“Tell Me More and Help Me to Decide, Doctor” – Information Seeking Attitudes and Use of Information Resources in Patients with Depression

2017 ◽  
Vol 41 (S1) ◽  
pp. S146-S146
Author(s):  
H. Almeida ◽  
A.M. Pisco Almeida ◽  
M. Figueiredo-Braga
Keyword(s):  
Decision Making ◽  
Information Seeking ◽  
Psychiatric Treatment ◽  
A Priori ◽  
Information Resources ◽  
Self Report ◽  
Mental Condition ◽  
Future Research ◽  
Limited Information ◽  
Convenience Sample

IntroductionShared decision-making (SDM) has shown to improve adherence, decrease hospitalization, and enhance knowledge of the illness and satisfaction with mental health services. Eliciting each patient's preferences for information allows tailoring the physician behavior according perspectives and expectations. Patients with depression (PWD) have frequently limited information regarding the availability and efficacy of psychiatric treatments.Aims/objectivesUnveil information seeking attitudes of patients with depression and their a priori use of digital sources of information.MethodsA convenience sample of PWD was submitted to a battery of self-report questionnaires. Standardized instruments were used to measure information seeking attitudes and the accessibility and usage of digital information resources.ResultsThirty-six patients were inquired, with a mean age of 39.8 (13.4) years. Information-seeking preferences were high, with an API-I score of 90.1 (13.8). Preferences for information-seeking behaviors were higher in severely depressed (P = 0.010) and less educated (P = 0.026) patients. Preferences were negatively correlated with length of psychiatric treatment (r = −0.514; P = 0.002). Sixty-one percent had a priori information regarding their psychiatric problem, and 68.8% considered it was influential in the decision-making behavior. Access and use of digital resources were correlated with education level (0.644; P = 0.000 and 0.554; P = 0.003), age (−0.357; P = 0.001 and −0.559; P = 0.007) and illness severity (−0.431; P = 0.04).ConclusionPatients with depression want to be informed about their mental condition and treatment options. Few resources are used and decision mostly relies on health professional's opinion and guidance. Accessible resources seem scarce and future research shall address the acceptance and impact of decisional-aid instruments on this population.

Prophetic Leadership Model: Conceptualizing a Prophet’s Leadership Behaviour, Leader-Follower Mutuality and Altruism to Decision Making Quality

2015 ◽  
Vol 3 (1) ◽  
pp. 93
Author(s):  
Nik Maheran Nik Muhammad
Keyword(s):  
Decision Making ◽  
Social Network ◽  
A Priori ◽  
Complex Function ◽  
Spiritual Leadership ◽  
Leadership Theory ◽  
Future Research ◽  
Leadership Model ◽  
Leadership Behaviour ◽  
Current Leadership

This article advocates that research is lacking on the connection between leadership theory and social network theory. To date, little empirical research has been conducted on leadership and social networks. Thus, the proposition of this article goes beyond traditional leadership models to advocate for a fuller and more integrative focus that is multilevel, multi-component and interdisciplinary, while recognizing that leadership is a complex function of both the organisational leaders and the followers who perform tasks, all of which subsequently leads to decision making qualities. Indeed, the current leadership model focuses on leadership behaviour and the ability to gain followers mutuality, to achieve decision making quality involving the integration of leadership and social network theories. Given the apparent mutable palette of contemporary leadership theory, this emergent construct of the leadership paradigm can expand the poles of the leadership continuum and contribute to a richer and deeper understanding of the relationships and responsibilities of leaders and followers as they relate to decision making qualities. This new construct, which is termed prophetic leadership, explores the literature of the life experiences of the prophet in the ‘Abrahamic Faith’ religion. Drawing on a priori links between the personality trait and spiritual leadership that has recently garnered the interest of scholars, the present study asserts a normative leadership theory that links the personal quality of a leader, posture and principal (based on the Prophet’s leadership behaviour) to synergy and decision making quality. Altruism is proposed to enhance relationships between leadership behaviour and decision making quality. For future research, much work needs to be done specifically aiming to (a) achieve greater clarity of construct definitions, (b) address measurement issues, and (c) avoid construct redundancy.

