scholarly journals Decreased Emotional Dysregulation Following Multi-modal Motion-assisted Memory Desensitization and Reprocessing Therapy (3MDR): Identifying Driving Factors in Remediation of Treatment-Resistant PTSD

2021 ◽  
Author(s):  
Emily Tang ◽  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
Matthew R.G. Brown ◽  
Eric H.G.J. Vermetten ◽  
...  
Keyword(s):  
Emotional Regulation ◽  
Divergent Thinking ◽  
Emotional Dysregulation ◽  
Treatment Resistant ◽  
Post Intervention ◽  
Traumatic Memories ◽  
Novel Approach ◽  
Military Members ◽  
Task Processing ◽  
The Impact

Multi-modal Motion-assisted Memory Desensitization and Reprocessing Therapy (3MDR), an interactive, virtual-reality assisted, exposure-based intervention for PTSD, has shown promising results for treatment-resistant Posttraumatic Stress Disorder (TR-PTSD) among military members (MMs) and Veterans in Randomized Controlled Trials. Previous research has suggested that emotional regulation (ER) and emotional dysregulation (ED) may be factors which are correlated with symptom severity and maintenance of TR-PTSD. This embedded mixed-methods pilot study (n=9) sought to explore the impact of 3MDR on ER and ED of MMs and Veterans. Difficulties in Emotional Regulation Scale (DERS-18) data was collected at baseline, prior to each session, and at 1 week, 1 month and 3 months post-intervention and analyzed using a Wilcoxon signed-ranks test. Qualitative data collected from sessions, debriefs, and follow-up interviews were transcribed and descriptively analyzed. Results demonstrated statistically significant decreases in DERS-18 scores from pre-intervention to post-intervention at each timepoint. Qualitatively, participants perceived improvements in ER within specified DERS-18 domains. We describe how 3MDR’s unique and novel approach may address ED through cognitive-motor stimulation, narration, divergent thinking, reappraisal of aversive stimuli, dual-task processing, and reconsolidation of traumatic memories. Further investigation is underway to better understand the underlying neurobiological mechanisms by which 3MDR addresses ER and PTSD.

scholarly journals Decreased Emotional Dysregulation Following Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation Therapy (3MDR): Identifying Possible Driving Factors in Remediation of Treatment-Resistant PTSD

2021 ◽  
Vol 18 (22) ◽  
pp. 12243
Author(s):  
Emily Tang ◽  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
Matthew R. G. Brown ◽  
Eric H. G. J. M. Vermetten ◽  
...  
Keyword(s):  
Emotional Regulation ◽  
Divergent Thinking ◽  
Emotional Dysregulation ◽  
Treatment Resistant ◽  
Traumatic Memories ◽  
Novel Approach ◽  
Military Members ◽  
Task Processing ◽  
The Impact

Multi-modal motion-assisted memory desensitization and reconsolidation therapy (3MDR), an interactive, virtual reality-assisted, exposure-based intervention for PTSD, has shown promising results for treatment-resistant posttraumatic stress disorder (TR-PTSD) among military members (MMs) and veterans in randomized controlled trials (RCT). Previous research has suggested that emotional regulation (ER) and emotional dysregulation (ED) may be factors which are correlated with symptom severity and maintenance of TR-PTSD. This embedded mixed-methods pilot study (n = 9) sought to explore the impact of 3MDR on ER and ED of MMs and veterans. Difficulties in Emotional Regulation Scale (DERS-18) data were collected at baseline, prior to each session, and at one week, one month, and three months postintervention and analyzed. Qualitative data collected from sessions, debriefs, and follow-up interviews were transcribed and descriptively analyzed. Results demonstrated statistically significant decreases in DERS-18 scores from preintervention to postintervention at each timepoint. Qualitatively, participants perceived improvements in ER within specified DERS-18 domains. We describe how 3MDR’s unique and novel approach addresses ED through cognitive–motor stimulation, narration, divergent thinking, reappraisal of aversive stimuli, dual-task processing, and reconsolidation of traumatic memories. More studies are needed to better understand the underlying neurobiological mechanisms by which 3MDR addresses ER and PTSD.

