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Rispoli M, O'Reilly M, Lang R, Machalicek W, Kang S, Davis T, Neely L. An examination of within-session responding following access to reinforcing stimuli. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:25-34. [PMID: 26524727 DOI: 10.1016/j.ridd.2015.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/10/2015] [Accepted: 10/19/2015] [Indexed: 06/05/2023]
Abstract
Previous research has shown tangibly maintained challenging behavior can be temporarily decreased by providing presession access to the relevant tangible. However, the duration of this beneficial effect is unknown. We measured the subsequent duration of behavior reduction effects following presession access during extended classroom observation sessions by analyzing within-session patterns of responding in three children with autism. An alternating treatments design was used to analyze within- and across-session responding following presession access and presession restriction conditions. The cumulative frequency of challenging behavior was higher following the presession restriction condition for all participants and lower following presession access. Within-session analysis revealed the same basic pattern of responding across participants. Specifically, the first half of the sessions contained very little, if any, challenging behavior; however, after 60 min, the rate of challenging behavior began to increase rapidly for two of the three participants. Results are discussed in terms of implications for practitioners, satiation, habituation, and behavioral contrast.
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Hanson EM, Sideridis G, Jackson FI, Porche K, Campe KL, Huntington N. Behavior and Sensory Interests Questionnaire: Validation in a sample of children with autism spectrum disorder and other developmental disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:160-175. [PMID: 26579706 DOI: 10.1016/j.ridd.2015.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/10/2015] [Accepted: 09/13/2015] [Indexed: 06/05/2023]
Abstract
Repetitive behaviors, restricted interests and other unusual sensory behaviors often significantly impact the lives of many individuals with developmental disabilities, including Autism Spectrum Disorder (ASD). Identifying specific patterns of atypical behaviors across different disorders allows for improved specificity of diagnoses, monitoring response to treatment and elucidating the genetic and neurobiological underpinnings of these disorders. The Behavior and Sensory Interests Questionnaire (BSIQ) is a newly designed, continuous dimensional instrument that comprehensively assesses the type, frequency, intensity, age of onset, and duration of these behaviors. The BSIQ takes 15-40 min to administer to a caregiver in an interview format. Using a large sample of children with either ASD, intellectual disabilities or who were typically developing, the construct validity of the BSIQ was confirmed using a series of multi-group confirmatory factor analysis models. Configural and metric invariance were satisfied, but not scalar invariance, as expected. The BSIQ showed acceptable internal consistency, excellent inter-rater reliability and excellent test-retest reliability.
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Cantrell V. Psychogenic Nonepileptic Seizures versus Epileptic Seizures: An Unusual Case Report. Neurodiagn J 2016; 56:165-177. [PMID: 28436775 DOI: 10.1080/21646821.2016.1166028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Psychogenic nonepileptic seizures may closely resemble epileptic seizures. Video EEG is an important tool in the diagnostic work-up to differentiate between seizures of neurological origin and nonepileptic events mimicking seizures. This article will review the case of a 30-year-old female presenting with a new onset of possible seizure activity and her stay in the epilepsy monitoring unit.
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Coutinho V, Kemlin I, Dorison N, Billette de Villemeur T, Rodriguez D, Dellatolas G. Neuropsychological evaluation and parental assessment of behavioral and motor difficulties in children with neurofibromatosis type 1. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:220-230. [PMID: 26625207 DOI: 10.1016/j.ridd.2015.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 10/27/2015] [Accepted: 11/12/2015] [Indexed: 06/05/2023]
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant multisystem disorder, with large inter and intrafamilial clinical variability and uncertain prognosis. In children with NF1 cognitive disorders, learning difficulties and behavioral problems are common. The present study aims to establish the neuropsychological and behavioral profiles of 78 patients with NF1, aged between 5 and 18 years, and to examine the relationship between these profiles and the transmission of NF1 (sporadic vs. familial), clinical manifestations, and environmental factors. We used several questionnaires completed by parents and neuropsychological tests. The results confirmed specific neuropsychological disabilities in children with NF1, especially involving visuospatial and fine motor skills, learning difficulties and behavioral problems. Cognitive difficulties were significantly more frequent in patients with familial than in those with sporadic NF1. All parental questionnaires were correlated with each other, but parental reports were not associated with FSIQ, SES, school status, and clinical manifestations of the disease. Neuropsychological tests were poorly related to parental reports of cognitive and behavioral difficulties.