Prophetic Leadership Model: Conceptualizing a Prophet’s Leadership Behaviour, Leader-Follower Mutuality and Altruism to Decision Making Quality

2015 ◽  
Vol 1 (3) ◽  
pp. 93
Author(s):  
Nik Maheran Nik Muhammad
Keyword(s):  
Decision Making ◽  
Social Network ◽  
A Priori ◽  
Complex Function ◽  
Spiritual Leadership ◽  
Leadership Theory ◽  
Future Research ◽  
Leadership Model ◽  
Leadership Behaviour ◽  
Current Leadership

This article advocates that research is lacking on the connection between leadership theory and social network theory. To date, little empirical research has been conducted on leadership and social networks. Thus, the proposition of this article goes beyond traditional leadership models to advocate for a fuller and more integrative focus that is multilevel, multi-component and interdisciplinary, while recognizing that leadership is a complex function of both the organisational leaders and the followers who perform tasks, all of which subsequently leads to decision making qualities. Indeed, the current leadership model focuses on leadership behaviour and the ability to gain followers mutuality, to achieve decision making quality involving the integration of leadership and social network theories. Given the apparent mutable palette of contemporary leadership theory, this emergent construct of the leadership paradigm can expand the poles of the leadership continuum and contribute to a richer and deeper understanding of the relationships and responsibilities of leaders and followers as they relate to decision making qualities. This new construct, which is termed prophetic leadership, explores the literature of the life experiences of the prophet in the ‘Abrahamic Faith’ religion. Drawing on a priori links between the personality trait and spiritual leadership that has recently garnered the interest of scholars, the present study asserts a normative leadership theory that links the personal quality of a leader, posture and principal (based on the Prophet’s leadership behaviour) to synergy and decision making quality. Altruism is proposed to enhance relationships between leadership behaviour and decision making quality. For future research, much work needs to be done specifically aiming to (a) achieve greater clarity of construct definitions, (b) address measurement issues, and (c) avoid construct redundancy.

Differences in Reward and Persistency characterise Behavior in Chronic Pain for the Iowa Gambling Task in a Web-based Lab-in-the-field study (Preprint)

2020 ◽  
Author(s):  
Lili Zhang ◽  
Himanshu Vashisht ◽  
Alekhya Nethra ◽  
Brian Slattery ◽  
Tomas Ward
Keyword(s):  
Decision Making ◽  
Social Media ◽  
Chronic Pain ◽  
Iowa Gambling Task ◽  
Learning Curves ◽  
Self Report ◽  
Healthy Controls ◽  
Gambling Task ◽  
Convenience Sample ◽  
Pain Experiences

BACKGROUND Chronic pain is a significant world-wide health problem. It has been reported that people with chronic pain experience decision-making impairments, but these findings have been based on conventional lab experiments to date. In such experiments researchers have extensive control of conditions and can more precisely eliminate potential confounds. In contrast, there is much less known regarding how chronic pain impacts decision-making captured via lab-in-the-field experiments. Although such settings can introduce more experimental uncertainty, it is believed that collecting data in more ecologically valid contexts can better characterize the real-world impact of chronic pain. OBJECTIVE We aim to quantify decision-making differences between chronic pain individuals and healthy controls in a lab-in-the-field environment through taking advantage of internet technologies and social media. METHODS A cross-sectional design with independent groups was employed. A convenience sample of 45 participants were recruited through social media - 20 participants who self-reported living with chronic pain, and 25 people with no pain or who were living with pain for less than 6 months acting as controls. All participants completed a self-report questionnaire assessing their pain experiences and a neuropsychological task measuring their decision-making, i.e. the Iowa Gambling Task (IGT) in their web browser at a time and location of their choice without supervision. RESULTS Standard behavioral analysis revealed no differences in learning strategies between the two groups although qualitative differences could be observed in learning curves. However, computational modelling revealed that individuals with chronic pain were quicker to update their behavior relative to healthy controls, which reflected their increased learning rate (95% HDI from 0.66 to 0.99) when fitted with the VPP model. This result was further validated and extended on the ORL model because higher differences (95% HDI from 0.16 to 0.47) between the reward and punishment learning rates were observed when fitted on this model, indicating that chronic pain individuals were more sensitive to rewards. It was also found that they were less persistent in their choices during the IGT compared to controls, a fact reflected by their decreased outcome perseverance (95% HDI from -4.38 to -0.21) when fitted using the ORL model. Moreover, correlation analysis revealed that the estimated parameters had predictive value for the self-reported pain experiences, suggesting that the altered cognitive parameters could be potential candidates for inclusion in chronic pain assessments. CONCLUSIONS We found that individuals with chronic pain were more driven by rewards and less consistent when making decisions in our lab-in-the-field experiment. In this case study, it was demonstrated that compared to standard statistical summaries of behavioral performance, computational approaches offered superior ability to resolve, understand and explain the differences in decision- making behavior in the context of chronic pain outside the lab.

scholarly journals Evaluation of a short version of the Experiences in Close Relationships-Revised questionnaire (ECR-RD8): results from a representative German sample

