Sarah L. Jones’s research while affiliated with South West Yorkshire Partnership NHS Foundation Trust and other places

Background Advancements in medical science have focused largely on patient care, often overlooking the well-being of health care professionals (HCPs). This oversight has consequences; not only are HCPs prone to mental and physical health challenges, but the quality of patient care may also endure as a result. Such concerns are also exacerbated by unprecedented crises like the COVID-19 pandemic. Compared to other sectors, HCPs report high incidence of stress, depression, and suicide, among other challenging factors that have a significant negative impact on their well-being. Objective Given these substantial concerns, the development of a tool specifically designed to be used in clinical settings to measure the well-being of HCPs is essential. Methods A United Kingdom–based cross-sectional pilot study was carried out to measure self-reported well-being in a cohort of 148 physicians, using the newly developed well-being thermometer. The aim of the tool is to allow respondents to develop an individual sense of “well-being intelligence” thus supporting HCPs to have better insight and control over their well-being and allow insights into how to manage it. The tool consists of 5 well-being domains—health, thoughts, emotions, spiritual, and social. Each domain can be measured individually or combined to produce an overall well-being score. Results The tool demonstrated good internal consistency; the Cronbach α in this study was 0.84 for the total scale. Conclusions Results from this cohort demonstrated that the well-being thermometer can be used to gather intelligence of staff well-being. This is a promising new tool that will assist HCPs to recognize their own well-being needs and allow health care organizations to facilitate change in policies and practices to reflect a better understanding of staff well-being.

Background: Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition characterized by difficulties in social cognition and repetitive or rigid behaviours, affecting 1.1% of adults. The increasing incidence of ASD has led to pressurized diagnostic services, with specific challenges such as limited specialist workforce, lengthy waiting lists, and complex multidisciplinary evaluations that are not economically favourable. Objectives: This study evaluates criteria-informed triage assessment in an adult autism diagnostic service in the UK, supporting the implementation of clinical triage as a necessary measure for optimal resource allocation.Methods: The study was conducted at a specialist adult Autism Service in West Yorkshire, UK, from November 2021 to August 2022. All eligible referrals were accepted, with criteria requiring service users to be over 18 years old and without an intellectual disability. The evaluation consisted of 60 cases. Results: None of the evaluation cases resulted in a clinical diagnosis of ASD, yielding an infinite number needed to harm (NNH), demonstrating that every case benefiting from the triage process without significant risk of harm.Conclusions: Triage enables services to gather comprehensive information about individual presentations and clinical needs, facilitating informed decision-making. The evaluation demonstrates the safety and effectiveness of the triage process, with directions for further research discussed.

Objective Continuous performance tests are widely used to aid diagnostic decision making and measure symptom reduction in adult ADHD clinical populations. The diagnostic accuracy of the Quantified Behavior Test plus (QbTest+), developed to identify ADHD populations as an objective measure of ADHD symptoms, was explored. Methods The utility of the QbTest+ was investigated in a clinical cohort of 69 adult patients referred to a specialist ADHD clinic in the UK. Results Scores from the QbTest+ failed to differentiate between patients diagnosed with ADHD and those who did not receive a diagnosis after full clinical assessment. Conclusions Based on our findings, we recommend clinicians are cautious when interpreting results of the QbTest+ in clinical populations. This study highlights the need for investigation into the lack of validation of commonly used objective measures in ADHD populations.

Adult referrals to specialist autism spectrum disorder diagnostic services have increased in recent years, placing strain on existing services and illustrating the need for the development of a reliable screening tool, in order to identify and prioritize patients most likely to receive an ASD diagnosis. In this work a detailed overview of existing approaches is presented and a data driven analysis using machine learning is applied on a dataset of adult autism cases consisting of 192 cases. Our results show initial promise, achieving total positive rate (i.e., correctly classified instances to all instances ratio) up to 88.5%, but also point to limitations of currently available data, opening up avenues for further research. The main direction of this research is the development of a novel autism screening tool for adults (ASTA) also introduced in this work and preliminary results indicate the ASTA is suitable for use as a screening tool for adult populations in clinical settings.