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Fulceri F, Narzisi A, Apicella F, Balboni G, Baldini S, Brocchini J, Domenici I, Cerullo S, Igliozzi R, Cosenza A, Tancredi R, Muratori F, Calderoni S. Application of the Repetitive Behavior Scale-Revised--Italian version--in preschoolers with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:43-52. [PMID: 26540296 DOI: 10.1016/j.ridd.2015.10.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 09/18/2015] [Accepted: 10/19/2015] [Indexed: 06/05/2023]
Abstract
Restricted repetitive and stereotyped patterns of behavior, interests, and activities (RRB) are mandatory features for a diagnosis of Autism Spectrum Disorder (ASD) according to the Diagnostic and Statistical Manual of mental disorders-fifth edition (DSM-5). Despite the strong diagnostic role of RRB, their expressiveness and their relationship with other clinical/demographic features in ASD is not fully elucidated. The Italian version of the Repetitive Behavior Scale-Revised (RBS-R) was applied to a relatively large sample of preschool-aged children with ASD who underwent a comprehensive clinical assessment. The relationship between RRB and sex, age, non-verbal IQ, autism severity, as well as the diagnostic accuracy of the RBS-R were explored. Stereotyped and Ritualistic/Sameness behaviors were the most common RRB in preschoolers with ASD, without widespread differences between males and females. No significant correlations between RRB and chronological age, or non-verbal IQ were detected. The expressiveness of ritualistic/sameness behaviors positively correlated with autism severity, assessed through the Calibrated Severity Score (CSS) derived from the Autism Diagnostic Observation Schedule (ADOS). Receiver Operator Characteristic (ROC) analysis showed high diagnostic accuracy using the Global Rating Score, which represents the judgment of the parents of as the RRB affect the child's life. However, while the Global Rating Score performed well, the remaining subscales did not. This investigation extends the limited research on early pattern and associated features of RRB in young children with ASD. The use of the RBS-R may increase the knowledge of the RRB complexity and variability and in turn improve the diagnostic and therapeutic procedures within the autistic spectrum.
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Mnatsakanyan MG, Dyukova GM, Pogromov AP, Tashchyan OV. [Emotional and personality features of patients with irritable bowel syndrome and bowel inflammatory diseases]. KLINICHESKAIA MEDITSINA 2016; 94:764-769. [PMID: 30299020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To conduct a comparative analysis of the emotional and personality characteristics of patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in remission with IBS-like symptoms. PATIENTS AND METHODS This study carried out based at a specialized gastroenterology clinic in the period from 2010 to 2015 included 125 patients with IBS (IBS-D - 46, IBS-C - 20, IBS-M - 59) and 37 patients with IBD in remission: Crohn's disease (CD) - 11 and ulcerative colitis (UC) -26 patients. The levels of depression (Beck questionnaire), urgent and personal anxiety (Spielberger questionnaire), the degree of alexithymia (Toronto scale) as well as the severity of psychopathology and behavioral symptoms (PBS) were estimated. RESULTS Patients with IBS were not significantly different from those with IBD in remission with IBS-like symptoms in terms of depression, actual anxiety, alexithymia and PBS. Only the index of personal anxiety was significantly higher in the group of patients with IBS compared with IBD in remission with IBS-like symptoms (p = 0.0376). Men with IBS exhibited significantly higher actual anxiety than men with IBD (p = 0.04). Maximum severity of depression, anxiety and alexithymia was documented in the locking version of IBS (IBS-C) in comparison with other variants of IBS (p <0.05). Patients with CD in remission are characterized by higher rates of depression and alexithymia compared to UC (p <0.05). Behavioural disorders are most pronounced in the diarrheal variant of IBS and CD. CONCLUSION A higher personal anxiety was observed in patients with IBS compared to those in remission of IBD with IBS-like symptoms although other parameters were not significantly different. Patients with IBS-C were characterized by more pronounced manifestations of emotional and personality disorders. More severe emotional and behavioral disorders distinguish CD from UC.