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Johannes C. Ehrenthal ◽  
Johannes Zimmermann ◽  
Katja Brenk-Franz ◽  
Ulrike Dinger ◽  
Henning Schauenburg ◽  
...  
Keyword(s):  
Close Relationships ◽  
Full Scale ◽  
Self Report ◽  
Future Research ◽  
Short Version ◽  
German Population ◽  
Attachment Insecurity ◽  
Convenience Sample ◽  
Norm Values ◽  
Experiences In Close Relationships

Abstract Background Attachment insecurity is a prominent risk factor for the development and course of psychiatric and psychosomatic disorders. The Experiences in Close Relationships - Revised (ECR-R) questionnaire is a widely used self-report to assess attachment related anxiety and avoidance. However, its length has the potential to restrict its use in large, multi-instrument studies. The aim of this study was to develop and evaluate a brief version of the ECR-R, and provide norm values for the German population. Methods A screening version of the original ECR-R was developed through principal components analysis of datasets from several previous studies. In a representative sample of 2428 randomly selected individuals from the German population, we compared fit indices of different models by means of confirmatory factor analyses (CFA). We investigated the convergent validity of the screening version in an independent convenience sample of 557 participants. Correlations between the short and the full scale were investigated in a re-analysis of the original German ECR-R evaluation sample. Results CFA indicated a satisfactory model fit for an eight-item version (ECR-RD8). The ECR-RD8 demonstrated adequate reliability. The subscales correlated as expected with another self-report measure of attachment in an independent sample. Individuals with higher levels of attachment anxiety, but especially higher levels of attachment avoidance were significantly more likely to not be in a relationship, across all age groups. Correlations between the short and the full scale were high. Conclusions The ECR-RD8 appears to be a reliable, valid, and economic questionnaire for assessing attachment insecurity. In addition, the reported population-based norm values will help to contextualize future research findings.

The effectiveness, feasibility and acceptability of a school-based intervention to improve sleep and psychological wellbeing in adolescents.

2021 ◽  
Author(s):  
Stephanie McCrory ◽  
Astrid McLellan ◽  
Karolina Kiper ◽  
Clare Munro ◽  
Christopher-James Harvey ◽  
...  
Keyword(s):  
Behavioural Therapy ◽  
Self Report ◽  
Psychological Wellbeing ◽  
Future Research ◽  
Convenience Sample ◽  
School Based ◽  
Cognitive Behavioural ◽  
Physical Health Problems ◽  
Improvement Interventions ◽  
Measure Change

Introduction: Adolescents are vulnerable to experiencing insufficient sleep which can increase the risk of developing insomnia, mental/physical health problems and mood regulation. School-based sleep improvement interventions (SBSII) have been developed utilising Cognitive Behavioural Therapy for Insomnia techniques and found improvements in sleep knowledge and behaviour. This study aimed to evaluate the effectiveness, feasibility and acceptability of a school-based sleep improvement intervention (iSLEEP) for improving sleep and psychological wellbeing in adolescents.Methods: A mixed-methods approach was adopted. The participants (115, aged 12-15) were recruited from secondary schools in Scotland. iSLEEP comprised of three lessons, combining formal sleep education and CBT-I, and were delivered over three consecutive weeks. Baseline (1 week before lesson 1) and follow-up (1 week following lesson 3) assessments comprised of self-report questionnaires to measure change in sleep, depression, anxiety and stress. Two weeks following the final lesson, a convenience sample of 19 pupils (14 females) were recruited to participate in focus groups.Results: There were significant improvements in overall sleep and marginal differences between those who were categorised with ‘probable insomnia’ at baseline and likewise for ‘good sleepers’. There were no significant improvements in symptoms of depression, anxiety or stress. Two themes and two sub-themes were generated. Participants reported that iSLEEP was acceptable and improved their sleep.Conclusions: These findings indicate that iSLEEP is an effective, feasible and acceptable SBSII. Future research should aim to utilise a controlled design to further investigate the efficacy of iSLEEP.

scholarly journals Reduction of depressive symptoms during inpatient treatment is not associated with changes in heart rate variability

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248686
Author(s):  
Sabrina Neyer ◽  
Michael Witthöft ◽  
Mark Cropley ◽  
Markus Pawelzik ◽  
Ricardo Gregorio Lugo ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Depressive Symptoms ◽  
Rating Scale ◽  
Psychiatric Treatment ◽  
Self Report ◽  
Future Research ◽  
Symptom Improvement ◽  
Vagal Activity ◽  
Before And After

