Psychological factors predicting stress symptoms: metacognition, thought control, and varieties of worry

This study tested predictions of the metacognitive model of post-traumatic stress disorder (Wells, 2000) concerning relationships between stress symptoms and maladaptive control of thoughts. We tested the hypothesis that the tendency to use worry as a means of controlling thoughts will be positively predictive of stress symptoms. In doing so, overlaps with symptomatic worry, stress symptoms, and stress exposure at time 1 was controlled. One hundred and ten (110) college students were assessed twice, over a three-month period. Consistent with predictions, use of worry as a thought control strategy made a significant and independent contribution to the prediction of stress symptoms. The findings provide further support for Wells' metacognitive model of stress reactions.

Oligosaccharide-mediated inhibition of the adhesion of pathogenic Escherichia coli strains to human gut epithelial cells in vitro

The aim of the study was to investigate the ability of pectic oligosaccharides (POS) to inhibit adhesion of three strains of verotoxigenic Escherichia coli, three strains of enteropathogenic E. coli, and one nonclinical strain of Desulfovibrio desulfuricans to human intestinal epithelial cell cultures. Lactobacillus acidophilus and Lactobacillus gasseri were included for comparison. Attachment was determined in the human HT29 cell line by viable count of adherent bacteria. POS in buffer at pH 7.2 were antiadhesive at a dose of 2.5 mg ml(-1), reducing adhesion of enteropathogenic E. coil and verotoxigenic E. coli strains to less than 30% of control values. Concentrations resulting in 50% inhibition ranged from 0.15 to 0.46 mg ml(-1). L. acidophilus was not significantly affected, but adhesion of L. gasseri was reduced to 29% of the control value. POS reduced the adhesion of D. desulfuricans to 0.33% of the control value. POS also had a protective effect against E. coli verocytotoxins VT1 and VT2 at concentrations of 0.01 and 1 microg ml(-1), respectively.

Belief domains of the Obsessive Beliefs Questionnaire-44 (OBQ-44) and their specific relationship with obsessive-compulsive symptoms

The Obsessive Beliefs Questionnaire-44 (OBQ-44) was developed by the Obsessive Compulsive Cognitions Working Group to measure beliefs considered important in the development and maintenance of obsessive-compulsive disorder (OCD). In this study an exploratory factor analysis of the questionnaire was conducted with a student population (n=238). Results indicated four factors: (1) perfectionism and intolerance of uncertainty, (2) importance and control of thoughts, (3) responsibility, and (4) overestimation of threat. All four factors were positively associated with obsessive-compulsive symptoms and worry. A series of regression analyses was run to test the relative contributions of cognitive and metacognitive factors. In doing so, we controlled for worry and general threat. The metacognitive dimension of importance and control of thoughts emerged as a consistent unique predictor of overall obsessive-compulsive symptoms. Exploratory analyses of predictors of obsessive-compulsive symptom subtypes showed that metacognition and perfectionism contributed to different symptom domains. The data suggests that particular beliefs may be important in OCD.

Metacognitive therapy for obsessive-compulsive disorder: a case series

Cognitive-behavior therapy and exposure and response prevention are the most effective psychological treatments for obsessive-compulsive disorder (OCD). However, these approaches often produce variable results with the majority of treated individuals remaining symptomatic. This study evaluated a new form of cognitive therapy based on Wells' metacognitive model of OCD. Treatment efficacy was assessed using single case methodology in 4 consecutively referred individuals. At post-treatment, all participants made clinically significant change on a range of standardized outcome measures and these gains were largely maintained through to 6-month follow-up. Metacognitive therapy could be an effective and time efficient treatment for OCD.

Metacognitive beliefs about alcohol use: development and validation of two self-report scales

The goal of this research was to develop clinical assessment tools of positive and negative metacognitive beliefs about alcohol use. In Study 1 we constructed two scales and conducted preliminary factor analyses. Studies 2 and 3 investigated the predictive validity and temporal stability of the scales. Study 4 examined the factor structure, predictive validity and classification accuracy of the scales in a clinical sample. The Positive Alcohol Metacognitions Scale (PAMS) and the Negative Alcohol Metacognitions Scale (NAMS) were shown to possess good psychometric properties, as well as predictive validity and classification accuracy, in both clinical and community populations. The scales may aid future research into problem drinking and facilitate clinical assessment and case formulation.

