controlled trial of multimodular motion-assisted memory desensitization and reconsolidation (3MDR) for male military veterans with treatment-resistant posttraumatic stress disorder. Objective: To explore the potential efficacy of multi-modular motionassisted memory desensitization and reprocessing (3MDR) in British military veterans with treatment-resistant service-related PTSD. Methods: Exploratory single-blind, randomized, parallel arm, crossover controlled trial with nested process evaluation to assess fidelity, adherence and factors that influence outcome. Results: A total of 42 participants (all male) were randomized with 83% retention at 12 weeks and 86% at 26 weeks. The difference in mean Clinician-Administered PTSD Scale for DSM-5 scores between the immediate and delayed 3MDR arms was À9.38 (95% CI À17.33 to À1.44, P = 0.021) at 12 weeks and À3.59 (À14.39 to 7.20, P = 0.513) at 26 weeks when both groups had received 3MDR. The likely effect size of 3MDR was found to be 0.65. Improvements were maintained at 26-week follow-up. 3MDR was found to be acceptable to most, but not all, participants. Several factors that may impact efficacy and acceptability of 3MDR were identified. Conclusion: 3MDR is a promising new intervention for treatmentresistant PTSD with emerging evidence of effect.

Background: The mood and psychomotor effects of caffeine are well documented; however, many previous studies assessing these factors have been carried out on habitual consumers of caffeine. Thus, it is difficult to discern whether beneficial findings are due to the positive effects of caffeine or the reversal of negative withdrawal symptoms. Aims: The current placebo-controlled balanced-crossover study aimed to investigate the acute effects of caffeine on mood and psychomotor performance in both moderate consumers and minimal/nonconsumers of caffeine. Materials and Methods: Following overnight caffeine abstinence (*12 hours), 15 moderate consumers (mean 316.2 mg/day) and 14 minimal/nonconsumers (mean 37.07 mg/day) received a beverage containing either 150 mg caffeine or a matched placebo at ‡ 48 hours apart. Mood and psychomotor assessments were carried out at baseline and 30 minutes postdrink. Bond-Lader visual analogue scales (VAS) and caffeine research VAS were used to assess mood, while three simple motion tasks (using an accelerometer device to record dynamic bodily movement) were used to assess psychomotor control. Results: Baseline differences after a night's abstinence were observed for only two outcome measures, with moderate consumers reporting significantly worse headaches and experiencing more tremors on accelerometer Task 2 (holding both arms out to the sides). Following caffeine, ratings of alertness and jitteriness significantly increased and ratings of calmness significantly decreased. Furthermore, accelerometer Task 2 revealed a significant increase in tremor following caffeine compared to when following placebo. It was concluded that these results do not support the withdrawal reversal hypothesis of caffeine consumption but are more indicative of a net effect of caffeine consumption.

There has been a substantial increase in recent years in the availability of powered wheelchairs and associated features. However, the psychological factors explaining feature use are poorly understood. The current study aims to explore this issue. Semistructured interviews of 15 British wheelchairs users were conducted; all had a range of disabilities and clinically prescribed seating functions. Our aim was to explore participants' perceptions in terms of engagement and use of their wheelchair technology. Interview schedules were generated based on prior research on psychological factors associated with health and well-being. Questions focused on participants' knowledge of features and how to use them, perceived barriers and facilitating factors, motivation to use, and perceptions of social support. A theory led thematic analysis identified three themes: (a) clinical benefits and functional alternatives, (b) expectations versus reality, and (c) the impact of other people. There was diversity in the perceptions that users had of their equipment, with positive views of features linking to users' experience of functional benefits and matches between equipment and prior expectations. Recommendations are made to highlight functional as well as clinical benefits, to explore therapists' experiences of their practice, to consider how information could be presented, and to explore uses of social support and innovative technologies in future work.

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