Psychological Services最新文献

{"title":"Clinician profiles of suicide prevention attitudes and confidence and their association with reported suicide prevention practices.","authors":"Alexandra L Morena, Larissa M Gaias, Celine Larkin, Yan Wang, Catarina Kiefe, Edwin D Boudreaux","doi":"10.1037/ser0000981","DOIUrl":"https://doi.org/10.1037/ser0000981","url":null,"abstract":"<p><p>Many who die by suicide seek care in general health care settings within a year before death, but only recently has suicide prevention become a core responsibility in these settings. Implementing suicide prevention practices is challenging, and common barriers to adoption include clinician attitudes and self-efficacy. Identifying clinician profiles can further illuminate patterns of suicide prevention practice attitudes and self-efficacy within clinician subgroups to inform implementation strategy selection and development. This study identified distinct clinician profiles of suicide prevention attitudes and confidence and examines their associations with suicide prevention practice delivery to patients. This study also investigated variables that help explain an individual's likelihood of belonging to latent profiles. Clinicians (<i>N</i> = 1,570) from one health care system completed a survey assessing attitudes, confidence in using suicide prevention practices, and current practice use. Latent profile analysis was conducted, followed by outcome and predictor analyses. Four unique profiles characterized by varying levels of attitudes and self-efficacy were identified. The profile characterized by poor attitudes toward the universal screening practice but high self-efficacy to utilize suicide prevention practices reported higher practice use with patients. Clinician characteristics (e.g., role) and contextual factors (e.g., leadership support) predicted profile membership. Results highlight meaningful variations in clinicians' suicide prevention attitudes and self-efficacy, identifying four distinct profiles. These findings highlight the need for further tailoring suicide prevention training and implementation strategy selection. Profiles characterized by neutral or low self-efficacy may benefit from implementation strategies that provide interactive assistance, while high confidence profiles may benefit from strategies targeting sustainment. Specific approaches to leverage these profiles for improved practice adoption are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of indoor versus outdoor mindfulness interventions for veterans: A pilot randomized controlled trial.","authors":"Tracy Herrmann, Joanna Ellen Bettmann, Adam Hanley, Annelise Jolley, Ryan Lackner, Elena Nazarenko","doi":"10.1037/ser0000976","DOIUrl":"https://doi.org/10.1037/ser0000976","url":null,"abstract":"<p><p>Veterans' reluctance to engage in mental health treatment coupled with high attrition in such treatment should motivate practitioners and researchers to create innovative ways to treat veterans. Nature-based interventions show promise as a means for addressing veterans' mental health needs. The present study aimed to test the feasibility and acceptability of a manualized nature-based mindfulness intervention for veterans with mental illness. The authors hypothesized that veterans participating in the outdoor, nature-based intervention would report greater reductions in posttraumatic stress disorder symptoms and psychological distress compared to those participating in an indoor mindfulness intervention. Recruited from a Veterans Affairs health care center, 41 veterans with diagnosed mental illness were randomized to either a six-session outdoor group mindfulness intervention or a comparable six-session group mindfulness intervention delivered indoors at the Veterans Affairs. A <i>t</i> test and chi-square tests were used to examine treatment session attendance and treatment completer status. An intent-to-treat framework was used to assess between-group differences by fitting separate generalized linear mixed models with robust estimation for the outcomes of posttraumatic stress disorder symptoms, psychological distress, sense of restoration, and nature connectedness. Results showed that, while the average number of training sessions attended did not statistically differ by group, the number of treatment completers did; there were more treatment completers in the outdoor group. Additionally, linear mixed modeling with robust estimation revealed a significant Condition × Time interaction for posttraumatic stress disorder symptoms. The findings of this research demonstrate that nature-based interventions show promise as an approach to treating veteran mental illness while combating mental health care stigma and increasing treatment completion rates. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief group adaptation of the Unified Protocol for integrated primary care: Open trial of a transdiagnostic intervention delivered via telehealth.","authors":"Robyn L Shepardson, Nicola F De Paul, Kelly A Caver, David J Giard, Jennifer S Funderburk","doi":"10.1037/ser0000983","DOIUrl":"https://doi.org/10.1037/ser0000983","url":null,"abstract":"<p><p>There is a pressing need to scale up access to evidence-based mental health treatment. Offering transdiagnostic treatments that accommodate a variety of presenting concerns and comorbidities in integrated primary care settings via group format and telehealth modalities can help to efficiently increase access to care. To meet this need, we refined a brief group adaptation of the Unified Protocol for the transdiagnostic treatment of emotional disorders, called managing stress and emotions (MSE), which was modified for feasibility in integrated primary care settings and telehealth delivery. MSE comprises five 60-min classes emphasizing experiential skills-based learning. This pilot study evaluated the feasibility and acceptability of MSE while preliminarily evaluating effectiveness. We conducted an open trial with 18 patients (33% female, 89% White, <i>M</i>_age = 47 years) experiencing anxiety, depression, or adjustment difficulties who were recruited from Veterans Health Administration primary care. Using mixed methods, we assessed mental health symptoms and functioning from pre- to posttreatment and 3-month follow-up as well as treatment feasibility, acceptability, and satisfaction. MSE was feasible (89% engaged), and patients reported high treatment satisfaction. Pre- to posttreatment changes were promising, with medium-to-large effect sizes, and treatment gains generally remained stable at 3-months. Mixed methods data showed increased awareness of emotions and more use of adaptive coping strategies after MSE. Findings suggest further research evaluating effectiveness and implementation is warranted, as this is the briefest version of group Unified Protocol that has been tested thus far and can help to efficiently increase access to mental health treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preintake attrition among children and adults waiting for trauma-focused treatment.","authors":"Caitlin Rancher, Owen Winters, Emily Tilstra-Ferell, Austen McGuire, Megan M Wallace, Alyssa A Rheingold, Daniel W Smith","doi":"10.1037/ser0000973","DOIUrl":"10.1037/ser0000973","url":null,"abstract":"<p><p>Exposure to trauma is a pervasive stressor that globally impacts millions of children and adults and can lead to severe adjustment problems. Although receiving evidence-based trauma-focused mental health treatment can effectively reduce distress associated with exposure to trauma, over half of those who schedule an intake session fail to attend, known as preintake attrition. Understanding factors that predict preintake attrition is essential for improving clinical care and triaging the allocation of clinic resources. This study examined clinic archival data sourced from an outpatient training clinic that focuses on delivering evidence-based trauma treatment. Data included records from 249 clients (<i>n</i> = 96 children; <i>n</i> = 153 adults) who completed a phone screen at the clinic between January 2022 and December 2023. Of the 249 total clients placed on the clinic waitlist, 52% (<i>n</i> = 129) attended their intake appointment. Results indicated that certain factors assessed during the initial phone screen (demographic characteristics, index trauma, and referral source) predicted preintake attrition. Notably, waitlist duration also emerged as a predictor of attrition; children who did not attend their intake spent nearly twice as many days on the waitlist compared with children who attended their intake. These findings provide insight into predictors of preintake attrition and suggest potential targets for developing strategies to increase engagement in trauma-focused treatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of providers delivering evidence-based psychotherapy for PTSD to Black veterans: A qualitative study.","authors":"Rachel M Ranney, Haein Jun, Danielle Cottonham, Asale Hubbard, Joy Huggins, Natalie Purcell, Kristine Burkman, Shira Maguen","doi":"10.1037/ser0000982","DOIUrl":"https://doi.org/10.1037/ser0000982","url":null,"abstract":"<p><p>Previous research has found that Black veterans (vs. White veterans) evidence less symptom improvement following trauma-focused evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD). Black veterans' experiences of racism and discrimination, as well as how providers respond to these experiences during PTSD EBPs, may help to explain these racial disparities in outcomes. However, there is a lack of qualitative research exploring providers' experiences delivering PTSD EBPs to Black veterans. This study aimed to fill this gap in the literature by interviewing 15 mental health providers with experience delivering PTSD EBPs working at a West Coast Veterans Affairs Medical Center about (a) their comfort in discussing racism and discrimination with veterans, (b) the role of their identity in these discussions, (c) the extent to which racism and discrimination are presenting problems in PTSD EBPs, (d) Black veterans' response to PTSD EBPs, and (e) ways PTSD EBPs may be improved for Black veterans. Rapid analysis procedures were used to identify prominent and relevant themes, which are summarized and discussed with a focus on informing clinical recommendations and the development of provider training that may improve experiences and outcomes for Black veterans engaging in PTSD EBPs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing meditation practice in individuals with elevated psychological distress