scholarly journals Emotional Regulation in Teens and Improvement of Constructive Skills (EmoTIConS): study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Laura Pedrini ◽  
Roberta Rossi ◽  
Laura Rosa Magni ◽  
Mariangela Lanfredi ◽  
Serena Meloni ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotional Regulation ◽  
Skills Training ◽  
Emotional Dysregulation ◽  
Control Group ◽  
Post Intervention ◽  
Adolescent Students ◽  
Biological Features ◽  
Biological Variables ◽  
The Impact

Abstract Background Emotional dysregulation (ED) constitutes a relevant factor involved in the onset and maintenance of many mental disorders. Targeting ED during adolescence could be a determinant both to identify high-risk individuals and to promote preventive interventions. This study will aim to evaluate the impact of a brief Dialectical Behavioral Therapy (DBT)-based intervention for adolescent students by measuring changes in emotional regulation skills and impulsive behaviors. Moreover, alterations in biological features related to stress response and inflammation will be assessed as potential biological variables associated with ED. Methods This is a randomized trial. A total of 20 classes of adolescent students will be recruited among high schools in Brescia, a city in northern Italy. They will be randomized to the psychoeducational intervention (experimental group) or to a control condition (control group). The intervention will be based on DBT Skills Training for Emotional Problem Solving for Adolescents, and will consist of four monthly, 2-h sessions (for a total of 8 h) scheduled during regular school time. Participants will be assessed at baseline, post-intervention, and at 3 and 6 months of follow-up. The primary outcome measures will be represented by changes in the use of emotional regulation skills and by changes in the frequency of impulsive behaviors. Salivary samples will be collected at baseline and post-intervention to explore possible biological features underlying ED. Discussion Data from the present project will offer the opportunity to better understand the complex phenomenon of ED. Repeated assessment will cover several domains (emotional, behavioral, social, biological) as potential factors associated with ED. Moreover, it will be possible to establish the effect of the proposed intervention, thus helping to improve knowledge on the impact of school-based universal preventive programs. Finally, the current trial will propose an integrated screening and intervention-based model. Ultimately, this could reduce barriers to youths’ mental health care by fostering collaboration between schools and mental health services. Trial registration ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT04349709?cond=emotional+dysregulation&cntry=IT&draw=2&rank=1. Registered on April 16, 2020.

scholarly journals Emotional Regulation In Teens And Improvement of Constructive Skills (EmoTIConS): Study Protocol For A Randomized Controlled Trial

2021 ◽  
Author(s):  
Laura Pedrini ◽  
Roberta Rossi ◽  
Laura Rosa Magni ◽  
Mariangela Lanfredi ◽  
Serena Meloni ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotional Regulation ◽  
Emotional Problem ◽  
Skills Training ◽  
Control Group ◽  
Post Intervention ◽  
Adolescent Students ◽  
Biological Features ◽  
Biological Variables ◽  
The Impact