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Kanchika M, Iwasaki S, Konish A, Deguchi Y, Kobayashi Y, Nakada A, Inoue K. Aggression in Teachers is Related to Role Conflict and Role Ambiguity as Occupational Stress. OSAKA CITY MEDICAL JOURNAL 2015; 61:93-104. [PMID: 26995853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Aggression in the workplace is increasingly recognized as a serious problem, but there are few studies about worker aggression toward outsiders in the workplace. We investigated the association between aggression and occupational stress among teachers. METHODS This was a cross-sectional study of 1583 teachers, principals, and vice-principals. Aggression was measured using the Japanese version of the Buss-Perry Aggression Questionnaire (BAQ). The survey respondents were classified into tertiles according to the BAQ score. The high BAQ group was defined as the upper tertile for the BAQ total score (BAQ total score 625). Occupational stress was measured using the Japanese version of the Generic Job Stress Questionnaire. Comparisons among the groups were performed using multiple logistic regression analysis. RESULTS Of the 1583 respondents, 488 were included in the high BAQ group. After adjusting for demographic and occupational variables, high role conflict and role ambiguity were significantly associated with belonging to the high BAQ group. In subscales of the BAQ, high role conflict and role ambiguity related to high levels of hostility, and physical aggression. CONCLUSIONS Occupational stress such as role conflict and role ambiguity was associated with aggression among teachers. It is necessary to reduce problems which relates to role conflict and role ambiguity for preventing teachers' aggression.
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Brady RO, Keshavan M. Emergent treatments based on the pathophysiology of bipolar disorder: A selective review. Asian J Psychiatr 2015; 18:15-21. [PMID: 26525885 PMCID: PMC4745256 DOI: 10.1016/j.ajp.2015.07.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 12/20/2022]
Abstract
Bipolar disorder is a chronic psychiatric disorder that is a cause of significant symptomatology even in the setting of optimal treatment. Most current treatments are developed from serendipity, and not based on known pathophysiology. In this review we examine a number of somatic and pharmacologic therapies that are poised to become part of the armamentarium of interventions to treat bipolar illness. As a group, these interventions are derived from a growing understanding of the biological underpinnings of bipolar disorders. We will look at emergent treatments based on our understanding of the molecular biology, neuroanatomy, and the genetics of bipolar disorder.
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Abstract
The older patient population is growing rapidly around the world and in the USA. Almost half of seniors over age 65 who live at home are dissatisfied with their sleep, and nearly two-thirds of those residing in nursing home facilities suffer from sleep disorders. Chronic and pervasive sleep complaints and disturbances are frequently associated with excessive daytime sleepiness and may result in impaired cognition, diminished intellect, poor memory, confusion, and psychomotor retardation all of which may be misinterpreted as dementia. The key sleep disorders impacting patients with dementia include insomnia, hypersomnolence, circadian rhythm misalignment, sleep disordered breathing, motor disturbances of sleep such as periodic leg movement disorder of sleep and restless leg syndrome, and parasomnias, mostly in the form of rapid eye movement (REM) sleep behavior disorder (RBD). RBD is a pre-clinical marker for a class of neurodegenerative diseases, the "synucleinopathies", and requires formal polysomnographic evaluation. Untreated sleep disorders may exacerbate cognitive and behavioral symptoms in patients with dementia and are a source of considerable stress for bed partners and family members. When left untreated, sleep disturbances may also increase the risk of injury at night, compromise health-related quality of life, and precipitate and accelerate social and economic burdens for caregivers.
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Brusov OS, Zlobina GP. [Peculiarities of Platelet Activation Changes in Patients with Chronic Schizophrenia, Depending on the Severity of Positive and Negative Symptoms during the Remission Formation]. ACTA ACUST UNITED AC 2015:355-9. [PMID: 26495725 DOI: 10.15690/vramn.v70i3.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of our study was to compare the changes in the severity of positive, negative and psychopathological PANSS symptoms which occur at an outcome of an attack in schizophrenic patients along with remission formation and the degree of platelet activation in these patients. METHODS Psychometric scale of the Positive and Negative Syndrome Scale (PA NSS) and the method of estimation of platelet activation based on the calculation of cells number after elution from the column with sepharose CL-2B were used. RESULTS The changes in the severity of the disease were estimated using the PANSS scale of chronic schizophrenic patients in remission formation. An increase in platelet activation was determined on the basis of the above described quantitative parameter. Comparison of changes in platelet activation parameter with changes in the disease severity rating detected similar statistically indistinguishable (p > 0.05) changes in the severity of positive symptoms and quantitative variable of platelet activation between the 1st and the 3rd visits in the period of remission formation. Platelet number after elution from the column during the 3rd visit was approximately two times less than during the 1st visit (p < 0.002). PANSS positive subscale shows a decrease of the severity of the syndrome by 1.6 times (p < 0.0002). In addition the difference between the platelet activation parameter and severity of the negative syndrome was fixed during the 3rd visit (p < 0.034). CONCLUSION Similar changes in the severity of positive syndrome and platelet activation parameter were presented from 1st to 3rd visit in the remission formation. A distinction between the platelet activation parameter and severity of the negative syndrome was fixed during the 3rd visit.