I'll believe it when I can see it: imagery rescripting of intrusive sensory memories in depression

Intrusive sensory memories are a common feature of depression but these are not targeted in standard cognitive treatments. Imagery rescripting of distressing memories has so far been mainly used to treat trauma-related disorders and as a component of the treatment of personality disorders. We propose that this approach might also be effective in treating depression. This paper describes the initial application of imagery rescripting as a stand-alone treatment for two patients with a sole diagnosis of major depressive disorder. The two cases are described in detail and follow-up data are reported. Implications for the cognitive treatment of depression and for our theoretical understanding about the mechanisms of change in cognitive therapy are considered.

Metacognition as a mediator of the relationship between emotion and smoking dependence

This study investigated the role of metacognition as a mediator of the relationship between emotion and smoking dependence. A sample of 104 smokers completed the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Metacognitions Questionnaire 30 (MCQ-30), and Fagerström Test of Nicotine Dependence (FTND). Three dimensions of metacognition (positive beliefs about worry, negative beliefs about worry concerning uncontrollability and danger, and beliefs about cognitive confidence) were found to be positively and significantly correlated with smoking dependence. A positive and significant correlation was also observed between anxiety and depression on the one hand, and smoking dependence on the other. Structural equation modeling was used to test a mediational model in which emotion predicted metacognition which in turn predicted smoking dependence. The results supported the hypothesis that the relationship between emotion and smoking dependence is partially mediated by metacognition, suggesting that metacognitive theory may be relevant to understanding smoking dependence. The implications of these findings are discussed.

Metacognitive beliefs across the continuum of psychosis: Comparisons between patients with psychotic disorders, patients at ultra-high risk and non-patients

BACKGROUND

Recent models of emotional disorders and psychosis implicate metacognitive beliefs in the development and maintenance of psychological distress. We predicted that patients with established psychotic disorders and those meeting at risk mental state (ARMS) criteria (and, thus, at increased risk of developing psychosis) would show higher levels of metacognitive beliefs than non-patient controls. Furthermore, we predicted that patients with psychosis would show higher levels of such beliefs than the at risk group.

METHOD

The Metacognitions Questionnaire was administered to 73 patients with psychotic disorders, 43 ARMS patients and 188 non-patients.

RESULTS

As predicted, patients with psychotic diagnoses and those at risk scored higher on metacognitive belief dimensions than non-patients. Patients with psychosis showed higher positive metacognitive beliefs than the at risk patients, indicating a greater range of unhelpful metacognitions overall, when compared to non-patients.

CONCLUSIONS

These findings are consistent with metacognitive conceptualisations of psychological disorders. The implications of these findings for clinical practice are discussed.

The relative contribution of metacognitive beliefs and expectancies to drinking behaviour

AIM

Alcohol expectancies refer to the effects of alcohol use anticipated by an individual. Metacognitive beliefs about alcohol use are a specific form of alcohol expectancy relating to the beliefs individuals hold about the effects of alcohol on cognition and emotion.

METHOD

A community sample of 355 individuals completed measures of alcohol expectancies, metacognitive beliefs about alcohol use, and drinking behaviour.

RESULTS

Correlation analyses indicated that alcohol expectancies and metacognitive beliefs about alcohol use were positively correlated with drinking behaviour. Structural regression modelling revealed that three of the four facets of metacognitive beliefs about alcohol use were independent contributors to drinking behaviour, and that, when controlling for such beliefs, only negative social performance alcohol expectancies explained additional variance in drinking behaviour.

CONCLUSIONS

These results add to the argument that there is a value in differentiating between metacognitive beliefs about alcohol use and alcohol expectancies in predicting drinking behaviour.

Relationships between worry, psychotic experiences and emotional distress in patients with schizophrenia spectrum diagnoses and comparisons with anxious and non-patient groups

BACKGROUND

This study tests the hypothesis that worry is associated with psychotic experiences and examines whether worry would contribute significantly to emotional response independently of the intensity of psychotic experiences. This study also explores differences in worry between patients with a diagnosis of a schizophrenia spectrum disorder, patients with anxiety disorders and non-patients.