Abstract Background: Emotional dysregulation (ED) constitutes a relevant factor involved in the onset and maintenance of many mental disorders. Targeting ED during adolescence could be determinant both to identify high risk individuals and to promote preventive interventions. This study will aim to evaluate the impact of a brief Dialectical Behavioral Therapy (DBT)-based intervention for adolescent students by measuring changes in emotional regulation skills and impulsive behaviors. Moreover, alterations in biological features related to stress response and inflammation will be assessed as potential biological variables associated to ED.Methods: This is a randomized trial. A total of 20 classes of adolescent students will be recruited among high schools in Brescia, a city in the North of Italy. They will be randomized to the psychoeducational intervention (experimental group) or to a control condition (control group). The intervention will be based on DBT Skills Training for Emotional Problem Solving for Adolescents, and it will consist in four monthly 2-hours sessions (for a total of 8 hours) scheduled during regular school-time. Participants will be assessed at baseline, post-intervention, and at 3 and 6-month of follow-up. The primary outcome measures will be represented by changes in the use of emotional regulation skills (measured by the DBT-Ways of Coping Checklist) and by changes in the frequency of impulsive behaviours (measured by an ad-hoc created checklist). Salivary samples will be collected at baseline and post-intervention to explore possible biological features underlying ED.Discussion: Data from the present project will offer the opportunity to better understand the complex phenomenon of ED. Repeated assessment will cover several domains (emotional, behavioral, social, biological) as potential factors associated with ED. Moreover, it will be possible to measure the effect of the proposed intervention, contributing to improve knowledge on the impact of school-based universal preventive programs. Finally, the current trial will propose an integrated screening- and intervention-based model. Ultimately, this could reduce barriers to youth’s mental health care by fostering collaboration between schools and mental health services. Trial registration: ClinicalTrials.gov ID: NCT04349709. Registration date: 16/04/2020https://clinicaltrials.gov/ct2/show/NCT04349709

The impact of including babies on the effectiveness of dialectical behaviour therapy skills groups in a community perinatal service

2020 ◽  
pp. 1-13
Author(s):  
Adele E. Greaves ◽  
Hannah McKenzie ◽  
Rachel O’Brien ◽  
Anna Roberts ◽  
Kate Alexander
Keyword(s):  
Emotional Regulation ◽  
Qualitative Interviews ◽  
Mental Illnesses ◽  
Public Health Issue ◽  
Behaviour Therapy ◽  
Post Intervention ◽  
Major Public Health Issue ◽  
Dialectical Behaviour Therapy ◽  
Within Subjects ◽  
The Impact

Abstract Background: Perinatal mental illnesses are a major public health issue, which untreated can have devastating impacts on women and their families. Problems with emotion regulation are a common feature across perinatal mental illnesses. Aims: This study sought to evaluate the impacts of dialectical behaviour therapy (DBT) skills groups for mothers and babies in a community perinatal service. We hypothesised that community perinatal DBT skills groups that included babies would reduce distress and improve emotional regulation. Method: A mixed-methods within-subjects design was utilised with outcome measures collected pre- and post-intervention. Qualitative interviews exploring mothers’ experiences of bringing their baby to group were also conducted. Results: Results indicated that DBT skills groups significantly improved levels of psychological distress and emotional regulation. Conclusions: Community perinatal DBT skills groups are effective when babies are present. Moreover, benefits of including babies were identified, under the themes of Self as Mother, Shared Experience, and Impact of Babies.

080 Is Napping Only Beneficial to Evening Chronotypes? A Pilot Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A33-A33
Author(s):  
Zachary Zamore ◽  
Jennifer Goldschmied ◽  
Patricia Deldin
Keyword(s):  
Emotional Regulation ◽  
Repeated Measures ◽  
Emotional Dysregulation ◽  
Self Control ◽  
Frustration Tolerance ◽  
Within Subjects ◽  
Median Split ◽  
Impossible Task ◽  
And Behavior ◽  
The Impact

