The Brief Infant-Toddler Social and Emotional Assessment (BITSEA) is a relatively new and short (42-item) questionnaire that measures psychosocial problems in toddlers and consists of a Problem and a ...Competence scale. In this study the reliability and validity of the Dutch version of the BITSEA were examined for the whole group and for gender and ethnicity subgroups.
Parents of 7140 two-year-old children were invited in the study, of which 3170 (44.4%) parents completed the BITSEA. For evaluation of the score distribution, the presence of floor/ceiling effects was determined. The internal consistency (Cronbach's alpha) was evaluated and in subsamples the test-retest, parent-childcare provider interrater reliability and concurrent validity with regard to the Child Behavioral Checklist (CBCL). Discriminative validity was evaluated by comparing scores of parents that worry and parents that do not worry about their child's development.
The BITSEA showed no floor or ceiling effects. Psychometric properties of the BITSEA Problem and Competence scale were respectively: Cronbach's alphas were 0.76 and 0.63. Test-retest correlations were 0.75 and 0.61. Interrater reliability correlations were 0.30 and 0.17. Concurrent validity was as hypothesised. The BITSEA was able to discriminate between parents that worry about their child and parents that do not worry. The psychometric properties of the BITSEA were comparable across gender and ethnic background.
The results in this large-scale study of a diverse sample support the reliability and validity of the BITSEA Problem scale. The BITSEA Competence scale needs further study. The performance of the BITSEA appears to be similar in subgroups by gender and ethnic background.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Purpose
The association between childhood maltreatment (ChM) and psychotic disorders is well established. However, there is an ongoing debate about which factors account for this relationship. One ...explanation is that the relationship between ChM and psychosis is mediated by adult attachment style. Therefore, in this study, we aimed to investigate whether adult attachment style mediates the relationship between ChM and positive and negative symptomatology.
Methods
We investigated the relation between ChM and psychotic symptoms, taking into account levels of (insecure) attachment, in 131 patients with psychotic illness, 123 siblings and 72 controls. ChM was assessed with the Childhood Trauma Questionnaire (CTQ). Attachment dimensions of anxiety and avoidance were measured using the Psychosis Attachment Measure (PAM).
Results
In both patients and siblings, ChM predicted positive symptoms and this relationship was partly mediated by attachment style. This relationship was found to be stronger for siblings than for patients. ChM predicted negative symptoms in patients and siblings. In the patient sample, attachment style did not mediate the relationship between ChM and negative symptoms, whereas attachment style was found to be a mediator in the sibling sample.
Conclusions
ChM was associated with positive and negative symptomatology in both patients and siblings. Particularly in siblings, the relationship between ChM and psychosis seems to be mediated by adult attachment style. Perhaps attachment style may play a more prominent role on a subclinical level.
In a recent placebo-controlled, double-blind crossover trial (n = 52), significant beneficial effects on memory (d = 0.30) and negative symptoms (d = 0.29) were found after 12 weeks of memantine ...augmentation in patients with clozapine-refractory schizophrenia. In this open-label 1-year extension study we report the long-term effects and tolerability of memantine add-on therapy to clozapine.
Completers of the first trial who experienced beneficial effects during 12 weeks of memantine treatment received memantine for 1 year. Primary endpoints were memory and executive function using the Cambridge Neuropsychological Test Automated Battery, the Positive and Negative Syndrome Scale (PANSS), and the Clinical Global Impression Severity Scale (CGI-S).
Of 31 randomized controlled trial completers who experienced beneficial effects from memantine, 24 received memantine for 1 year. The small improvement in memory found in the memantine condition in the placebo-controlled trial remained stable in the extension study. Executive function did not improve. After 26 weeks of memantine add-on therapy to clozapine, PANSS negative symptoms (r = 0.53), PANSS positive symptoms (r = 0.50) and PANSS total symptoms (r = 0.54) significantly improved. Even further significant improvement in all these measures was observed between 26 weeks and 52 weeks of memantine, with effect sizes varying from 0.39 to 0.51. CGI-S showed a non-significant moderate improvement at 26 weeks (r = 0.36) and 52 weeks (r = 0.34). Memantine was well tolerated without serious adverse effects.
In the 1-year extension phase the favourable effect of adjunctive memantine on memory was sustained and we observed further improvement of negative, positive and overall symptoms in patients with clozapine-treated refractory schizophrenia.
We consider daily rainfall observations at 32 stations in the
province of North Holland (the Netherlands) during 30 years. Let
T be the total rainfall in this area on one
day. An important question ...is: what is the amount of rainfall
T that is exceeded once in 100 years? This is
clearly a problem belonging to extreme value theory. Also, it is
a genuinely spatial problem.
