Psychological Sciences

Introduction: Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED.

Methods: We examined data from a tertiary pediatric care facility. A health survey questionnaire was administered after ED discharge to capture the outcome of parental likelihood of providing a positive facility rating. We abstracted patient demographic, clinical, and top diagnostic information using electronic health records. Data were merged and multivariable models were constructed. 

Results: We collected data from 15,895 pediatric patients between the ages of 0–17 years (mean = 6.69; standard deviation = 5.19) and their parents. Approximately 786 (4.94%) patients were administered an opioid; 8212 (51.70%) were administered a non-opioid analgesic; and 3966 (24.95%) expressed clinically significant pain (pain score >/= 4). Results of a multivariable regression analysis from these pediatric patients revealed a three-way interaction of age, pain severity, and opioid administration (odds ratio 1.022, 95% confidence interval, 1.006, 1.038, P = 0.007). Our findings suggest that opioid administration negatively impacted parent satisfaction of older adolescent patients in milder pain who were administered an opioid analgesic, but positively influenced the satisfaction scores of parents of younger children who were administered opioids. When pain levels were severe, the relationship between age and patient experience was not statistically significant.

Conclusion: This investigation highlights the complexity of the relationship between opioid administration, pain severity, and satisfaction, and suggests that the impact of opioid administration on parent satisfaction is a function of the age of the child.

BACKGROUND: A number of studies document the benefits of face-to-face social interactions for cognitive functioning among middle-aged and older adults. Social activities in virtual worlds may confer similar if not enhanced cognitive benefits as face-to-face social activities, given that virtual interactions require the additional cognitive tasks of learning and navigating communicative tools and technology platforms. Yet, few studies have examined whether social activities in internet-based settings may have synergistic effects on cognitive functioning beyond those of face-to-face interactions. OBJECTIVE: This study examined whether internet-based social activity participation is associated with concurrent and later cognitive functioning, after adjusting for face-to-face social activity participation and sociodemographic covariates. METHODS: For cross-sectional analyses, we included 3650 adults aged 50 years and older who completed questions in the 2020 Health and Retirement Study about social activity participation, including specific internet-based social activities such as emailing or accessing social networks. Cognitive functioning was measured using the standardized cognitive tasks assessing working memory, episodic memory, and attention and processing speed. The longitudinal analyses included the 2034 participants who also completed follow-up cognitive assessments in 2022. RESULTS: Our results revealed that those with higher levels of internet-based social activity participation had higher levels of concurrent cognitive functioning than those with low levels of internet-based social activity participation, after adjusting for demographic and health-related factors and face-to-face social activity participation (b=0.44, SE 0.07; P<.001). More internet-based social activity participation also predicted better cognitive functioning 2 years later, even when adjusting for baseline cognitive functioning and other covariates (b=0.35, SE 0.09; P<.001). CONCLUSIONS: Our findings suggest that greater engagement in internet-based social activities is associated with higher levels of concurrent cognitive functioning and slower cognitive decline in middle-aged and older adults.

In the last century, the paradigm of fear conditioning has greatly evolved in a variety of scientific fields. The techniques, protocols, and analysis methods now most used have undergone a progressive development, theoretical and technological, improving the quality of scientific productions. Fear-induced bradycardia is among these techniques and represents the temporary deceleration of heart beats in response to negative outcomes. However, it has often been used as a secondary measure to assess defensive responding to threat, along other more popular techniques. In this review, we aim at paving the road for its employment as an additional tool in fear conditioning experiments in humans. After an overview of the studies carried out throughout the last century, we describe more recent evidence up to the most contemporary research insights. Lastly, we provide some guidelines concerning the best practices to adopt in human fear conditioning studies which aim to investigate fear-induced bradycardia.