Abstract Introduction Research shows associations between chronotype and behavior. While eveningness is associated with lower levels of self-control, morningness is associated with increased conscientiousness. Additionally, throughout the day, the increase in homeostatic sleep pressure due to wakefulness can affect executive functioning, including emotional regulation. Napping is an effective countermeasure to sleepiness and associated emotional dysregulation, but the impact of chronotype on this benefit is unknown. Therefore, this study aimed to examine the impact of chronotype and a midday nap on an aspect of emotional regulation: frustration tolerance. Methods 40 participants between the ages of 18–50 were randomized into a 60-minute, midday nap or no-nap condition. Chronotype was measured using the Horne-Östberg Morningness-Eveningness Questionnaire (MEQ). Frustration tolerance (FT) was measured pre and post nap using an adaption of Feather’s frustration tolerance task where FT was measured as the time spent on an impossible task. To examine the association of chronotype and FT, correlational analysis was used. Chronotype was also determined using a median split of the MEQ due to few true morning and evening types in the sample. This data was then subjected to a repeated measures ANOVA with condition (pre or post-nap) as a within-subjects factor and group (nap or no-nap; high or low MEQ score) as between-subject factors. Results Results revealed a significant correlation between MEQ score and change in time spent on the impossible task, with those with lower MEQ scores (more evening) showing an increase in time spent on the impossible task, r(20) = -.51, p = .016. Similarly, results of the ANOVA revealed a significant condition (pre or post-nap) by group (nap, no nap; high, low MEQ) interaction, F(1,1) = 4.694, p = .039, such that, those in the nap group with lower MEQ (more evening) spent more time on the impossible task following the nap. Conclusion Our results indicate that chronotype may impact a nap’s positive effect on emotional regulation, with greater benefit for those with the eveningness chronotype. Because napping is currently practiced by 1/3 of American adults, from a personalized medicine perspective, it’s imperative that its chronotype-dependent benefits be investigated further to effectively guide evidence-based recommendations. Support (if any):

Report1: Impact of Covid-19 on young people aged 13-24 in the UK- preliminary findings

2020 ◽  
Author(s):  
Liat Levita ◽  
Jilly Gibson Miller ◽  
Todd K. Hartman ◽  
Jamie Murphy ◽  
Mark Shevlin ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Emotional Regulation ◽  
Health Anxiety ◽  
Self Control ◽  
Social Risk ◽  
Need For Support ◽  
The Uk ◽  
Social Recovery ◽  
The Impact

COVID-19 has led to an unprecedented disruption of normal social relationships and activities, which are so important during the teen years and young adulthood, and to education and economic activity worldwide. The impact of this on young people’s mental health and future prospects may affect their need for support and services, and the speed of the nation’s social recovery afterwards. This study focused on the unique challenges facing young people at different points during adolescent development, which spans from the onset of puberty until the mid-twenties. Although this is an immensely challenging time and there is a potential risk for long term trauma, adolescence can be a period of opportunity, where the teenagers’ brain enjoys greater capacity for change. Hence, the focus on young people is key for designing age-specific interventions and public policies, which can offer new strategies for instilling resilience, emotional regulation, and self-control. In fact, adolescents might be assisted to not only cope, but excel, in spite of the challenges imposed by this pandemic. Our work will feed into the larger societal response that utilizes the discoveries about adolescence in the way we raise, teach, and treat young people during this time of crisis. Wave 1 data has already been collected from 2,002 young people aged 13-24, measuring their mental health (anxiety, depression, trauma), family functioning, social networks, and resilience, and social risk-taking at the time of the pandemic. Here we present a preliminary report of our findings, (Report 1). Data collected 21/4/20- 29/4/20 - a month after the lockdown started).

scholarly journals Metagenomic Analysis of the Fecal Archaeome in Suckling Piglets Following Perinatal Tulathromycin Metaphylaxis

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1825
Author(s):  
Mohamed Zeineldin ◽  
Ameer Megahed ◽  
Benjamin Blair ◽  
Brian Aldridge ◽  
James Lowe
Keyword(s):  
Sequencing Analysis ◽  
Metagenomic Sequencing ◽  
Post Intervention ◽  
Gastrointestinal Microbiome ◽  
Health And Wellbeing ◽  
Suckling Piglets ◽  
And Function ◽  
Changes Over Time ◽  
And Control ◽  
The Impact

