background: Asthma control in adolescents is low with half of the young people in a London study identified as having suboptimal control when measured using the Asthma Control Test. Control of asthma symptoms can be improved by addressing barriers to good self-management, such as poor understanding of asthma and adherence to medication. The aim of this study was therefore to develop the My Asthma in School (MAIS) intervention for the improvement of asthma control and self-management in adolescents and to test its initial feasibility. The intervention intended to combine a strong focus on theory with a design specifically aimed to engage adolescents. Methods: The intervention development was based on previous qualitative and quantitative findings, and on guidelines from the Medical Research Council for the development of complex interventions. The COM-B (Capability, Opportunity, Motivation-Behaviour) model was applied to inform the design of intervention elements. Behavioural targets were identified from existing barriers to good asthma self-management and were then used to guide the development of engaging intervention elements, which were described using the Behavioural Change Technique (BCT) Taxonomy version 1. Adolescents were involved throughout this process. The MAIS intervention was tested in a feasibility phase in London secondary schools with adolescents aged between 11 and 13. Results: The complex school-based MAIS intervention comprised a first school visit from a theatre group, who conducted a workshop with all year 7-8 students and addressed peer understanding and attitudes to asthma. The second visit included four self-management workshops for adolescents with asthma, including games, short-films and role play activities. Forty different types of techniques to change behaviour were applied, totalling 163 instances of BCT use across intervention elements, addressing all areas of capability, opportunity and motivation. In this initial feasibility study, 1814 adolescents with and without asthma from nine schools received the theatre intervention visit; 23 adolescents with asthma from one of the schools attended the workshop visit. The intervention was found acceptable and engaging, and 91.4% of participants agreed that the workshops changed how they think or feel about asthma. Conclusion: This study demonstrates development and initial feasibility of a complex theory-based intervention, and how it can combine engaging media and interactive elements, to achieve a multi-directional approach to behavioural change. However more work is needed to assess the feasibility of trial processes, including recruitment and delivery format of the workshops