The role of tinnitus distress in the development of somatization symptoms among patients: implications for health care in Pakistan

Purpose Tinnitus patients are among the most vulnerable group to develop psychopathological symptoms over time if left unresolved. This study aims to investigate the role of tinnitus distress between tinnitus magnitude, cognitions and functional difficulties in the development of somatization symptoms among male and female patients experiencing ear-related problems due to lack of proper access to health care. Design/methodology/approach This study was based on a purposive sampling technique and sample consisted on 159 patients (97 male, 62 female) having tinnitus complaints, with age range 18–87 (M = 47.94, SD = 17.47) years, recruited from various clinics and hospitals of Islamabad, Pakistan, from December 2020 to July 2021. Findings The findings of this study showed that tinnitus distress is significant positively associated with tinnitus-related magnitude, negative cognitions, functional difficulties and somatization symptoms. Gender-related differences between male and female tinnitus patients revealed that females are more prone to depict higher levels of tinnitus distress, tinnitus magnitude, negative cognitions and somatization symptoms than male patients. Mediation analysis demonstrated that tinnitus distress serves as a mediator between tinnitus magnitude, cognitions, functional difficulties and somatization symptoms. Research limitations/implications Cross-sectional nature and self-reporting measures serve as a limitation of the study. An experimental study appears to be vital to ascertain the time-based relationship with tinnitus magnitude in the development of various psychopathological issues. The findings of this study contribute to the literature by highlighting the role of tinnitus distress in the origination of psychopathological symptoms like somatization and need of upgraded health-care systems in Pakistan. Originality/value This study has explored the mediating role of tinnitus distress between magnitude, cognitions, functional difficulties and somatization symptoms among Pakistani population, specifically mentioning the development of somatization symptoms among this population, which can contribute in the loss of earning and increased health expenses due to unawareness of proper health-care approach.

mHealth in the wild: A global examination of a publicly available app for depression (Preprint)

BACKGROUND The scope and impact of depression worldwide is breathtaking. Reducing the global burden of depression will require a multi-pronged approach. OBJECTIVE The purpose of this study is to examine naturalistic user behavior of MoodTools, a publicly available, self-guided mHealth app designed to improve symptoms of depression, in a global community sample. METHODS Mobile analytics data was collected from all unique downloads of the Android version of MoodTools between March 1, 2016 and February 28, 2018. RESULTS MoodTools was used by 158,930 people from 198 countries. 51.14% of users returned to the app after initial download. The typical person used the app for 3 sessions for a total of 12 minutes over the span of 90 days. Users most often visited tools designed for self-monitoring of symptoms and for targeting a core mechanism of depressive psychopathology, negative cognitions. CONCLUSIONS Results suggest that there is global interest in a publicly available app for improving depression. Self-guided apps like MoodTools, therefore, could be a tool in the toolbox to address the global burden of depression. Future research is needed to determine whether people who use self-guided apps experience improvement in depressive symptoms. Given the low motivation and behavioral avoidance associated with the disorder, a key challenge for self-guided apps for depression is to engage and to retain users. CLINICALTRIAL none, not a trial

Negative Cognitions and Emotional Distress Following Job Loss: Development and Validation of the Beliefs About Loss of Work (BLOW) Scale

Negative cognitions following job loss can contribute to emotional distress by motivating individuals to adopt coping styles that reduce stress in the short run while obstructing adjustment in the long run. It is unclear which specific cognitions are related to symptoms of complicated grief, depression, and anxiety following job loss. To fill this gap, this study introduces the Beliefs about Loss of Work (BLOW) scale and examines its psychometric properties. We recruited 222 Dutch workers who had lost their job, including 70 men and 152 women, with an average age of 52.5 years. Confirmatory factor analyses revealed that a second-order eight-factor model had the best fit to the data. The BLOW scale is a reliable instrument with a good convergent and divergent validity. This instrument may stimulate research on mechanisms involved in job loss-related distress and could inform the development of interventions to reduce this distress.