METHOD

Fifty-one patients with psychotic diagnoses, 40 patients with anxiety disorders and 60 non-patients were assessed on measures of psychotic experiences, cognitive components of anxiety and depression.

RESULTS

Dimensions of worry were associated with dimensions of delusional ideation and with psychotic experiences and social worry predicted emotional responses over and above the intensity of psychotic experiences. Both clinical groups had significantly higher levels of worry in comparison with non-patients.

CONCLUSIONS

These findings suggest that worry may be implicated in psychotic experiences and that people with psychotic diagnoses experience high levels of worry. The clinical implications of the findings are also discussed.

Intrusive images and memories in major depression

Individuals with current major depression were interviewed to investigate the prevalence of distressing intrusive mental imagery among depressed patients and study the phenomenology of these intrusions. Of the 39 currently depressed patients, 17 experienced some form of repetitive intrusive imagery (i.e., either an intrusive memory or image), with intrusive memories being more common than images. The intrusive imagery was experienced as highly uncontrollable and interfered significantly with patients' everyday lives. The intrusions were experienced with a sense of 'nowness', as well as physical and emotional re-experiencing. Despite high levels of re-experiencing, levels of dissociation were very low. The intrusive imagery was in some patients part of a wider network of key defining autobiographical memories, consistent with the idea that it is likely to play a significant role in maintaining the patient's depressive mood. Interventions targeting these intrusions could potentially result in a positive shift in depressed mood.

A survey of the demographics of blood use

Epidemiological information was obtained by a series of questions to experts in the field of epidemiology of transfusion from the United States, England, Australia and Denmark. Although it became clear that the methods for collecting the data had differed between the countries, useful information was obtained for all questions. The data highlighted some major differences between the countries: the incident rate for red cell transfusion varied from 44.7 to 54.1 units, for platelets from 2.0 to 6.0 units and for plasma from 4.8 to 13.8 units transfused per 1000 population per year. Age and sex distribution of transfused patients was similar in all countries. Most of the red cell products are transfused to older recipients, and the distribution between men and women is approximately equal. The distribution for platelets is over a wider age range, and the difference between men and women is marked, with men predominating in all countries. The distribution for plasma is also directed to the elderly, and there is a predominance of men. The relationship between the disease or surgical procedure and the use of blood products was similar between countries. The use of red cells in cardiovascular surgery predominated. Neoplasms and digestive disorders were also prevalent. Neoplasms, including those relating to haematology, were the main use for platelets, but cardiovascular surgery was also important. In all countries, plasma is largely used in cardiovascular surgery. Two countries provided data relating to the number of units per transfusion episode including information relating to massive transfusion. In Australia, red cell use of >or=50 units per episode was largely associated with multiple traumas. In Denmark, it was associated with gastrointestinal bleeding and various medical requests.

Belief disconfirmation versus habituation approaches to situational exposure in panic disorder with agoraphobia: A pilot study

Exposure therapy and cognitive behaviour therapy (CBT) are both effective in the treatment of panic disorder with agoraphobia. Cognitive theories suggest that the way in which exposure to avoided situations is implemented in either treatment may be crucial. In particular, it is suggested that clinical improvement will be greatest if opportunities for disconfirmation of feared catastrophes are maximized. In a small pilot study, 16 patients with panic disorder and (moderate or severe) agoraphobia were randomly allocated to either habituation based exposure therapy (HBET) or exposure planned as a belief disconfirmation strategy and accompanied by dropping of safety-seeking behaviours. Both treatments were brief (total of 3.25 h of exposure) and were similar in terms of expectancy of change. Patients in the CBT condition showed significantly greater improvements in self-report measures of anxiety, panic and situational avoidance. They also completed significantly more steps in a standardized behavioural walk, during which they experienced significantly less anxiety. The controlled effect sizes for CBT were substantial (range 1.7-2.7), which suggests it may be a particularly efficient way of managing therapeutic exposure to feared situations in panic disorder with agoraphobia. Further research is needed to clarify the mechanism of change involved.