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Tsilioni I, Taliou A, Francis K, Theoharides TC. Children with autism spectrum disorders, who improved with a luteolin-containing dietary formulation, show reduced serum levels of TNF and IL-6. Transl Psychiatry 2015; 5:e647. [PMID: 26418275 PMCID: PMC5545641 DOI: 10.1038/tp.2015.142] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 07/10/2015] [Accepted: 08/05/2015] [Indexed: 02/07/2023] Open
Abstract
Autism spectrum disorders (ASDs) have been associated with brain inflammation as indicated by microglia activation, as well as brain expression and increased plasma levels of interleukin-6 (IL-6) and tumor necrosis factor (TNF). Here we report that serum levels of IL-6 and TNF were elevated (61.95 ± 94.76 pg ml(-1) and 313.8 ± 444.3 pg ml(-1), respectively) in the same cohort of patients with elevated serum levels of corticotropin-releasing hormone (CRH) and neurotensin (NT), while IL-9, IL-31 and IL-33 were not different from controls. The elevated CRH and NT levels did not change after treatment with a luteolin-containing dietary formulation. However, the mean serum IL-6 and TNF levels decreased significantly (P=0.036 and P=0.015, respectively) at the end of the treatment period (26 weeks) as compared with levels at the beginning; these decreases were strongly associated with children whose behavior improved the most after luteolin formulation treatment. Our results indicate that there are distinct subgroups of children within the ASDs that may be identifiable through serum levels of IL-6 and TNF and that these cytokines may constitute distinct prognostic markers for at least the beneficial effect of luteolin formulation.
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Kang Y, Han YR, Chang SJ, Chee W, Im EO. The Psychometric Properties of the Midlife Women's Symptom Index. J Obstet Gynecol Neonatal Nurs 2015; 44:600-9. [PMID: 26285126 DOI: 10.1111/1552-6909.12741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To evaluate the psychometric properties of the Midlife Women's Symptom Index (MSI) among four racial/ethnic groups of midlife women in the United States. DESIGN A secondary data analysis. SETTING Internet communities/groups. PARTICIPANTS A total of 494 midlife women with symptoms of menopause who self-reported using an Internet survey and completed all sections of the MSI questionnaire. METHODS Data were collected from January 1, 2008 to December 31, 2010. The psychometric properties of the MSI were evaluated using measures of internal consistency, item-total correlation coefficients, and discriminant validity. RESULTS There were statistically significant differences in marital status, employment, income, religion, country of birth, level of education, diagnosed disease, and self-reported health status across the four racial/ethnic groups. The Kuder-Richardson Formula 20 (KR-20) coefficients for the three subscales of the MSI prevalence section (i.e., physical, psychological, and psychosomatic) ranged from 0.58 (psychosomatic symptoms in Whites) to 0.91 (psychological symptoms in Asian Americans). The Cronbach's alpha coefficients for the three subscale scores ranged from 0.60 (psychosomatic symptoms in Whites) to 0.93 (psychological symptoms in Asian Americans). The mean scores of the MSI differed significantly by race/ethnicity among midlife women of each menopausal status, except for the prevalence section of the psychosocial symptoms. CONCLUSION The MSI has demonstrated an acceptable reliability and appropriate discriminant validity across the four racial/ethnic groups, except in the domain of psychosomatic symptoms. Health care providers as well as researchers could use the MSI to assess the symptoms of menopause of midlife women from diverse racial/ethnic backgrounds.
