Background
Internet-delivered cognitive behavioural therapy (ICBT) is a promising treatment for refugee and immigrant populations suffering from common mental disorders. The aim of the present study was to investigate experiences of participating in a guided ICBT program among resettled Arabic-speaking individuals suffering from symptoms of anxiety and depression.
Methods
Ten individuals who had previously received ICBT consented to participate and were interviewed using semi-structured telephone interviews. The interviews were conducted 10 months after treatment termination. Data were transcribed and analysed using a Thematic Analysis framework.
Results
The Thematic Analysis resulted in five overarching themes 1) The importance of being seen, 2) New ways of knowing and doing, 3) Treatment format not for everyone, 4) Changing attitudes towards mental health and help-seeking and 5) The healthcare system as a complex puzzle. Participants described varying levels of success in applying the new information learned from the treatment in their everyday lives. The results also indicate that participation in the ICBT program to some extent mitigated mental health stigma and acted as a precursor to other forms of treatment seeking.
Conclusions
The findings in the present study are largely in line with previous qualitative research studies on ICBT participants. Future research should investigate whether a more explicit focus on refugee-specific stressors and barriers to treatment engagement and implementation can increase adherence to ICBT programs in this population.
The distribution of activated cerebral regions was examined in nine normal subjects during four different eye movement‐related conditions: (1) fixation – fixation on a central light emitting diode; (2) saccadic suppression – fixation on a diode in the presence of flashing lateral targets; (3) reflexive/volitional saccades – performance of overt eye movements to two laterally lit targets and back to the centre; and (4) imagined saccades – imagining, but not performing, the same eye movements. The regional neural activity was measured indirectly using repetitive bolus injections of oxygen‐15‐labelled water and positron emission tomography (PET) to yield time‐integrated images of the normalized count distribution. These were aligned and anatomically normalized to a standard stereotactic space and the averages of each condition were analysed categorically using statistical parametric mapping. Compared to central fixation, reflexive/volitional saccades significantly activated regions in the classically known cortical oculomotor regions. The most notable activation during the saccade suppression task, compared to central fixation alone, was a bilateral activation of the parietal cortex with a right‐sided preponderance, activation of the supplementary eye field/caudal cingulate regions, and activation of frontal regions close to the frontal eye fields. Imagined performance of eye movements without overt eye movements activated the supplementary eye field and frontal eye fields identically to regions involved in overt eye movements, thus demonstrating that overt eye movements are not a prerequisite of the activation of these regions in normal humans.
Impaired cognitive function in adult offspring of women with Type 1 diabetes compared with the background population apparently reflects differences with respect to well-known confounders. However, harmful effects of maternal hyperglycaemia may be mediated through delivery at < 34 weeks.
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