Co-culturing human prostate carcinoma cells with hepatocytes leads to increased expression of E-cadherin

Metastasis is a multi-step process wherein tumour cells detach from the primary mass, migrate through barrier matrices, gain access to conduits to disseminate, and subsequently survive and proliferate in an ectopic site. During the initial invasion stage, prostate carcinoma cells undergo epithelial–mesenchymal-like transition with gain of autocrine signalling and loss of E-cadherin, hallmarks that appear to enable invasion and dissemination. However, some metastases express E-cadherin, and we found close connections between prostate carcinoma cells and hepatocytes in a liver microtissue bioreactor. We hypothesise that phenotypic plasticity occurs late in prostate cancer progression at the site of ectopic seeding. Immunofluorescence staining for E-cadherin in co-cultures of hepatocytes and DU-145 prostate cancer cells revealed E-cadherin upregulation at peripheral sites of contact by day 2 of co-culture; E-cadherin expression also increased in PC-3 cells in co-culture. These carcinoma cells bound to hepatocytes in an E-cadherin-dependent manner. Although the signals by which the hepatocytes elicited E-cadherin expression remain undetermined, it appeared related to downregulation of epidermal growth factor receptor (EGFR) signalling. Inhibition of autocrine EGFR signalling increased E-cadherin expression and cell–cell heterotypic adhesion; further, expression of a downregulation-resistant EGFR variant prevented E-cadherin upregulation. These findings were supported by finding E-cadherin and catenins but not activated EGFR in human prostate metastases to the liver. We conclude that the term epithelial–mesenchymal transition only summarises the transient downregulation of E-cadherin for invasion with re-expression of E-cadherin being a physiological consequence of metastatic seeding.

Does maternal psychopathology discriminate between children with DSM-IV generalised anxiety disorder or oppositional defiant disorder? The predictive validity of maternal axis I and axis II psychopathology

What dimensions of maternal psychopathology predict internalising or externalising disorder in children? We conducted a study of maternal axis I and axis II psychopathology in a group of children 8-12 years of age with Generalised Anxiety Disorder (GAD), Oppositional Defiant Disorder (ODD) and non-patient controls (NC). By using Multigroup Discriminant Analyses (MDA) on three groups of children (N = 85) and measures of axis I and axis II psychopathology of their mothers, we attempted to discriminate between these groups on a data driven basis. Two separate MDA were computed, one based on maternal axis I disorders, and one based on maternal axis II disorders. The results demonstrated that maternal symptomatic and personality psychopathology was differentially related to childhood anxiety or behavioural disorders. Mothers of children with ODD were characterised by more negative emotions and detached personality styles, whereas mothers of children with GAD seemed to be more somatic preoccupied, controlling and over-protective.

PLCγ contributes to metastasis of in situ-occurring mammary and prostate tumors

Phospholipase C-gamma (PLCgamma) has been implicated in tumor cell motility required for invasiveness and metastasis. Diminished tumor dissemination has been demonstrated in xenograft models, but studies in naturally-occurring tumors are lacking, having been limited by the timing of the interventions. Therefore, we generated mice that express a doxycycline (DOX)-inducible dominant-negative fragment of PLCgamma, PLCz; this approach avoids the in utero lethality caused by the absence of PLCgamma. As we targeted two de novo-occurring carcinomas of the mammary (MMTV-driven polyoma middle T antigen model, PyVmT) and prostate (TRAMP model) glands, we limited expression to these epithelial cells by driving DOX transactivator from the prostatein C3 promoter. This avoids the confounding variable of potentially abrogating motility in stromal and endothelial cells. These mice developed normally in the presence of DOX, except for limited mammary development if treated before 6 weeks and immaturity of the prostate gland if treated before 2 weeks of age. DOX-mediated induction of PLCz from age 8 to 16 weeks in PyVmT mice decreased the number of lung metastases by >10-fold (P<0.06) without a detectable effect on in situ tumor cell proliferation or tumor size. Lung metastases were also significantly decreased in the TRAMP model in which the mice expressed the PLCz fragment (P<0.05). DOX treatment itself had no effect on tumor size or metastasis in control mice, nor did it affect tumor dissemination in nontransgenic littermates. In conclusion, abrogation of the PLCgamma signaling pathway can limit the metastatic potential of carcinomas.