The gastrointestinal microbiome plays an important role in swine health and wellbeing, but the gut archaeome structure and function in swine remain largely unexplored. To date, no metagenomics-based analysis has been done to assess the impact of an early life antimicrobials intervention on the gut archaeome. The aim of this study was to investigate the effects of perinatal tulathromycin (TUL) administration on the fecal archaeome composition and diversity in suckling piglets using metagenomic sequencing analysis. Sixteen litters were administered one of two treatments (TUL; 2.5 mg/kg IM and control (CONT); saline 1cc IM) soon after birth. Deep fecal swabs were collected from all piglets on days 0 (prior to treatment), 5, and 20 post intervention. Each piglet’s fecal archaeome was composed of rich and diverse communities that showed significant changes over time during the suckling period. At the phylum level, 98.24% of the fecal archaeome across all samples belonged to Euryarchaeota. At the genus level, the predominant archaeal genera across all samples were Methanobrevibacter (43.31%), Methanosarcina (10.84%), Methanococcus (6.51%), and Methanocorpusculum (6.01%). The composition and diversity of the fecal archaeome between the TUL and CONT groups at the same time points were statistically insignificant. Our findings indicate that perinatal TUL metaphylaxis seems to have a minimal effect on the gut archaeome composition and diversity in sucking piglets. This study improves our current understanding of the fecal archaeome structure in sucking piglets and provides a rationale for future studies to decipher its role in and impact on host robustness during this critical phase of production.

Care of children with type 1 diabetes mellitus in school – An interventional study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Umamaheswari Gurunathan ◽  
Hemchand Krishna Prasad ◽  
Sherline White ◽  
Bala Prasanna ◽  
Thangavelu Sangaralingam
Keyword(s):  
Type 1 Diabetes ◽  
Education Program ◽  
School Teachers ◽  
Post Intervention ◽  
Community Based ◽  
Structured Education ◽  
Type 1 Dm ◽  
The Impact ◽  
Determining Factor

AbstractObjectivesPaucity of data from India on care of children with Type 1 diabetes in schools. Aims: To study assess the knowledge, attitude, practices and fear of Type 1 diabetes in school teachers and to assess the impact of an educational model on the fear of teachers and care of children in Type 1 DM at school hours.MethodsA community based study, involving school teachers and the intervention being educating them about diabetes conducted. Data pertaining to basic demography, attitude of teachers towards diabetic children, Hypoglycemia fear factor survey- parent version with worries domain and preparedness of school was collected. An education program was conducted on diabetes care in children. Immediately and after three months, the proforma details and HFSP-W scores reassessed.ResultsForty two teachers (mean age: 38.7±5.4; M:F ratio 2:40) participated in the study. Post intervention, a higher willingness to have the diabetic child in class (100 vs. 57.1%; p>0.05), better support in daily care (100 vs. 92%; p>0.05), participation in sports activities (100 vs. 7.1%; p<0.05) observed. HFSP-W scores were 38.8±4.5 (pre-intervention), 22.5±4.3 (immediate post intervention) and 29.5±3.2 (at 3months) (p<0.05). To study the determinants of improvement in HFSP-W a regression analysis was performed: presence of glucometer the most likely determining factor (T=1.999, p=0.05).ConclusionThere is a significant element of fear in the minds of teachers towards hypoglycemia which improves with a structured education program.

scholarly journals 87. Utilization of Methicillin-Sensitive/Resistant Staphylococcus aureus Nares Screen to Decrease Vancomycin and Linezolid Use in Hospitalized Patients with Respiratory Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S60-S60
Author(s):  
Noor F Zaidan ◽  
Rachel S Britt ◽  
David Reynoso ◽  
R Scott Ferren
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Infections ◽  
Intervention Group ◽  
Kidney Injury ◽  
Post Intervention ◽  
Gram Positive ◽  
Stewardship Program ◽  
Screening Protocol ◽  
The Impact ◽  
Post Intervention Group

