Sexual health in adult survivors of childhood cancer: A Project REACH study.

Background: Sexual dysfunction is a significant complication of treatment for many adult-onset cancers. However, comparatively less is known about sexual dysfunction in adult childhood cancer survivors (CCSs). Research has been limited by the exclusion of specific cancers (e.

Evaluating SunSmart: a brief educational intervention promoting sun protection in young adult cancer survivors.

Purpose: Young adult cancer survivors (YACS) are at risk for secondary skin cancers but relevant interventions have not been validated in this population. To address this, we designed and tested SunSmart, a set of two educational videos designed to promote sun protection (SP). One provides SP education (Information) and the second combines SP education with content on negative appearance consequences of sun exposure (Information + Appearance).

Screening young adult cancer survivors for depression and anxiety with the Primary Care Evaluation of Mental Disorders (PRIME-MD): Comparisons with a structured clinical diagnostic interview.

Objective: Survivorship guidelines recommend screening for depression and anxiety in young adult cancer survivors (YACS), but research validating measures in this population is limited. The current study aimed to examine use of the Primary Care Evaluation of Mental Disorders (PRIME-MD) to screen for depression and anxiety in YACS.

Methods: 249 YACS (aged 18-40, 50% male) completed PRIME-MD via Telephone Automated Computer Assisted Structured Interview and the Structured Clinical Interview for the DSM-IV (SCID) via in-person interview.

Evaluating the Sleep Treatment Education Program (STEP-1): A single-session educational workshop addressing insomnia in cancer survivors.

Insomnia is a common late effect of cancer, affecting as many as 27% of cancer survivors. Although cognitive behavioral therapy for insomnia (CBT-I) is highly effective, treatment-associated burdens and limited availability of providers result in few survivors receiving this treatment. To address this gap, we developed the Sleep Treatment Education Program-1 (STEP-1), a single-session intervention addressing insomnia after cancer.

Validation of the Three-Item Insomnia Severity Index Short Form in Young Adult Cancer Survivors: Comparison with a Structured Diagnostic Interview.

Chronic insomnia affects ∼25% of young adult cancer survivors (YACS) but is often overlooked in routine follow-up. A recently introduced three-item version of the Insomnia Severity Index (ISI-3) was compared with a diagnostic interview (SCID-5) in 250 YACS (ages 18-40) to evaluate its validity in this population. The ISI-3 had good discrimination compared with the SCID-5 (area under the receiver operating characteristic curve = 0.

The effect of pediatric central nervous system tumors on identity in young adult survivors: a project REACH study.

Purpose: Of all childhood cancers, adult survivors of pediatric central nervous system (CNS) tumors are at the highest risk for late mortality as well as neurocognitive, physical, and psychosocial late effects. Their identity with cancer survivorship, the relationship of their identity to health outcomes, and how their identity differs from other childhood cancer survivors is poorly understood.

Methods: A total of 127 young adults previously treated for pediatric CNS tumors enrolled in Project REACH, a locally-treated childhood cancer survivor cohort.

The Effect of Pediatric Cancer on Identity in Young Adult Survivors: Results from Project REACH.

Living through cancer can have a profound effect on identity. Among those treated for adult-onset cancer, identifying as a cancer is common and has been linked to positive mental and physical health outcomes. Although childhood is a critical period for identity formation, comparatively less is known about identity development after pediatric cancers.

Cultural Influences on Sibling Relationships, Roles, and Self-Concept in the Context of Autism: Perspectives of Latino/a/x and non-Latino/a/x Siblings.

Siblings describe positive and negative aspects of autism and often assume lifelong support roles. Less is known about cultural influences on sibling relationships. This qualitative study characterizes processes linking siblings' autism conceptualizations, sibling relationships, and self-concept using a multicultural framework.

Validating the Patient-Reported Outcomes Measurement Information System Short Form v1.0-Anxiety 8a in a sample of young adult cancer survivors: Comparison with a structured clinical diagnostic interview.

Background: The objective of this study was to validate the Patient-Reported Outcomes Measurement Information System Short Form v1.0-Anxiety 8a (PROMIS-A-SF) against a structured diagnostic interview in order to determine its accuracy and the most appropriate cutoff score for identifying anxiety disorders in young adult cancer survivors (YACSs).

Methods: Two hundred forty-nine YACSs aged 18 to 40 years (50% male) completed the PROMIS-A-SF and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID).