Metacognitive therapy for generalized anxiety disorder: an open trial

Generalized anxiety disorder (GAD) responds only modestly to existing cognitive-behavioural treatments. This study investigated a new treatment based on an empirically supported metacognitive model [Wells, (1995). Metacognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23, 301-320; Wells, (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester, UK: Wiley]. Ten consecutive patients fulfilling DSM-IV criteria for GAD were assessed before and after metacognitive therapy, and at 6, and 12-month follow-up. Patients were significantly improved at post-treatment, with large improvements in worry, anxiety, and depression (ESs ranging from 1.04-2.78). In all but one case these were lasting changes. Recovery rates were 87.5% at post treatment and 75% at 6 and 12 months. The treatment appears promising and controlled evaluation is clearly indicated.

Nontuberculous mycobacterial disease and Aspergillus-related lung disease in bronchiectasis

The aim of the present study was to determine whether patients with bronchiectasis and nontuberculous mycobacteria (NTM) have a higher prevalence of Aspergillus-related lung disease. A series of 30 consecutive patients with bronchiectasis and NTM (cases) were compared with 61 patients with bronchiectasis and no evidence of NTM (controls). Aspergillus serology and computerised tomography of the thorax were used to identify Aspergillus-related lung diseases, including aspergilloma, allergic bronchopulmonary aspergillosis and chronic necrotising pulmonary aspergillosis. The rate of positive Aspergillus serology was higher in cases with NTM disease compared with controls (10 out of 30 versus six out of 61). The radiological features of Aspergillus-related lung disease were also more common among patients with NTM disease than controls (six out of 30 versus none out of 61). This association between NTM disease and Aspergillus-related lung disease remained significant after adjustment for confounding effects of age and lung function (adjusted odds ratio 5.1, 95% confidence interval 1.5-17.0). Patients with bronchiectasis and nontuberculous mycobacterial disease have a higher prevalence of coexisting Aspergillus-related lung disease than patients with bronchiectasis and without nontuberculous mycobacteria. Identification of Aspergillus-related lung disease is important as prognosis amongst undetected cases is invariably poor.

STAT3 is required but not sufficient for EGF receptor-mediated migration and invasion of human prostate carcinoma cell lines

Growth factor-induced migration is a rate-limiting step in tumour invasiveness. The molecules that regulate this cellular behaviour would represent novel targets for limiting tumour cell progression. Epidermal growth factor (EGF) receptor (EGFR)-mediated motility, present in both autocrine and paracrine modes in prostate carcinomas, requires de novo transcription to persist over times greater than a few hours. Therefore, we sought to define specific signalling pathways that directly alter cellular transcription. Signal transducer and activator of transcription 3 (STAT3) is activated, as determined by electrophoretic motility shift assays, by EGFR in DU145 and PC3 human prostate carcinoma cells in addition to the motility model NR6 fibroblast cell line. Inhibition of STAT3 activity by antisense or siRNA downregulation or expression of a dominant-negative construct limited cell motility as determined by an in vitro wound healing assay and invasiveness through a extracellular matrix barrier. The expression of constitutively activated STAT3 did not increase the migration, which indicates that STAT3 is necessary but not sufficient for EGFR-mediated migration. These findings suggest that STAT3 signalling may be a new target for limiting prostate tumour cell invasion. In a microarray gene analysis of what transcription units are altered by EGF in a STAT3-dependent manner we found that the expression of motility-limiting VASP protein and the apoptosis nexus caspase 3 were both downregulated upon EGF exposure. These findings suggest a molecular basis for the STAT3 dependence of EGFR-mediated prostate tumour progression.

Progression-free interval in ovarian cancer and predictive value of an ex vivo chemoresponse assay

The study objective was to determine the effectiveness of a phenotypic chemoresponse assay in predicting response to chemotherapy measured by progression-free interval (PFI) in a retrospective series of ovarian cancer patients whose tumor specimens had been tested with the ChemoFx assay. A statistically significant correlation between assay prediction of response and PFI was observed in 256 cases with an exact or partial match between drug(s) assayed and received. In 135 cases with an exact match, the hazard ratio for progression of the resistant group was 2.9 (confidence interval [CI]: 1.4-6.3; P < 0.01) compared to the sensitive group and 1.7 (CI: 1.2-2.5) for the intermediate compared to the sensitive group. The median PFI for patients treated with drugs assayed as resistant was 9 months, 14 months for those with drugs assayed as intermediately sensitive, and PFI had not been achieved for those with drugs assayed as sensitive. These data indicate that the ChemoFx assay is predictive of PFI in ovarian cancer. As the majority of ovarian cancers display different degrees of response to different chemotherapy agents ex vivo, the incorporation of assay information into treatment selection has the potential to improve clinical outcomes in ovarian cancer patients.