via a meditation app intervention: An implementation science-informed qualitative investigation of barriers and facilitators.","authors":"Rachel L Dyer, Katherine M Zimmerman, Xinxuyang Zhao, Qiang Xie, Cortland J Dahl, Andrew Quanbeck, Simon B Goldberg","doi":"10.1037/ser0000980","DOIUrl":"10.1037/ser0000980","url":null,"abstract":"<p><p>In recent decades, depression and anxiety have worsened among American adults. Meditation apps may provide an accessible route for reducing these symptoms. However, many users experience barriers to persisting in their use of these apps. Prior research has identified psychosocial and practical barriers and facilitators to the use of meditation apps, as well as barriers and facilitators related to the apps themselves. Yet few prior studies have drawn on frameworks from the highly relevant field of implementation science, such as the Consolidated Framework for Implementation Research. A lack of unifying implementation science frameworks has limited shared language to describe barriers and facilitators and has made it challenging to identify and account for multilevel factors impacting the implementation of meditation apps. As such, this study used the Consolidated Framework for Implementation Research to explore the implementation of the Healthy Minds Program meditation app among users experiencing elevated depressive and/or anxiety symptoms. Participants (<i>n</i> = 20) were drawn from a meditation dosage clinical trial and interviewed about their experiences establishing a meditation practice using the Healthy Minds Program app. Using the Consolidated Framework for Implementation Research and deductive qualitative content analysis, four categories were generated: practical facilitators to developing a meditation practice, motivations for developing and maintaining a meditation practice, barriers to developing a meditation practice, and recommendations for improving the app. Overall, participants reported positive outcomes from their practice, which, for some, motivated their continued use of the Healthy Minds Program app. Future research should consider how barriers and facilitators may change over time with increased engagement and experience with meditation apps and practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Veterans' engagement in mindfulness practices following intervention.","authors":"Tracy Herrmann, Amir Ramezani, Ryan Lackner, William R Marchand, Danielle Perez, Allison O'Connor, Joanna E Bettmann","doi":"10.1037/ser0000950","DOIUrl":"https://doi.org/10.1037/ser0000950","url":null,"abstract":"<p><p>Mindfulness-based interventions are complementary and integrative health interventions, widely used for mental health. However, while these interventions show significant benefits for veterans, veterans are more likely to drop out of mindfulness-based interventions than other treatments. This study aimed to evaluate veterans' motivations for and long-term engagement in mindfulness practices following mindfulness-based interventions. One hundred sixty-one veterans completed phone surveys 6-12 months after receiving mindfulness interventions through the Veteran Affairs Health Care System. Bivariate statistics were utilized to estimate relationships between demographic variables and theme scores, effect size for significant findings, and to estimate relationships between theme scores. Veterans reported that they sought treatment for trauma, health concerns, depression, and anxiety. They reported benefits from treatment in their depressive symptoms, anxiety, health concerns, and pain levels. More than half of participants reported maintaining a daily mindfulness practice following treatment. Findings suggest that different types of mindfulness interventions had comparable outcomes at follow-up, but demographic variables correlated with different veteran outcomes. Presenting certain mindfulness skills early in mindfulness-based intervention programming and building daily mindfulness practices throughout treatment may help veterans access the most efficacious components of mindfulness-based intervention and reduce the likelihood of dropout. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrimination and calibration properties of Violence Risk Scale scores as a function of Indigenous Canadian heritage in a multisite forensic-correctional sample.","authors":"Mark Olver, Franca Cortoni, Richard B A Coupland, Tamsin Higgs, Neil R Hogan, Kathy Lewis, Audrey Gordon, Stephen C P Wong","doi":"10.1037/ser0000972","DOIUrl":"https://doi.org/10.1037/ser0000972","url":null,"abstract":"<p><p>The present study examined the discrimination and calibration properties of Violence Risk Scale (VRS; Wong & Gordon, 1999-2023) risk and change scores in a predominantly adult male, combined sample of Indigenous (<i>n</i> = 439) and non-Indigenous, White majority (<i>n</i> = 597) persons with conviction histories for violent offenses; approximately, two thirds of whom completed risk-need-responsivity based violence reduction treatment services. Indigenous men tended to score higher on VRS static, dynamic, and total scores and to be classified as higher risk; however, there were no differences between the groups in treatment change. In the aggregate sample, VRS total scores demonstrated broadly medium to