FUZZY TAKAGI-SUGENO-KANG FOR MENTAL HEALTH CONSULTATION RECOMMENDATIONS

The condition of students experiencing trauma makes consultation a necessity, there is no mental health examination that can be accessed by students, parents, psychologists, student affairs using the fuzzy Takagi-Sugeno-Kang method so it is necessary to be able to create a recommendation system for student mental health consultations by using fuzzy Takagi-Sugeno-Kang. In accordance with the case given, each student with a neurosis score of 8, psychoactive substances 11, psychotic 10 and post stress trauma disorder 13 had a mental health symptom level of 24.28, meaning they were at a moderate level. With a mental health recommendation system, it can be handled earlier so that learning activities can run according to the desired achievements.

Anxiety and depressive symptoms in college students during the late stage of the COVID-19 outbreak: a network approach

Mental health problems are common in college students even in the late stage of the coronavirus disease 2019 (COVID-19) outbreak. Network analysis is a novel approach to explore interactions of mental disorders at the symptom level. The aim of this study was to elucidate characteristics of depressive and anxiety symptoms network in college students in the late stage of the COVID-19 outbreak. A total of 3062 college students were included. The seven-item Generalized Anxiety Disorder Scale (GAD-7) and nine-item Patient Health Questionnaire (PHQ-9) were used to measure anxiety and depressive symptoms, respectively. Central symptoms and bridge symptoms were identified based on centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. The strongest direct relation was between anxiety symptoms “Nervousness” and “Uncontrollable worry”. “Fatigue” has the highest node strength in the anxiety and depression network, followed by “Excessive worry”, “Trouble relaxing”, and “Uncontrollable worry”. “Motor” showed the highest bridge strength, followed by “Feeling afraid” and “Restlessness”. The whole network was robust in both stability and accuracy tests. Central symptoms “Fatigue”, “Excessive worry”, “Trouble relaxing” and “Uncontrollable worry”, and critical bridge symptoms “Motor”, “Feeling afraid” and “Restlessness” were highlighted in this study. Targeting interventions to these symptoms may be important to effectively alleviate the overall level of anxiety and depressive symptoms in college students.

Mechanisms of cognitive-behavioral therapy effects on symptoms of body dysmorphic disorder: a network intervention analysis

Background Body dysmorphic disorder (BDD) is a severe and undertreated condition. Although cognitive-behavioral therapy (CBT) is the first-line psychosocial treatment for this common disorder, how the intervention works is insufficiently understood. Specific pathways have been hypothesized, but only one small study has examined the precise nature of treatment effects of CBT, and no prior study has examined the effects of supportive psychotherapy (SPT). Methods This study re-examined a large trial (n = 120) comparing CBT to SPT for BDD. Network intervention analyses were used to explore symptom-level data across time. We computed mixed graphical models at multiple time points to examine relative differences in direct and indirect effects of the two interventions. Results In the resulting networks, CBT and SPT appeared to differentially target certain symptoms. The largest differences included CBT increasing efforts to disengage from and restructure unhelpful thoughts and resist BDD rituals, while SPT was directly related to improvement in BDD-related insight. Additionally, the time course of differences aligned with the intended targets of CBT; cognitive effects emerged first and behavioral effects second, paralleling cognitive restructuring in earlier sessions and the emphasis on exposure and ritual prevention in later sessions. Differences in favor of CBT were most consistent for behavioral targets. Conclusions CBT and SPT primarily affected different symptoms. To improve patient care, the field needs a better understanding of how and when BDD treatments and treatment components succeed. Considering patient experiences at the symptom level and over time can aid in refining or reorganizing treatments to better fit patient needs.

Measurement to Improve Treatment Delivery: A Commentary on the HiTOP Measure Development Project

The focus on this commentary will be on how dimensional models of psychopathology, particularly HiTOP model, have the potential to significantly streamline treatment efforts and increase the likelihood that evidence-based interventions are more widely integrated in clinical practice. The approach to assessment adopted by the HiTOP consortium is likely to have an outsized impact on whether these innovations are adopted in routine clinical practice. Toward that end, I provide suggestions for a measurement strategy that can maximize clinical utility. In particular, the tension between creating items that reflect all phenomena at the sign/symptom level to refine our understanding of relationships among psychopathological constructs and creating a measure that is suitable for clinical practice is explored.