Gamma-ray bursts: huge explosion in the early Universe

Long gamma-ray bursts (GRBs) are bright flashes of high-energy photons that can last for tens of minutes; they are generally associated with galaxies that have a high rate of star formation and probably arise from the collapsing cores of massive stars, which produce highly relativistic jets (collapsar model). Here we describe gamma- and X-ray observations of the most distant GRB ever observed (GRB 050904): its redshift (z) of 6.29 means that this explosion happened 12.8 billion years ago, corresponding to a time when the Universe was just 890 million years old, close to the reionization era. This means that not only did stars form in this short period of time after the Big Bang, but also that enough time had elapsed for them to evolve and collapse into black holes.

Green oxidations with laccase–mediator systems

Laccases are oxidase enzymes produced by 'white rot' fungi as part of a complex armoury of redox enzymes used to break down lignin--part of the carbon cycle of nature. Laccases alone or in combination with redox co-catalysts have been shown to oxidize xenobiotic compounds under conditions that can be described as 'green'. This paper describes some novel oxidations using the laccase-mediator method and some current limitations to the use of this technology.

Number of bodily symptoms predicts outcome more accurately than health anxiety in patients attending neurology, cardiology, and gastroenterology clinics

BACKGROUND

In consecutive new outpatients, we aimed to assess whether somatization and health anxiety predicted health care use and quality of life 6 months later in all patients or in those without demonstrable abnormalities.

METHOD

On the first clinic visit, participants completed the Illness Perception Questionnaire (IPQ), the Health Anxiety Questionnaire (HAQ), and the Hospital Anxiety and Depression Scale (HADS). Outcome was assessed as: (a) the number of medical consultations over the subsequent 6 months, extracted from medical records, and (b) Short-Form Health Survey 36 (SF36) physical component score 6 months after index clinic visit.

RESULTS

A total of 295 patients were recruited (77% response rate), and medical consultation data were available for 275. The number of bodily symptoms was associated with both outcomes in linear fashion (P<.001), and this was independent of anxiety and depression. Similar associations were found in people with or without symptoms due to demonstrable structural abnormalities. Health anxiety was associated only with health-related quality of life in patients with symptoms explained by demonstrable abnormalities.

CONCLUSION

The number of bodily symptoms and degree of health anxiety have different patterns of association with outcome, and these need to be considered in revising the diagnoses of somatization and hypochondriasis.

Obsessive-compulsive symptoms: the contribution of metacognitions and responsibility

Two different cognitive models of obsessive-compulsive symptoms were evaluated. One model [Salkovskis, P. M. (1985). Obsessional-compulsive problems a cognitive-behavioral analysis. Behaviour Research and Therapy, 23, 571-583.] gives a central and necessary role to beliefs and appraisals concerning responsibility. The other [Wells, A. (1997). Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. Chichester, UK: Wiley.] attaches a central and necessary role to metacognitive beliefs about the meaning and danger of thoughts/feelings and the need for control. We tested the unique contributions of responsibility or metacognitions to obsessive-compulsive symptoms whilst controlling for their intercorrelations and worry. Consistent with each model, responsibility and metacognitions were positively associated with obsessive-compulsive symptoms, even when worry was controlled for. However, responsibility was not associated with obsessive-compulsive symptoms when metacognitions and worry were controlled, but the relationship between metacognitive beliefs and obsessive-compulsive symptoms was independent of responsibility and worry. Responsibility did not add anything to the variance in symptoms explained by metacognitions. The data provide further support for the metacognitive model.