Abstract Background Pharmacist-driven protocols for utilization of methicillin-resistant Staphylococcus aureus (MRSA) nares screenings have shown to decrease duration of empiric gram-positive therapy and rates of acute kidney injury (AKI) in patients with respiratory infections. This study evaluated the impact of a pharmacist-driven MRSA nares screening protocol on duration of vancomycin or linezolid therapy (DT) in respiratory infections. Methods Patients aged 18 years and older with a medication order of vancomycin or linezolid for respiratory indication(s) were included. The MRSA nares screening protocol went into effect in October 2019. The protocol allowed pharmacists to order an MRSA nares polymerase chain reaction (PCR) for included patients, while the Antimicrobial Stewardship Program (ASP) made therapeutic recommendations for de-escalation of empiric gram-positive coverage based on negative MRSA nares screenings, if clinically appropriate. Data for the pre-intervention group was collected retrospectively for the months of October 2018 to March 2019. The post-intervention group data was collected prospectively for the months of October 2019 to March 2020. Results Ninety-seven patients were evaluated within both the pre-intervention group (n = 50) and post-intervention group (n = 57). Outcomes for DT (38.2 hours vs. 30.9 hours, P = 0.601) and AKI (20% vs. 14%, P = 0.4105) were not different before and after protocol implementation. A subgroup analysis revealed a significant reduction in DT within the pre- and post-MRSA PCR groups (38.2 hours vs. 24.8 hours, P = 0.0065) when pharmacist recommendations for de-escalation were accepted. Conclusion A pharmacist-driven MRSA nares screening protocol did not affect the duration of gram-positive therapy for respiratory indications. However, there was a reduction in DT when pharmacist-driven recommendations were accepted. Disclosures All Authors: No reported disclosures

scholarly journals 1346. Implementation of a Multidisciplinary 48 Hour Antibiotic Timeout in a Pediatric Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S684-S684
Author(s):  
Victoria Konold ◽  
Palak Bhagat ◽  
Jennifer Pisano ◽  
Natasha N Pettit ◽  
Anish Choksi ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Intervention Group ◽  
Post Intervention ◽  
Days Of Therapy ◽  
New Antibiotics ◽  
Core Elements ◽  
Quasi Experimental ◽  
Empirical Antibiotics ◽  
The Impact

Abstract Background To meet the core elements required for antimicrobial stewardship programs, our institution implemented a pharmacy-led antibiotic timeout (ATO) process in 2017 and a multidisciplinary ATO process in 2019. An antibiotic timeout is a discussion and review of the need for ongoing empirical antibiotics 2-4 days after initiation. This study sought to evaluate both the multidisciplinary ATO and the pharmacy-led ATO in a pediatric population, compare the impact of each intervention on antibiotic days of therapy (DOT) to a pre-intervention group without an ATO, and to then compare the impact of the pharmacy-led ATO versus multidisciplinary ATO on antibiotic days of therapy (DOT). Methods This was a retrospective, pre-post, quasi-experimental study of pediatric patients comparing antibiotic DOT prior to ATO implementation (pre-ATO), during the pharmacy-led ATO (pharm-ATO), and during the multidisciplinary ATO (multi-ATO). The pre-ATO group was a patient sample from February-September 2016, prior to the initiation of a formal ATO. The pharmacy-led ATO was implemented from February-September 2018. This was followed by a multidisciplinary ATO led by pediatric residents and nurses from February-September 2019. Both the pharm-ATO and the multi-ATO were implemented as an active non-interruptive alert added to the electronic health record patient list. This alert triggered when new antibiotics had been administered to the patient for 48 hours, at which time, the responsible clinician would discuss the antibiotic and document their decision via the alert workspace. Pediatric patients receiving IV or PO antibiotics administered for at least 48 hours were included. The primary outcome was DOT. Secondary outcomes included length of stay (LOS) and mortality. Results 1284 unique antibiotic orders (n= 572 patients) were reviewed in the pre-ATO group, 868 (n= 323 patients) in the pharm-ATO and 949 (n= 305 patients) in the multi-ATO groups. Average DOT was not significantly different pre vs post intervention for either methodology (Table 1). Mortality was similar between groups, but LOS was longer for both intervention groups (Table 1). Impact of an ATO on DOT, Mortality and LOS Conclusion An ATO had no impact on average antibiotic DOT in a pediatric population, regardless of the ATO methodology. Disclosures All Authors: No reported disclosures

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