¶ Recently, a theory of extremes of continuous stochastic processes
has been developed. Using the ideas of that theory and much
computer power (simulations), we have been able to come up with
a reasonable answer to the question above.
Posttraumatic stress disorder (PTSD) is a complex condition often influenced by personality characteristics and comorbidity with other psychiatric disorders. More recent understandings of PTSD have ...suggested that schemas play a role in the development and maintenance of this condition. Schema therapy (ST) was developed to address more characterological disturbances in chronic disorders. It is an integrative approach for treatment that incorporates practices from other therapeutic orientations. The purpose of this article is to describe some key components of ST and how these can be applied to the treatment of patients with more chronic or complex forms of PTSD. These components include formulating a patients' symptom presentation in terms of their early maladaptive schemas (EMSs) and modes. The assessment of EMS, in particular, takes into account a patients' developmental history and how it has impacted their response to a trauma. In addition, emotion-oriented and experiential techniques are key interventions in ST. Finally, ST has a unique perspective on the therapy relationship, which has been described as "limited reparenting." A case study will be used to demonstrate how these components of ST were effective for intervention where previous techniques had failed. The article concludes with some of the research that supports these components of ST. Specific recommendations are made for future research.
Un enfoque de terapia de esquema para el tratamiento del trastorno por estrés postraumático
El trastorno de estrés postraumático (PTSD) es una condición compleja a menudo influenciada por las características de la personalidad y la comorbilidad con otros trastornos psiquiátricos. Entendimientos mas recientes de PTSD ha sugerido que los esquemas desempeñan un papel en el desarrollo y mantenimiento de esta condicion La terapia de esquema (ST) se desarrolló para abordar más trastornos caracterológicos en los trastornos crónicos. Es un enfoque integrador para el tratamiento que incorpora prácticas de otras orientaciones terapéuticas. El propósito de este artículo es describir algunos componentes clave de la ST y cómo se pueden aplicar al tratamiento de pacientes con formas más crónicas o complejas de trastorno de estrés postraumático. Estos componentes incluyen la formulación de una presentación de los síntomas de los pacientes en términos de sus esquemas de mala adaptación temprana (EMS) y modos. La evaluación de EMS, en particular, tiene en cuenta el historial de desarrollo de los pacientes y cómo ha impactado su respuesta a un trauma. Además, orientado a la emoción y las técnicas experienciales son intervenciones clave en ST. Finalmente, ST tiene una perspectiva única sobre la relación de terapia, que se ha descrito como "reparación limitada". Se usará un estudio de caso para demostrar cómo estos componentes de ST fueron efectivos para la intervención donde las técnicas anteriores habían fallado. El artículo concluye con algunas de las investigaciones que respaldan estos componentes de ST. Se hacen recomendaciones específicas para futuras investigaciones.
一个图式治疗方法治疗创伤后应激障碍
创伤后应激障碍（PTSD）是一种复杂的情况。它常受人格和其他心理疾病合并症的影响。最近的对创伤后应激障碍的理解表明，图式在这一情况的发展和维持中扮演了非常重要的角色。图式疗法（ST）的开发旨在解决慢性疾病中的更多的特征性紊乱。它吸收了其他治疗方向的实践。本文的目的是描述图示疗法的一些关键组成部分以及如何将这些部分应用于慢性或者复杂形式的创伤后应激障碍患者的治疗中。这些组成部分包括制定患者的早期适应不良模式（EMS）和症状表现模式。对EMS的评估，特别要考虑患者的发育历史以及它如何影响患者对创伤的反应。此外，情感导向和经验技术是图示疗法的关键干预措施。最后，关于治疗关系，图示疗法有一个已被描述为"有限的重新定位"的独特视角。文中将会列举一个案例研究，它会证明图示疗法的这些成分如何对那些曾经失败的干预措施发挥作用。文章最后总结了一些研究，来支持图示疗法的这些组成部分。对未来的研究提出了具体的建议。
Highlights • Risk-taking and risk assessment increased the odds of binge drinking for both men and women. • For women the odds of non-binge drinking compared to abstinence were increased by ...risk-taking. • Risk-taking behavior exerts, corrected for gender, age, lifestyle, depression, anxiety, and stress levels, an effect on alcohol use.