Purpose The Adult Asperger Assessment (AAA), comprising the Autism Questionnaire, the Empathy Quiotient and the Relatives Questionnaire is a commonly used screening tool designed to identify adults who may benefit from a further clinical assessment for autism spectrum disorder. The purpose of this paper is to investigate the usefulness of this screening measure in a clinical setting. Design/methodology/approach This retrospective cohort study comprised of 192 service users referred for diagnostic assessment of Autism by a specialist service of the National Health Service. The authors evaluated the diagnostic accuracy of the AAA by investigating if the Autism Questionnaire, the Empathy Quiotient and the Relatives Questionnaire were able to predict the diagnostic outcome of Autism in a clinical setting. Findings Scores from the Relatives Questionnaire can accurately predict diagnostic outcome. No evidence of accuracy for the Autism Questionnaire or the Empathy Quotient was apparent. Based on the findings, the authors recommend clinicians are cautious when interpreting results of the AAA. Research limitations/implications It should be acknowledged that the results may not be generalisable to whole populations. Also, the authors used the full item versions of the scales; therefore, the findings are most applicable to studies which did similar. Originality/value This study highlights the need for investigation into the lack of validation of commonly used screening measures in autistic populations.

Advances in digital health have enabled clinicians to move away from a reliance on face to face consultation methods towards making use of modern video and web-based conferencing technology. In the context of the COVID-19 pandemic, remote telecommunication methods have become much more common place in mental health settings. The current study sought to investigate whether remote telecommunication methods are preferable to face to face consultations for adults referred to an Autism and ADHD Service during the COVID-19 pandemic. Also, whether there are any differences in preferred consultation methods between adults who were referred for an assessment of Autism as opposed to ADHD. 117 service users who undertook assessment by the ADHD and Autism Service at South West Yorkshire NHS Partnership Foundation Trust from April to September 2020 completed an adapted version of the Telehealth Usability Questionnaire (TUQ). Results demonstrated that service users found remote telecommunication to be useful, effective, reliable and satisfactory. Despite this, almost half of service users stated a general preference for face to face consultations. There was no difference in the choice of methods of contact between Autism and ADHD pathways. Remote telecommunication methods were found to be an acceptable medium of contact for adults who undertook an assessment of Autism and ADHD at an NHS Service during the COVID-19 pandemic.

Background The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) module four assessment for diagnosing autism spectrum disorder in adults has shown good sensitivity and specificity in research settings. Method This study aimed to evaluate the predictive accuracy of the ADOS-2 module four by investigating the components of the assessment, in relation to diagnostic outcome in a clinical setting. Data from 88 service users referred to a Specialist Adult Autism Service was explored. Results ADOS-2 scores failed to predict the diagnostic outcome (overall sensitivity = 92%, specificity = 57%). Interestingly, scores from the ‘restricted interests’ component of the ADOS-2 have the potential to predict diagnostic outcome, despite this domain not been included in the scoring algorithm. Conclusions Based on our findings, we recommend clinicians are cautious when interpreting results of the ADOS-2 assessment.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, characterized by symptoms of inattention, hyperactivity and or impulsivity. First line treatment is medication; however, medication alone may not provide sufficient functional improvement for some patients, or be universally tolerated. A recent surge in research to treat ADHD using non-pharmacological interventions demands a comprehensive, systematic review of the literature. The aim of this review was to examine the evidence base for psychological treatments for ADHD management in adulthood. A systematic search of PsycINFO, MEDLINE, CINAHL, AMED, PubMed, and EMBASE was undertaken until January 2019 for peer-reviewed articles exploring psychological interventions for adults (18 years with no upper limit) diagnosed with ADHD. A total of 53 papers were identified for inclusion. Collectively, 92% of studies (employing various non-pharmacological interventions) found a variant of significant positive effect on either primary or secondary outcomes associated with ADHD. The strongest empirical support derived from Cognitive Behavioral Therapy interventions. In addition, findings indicated support for the effectiveness of Mindfulness, Dialectical Behavior Therapy and Neurofeedback. Other types of interventions also demonstrated effectiveness; however, support was limited due to lack of available research and methodological rigor. Psychological interventions should be considered a valid and useful addition to clinical practice. Implications and areas for future research are discussed.

Background Attention deficit hyperactivity disorder is a common neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity and or impulsivity. Since the development of the concept, a reliable biomarker to aid diagnosis has been sought. One potential method is the use of electroencephalogram to measure neuronal activity. The aim of this review is to provide an up to date synthesis of the literature surrounding the potential use of electroencephalogram for diagnosis of attention deficit hyperactivity disorder in adulthood. Methods A search of PsycINFO, PubMed, and EMBASE was undertaken in February 2019 for peer-reviewed articles exploring electroencephalogram patterns in adults (18 years with no upper limit) diagnosed with attention deficit hyperactivity disorder. Results Differences in electroencephalogram activity are potentially unique to adult attention deficit hyperactivity disorder populations. Strongest support was derived for elevated levels of both absolute and relative theta power, alongside the observation that alpha activity is able to typically differentiate between adult attention deficit hyperactivity disorder and normative populations. Conclusions Electroencephalogram can have a use in clinical settings to aid adult attention deficit hyperactivity disorder diagnosis, but areas of inconsistency are apparent.