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Narayanan K, Gupta A, Manoj S, Seshadri K. HIV Infection Presenting with Dementia. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2015; 63:85-86. [PMID: 27604445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present a case of dementia in a young healthy individual. On evaluation he was detected to have HIV infection with low CD4 count and a high viral load. He had no opportunistic infections or any other AIDS defining illnesses. He recovered fully within 3 months of antiretroviral therapy.
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Houghton DC, Balsis S, Stein DJ, Compton SN, Twohig MP, Saunders SM, Franklin ME, Neal-Barnett AM, Woods DW. Examining DSM criteria for trichotillomania in a dimensional framework: implications for DSM-5 and diagnostic practice. Compr Psychiatry 2015; 60:9-16. [PMID: 25972228 PMCID: PMC4459902 DOI: 10.1016/j.comppsych.2015.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 04/06/2015] [Accepted: 04/18/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Diagnosis of trichotillomania (TTM) requires meeting several criteria that aim to embody the core pathology of the disorder. These criteria are traditionally interpreted monothetically, in that they are all equally necessary for diagnosis. Alternatively, a dimensional conceptualization of psychopathology allows for examination of the relatedness of each criterion to the TTM latent continuum. OBJECTIVES First, to examine the ability of recently removed criteria (B and C) to identify the latent dimensions of TTM psychopathology, such that they discriminate between individuals with low and high degrees of hair pulling severity. Second, to determine the impact of removing criteria B and C on the information content of remaining diagnostic criteria. Third, to determine the psychometric properties of remaining TTM diagnostic criteria that remain largely unchanged in DSM-5; that is, whether they measure distinct or overlapping levels of TTM psychopathology. Fourth, to determine whether information content derived from diagnostic criteria aid in the prediction of disease trajectory (i.e., can relapse propensity be predicted from criteria endorsement patterns). METHOD Statistics derived from item response theory were used to examine diagnostic criteria endorsement in 91 adults with TTM who underwent psychotherapy. RESULTS The removal of two criteria in DSM-5 and psychometric validity of remaining criteria was supported. Additionally, individual trait parameters were used to predict treatment progress, uncovering predictive power where none previously existed. CONCLUSIONS Diagnostic criteria for TTM should be examined in dimensional models, which allow for nuanced and sensitive measurement of core symptomology in treatment contexts.
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Pilling S, Marcus E, Whittington C, Murphy G. Challenging behaviour and learning disabilities: summary of NICE guidance. BMJ 2015; 350:h2652. [PMID: 26037204 DOI: 10.1136/bmj.h2652] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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91
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Hess S, Zemishlany Z. [THE PSYCHIATRIC DIAGNOSIS GUIDE - DSM-5 - INNOVATIONS AND CRITICISM]. HAREFUAH 2015; 154:319-338. [PMID: 26168644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA) as a guide for diagnosing psychiatric diseases and enables the alignment of psychiatric diagnoses with those of the psychologists, the social workers, the nursing staff and other mental health professionals. In addition, it helps bring cohesion to research, public health policy, education, the field of insurance and compensation and the legal system. After 14 years of hard work, the updated version of the DSM, the DSM-5, was published on May 2013. The current review aims to update the readers on the essence of the DSM and the methods of psychiatric diagnosing and to present the main changes in the field, as expressed in the 5th edition of the guide. In addition to details of those changes we included discussions of the criticisms brought against them. We hope that the review will contribute to broadening the readers' knowledge, broaden exposure and familiarity with the psychiatric lingo and to strengthening the professional ties between psychiatrists and professionals in other, tangential, medical fields.