large effects in the prediction of violent and general recidivism (median AUCs = .72 [Indigenous] and .71 [non-Indigenous]) across ethnocultural groups. Conversely, VRS change scores (controlling for pretreatment score) were significantly associated with decreased violent and general recidivism for Indigenous persons (median AUC = .62) but considerably less so, with small or lower effects, for non-Indigenous persons (median AUC = .48). These results were upheld when effect sizes were aggregated across the samples through meta-analysis. Calibration analyses demonstrated that integrating risk and change information via logistic regression modeling decreased disparities between ethnoracial groups in rates of recidivism associated with VRS scores. Implications for violence risk assessment, treatment, and management using the VRS with Indigenous persons who have a history of criminal violence are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of homelessness and incarceration in time-to-decision on veterans affairs disability benefits for a mental health condition.","authors":"Hind A Beydoun, Mayumi Gianoli, Andrew Meisler, Jack Tsai","doi":"10.1037/ser0000971","DOIUrl":"https://doi.org/10.1037/ser0000971","url":null,"abstract":"<p><p>Homelessness and incarceration are major psychosocial concerns in the United States that may be mitigated by access to disability benefits. Data from the Veterans Benefits Administration (VBA) provides a unique opportunity to study how the process of obtaining disability benefits and time-to-decision might be affected by homelessness and/or incarceration among veterans in the Veterans Health Administration (VHA). The purpose of this study was to examine how homelessness and/or incarceration status among VHA-enrolled U.S. veterans might affect outcomes of VBA disability benefits claims for a mental health condition, including time-to-decision and rating outcomes. Using a retrospective cohort design, linked VHA/VBA data from 2022 to 2023 on 327,047 U.S. veterans (including 7,202 homeless veterans and 280 incarcerated veterans) were analyzed with multivariable Cox regressions. Overall, 85.7% of veterans received award of a Department of Veterans Affairs (VA) service-connected disability for a mental health condition. Although VA service-connected disability for a mental health condition was awarded less frequently for homeless and incarcerated veterans, the time-to-decision for homeless veterans-with or without incarceration-was twice as fast as nonhomeless and nonincarcerated veterans, after adjustment for demographic and clinical characteristics. In conclusion, although homeless and/or incarcerated veterans were less likely to receive VA service-connected disability for a mental health condition than other VA disability-seeking veterans, homeless veterans had faster decision times on VA disability applications. These findings inform ongoing efforts to ensure veterans with diverse backgrounds and needs receive the VBA benefits for which they qualify. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provider and leader perspectives on eating disorder screening and the importance of a clinical pathway in the Veterans Health Administration: A qualitative study.","authors":"Shira Maguen, Jennifer L Snow, Sarah E Siegel, Lindsay Fenn Munro, Joy Huggins, Alison B Hamilton, Robin M Masheb","doi":"10.1037/ser0000967","DOIUrl":"10.1037/ser0000967","url":null,"abstract":"<p><p>We explored U.S. provider and leader perspectives on eating disorder screening, implementation, and clinical pathways in the Veterans Health Administration using qualitative interviews with 10 medical providers and seven leaders from Veterans Health Administration's National Program Offices (<i>N</i> = 17). Providers included two frontline primary care medical support staff, two nurses, two primary care providers, one dietitian, one women's health provider, one health psychologist, and one weight management program provider. We asked about the utility of screening for eating disorders and potential implementation challenges. The tool was in development at the time the qualitative interviews were conducted so that feedback could be taken into consideration. Rapid qualitative analysis was used to identify themes. Three themes were identified. First, a gap was identified in eating disorder screening, with acknowledgement that there is not a uniform way to systemically screen patients. Second, most agreed that a brief tool such as the one we developed could be helpful in a large health care system, especially a tool with language that was mindful of stigma issues. Third, there was agreement that a screening tool would need to be part of a more extensive clinical pathway that included diagnosis and treatment within the larger health care system. While participants supported the need for an eating disorder screening tool, their perspectives varied on how such a tool would be implemented in a national health care system. Specific recommendations were made for ensuring that there was a clear clinical pathway from the tool to treatment referral to best serve veterans with eating disorders. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20749,"journal":{"name":"Psychological Services","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}