Suicidality and Mood: The Impact of Trends, Seasons, Day of the Week, and Time of Day on Implicit and Explicit Cognitions

Decades of research have established seasonality effects on completed and attempted suicides, with an increase in rates during spring and early summer. Using more than six years of data (April 2012 – November 2018), we used new Prophet models to forecast mood and explicit and implicit measures of self-harm among an online community sample residing in the US and UK (N > 7,975). We decomposed the time series into trends across the years, within years (seasons), weekly, and daily seasonal patterns. Across all outcomes, the long-term changes across the years and the seasonal patterns show the strongest variation on explicit and implicit cognitions, followed by the time of day (negative cognitions peaking around 4 am – 5 am), with the day of the week showing the weakest effects. The data show a general increase of negative cognitions across the six years, paralleling trends in suicide rates and depression prevalence in the US and UK. Autoregressive-integrated moving average (ARIMA) models showed seasonality effects for mood and desire to die among US, UK, and Canadian respondents (N > 10,445), particularly in the group of respondents who previously made a suicide attempt. Negative cognitions were generally the lowest in summer (June) and peaked in winter (December). These negative cognitions precede the rise in suicidal behaviors during spring and early summer. We discuss potential reasons for lagged effects of negative cognitions on suicidal behavior and implicit cognitions, which may be crucial for theoretical advancements. Our findings have implications for the clinical risk assessment of patients witha history of suicide attempts and public policies regarding the availability of health services.

Development and Preliminary Validation of the Child & Adolescent Social Cognitions Questionnaire

Negative cognitions play a central role in adolescent social anxiety, and yet there is a lack of empirically validated measures assessing these in detail. This study describes the adaptation of the Child & Adolescent Social Cognitions Questionnaire (CASCQ) from the adult version of the scale and its preliminary validation in a general adolescent school sample (N = 671). Exploratory and confirmatory factor analysis on split halves of the data indicated two factors, labelled ‘negative self-concept’ and ‘anxious appearance’, provided the best fit. Totals and subscales possessed good internal consistency and convergent validity. Findings suggest that the CASCQ is a reliable and valid measure of social anxiety-related cognitions in youth and may be useful for research and clinical purposes. Further examination of the scale with pre-adolescents and clinical samples is warranted.

Evaluating the Factor Structure of the Posttraumatic Cognitions Inventory

The Posttraumatic Cognitions Inventory (PTCI) is one of the most widely used measure of posttraumatic cognitions. The original factor analysis of the PTCI provided evidence for a three-factor model of negative cognitions about self, world, and self-blame. However, subsequent research has failed to replicate this factor structure without removing multiple items. Given these inconsistent findings, we examined the PTCI factor structure in a sample of trauma-exposed undergraduates ( n = 868). First, we conducted a series of four confirmatory factor analyses (CFAs) based on previously published models of the PTCI and a modified model based on previously removed items, all which indicated poor fit. Next, we conducted a CFA of the recently published three-factor PTCI-9, which approached adequate fit. We then replicated the CFA of the PTCI-9 in a second independent sample ( n = 971), finding a similar pattern of near adequate fit. These findings highlight the need to revise the PTCI. In addition, results indicate the promising nature of the PTCI-9 as an alternative measure of posttraumatic cognitions.

A systematic review on mediators between adversity and psychosis: potential targets for treatment

Various psychological and biological pathways have been proposed as mediators between childhood adversity (CA) and psychosis. A systematic review of the evidence in this domain is needed. Our aim is to systematically review the evidence on psychological and biological mediators between CA and psychosis across the psychosis spectrum. This review followed PRISMA guidelines. Articles published between 1979 and July 2019 were identified through a literature search in OVID (PsychINFO, Medline and Embase) and Cochrane Libraries. The evidence by each analysis and each study is presented by group of mediator categories found. The percentage of total effect mediated was calculated. Forty-eight studies were included, 21 in clinical samples and 27 in the general population (GP) with a total of 82 352 subjects from GP and 3189 from clinical studies. The quality of studies was judged as ‘fair’. Our results showed (i) solid evidence of mediation between CA and psychosis by negative cognitive schemas about the self, the world and others (NS); by dissociation and other post-traumatic stress disorder symptoms; and through an affective pathway in GP but not in subjects with disorder; (iii) lack of studies exploring biological mediators. We found evidence suggesting that various overlapping and not competing pathways involving post-traumatic and mood symptoms, as well as negative cognitions contribute partially to the link between CA and psychosis. Experiences of CA, along with relevant mediators should be routinely assessed in patients with psychosis. Evidence testing efficacy of interventions targeting such mediators through cognitive behavioural approaches and/or pharmacological means is needed in future.