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Folke F, Hursti T, Tungström S, Söderberg P, Kanter JW, Kuutmann K, Olofsson H, Ekselius L. Behavioral activation in acute inpatient psychiatry: a multiple baseline evaluation. J Behav Ther Exp Psychiatry 2015; 46:170-81. [PMID: 25460264 DOI: 10.1016/j.jbtep.2014.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 10/16/2014] [Accepted: 10/17/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVES The present study employed a multiple baseline study design with repeated measures to explore clinical outcomes, therapy mechanisms, and feasibility of Behavioral Activation for persons admitted to inpatient psychiatry. METHODS Six adult inpatients with depressive symptoms and different psychiatric disorders were randomized to different lengths of baseline standard inpatient treatment. Subsequently a 5-day, 10-session Behavioral Activation protocol was added. Daily self-report outcome and process measures were administered and supplemented with hourly self-reports and clinician assessments before and after each study phase. RESULTS After a relatively stable baseline, at least four participants showed marked gradual improvements both in terms of outcome as well as activation and avoidance as Behavioral Activation was initiated. The temporal relation between process and outcome differed somewhat across metrics. In most instances however, change in activation and avoidance either coincided or preceded decreased depression. LIMITATIONS We did not include some relatively common disorders, did not control for the effects of increased attention, did not investigate treatment integrity, and did not conduct follow-up after discharge. Raters were not blind and measures were mainly focused on depressive symptoms. All received concurrent medical treatment. CONCLUSIONS This preliminary study further supports the promise of Behavioral Activation as an inpatient treatment for persons with a variety of psychiatric disorders. Results also lends preliminary support for the purported mechanisms of Behavioral Activation.
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Neal TL, Diamond AB, Goldman S, Liedtka KD, Mathis K, Morse ED, Putukian M, Quandt E, Ritter SJ, Sullivan JP, Welzant V. Interassociation recommendations for developing a plan to recognize and refer student-athletes with psychological concerns at the secondary school level: a consensus statement. J Athl Train 2015; 50:231-49. [PMID: 25730175 PMCID: PMC4477918 DOI: 10.4085/1062-6050-50.3.03] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Oliveira CC, McGinley J, Lee AL, Irving LB, Denehy L. Fear of falling in people with chronic obstructive pulmonary disease. Respir Med 2015; 109:483-9. [PMID: 25708268 DOI: 10.1016/j.rmed.2015.02.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/04/2015] [Accepted: 02/05/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Increased fear of falling (FOF) has been associated with impaired physical function, reduced physical activity and increased fall risk in older adults. Preliminary evidence suggests that individuals with chronic obstructive pulmonary disease (COPD) may have an increased FOF. This study aims to compare the level of FOF in people with COPD with healthy controls, and to determine the associations between FOF and measures of physical function, physical activity and fall risk in COPD. METHODS FOF was assessed in 40 participants with COPD and 25 age- and gender-matched controls using the Falls Efficacy Scale-International (FES-I). Physical function was evaluated using quadriceps hand-held dynamometry, the Berg Balance Scale and the Six-minute Walk Test. Associations between FOF, physical activity and fall risk were evaluated using the Physical Activity Scale for the Elderly and the Falls Risk in Older People - Community Setting. Pearson's correlation coefficient and stepwise multivariate linear regression were used. RESULTS Individuals with COPD (mean ± SD; age: 71 ± 8 years, FEV1: 45 ± 16 %pred) had higher FOF compared to controls (FES-I: 25.0 ± 7.9 vs 20.2 ± 5.2, p=0.01). Higher FOF was associated with lower quadriceps strength (p=0.02) and an impaired balance (p < 0.01); these explained 26% of the FOF variance. Reduced levels of physical activity (p=0.01) and a higher fall risk (p < 0.01) were associated with an increased FOF in COPD. CONCLUSION People with COPD have a higher FOF compared to the healthy peers, which is related to lower quadriceps muscle strength, impaired balance, lower levels of physical activity and an increased fall risk.
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Gonzalez-Ammatuna E, Sadler JZ. Behavioral Aspects of the Pre-transplant Assessment. Tex Med 2015; 111:47-50. [PMID: 25705939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Suar D, Das SS, Alat P. Bereavement, postdisaster trauma, and behavioral changes in tsunami survivors. DEATH STUDIES 2015; 39:226-33. [PMID: 25551551 DOI: 10.1080/07481187.2014.979957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This study examined whether the death of family members intensifies the survivors' posttraumatic stress and behavioral changes. Data were collected by interviewing 416 adult survivors from nine habitations of the Nagapattinam district in the state of Tamil Nadu in India 14 months after the 2004 tsunami. Compared to those nonbereaved, bereaved survivors reported more posttraumatic stress disorder, depression, anxiety, negative affect, deteriorated mental health, adverse physical health symptoms, alcohol consumption, family conflicts, and fear. When a tsunami trauma includes death of a loved one, psychological, physical, and behavioral ramifications are especially severe.