Culture and Sexual Medicine: A Road Map for Clinical Inquiry and Practice.

As the field of sexual medicine continues to grow, there has been increasing attention to the importance of the sociocultural components of the biopsychosocial model. Although important in all medical practice, culture and sexual health are particularly entwined, so engaging with sociocultural aspects of the patient experience as part of evaluation and treatment is necessary to optimize patient outcomes in this field. We invite clinicians to consider the importance of sexual health literacy, cultural humility, and support for patient volition as key aspects of moving care towards a model that embraces all aspects of the biopsychosocial model.

The Relationship Between Parental Accommodation and Sleep-Related Problems in Children with Anxiety.

Objective: Sleep-related problems, defined as sleep patterns atypical for the child's developmental stage, are common in children with elevated anxiety symptoms and linked to significant mental and physical health consequences. Despite the consequences of sleep-related problems, it remains unclear how these problems are initiated and maintained in children with elevated anxiety symptoms. The current study examines the relationship between sleep-related problems and parental accommodation (e.

Parental Behaviors, Emotions at Bedtime, and Sleep Disturbances in Children with Cancer.

Background: Poor sleep is common for children during cancer treatment, but there is limited understanding of the nature of children's sleep throughout the treatment trajectory. The current exploratory study used an explanatory sequential mixed method approach to examine quantitative associations among sleep problems in children with cancer, parental behavior, and children's sleep hygiene, with follow-up qualitative characterizations of children's sleep across cancer treatment stages.

Procedure: Eighty parents of children with cancer (aged 2-10 years; in active treatment, maintenance treatment, or off treatment) completed an online survey querying the child's sleep quality (Sleep Disturbance Scale for Children-Disorders of Initiating and Maintaining Sleep subscale) and behaviors (Child Sleep Hygiene Scale) and sleep-related parenting behaviors (Parental Sleep Strategies).

Parent and child emotion and distress responses associated with parental accommodation of child anxiety symptoms.

Objective: Parental accommodation contributes to the maintenance of child anxiety and related symptoms. The current study examines the contributions of parent and child factors to parental accommodation in a sample of anxious youth.

Methods: Sixty-four treatment-seeking youth (6-16 years) and their mothers, as well as a subset of fathers (N = 41) reported on parental accommodation, parental distress and emotion regulation, child psychopathology, child externalizing behaviors, and child intolerance of uncertainty.

Parental awareness of sibling adjustment: Perspectives of parents and siblings of children with cancer.

Childhood cancer is a significant psychosocial stressor, and sibling adjustment ranges from resilience to clinically significant psychopathology. Siblings and parents often describe siblings' psychosocial functioning differently, which may reflect parental unawareness of siblings' adjustment to cancer and increase the risk for negative sibling outcomes. The present study characterizes siblings' and parents' perceptions of parents' awareness of siblings' psychosocial functioning and describes how family functioning influences parental awareness.

Autonomic arousal and learning in Web-based simulation: a feasibility study.

Introduction: Autonomic arousal is an important component of understanding learning as it is related to cognitive effort, attention, and emotional arousal. Currently, however, little is known about its relationship to online education. We conducted a study to determine the feasibility of measuring autonomic arousal and engagement in online continuing medical education (CME).

Interprofessional differences in disposition decisions: results from a standardized web-based patient assessment.

Objective: This study examined differences in disposition decisions among mental health professionals using a standardized Web-based simulation.

Methods: Using a Web-based simulation that described, across users, the same complex psychiatric patient, credentialed clinicians in a psychiatry department conducted a violence risk assessment and selected a level of follow-up care.

Results: Of 410 clinicians who completed the simulation, 60% of psychiatrists were more likely than other types of clinicians to select higher levels of care (inpatient or emergency services) for the standardized virtual patient (odds ratio=2.

Simulation-based ongoing professional practice evaluation in psychiatry: a novel tool for performance assessment.

Background: Ongoing professional practice evaluation (OPPE) activities consist of a quantitative, competency-based evaluation of clinical performance. Hospitals must design assessments that measure clinical competencies, are scalable, and minimize impact on the clinician's daily routines. A psychiatry department at a large academic medical center designed and implemented an interactive Web-based psychiatric simulation focusing on violence risk assessment as a tool for a departmentwide OPPE.