Stress is a key factor in psychotic relapse, and mindfulness offers stress resilience and well-being benefits. This study examined the effects of mindfulness-based intervention for psychosis (MBI-p) in preventing relapse at 1 year among patients with remitted psychosis in Hong Kong. MBI-p is a newly developed manual-based mindfulness protocol and was tested to have improved well-being and clinical outcomes in a pilot study with remitted psychosis patients. In this multisite, single-blind, 1-year randomized controlled trial (RCT), 152 fully remitted patients diagnosed with schizophrenia or non-affective psychosis were randomized to receive either a 7-week MBI-p or a 7-week psychoeducation program. Outcomes were assessed before and after the intervention, and then monthly for one year. Relapse rate and severity at one year were the primary outcomes. Secondary outcomes included psychopathology, functioning, mindfulness, and psychosocial factors such as stress and expressed emotions. No significant differences were found in the rate and severity of relapse between the MBI-p and psychoeducation groups in either intention-to-treat or per-protocol analyses. While MBI-p improved observation and non-reactivity to the inner experience of mindfulness, psychoeducation was found to benefit functioning and psychosocial functioning more than MBI-p. This is the first RCT to test MBI-ps effectiveness in preventing relapse among patients with remitted psychosis in Hong Kong. We postulate that the lack of significance is due to the heightened effectiveness of psychoeducation in coping with stress during the pandemic and the multifactorial causes leading to relapse. This suggests the possibility of combining these two interventions to improve their efficacy. Trial registration: NCT04060498.

PURPOSE: There is a lack of systematic solutions to manage supportive care issues in racial/ethnic minorities (REM) receiving treatment for cancer. We developed and implemented an electronic patient-reported outcome (ePRO)-driven symptom management tool led by oncology pharmacists in a majority-minority cancer center located in Southern California. This study was designed to evaluate the implementation outcomes of our multilevel intervention. METHODS: This was a prospective, pragmatic, implementation study conducted between July 2021 and June 2023. Newly diagnosed adult patients with cancer receiving intravenous anticancer therapies completed symptom screening using ePRO that consists of the Patient-Reported Outcomes Measurement Information System measures at each infusion visit during the study. ePRO results were presented to an oncologist pharmacist for personalized symptom management and treatment counseling. The RE-AIM framework was used to guide implementation outcomes. Differences in symptom trajectories and clinical outcomes between groups were tested using generalized estimating equations. RESULTS: We screened 388 patients of whom 250 were enrolled (acceptance rate: 64.4%), with 564 assessments being completed. The sample consisted of non-Hispanic White (NHW, 42.4%), Hispanic/Latinx (H/L, 30.8%), and non-Hispanic Asian (20.4%), with one (21.6%) of five participants preferring speaking Spanish. Compared with NHW, H/L participants had greater odds of reporting mild to severe pain interference (odds ratio [OR], 1.91 [95% CI, 1.18 to 3.08]; P = .008) and nausea and vomiting (OR, 2.08 [95% CI, 1.21 to 3.58]; P = .008), and higher rates of urgent care utilization (OR, 1.92 [95% CI, 1.04 to 3.61]; P = .04) within 30 days. Nausea and vomiting (n = 131, 23.2%), pain (n = 91, 16.1%), and fatigue (n = 72, 12.8%) were most likely to be intervened, with 90% of the participants expressing satisfaction across all visits. CONCLUSION: Our multilevel ePRO-driven intervention led by oncology pharmacists helps facilitate symptom assessments and management and potentially reduce health disparities among REM.

INTRODUCTION: Despite the importance of the transition to fatherhood as a critical life stage among young adult men, much remains unknown about the factors predictive of ideal cardiovascular health (CVH) and how CVH is impacted as young men face new roles and responsibilities associated with fatherhood. METHODS AND ANALYSIS: To address this gap, the Dad Bod Study is a prospective, longitudinal and observational study designed to examine how fatherhood affects young mens CVH. A total of 125, first-time prospective fathers (men, 19-39 years) will be enrolled and followed over 1.5 years. Metrics of the American Heart Associations Lifes Essential 8 as well as demographic, social and psychosocial factors will be collected at four time points (baseline (during the pregnant partners second trimester), 1-month post partum, 6 months post partum and 1 year post partum). The primary aims are to measure predictors of CVH among first-time fathers and describe longitudinal changes in CVH. A secondary aim is to identify the best practices for recruitment, retention and remote data collection in this population. ETHICS AND DISSEMINATION: The study was approved by the University of California, Irvine Institutional Review Board (IRB #4907, approved 1 May 2024). Participants will provide written consent. Study data will be disseminated in manuscripts submitted to peer-reviewed journals as well as in abstracts submitted to conferences and in the resulting posters and presentations. After study completion, anonymised data and material will be made publicly available.