Pediatric Chronic Orofacial Pain: A Narrative Review of Biopsychosocial Associations and Treatment Approaches

Pediatric chronic orofacial pain (OFP) is an umbrella term which refers to pain associated with the hard and soft tissues of the head, face, and neck lasting >3 months in patients younger than 18 years of age. Common chronic pediatric OFP diagnoses include temporomandibular disorder, headaches, and neuropathic pain. Chronic OFP can adversely affect youth's daily functioning and development in many areas of well-being, and may be associated with emotional stress, depression, functional avoidance, and poor sleep, among other negative outcomes. In this mini-review, we will discuss common psychological comorbidities and familial factors that often accompany chronic pediatric OFP conditions. We will also discuss traditional management approaches for pediatric orofacial pain including education, occlusal appliances, and psychological treatments such as relaxation, mindfulness-based interventions, and cognitive-behavioral treatments. Finally, we highlight avenues for future research, as a better understanding of chronic OFP comorbidities in childhood has the potential to prevent long-term pain-related disability in adulthood.

The Utility of Animal Models for Studying the Metabo-Psychiatric Origins of Anorexia Nervosa

Anorexia nervosa (AN) is a severe eating disorder that primarily affects young women and girls, and is characterized by abnormal restrictive feeding and a dangerously low body-mass index. AN has one of the highest mortality rates of any psychiatric disorder, and no approved pharmacological treatments exist. Current psychological and behavioral treatments are largely ineffective, and relapse is common. Relatively little basic research has examined biological mechanisms that underlie AN compared to other major neuropsychiatric disorders. A recent large-scale genome-wide association study (GWAS) revealed that the genetic architecture of AN has strong metabolic as well as psychiatric origins, suggesting that AN should be reconceptualized as a metabo-psychiatric disorder. Therefore, identifying the metabo-psychiatric mechanisms that contribute to AN may be essential for developing effective treatments. This review focuses on animal models for studying the metabo-psychiatric mechanisms that may contribute to AN, with a focus on the activity-based anorexia (ABA) paradigm. We also highlight recent work using modern circuit-dissecting neuroscience techniques to uncover metabolic mechanisms that regulate ABA, and encourage further work to ultimately identify novel treatment strategies for AN.

Methods for Robot Behavior Adaptation for Cognitive Neurorehabilitation

An estimated 11% of adults report experiencing some form of cognitive decline, which may be associated with conditions such as stroke or dementia and can impact their memory, cognition, behavior, and physical abilities. While there are no known pharmacological treatments for many of these conditions, behavioral treatments such as cognitive training can prolong the independence of people with cognitive impairments. These treatments teach metacognitive strategies to compensate for memory difficulties in their everyday lives. Personalizing these treatments to suit the preferences and goals of an individual is critical to improving their engagement and sustainment, as well as maximizing the treatment's effectiveness. Robots have great potential to facilitate these training regimens and support people with cognitive impairments, their caregivers, and clinicians. This article examines how robots can adapt their behavior to be personalized to an individual in the context of cognitive neurorehabilitation. We provide an overview of existing robots being used to support neurorehabilitation and identify key principles for working in this space. We then examine state-of-the-art technical approaches for enabling longitudinal behavioral adaptation. To conclude, we discuss our recent work on enabling social robots to automatically adapt their behavior and explore open challenges for longitudinal behavior adaptation. This work will help guide the robotics community as it continues to provide more engaging, effective, and personalized interactions between people and robots. Expected final online publication date for the Annual Review of Control, Robotics, and Autonomous Systems, Volume 5 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Session-by-Session Improvements in Subjective Wellbeing and Satisfaction with Life Prospectively Predicts Session-by-Session Improvements in Bulimia Nervosa Symptoms.

PurposeBehavioral treatments (BT) have been credited for improving both subjective wellbeing (SWB) and satisfaction with life (SWL) among those with bulimia nervosa (BN); However, researchers have yet to examine whether the improvements in SWB and SWL during BTs occur prior to or after BN symptom reduction. The current study examines session-by-session change in SWB and SWL and BN symptoms.MethodsThe sample was comprised of 35 patients with BN-spectrum disorders. Participants received 20 sessions of BT and completed weekly pre-session surveys assessing their symptom frequency, SWB, and SWL. Data was analysed using linear mixed effect modelling.ResultsBN symptom reduction during preceding sessions prospectively predicted improvements in SWB and SWL during succeeding sessions. In addition, improvements in SWB and SWL during preceding sessions prospectively predicted reductions in BN symptoms in succeeding sessions.ConclusionThis study provides preliminary evidence of a bidirectional relationship between SWB and SWL and BN symptoms. Future research should test whether incorporating content focused on improving SWB and SWL into BT models could optimize treatment outcomes for BN.Level I, randomized controlled trials

Goodness of Fit

Disorder (HD) is a complex mental health problem defined by an overabundance of clutter, difficulty with organization and discarding, and problems regulating acquisition. This chapter describes the features of HD, evidence-based intervention approaches and outcomes, and the elements of a manualized treatment approach with emphasis on flexible delivery to meet clients’ needs. Opportunities to flexibly implement cognitive and behavioral treatments (CBT) for HD include modification of assessment methods, the order of therapy components, treatment timing and focus, responsiveness to client comorbidity and context, consideration of treatment planning, and approaches to increasing motivation and building skills. Also covered are supports for cognitive and behavioral changes in acquisition/organizing/discarding, assessing the appropriateness of a home cleanout, and determining “flexibility within fidelity” (Kendall & Frank, 2018) for group HD treatments and online interventions.