/library/oar/handle/123456789/23187 2026-05-29T21:24:28Z /library/oar/handle/123456789/145982 Title: Mediators of outcome in adolescent psychotherapy and their implications for theories and mechanisms of change : a systematic review Authors: Taubner, Svenja; Ioannou, Yianna; Saliba, Andrea; Sales, Célia M. D.; Volkert, Jana; Protić, Sonja; Adler, Asta; Barkauskiene, Rasa; Conejo‑Cerón, Sonia; Di Giacomo, Dina; Mestre, Jose M.; Moreno‑Peral, Patricia; Mucha Vieira, Filipa; Pinheiro Mota, Catarina; Santos Henriques, Margarida Isabel Rangel; Røssberg, Jan Ivar; Stepisnik Perdih, Tjasa; Schmidt, Stefanie Julia; Zettl, Max; Ulberg, Randi; Heinonen, Erkki Abstract: Psychotherapeutic treatment of adolescents requires age-specific approaches and thus plausibly also involves different change mechanisms than adult psychotherapy. To guide further research and improve therapeutic outcomes for adolescents, we reviewed all RCTs investigating mechanisms of change in the psychological treatment of adolescents to identify the most promising age-, disorder- or treatment-specific mediators. Following the preferred reporting items for systematic reviews (PRISMA), 106 studies were included that reported 252 statistical mediation tests assessed with 181 different measures. Most often studied and significant mediators were cognitive, followed by family-related, and behavioral variables. Several mediators were identified to be promising for future investigations: changes in negative thoughts, dysfunctional beliefs and metacognitive skills; family functioning and parenting skills; as well as successful engagement in therapy activities and increased impulse control. Symptom change during therapy was least often a mediator for other therapeutic changes. Relational and emotional mediators were largely understudied, whereas peer-influence appeared a promising mediator for intervention outcomes. Adolescence-specific mediators were most commonly investigated. Majority of studied mediators were not disorder-specific. There was a tendency to mainly test change mechanisms of specific theoretical models without considering other possible change theories. Further, virtually no studies fulfilled all criteria for rigorously investigating mediation and only nine were classified with an overall good study quality. While bearing in mind the current limitations in study designs, methodological rigor and reporting, there appears to be substantial evidence for transdiagnostic age-specific change models in the psychological treatment of adolescents. For future research, need for consensus on a core set of transdiagnostic and transtheoretical mediators and measures is highlighted. These should address likely core mechanisms of change, as well as take into account age-relevant developmental challenges and biological markers. 2024-01-01T00:00:00Z /library/oar/handle/123456789/142089 Title: Surrounded by predators : the lived experiences of online harassment by male public figures Authors: Bezzina, Malcolm; Sammut, Francesca; Scerri, Josianne Abstract: Online harassment is a pervasive threat to public figures, with journalists and politicians facing heightened exposure due to their visibility and engagement in public discourse. While international research has explored the gendered nature of cyberharassment, little is known about the lived experiences and coping strategies of male public figures. This study focuses on the lived experiences of cyberharassment among male journalists and Members of Parliament (MPs) in Malta. Online semi-structured interviews were conducted with three MPs and three journalists, aged between 28 and 70 years. Data were analysed using Interpretative Phenomenological Analysis (IPA). Findings reveal substantial commonalities between journalists and MPs in both the impact of harassment and the coping mechanisms employed. Two superordinate themes emerged: “A gladiator among tigers”, which captures a range of adverse physical, psychological, and emotional effects, as well as concerns for others and about the changing online environment; and “From ‘standing the heat’ to firefighting”, which examines the problem-solving, emotion-focused, and avoidance coping strategies used to manage cyberharassment. Notably, participants described unique coping methods, such as seeking reconciliation with perpetrators and deriving meaning from public service through investigative journalism. These findings contribute to a more nuanced understanding of the challenges faced by male public figures in the digital sphere. A series of individual and structural strategies are recommended to support individuals experiencing online harassment. Further research is needed to explore intersectional factors and to inform policy and practice recommendations for safeguarding the wellbeing of public figures against online harassment. 2025-01-01T00:00:00Z /library/oar/handle/123456789/139543 Title: Procedural ethics for participatory research : field-specific dilemmas and recommendations from researchers, co-researching community partners and the rec overseeing a community-academic ADHD research project Authors: Cilia Vincenti, Sarah; Grech, Paulann; Galea, Michael; Briffa, Vince; Borg Spiteri, Sarah; Cachia, Maria; Del Bene, Sharon; Briffa Desjardins, Jennifer; Galea McKay, Naomi; McElhatton, Mel; Privitera Brightwell, Herma; Saliba, Marie Claire; Schembri, Erica Abstract: Philosophical assumptions of the participatory worldview collide with the biomedical framework on which procedural ethics have been grounded. Consequently, obtaining or approving ethical clearance for participatory research can be challenging. Researchers may resent being pressed to water down participatory features to suit institutional requirements. Co-researching community partners’ trust towards academia may be compromised at the outset if the REC comes across unappreciative of their tacit knowledge or is insensitive to their self-determination appeals. REC members may be conflicted over unfamiliar dilemmas. A report detailing effective collaboration during design and approval of a protocol for a photovoice study aimed to empower ADHD women is provided. This collaboration culminated in study plans which satisfied one and all’s requirements. In an attempt to include co-researcher voice in publications and promote more positive perceptions of REC oversight in participatory scholarship, recommendations by academic and community partners and the REC chair who is overseeing this project are advanced. Many lessons were drawn from this positive experience by those who engaged in it. Ethicality, in the context of participatory research is certainly not straightforward, but its pursuit need not be a battlefield. It requires the mobilization of values embedded in the participatory worldview and, akin to the research itself, holds transformative potential. 2025-01-01T00:00:00Z /library/oar/handle/123456789/137180 Title: Emergence of a new me : experiences of women diagnosed with HER2-positive breast cancer Authors: Scerri, Josianne; Agius, Janice; Galea, Michael Abstract: Breast cancer subtypes vary in prevalence, prognosis, treatment protocols, and side-effect profiles, that may impact patients’ lived experiences. Despite this, studies often group the experiences of persons with breast cancer together. The aim of this study was to explore the lived experiences of non-metastatic women diagnosed with Herceptin2-positive breast cancer, from diagnosis to the completion of treatment. Semi-structured interviews were conducted with 13 women who had undergone treatment for HER2 + breast cancer within the past two years. Their ages ranged between 32–79 years. Data collected were analysed using interpretative phenomenological analysis. Four experiential themes emerged: ‘My world came crashing down,’ ‘The countdown,’ ‘To do or not to do, that is the question,’ and ‘Nearing the end of my journey.’ These themes correspond to four phases of the participants’ experiences: (i) the diagnostic phase, (ii) the neoadjuvant chemotherapy phase, (iii) the surgical phase, and (iv) the post-surgery adjuvant phase. The diagnosis elicited strong emotional reactions due the particularly aggressive nature of this type of cancer. However, the availability of targeted treatment and having a relatively common subtype of breast cancer provided hope for recovery. Throughout the neoadjuvant phase, participants experienced a range of emotions, including anxiety over missing any treatment, distress about changes in body-image, and concerns for their families. As treatment approached its end, they felt relieved but also anxious about the possibility of a recurrence. Understanding the narratives of women having Herceptin2-positive breast cancer, allows health professionals to better address their unique needs, concerns, and values, leading to the development of personalised care plans that target their lived experiences. 2025-01-01T00:00:00Z