Vagally mediated heart rate variability (HRV) is a psychophysiological indicator of mental and physical health. Limited research suggests there is reduced vagal activity and resulting lower HRV in patients with Major Depressive Disorder (MDD); however little is actually known about the association between HRV and symptoms of depression and whether the association mirrors symptom improvement following psychotherapy. The aim of this study was to investigate the association between antidepressant therapy, symptom change and HRV in 50 inpatients (68% females; 17–68 years) with a diagnosis of MDD. Severity of depressive symptoms was assessed by self-report (Beck Depression Inventory II) and the Hamilton Rating Scale of Depression. Measures of vagally mediated HRV (root mean square of successive differences and high-frequency) were assessed at multiple measurement points before and after inpatient psychotherapeutic and psychiatric treatment. Results showed an expected negative correlation between HRV and depressive symptoms at intake. Depressive symptoms improved (d = 0.84) without corresponding change in HRV, demonstrating a de-coupling between this psychophysiological indicator and symptom severity. To our knowledge, this study is the first to examine an association between HRV and depressive symptoms before and after psychotherapy. The observed de-coupling of depression and HRV, and its methodological implications for future research are discussed.

Payment Systems for Telemedicine: Comparative Study (Preprint)

2021 ◽  
Author(s):  
Sarah Raes ◽  
Jeroen Trybou ◽  
Lieven Annemans
Keyword(s):  
Decision Making ◽  
The Netherlands ◽  
Payment System ◽  
Future Research ◽  
Reimbursement Policy ◽  
Fee For Service ◽  
Physician Payment ◽  
Convenience Sample ◽  
Cardiac Devices ◽  
Payment Models

BACKGROUND Many researchers have addressed the lack of reimbursement for telemedicine as one of the most important barriers to telemedicine adoption. However, little is known on how telemedicine should be implemented in reimbursement policy, how it must be financed, and what the right incentives are for an effective and efficient telemedicine use. OBJECTIVE To help future researchers to provide reimbursement policy recommendations, and to facilitate reimbursement decision-making, this paper analyzed and compared the telemedicine payment models of ten countries. METHODS A convenience sample was created of Western countries inside and outside Europe that already reimburse to some extent telemedicine. Ten countries met this criterion: Australia, Belgium, Denmark, France, Germany, Luxembourg, the Netherlands, Canada (Ontario province), Switzerland, and the United Kingdom. The study was based on the countries’ official physician fee schedules, listing all reimbursed medical services performed by physicians, including telemedicine. Based on the fee schedules, a comparative analysis of the payment models of telemedicine was conducted. RESULTS Televisits are reimbursed in all countries, which is not the case for telemonitoring and tele-expertise services. Telemonitoring is often restricted for patients with implanted cardiac devices. Telemedicine services are mainly paid fee-for-service, except for the telemonitoring of patients with implanted cardiac devices, which is paid through an episodic payment system in Australia. Payment parity exists across televisits and visits in person in France, Luxembourg, the Netherlands, and Switzerland, meaning that an equal fee is given for both services. CONCLUSIONS Our findings show that fees for telemedicine are lacking, especially for telemonitoring and tele-expertise. As telemedicine might enlarge disparities in healthcare access, policymakers should consider payment parity across televisits and face-to-face visits, and across telephone and video visits. Furthermore, an episodic physician payment system complemented with bonuses for quality outcomes, should be considered by policymakers for telemonitoring as it might capture the specificities of telemonitoring better than a fee-for-service system. Future research is needed on payment models, including research linking cost-effectiveness analyses with analyses on payment models, to allow profound reimbursement recommendations and a faster decision-making process for the reimbursement of telemedicine.

scholarly journals The Role of Implicit and Explicit Staff Attitudes in the Use of Coercive Measures in Psychiatry

2021 ◽  
Vol 12 ◽  
Author(s):  
Angelika Vandamme ◽  
Alexandre Wullschleger ◽  
Amelie Garbe ◽  
Celline Cole ◽  
Andreas Heinz ◽  
...  
Keyword(s):  
Decision Making ◽  
Self Report ◽  
Future Research ◽  
Professional Experience ◽  
Staff Attitudes ◽  
Coercive Measures ◽  
Staff Members ◽  
Significant Difference ◽  
Implicit And Explicit ◽  
The Impact