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Hand I. [Behavioral excesses are symptom behaviours of heterogeneous etiology]. DER NERVENARZT 2014; 85:1436-1437. [PMID: 24668403 DOI: 10.1007/s00115-014-4033-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Management of non-cognitive symptoms associated with dementia. Drug Ther Bull 2014; 52:114-118. [PMID: 25298119 DOI: 10.1136/dtb.2014.10.0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Up to 75% of patients with dementia will experience non-cognitive symptoms.1 These often present as psychotic symptoms, behavioural disturbances and changes in mood.1 Such symptoms provide a significant challenge for patients and their carers, and are often difficult to manage. Antipsychotic drugs have been widely used to treat non-cognitive symptoms of dementia. However, in 2004 data emerged linking the use of some antipsychotic drugs with an increased risk of stroke and death in patients with dementia.2 Since then, there has been a national drive to ensure that antipsychotic drugs are used appropriately. In 2007, we reviewed the safety of antipsychotics in people with dementia.3 Here, we provide an update on the evidence for the efficacy and safety of interventions used to manage non-cognitive symptoms of dementia.
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Borson S, Scanlan JM, Sadak T, Lessig M, Vitaliano P. Dementia Services Mini-Screen: a simple method to identify patients and caregivers in need of enhanced dementia care services. Am J Geriatr Psychiatry 2014; 22:746-55. [PMID: 24315560 PMCID: PMC4018424 DOI: 10.1016/j.jagp.2013.11.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 11/01/2013] [Accepted: 11/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Improving dementia care in health systems requires estimates of need in the population served. We explored whether dementia-specific service needs and gaps for patients and caregivers could be predicted by simple information readily captured in routine care settings. METHOD Primary family caregivers (n = 215) rated their own current stress, challenging patient behaviors, and prior-year needs and gaps in 16 medical and psychosocial services. These were evaluated with other patient and caregiver characteristics in multivariate regressions to identify unique predictors of service needs and gaps. RESULTS Caregiver stress and patient behavior problems together accounted for an average of 24% of the whole-sample variance in total needs and gaps. All other variables combined (comorbid chronic disease, dementia severity, age, caregiver relationship, and residence) accounted for a mean of 3%, with none yielding more than 4% in any equation. We combined stress and behavior problem indicators into a simple screen. In early/mild dementia dyads (n = 111) typical in primary care settings, the screen identified gaps in total (84%) and psychosocial (77%) care services for high stress/high behavior problem dyads vs. 25% and 23%, respectively, of low stress/low behavior problem dyads. Medical care gaps were dramatically higher in high stress/high behavior problem dyads (66%) than all others (12%). CONCLUSION The Dementia Services Mini-Screen is a simple tool that could help clinicians and health systems rapidly identify dyads needing enhanced dementia care, track key patient and caregiver outcomes of interventions, and estimate population needs for new service development.
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Stores RJ, Stores G. The significance of aspects of screening for obstructive sleep apnoea in children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:381-392. [PMID: 23489956 DOI: 10.1111/jir.12033] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND The sleep problems of children with intellectual disabilities remains a relatively neglected topic in spite of the consistent reports that such problems are common, often severe and persistent with potentially serious consequences for the children and their families. Children with Down syndrome (DS) are a case in point. They often suffer from obstructive sleep apnoea (OSA), early detection of which is recommended because of its potentially adverse effects on development. This study is concerned with aspects of assessment that have been considered important in helping to recognise OSA in children with DS. The relationships between different objective measures, and between these measures and parental reports of their child's sleep and daytime behaviour, were explored. METHOD Overnight recordings were carried out on a group of children with DS (n = 31) involving video and audio recording, oximetry and activity monitoring during sleep. Parents also completed questionnaires concerning their child's sleep and daytime behaviour. RESULTS Parents' reports of restless sleep and noisy breathing were supported by objective measures of activity during sleep and audio recording respectively. No significant association was found between objective measures of restlessness during sleep and 'snoring' (see later for definition), nor were objective measures of restlessness related to reductions in overnight blood oxygen levels. However, the objective measure of snoring was significantly associated with reductions in overnight blood oxygen levels. All three of the objective measures were significantly associated with parental reports of various types of disturbed daytime behaviour. CONCLUSIONS The findings have implications for aspects of screening for OSA in children with DS and for the interpretation of the relevance of the results to the children's daytime behaviour.
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