Co-occurrence of severe PTSD, somatic symptoms and dissociation in a large sample of childhood trauma inpatients: a network analysis

Co-occurrence of mental disorders including severe PTSD, somatic symptoms, and dissociation in the aftermath of trauma is common and sometimes associated with poor treatment outcomes. However, the interrelationships between these conditions at symptom level are not well understood. In the present study, we aimed to explore direct connections between PTSD, somatic symptoms, and dissociation to gain a deeper insight into the pathological processes underlying their comorbidity that can inform future treatment plans. In a sample of 655 adult inpatients with a diagnosis of severe PTSD following childhood abuse (85.6% female; mean age = 47.57), we assessed symptoms of PTSD, somatization, and dissociation. We analyzed the comorbidity structure using a partial correlation network with regularization. Mostly positive associations between symptoms characterized the network structure. Muscle or joint pain was among the most central symptoms. Physiological reactivation was central in the full network and together with concentrations problems acted as bridge between symptoms of PTSD and somatic symptoms. Headaches connected somatic symptoms with others and derealization connected dissociative symptoms with others in the network. Exposure to traumatic events has a severe and detrimental effect on mental and physical health and these consequences worsen each other trans-diagnostically on a symptom level. Strong connections between physiological reactivation and pain with other symptoms could inform treatment target prioritization. We recommend a dynamic, modular approach to treatment that should combine evidence-based interventions for PTSD and comorbid conditions which is informed by symptom prominence, readiness to address these symptoms and preference.

Development of symptom-focused outcome measures for advanced and indolent systemic mastocytosis: the AdvSM-SAF and ISM-SAF©

Background Advanced systemic mastocytosis (AdvSM), indolent systemic mastocytosis (ISM), and smoldering systemic mastocytosis (SSM) are rare diseases characterized by neoplastic mast cell infiltration of more than one organ. A content-valid patient-reported outcome (PRO) questionnaire that assesses relevant signs and symptoms that are important and understandable to individuals with a condition is critical for assessing new treatment benefit as well as supporting product labeling claims. Notably, no such PRO questionnaire has been developed in accordance with regulatory and scientific guidelines for use in AdvSM, ISM, and SSM patient populations. To fill that gap, this study documents the development and content validity of instruments evaluating signs and symptoms of systemic mastocytosis. Methods A review of peer-reviewed literature, advice meetings with clinical therapeutic area experts, patient concept elicitation interviews, concept selection and questionnaire construction meetings, and patient cognitive debriefing interviews were conducted, and regulatory feedback was incorporated. Results For AdvSM, 26 sign- and symptom-level concepts were identified in literature, 39 by clinicians, and 33 by patients. For ISM/SSM, 38 sign- and symptom-level concepts were identified in the literature, 39 by clinicians, and 57 by patients. Two patient-reported instruments, the Advanced Systemic Mastocytosis Symptom Assessment Form (AdvSM-SAF) and Indolent Systemic Mastocytosis Symptom Assessment Form (ISM-SAF)(©Blueprint Medicines Corporation), were developed based on consolidated findings. Cognitive debriefing interviews with AdvSM and ISM patients showed the AdvSM-SAF and ISM-SAF were understood and interpreted as intended by the majority of patients. Conclusion The AdvSM-SAF and ISM-SAF are content-valid tools measuring symptoms from AdvSM and ISM patients’ perspective.

Video Game Addictive Symptom Level, Use Intensity, and Hedonic Experience: An Empirical Analysis of a Novel Survey Instrument (Preprint)

UNSTRUCTURED We conducted a survey of 835 individuals who regularly play video games to determine the relationship between Video Gaming (VG) intensity of use and hedonic experience of the user. We divide the sample into four quartiles by self-reported VG addictive symptom level (from the Internet Gaming Disorder Scale) and conduct polynomial regressions separately for each quartile. We find that the higher VG addictive symptom level groups experience a U-shaped (curvilinear) relationship between hedonic experience and intensity of play, whereas groups with lower VG addictive symptom levels exhibit no such relationship. Due to sensitization and tolerance, we conclude that high-symptom groups experience frustration and disappointment until achieving excessive dopamine release, at which point their hedonic experience improves in additional play. Conversely, low-symptom groups experience no such fall-and-rise pattern. Members of the latter group play the game for the direct experience; therefore, their hedonic experience is more directly related to events occurring in the game than to the increasingly-elusive pursuit of excessive dopamine release. We also find that high-symptom groups spend substantially more time and money to support VG use and are much more likely to engage in VG use at the expense of other important activities, such as work, sleep, and eating.