Many determinants leading to the use of different coercive measures in psychiatry have been widely studied and it seems that staff attitudes play a crucial role when it comes to the decision-making process about using coercion. However, research results about staff attitudes and their role in the use of coercive measures are inconsistent. This might be due to a focus on self-report studies asking for explicit answers, which involves the risk of bias. This study aimed to expand research on this topic by examining the impact of explicit and implicit staff attitudes on the use of coercive measures in clinical practice. In addition, the influence of gender, profession (nurses, psychiatrists), and years of professional experience as well as their influence on staff attitudes were examined. An adaption of the implicit association measure, the Go/No-Go Association Task (GNAT), with the target category coercion and distracter stimuli describing work load, as well as the explicit questionnaire Staff Attitudes to Coercion Scale (SACS) was completed by staff (N = 149) on 13 acute psychiatric units in 6 hospitals. Data on coercive measures as well as the total number of treated cases for each unit was collected. Results showed that there was no association between staff's implicit and explicit attitudes toward coercion, and neither measure was correlated with the local frequency of coercive measures. ANOVAs showed a significant difference of the GNAT result for the factor gender (F = 9.32, p = 0.003), demonstrating a higher tendency to justify coercion among female staff members (M = −0.23, SD = ±0.35) compared to their male colleagues (M = −0.41, SD = ±0.31). For the SACS, a significant difference was found for the factor profession (F = 7.58, p = 0.007), with nurses (M = 2.79, SD = ±1.40) showing a more positive attitude to the use of coercion than psychiatrists (M = 2.15, SD = ±1.11). No significant associations were found regarding the extent of professional experience. Results indicate a complex interaction between implicit and explicit decision-making processes dependent on specific contexts. We propose future research to include primers for more context-related outcomes. Furthermore, differences in gender suggest a need to direct attention toward occupational safety and possible feelings of anxiety in the workplace, especially for female staff members.

The Effect of Alcohol and Arousal on Criminal Decision Making

2017 ◽  
Author(s):  
M. Lyn Exum ◽  
Lauren A. Austin ◽  
Justin D. Franklin
Keyword(s):  
Decision Making ◽  
Prefrontal Cortex ◽  
Aggressive Behavior ◽  
Empirical Research ◽  
A Priori ◽  
Future Research ◽  
Costs And Benefits ◽  
Neurological Functioning ◽  
Neurological Effects ◽  
Striatal System

Consequentialist theories of criminal decision making assume crime is a choice that one undertakes if the perceived benefits of the act outweigh its costs. This a priori assessment of costs and benefits involves the use of several neurological components, including the amygdala–striatal system and the prefrontal cortex. Crime is commonly committed by individuals under the influence of alcohol and/or experiencing heightened states of emotional arousal. Both alcohol and arousal impact neurological functioning, including that of the amygdala–striatal system and prefrontal cortex. This chapter examines the influence of alcohol and arousal on criminal decision making from a neuroeconomic perspective. It discusses the neurological effects that alcohol and arousal may have on the identification and evaluation of criminal consequences. These effects bound one’s rationality and increase the likelihood of criminal/aggressive behavior. Empirical research on alcohol, arousal, and criminal decision making is summarized, and suggestions for future research are presented.

scholarly journals Depressive Adolescent Girls Exhibit Atypical Social Decision-Making in an Iterative Trust Game

2019 ◽  
Vol 38 (3) ◽  
pp. 224-244 ◽  
Author(s):  
William Mellick ◽  
Carla Sharp ◽  
Monique Ernst
Keyword(s):  
Decision Making ◽  
Adolescent Girls ◽  
Risk Taking ◽  
Repeated Measures ◽  
Adolescent Depression ◽  
Self Report ◽  
Trust Game ◽  
Future Research ◽  
Significant Group ◽  
Behavioral Economic

Introduction: Interpersonal trust behavior is an important target for the identification and treatment of psychiatric disorders with interpersonal dysfunction. Adolescent depression is a highly interpersonal disorder marked by impaired social interactions. However, trust has received little empirical attention. The examination of reward-related decision-making using behavioral economic methods is a relatively novel approach for studying trust in adolescent depression. The present study employed a modified trust game to examine whether depressive adolescents exhibited perturbed reward-related decision-making in social and/or nonsocial contexts. Methods: One hundred and thirty adolescent girls (65 depressive, 65 healthy comparisons) played a modified trust game under two conditions, interpersonal risk-taking (trust) and general risk-taking (lottery), and completed self-report psychopathology measures. Results: Three-way repeated measures ANCOVA analyses revealed a significant group × game interaction such that while the depressive group invested more across trials in the trust game they invested similarly to healthy comparisons in the lottery condition. Discussion: Findings highlight the interpersonal nature of adolescent depression. Future research may help determine whether increased trust behavior is characteristic of depression in adolescent girls. Behavioral economic games, like the trust game, may serve as valuable therapeutic tools for improving social interaction style among depressive adolescents.

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