How effective are cognitive and behavioral treatments for obsessive–compulsive disorder? A clinical significance analysis

Controlled outcome studies investigating the efficacy of psychological treatments for obsessive-compulsive disorder (OCD) have employed different methods of determining the clinical significance of treatment effects. This makes it difficult to draw conclusions regarding the absolute and relative efficacy of psychological treatments for OCD. To address this issue, standardized Jacobson methodology for defining clinically significant change was applied to recent psychological outcome trials for OCD. The proportion of asymptomatic patients following treatment was also calculated. When recovery is defined by Jacobson methodology, exposure and response prevention (ERP) appears the most effective treatment currently available (50-60% recovered). However, when the asymptomatic criterion is used as the index of outcome, ERP and cognitive therapy have low and equivalent recovery rates (approximately 25%).

An unexpectedly rapid decline in the X-ray afterglow emission of long γ-ray bursts

'Long' gamma-ray bursts (GRBs) are commonly accepted to originate in the explosion of particularly massive stars, which give rise to highly relativistic jets. Inhomogeneities in the expanding flow result in internal shock waves that are believed to produce the gamma-rays we see. As the jet travels further outward into the surrounding circumstellar medium, 'external' shocks create the afterglow emission seen in the X-ray, optical and radio bands. Here we report observations of the early phases of the X-ray emission of five GRBs. Their X-ray light curves are characterised by a surprisingly rapid fall-off for the first few hundred seconds, followed by a less rapid decline lasting several hours. This steep decline, together with detailed spectral properties of two particular bursts, shows that violent shock interactions take place in the early jet outflows.

Distress in Parkinson's disease: contributions of disease factors and metacognitive style

Research has suggested that the high levels of depression and anxiety observed in Parkinson's disease are a primary consequence of its pathophysiology. This study aimed to test the hypothesis that a psychological factor, metacognitive style, is significantly associated with distress, independent of previously identified disease-related risk factors. Distress, metacognitive style and disease factors were assessed in 44 people with a diagnosis of Parkinson's disease. People with a specific metacognitive style had an increased vulnerability to distress over and above previously identified disease factors; this suggests future directions for the development of psychological interventions.

Interpretations of voices in patients with hallucinations and non-patient controls: a comparison and predictors of distress in patients

BACKGROUND

This study tested the hypotheses that interpretations of voices will be associated with distress linked to auditory hallucinations, and that patients experiencing hallucinations will exhibit higher levels of negative interpretations in comparison with non-patients.

METHOD

The Interpretation of Voices Inventory (British Journal of Clinical Psychology 41 (2002) 259) was administered to patients who met DSM-IV criteria for schizophrenia spectrum disorders with auditory hallucinations and non-patients. Patients were also assessed using a semi-structured interview to asses clinical dimensions of their voices.

RESULTS

The results showed that people with psychosis who experience auditory hallucinations did exhibit higher levels of positive and negative interpretations of voices, in comparison to non-patients. Correlational analyses revealed that interpretations of voices were significantly associated with emotional, physical and cognitive characteristics of voices. Regression analyses demonstrated that physical characteristics of voices and metaphysical beliefs were significant predictors of emotional characteristics of voices.

CONCLUSIONS

The theoretical and clinical implications of these findings are discussed.

Luteinising hormone-releasing hormone analogue reverses the cell adhesion profile of EGFR overexpressing DU-145 human prostate carcinoma subline

Cetrorelix, a luteinising hormone-releasing hormone (LHRH) analogue, has been shown to limit growth of the human androgen-independent prostate cell line DU-145, although other inhibitory actions may also be affected. Both growth and invasion of DU-145 cells are linked to autocrine epidermal growth factor receptor (EGFR) signalling. Invasiveness requires not only cells to migrate to conduits, but also reduced adhesiveness between tumour cells to enable separation from the tumour mass. Thus, we investigated whether Cetrorelix alters the DU-145 cell-cell adhesion and if this occurs via altered EGFR signalling. Pharmacologic levels of Cetrorelix limited the invasiveness of a highly invasive DU-145 subline overexpressing full-length EGFR (DU-145 WT). Extended exposure of the cells to Cetrorelix resulted in increased levels of the cell-cell adhesion complex molecules E-cadherin, alpha- and beta-catenin, and p120. Puromycin blocked the increases in E-cadherin and beta-catenin levels, suggesting that de novo protein synthesis is required. The Cetrorelix effect appears to occur via transmodulation of EGFR by a protein kinase C (PKC)-dependent mechanism, as there were no changes in DU-145 cells expressing EGFR engineered to negate the PKC transattenuation site (DU-145 A654); downregulation of EGFR signalling produced a similar upregulation in adhesion complex proteins, further suggesting a role for autocrine signalling. Cetrorelix increased the cell-cell adhesiveness of DU-145 WT cells to an extent similar to that seen when autocrine EGFR signalling is blocked; as expected, DU-145 A654 cell-cell adhesion also was unaffected by Cetrorelix. The increased adhesiveness is expected as the adhesion complex molecules moved to the cells' periphery. These data offer direct insight into the possible crosstalk pathways between the LHRH and EGFR receptor signalling. The ability of Cetrorelix to downregulate EGFR signalling and subsequently reverse the antiadhesiveness found in metastatic prostate cancer highlights a novel potential target for therapeutic strategies.