Abstract Background Despite evidence for the effects of metals on neurodevelopment, the long-term effects on mental health remain unclear due to methodological limitations. Our objective was to ...determine the feasibility of studying metal exposure during critical neurodevelopmental periods and to explore the association between early-life metal exposure and adult schizophrenia. Methods We analyzed childhood-shed teeth from nine individuals with schizophrenia and five healthy controls. We investigated the association between exposure to lead (Pb2+ ), manganese (Mn2+ ), cadmium (Cd2+ ), copper (Cu2+ ), magnesium (Mg2+ ), and zinc (Zn2+ ), and schizophrenia, psychotic experiences, and intelligence quotient (IQ). We reconstructed the dose and timing of early-life metal exposures using laser ablation inductively coupled plasma mass spectrometry. Results We found higher early-life Pb2+ exposure among patients with schizophrenia than controls. The differences in log Mn2+ and log Cu2+ changed relatively linearly over time to postnatal negative values. There was a positive correlation between early-life Pb2+ levels and psychotic experiences in adulthood. Moreover, we found a negative correlation between Pb2+ levels and adult IQ. Conclusions In our proof-of-concept study, using tooth-matrix biomarker that provides direct measurement of exposure in the fetus and newborn, we provide support for the role of metal exposure during critical neurodevelopmental periods in psychosis.
Background:
Cannabis exposure, particularly heavy cannabis use, has been associated with neuroanatomical alterations in regions rich with cannabinoid receptors such as the hippocampus in some but not ...in other (mainly cross-sectional) studies. However, it remains unclear whether continued heavy cannabis use alters hippocampal volume, and whether an earlier age of onset and/or a higher dosage exacerbate these changes.
Methods:
Twenty heavy cannabis users (mean age 21 years, range 18–24 years) and 23 matched non-cannabis using healthy controls were submitted to a comprehensive psychological assessment and magnetic resonance imaging scan at baseline and at follow-up (average of 39 months post-baseline; standard deviation=2.4). Cannabis users started smoking around 16 years and smoked on average five days per week. A novel aspect of the current study is that hippocampal volume estimates were obtained from manual tracing the hippocampus on T1-weighted anatomical magnetic resonance imaging scans, using a previously validated protocol.
Results:
Compared to controls, cannabis users did not show hippocampal volume alterations at either baseline or follow-up. Hippocampal volumes increased over time in both cannabis users and controls, following similar trajectories of increase. Cannabis dose and age of onset of cannabis use did not affect hippocampal volumes.
Conclusions:
Continued heavy cannabis use did not affect hippocampal neuroanatomical changes in early adulthood. This contrasts with prior evidence on alterations in this region in samples of older adult cannabis users. In young adults using cannabis at this level, cannabis use may not be heavy enough to affect hippocampal neuroanatomy.
A key indicator of quality of treatment from the patient's perspective is expressed by satisfaction with care. Our aim was to (i) explore satisfaction and its relation to clinical outcome measures; ...and (ii) explore the predictive value of satisfaction for the course of outcomes over three years.
Data of 654 patients with a non-affective psychosis included in a naturalistic longitudinal cohort study were analyzed. We included 506 males and 148 females with a mean age of 30.47 (SD 7.24) from The Netherlands. Satisfaction was measured with the self-rating Client Satisfaction Questionnaire-8. A wide range of interviewer-rated (e.g., Positive and Negative Symptom Scale) and self-rated (e.g., World Health Organization Quality of Life); outcomes of low, intermediate and high satisfied patients were compared using ANOVA, Chi2 or Kruskal–Wallis tests. The predictive value of satisfaction level on clinical outcomes after three years was tested using regression models.
Satisfaction levels were low (19.4%), intermediate (48.9%) or high (31.7%). High satisfied patients showed significantly better interviewer-rated outcomes, e.g., less severe psychotic symptoms, and self-rated outcomes, e.g., better quality of life, compared to patients with intermediate or low satisfaction. Higher levels of satisfaction with care at baseline predicted a reduction of positive symptoms three years later (B=–.09, P-value=.013).
Satisfaction of patients with psychosis is a valuable monitoring measure since high satisfied patients show more favorable outcomes ranging from psychopathological symptoms to quality of life. Further research into explanations of lower levels of satisfaction is commendable in order to improve outcomes.
Abstract Background Several factors may contribute to duration of untreated psychosis (DUP): patient-delay, referral-delay and treatment-delay caused by mental health care services (MHS-delay). In ...order to find the most effective interventions to reduce DUP, it is important to know what factors in these pathways to care contribute to DUP. Aim To examine the relationship of the constituents of treatment delay, migration status and urbanicity. Method In first episode psychotic patients ( n = 182) from rural, urban and highly urbanized areas, DUP, migration status and pathways to care were determined. Results Mean DUP was 53.6 weeks (median 8.9, SD = 116.8). Patient-delay was significantly longer for patients from highly urbanized areas and for first generation immigrants. MHS-delay was longer for patients who were treated already by MHS for other diagnoses. Conclusions Specific interventions are needed focusing on patients living in highly urbanized areas and first generation immigrants in order to shorten patient delay. MHS should improve early detection of psychosis in patients already in treatment for other diagnosis.
PDF