Genetic variation in populations of Western Australian wild radish

Raphanus raphanistrum L. (wild radish) is a major problematic weed worldwide. Random amplified polymorphic DNA (RAPD) was used to estimate the degree of genetic diversity between and within 2 populations of wild radish (WARR 5 and WARR 6), found to exhibit multiple herbicide resistance compared with a susceptible population (WARR 7). It is believed that weed species with high degrees of genetic variation show potential for developing resistance to herbicides. Of the 13 RAPD primers screened, 9 primers generated 97 polymorphic bands concomitant with a high level of polymorphism (82%) between the wild radish populations, characteristics of an outbreeding species. Analysis of molecular variance (AMOVA) showed a markedly higher proportion of diversity within populations (87%) as opposed to between populations (13%). Principal component analysis (PCA) further highlighted the large amount of variation between individuals within populations. Only one marker, OPC19–8, was found to be unique to the WARR 7 population but absent in WARR 5 and in most individuals of the WARR 6 populations. This marker may potentially be correlated with herbicide susceptibility. The 2 resistant wild radish populations were found to be closely related (0.7% dissimilar) to each other, whereas the susceptible population was genetically dissimilar to them by 2.3%. This higher level of dissimilarity between the susceptible and resistant populations may be explained by limited gene flow between them since the susceptible population is geographically located further away from the resistant populations. Hence, it may be concluded that the underlying genetic structure of the 3 wild radish populations seems to be similar despite WARR 6 and WARR 5 having been exposed to mixed herbicide usage for over 17 years.

Metacognitive therapy for PTSD: a preliminary investigation of a new brief treatment

The effectiveness of a new treatment for post traumatic stress disorder (PTSD) is addressed. Treatment was based on a metacognitive theory of mechanisms by which natural traumatic processing is enabled or hindered by coping strategies. It suggests that elimination of worry/rumination, of maladaptive attention strategies, and enhancing metacognitive flexibility, will permit natural processing and a return to normal cognition. An A-B direct replication series (n = 6) with follow-up assessments at 3, 6, and 18-41 months was implemented. Treatment commenced 3-10 months post-trauma. All patients showed large and statistically significant improvements in general emotion and specific PTSD measures. Gains were maintained at follow-up. Two further consecutively referred patients were treated at 8 and 12 months post-trauma to add to sample size (n = 8). Overall Post treatment effect sizes were large, ranging from 3.0 to 5.0. Further evaluations are clearly warranted.

Differential in vitro effects of chemotherapeutic agents on primary cultures of human ovarian carcinoma

The treatment of ovarian cancer principally relies on the use of platinum and taxane chemotherapeutic agents. Short-term clinical results have been encouraging, but long-term responses remain limited. In this report, an in vitro assay system that utilizes cells grown from human tumor explants has been used to quantitatively evaluate responses to relevant concentrations of alternative chemotherapeutic agents. The results suggest that there are significant differences in the responses of explant-derived cultured cells to the different agents tested. In an evaluation of 276 primary ovarian cancer specimens, five nonstandard drugs were tested in 51 cases. Of these 51 cases, cyclophosphamide had the highest rate of response at 67%, followed by doxorubicin at 61%, gemcitabine at 49%, etoposide at 48%, and topotecan at 14%. Venn diagrams, representing the in vitro responses to the platins and taxanes, as well as the responses to the nonstandard drugs, illustrate that there clearly are distinct differences among patients in a given population. These data underscore the potential importance of evaluating each patient's response to a number of different drugs to optimize the therapeutic decision-making process.