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Tsigkaropoulou E, Michopoulos I, Porichi E, Dafnas K, Serretti A, Ferentinos P. Temperament and character dimensions explain self-reported resilience deficits in patients with affective disorders. Int Clin Psychopharmacol 2024; 39:59-69. [PMID: 37351577 DOI: 10.1097/yic.0000000000000483] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
This is the first study exploring how temperament and character personality dimensions impact self-reported resilience in major depressive disorder (MDD) and bipolar disorder (BD). We included 130 euthymic patients with affective disorders (AFD; 66 MDD and 64 BD) and 134 healthy controls (HC). Connor and Davidson resilience scale and Temperament and Character Inventory (TCI-140) were administered. Multiple linear regressions and interaction analyses were performed. Mediation analyses examined if personality dimensions explained group differences in resilience. Resilience was lower in MDD and BD vs. HC and in MDD vs. BD, adjusting for sex, age and education. Higher resilience was predicted by lower harm avoidance (HA) and higher persistence (P) in AFD and MDD, lower HA in BD and higher P and self-directedness (SD) in HC. However, only HA and P had a group-specific effect on resilience in AFD vs. HC. In mediation analyses, specific TCI dimensions at least partially explained differences in resilience: HA, P and SD in AFD or MDD vs. HC; SD in BD vs. HC; P in BD vs. MDD. Concludingly, two temperament traits (HA, P) and a character trait (SD) predict resilience in AFD. Focusing on personality could identify sources of compromised resilience as potential treatment targets.
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Affiliation(s)
- Evdoxia Tsigkaropoulou
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, Athens, Greece
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, Athens, Greece
| | - Evgenia Porichi
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, Athens, Greece
| | - Konstantinos Dafnas
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, Athens, Greece
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Panagiotis Ferentinos
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, Athens, Greece
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Rodriguez TR, Rufino KA, Patriquin MA, Anestis JC. An Examination of the Treatment Utility of the MMPI-2-RF: Prediction of Post-Treatment Depressive Symptoms and Increased Understanding of the Therapeutic Alliance in an Inpatient Mood Disorder Treatment. J Pers Assess 2023; 105:667-678. [PMID: 36352739 DOI: 10.1080/00223891.2022.2137029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 10/04/2022] [Indexed: 11/11/2022]
Abstract
The study examined the ability of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scales to predict depressive symptoms in a psychiatric inpatient setting. The indirect effect of patient-rated alliance with their treatment team on these relationships was also investigated. Participants included 678 (52.5% female, 97.1% White) inpatients diagnosed with a mood disorder. MMPI-2-RF scales, Patient Health Questionnaire (PHQ-9) at intake and discharge, and Working Alliance Inventory-Short at discharge were used to test study hypotheses regarding MMPI-2-RF predictive utility and the influence of alliance. Jacobson and Truax's (1991) reliable change index (RCI) was calculated to identify those who did (74% of the sample) and did not (24%) make reliable and clinically significant depressive symptom change, and the predictive utility of MMPI-2-RF scores in distinguishing these groups was examined. MMPI-2-RF scales assessing internalizing and somatic dysfunction accounted for an additional 2% to 8% of the variance in depressive symptoms reported at discharge, above and beyond depressive symptoms reported at intake. Somatic scales were also able to differentiate groups based on clinically significant change on the PHQ-9 (small-sized effect). The relationship between MMPI-2-RF scales and depressive symptoms at discharge was indirect through alliance in 64% of models. Clinical implications are discussed.
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Affiliation(s)
- Taylor R Rodriguez
- Department of Psychology, School of Arts & Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Katrina A Rufino
- The Menninger Clinic, Houston, Texas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
- The University of Houston Downtown, Houston, Texas
| | - Michelle A Patriquin
- The Menninger Clinic, Houston, Texas
- Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Joye C Anestis
- Department of Health Behavior, Society, & Policy, School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
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3
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Aafjes-van Doorn K, Kealy D, Ehrenthal JC, Ogrodniczuk JS, Joyce AS, Weber R. The Relationship Between Patients' Personality Traits, the Alliance, and Change in Interpersonal Distress in Intensive Group Treatment for Personality Dysfunction. J Pers Disord 2022; 36:731-748. [PMID: 36454157 DOI: 10.1521/pedi.2022.36.6.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
This study examined patients' personality traits as operationalized by the five-factor model in relation to early alliance and reduction of interpersonal distress through an intensive group treatment program for personality dysfunction. A sample of 79 consecutively admitted psychiatric outpatients with personality dysfunction who attended an 18-week intensive group treatment program completed the NEO Five-Factor Inventory at pretreatment, the Inventory of Interpersonal Problems at pre- and posttreatment, and the Edmonton Therapeutic Alliance Scale, a measure of the therapeutic alliance with the program therapist, at Session 5. Results indicated that patients who were relatively extraverted tended to rate the alliance with their program therapist higher and subsequently reported more improvement of interpersonal distress. The presence of a personality disorder did not moderate this mediation. Patients' extraversion likely promotes a bonding with the therapist and facilitates the interpersonal group work necessary for improvement. Assessing patients' level of extraversion before starting intensive group treatment might indicate which intervention strategies could be useful with that patient within the program frame.
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Affiliation(s)
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Anthony S Joyce
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Rainer Weber
- Clinic for Psychosomatics and Psychotherapy, University of Cologne, Germany
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Gukasyan N, Nayak SM. Psychedelics, placebo effects, and set and setting: Insights from common factors theory of psychotherapy. Transcult Psychiatry 2022; 59:652-664. [PMID: 33499762 DOI: 10.1177/1363461520983684] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Psychedelic-assisted treatment is at first glance markedly different in structure and approach from mainstream forms of psychotherapy in the West. A major criticism of clinical psychedelic research rests on the difficulty of executing placebo-controlled studies and distinguishing drug effects from those of the psychotherapeutic container in which psychedelics are typically presented. Detractors also tend to find fault in spiritual or mystical themes that often arise in the context of psychedelic use. Common factors theory of psychotherapy is a useful and extensively studied framework that can help make sense of these issues, and has much to contribute to our understanding of contextual effects that are often discussed in psychedelic literature as "set and setting." In this article, we examine four major contextual "common factors" shared by various healing traditions: 1) the therapeutic relationship; 2) the healing setting; 3) the rationale, conceptual scheme, or myth; and 4) the ritual. We explain how these factors show up in psychedelic-assisted treatment and how they may contribute to therapeutic effects. Lastly, we discuss the implications of these factors for the concept of placebo, and for future research.
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Affiliation(s)
| | - Sandeep M Nayak
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Bilodeau C, Meissner J, Antunes‐Alves S, Konecki R, Ruci L. Exploring alliance–outcome associations in a combined mental health and academic counselling setting for at‐risk students: The differential role of alliance components, personality, gender and pre‐treatment severity. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Parry S, Eve Z, Myers G. Exploring the Utility and Personal Relevance of Co-Produced Multiplicity Resources with Young People. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:427-439. [PMID: 35600531 PMCID: PMC9120276 DOI: 10.1007/s40653-021-00377-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 06/15/2023]
Abstract
Multiplicity, the experience of more than one self in the body, is an under-researched area of young people's mental health. The aim of this study was to explore the perspectives of experts-by-experience within a community sample regarding two specific resources: a co-produced self-help guide about multiplicity for adolescents, and a set of guidelines for supporting someone who identifies as 'multiple'. 34 participants (Mage= 22.06, 2.26 SD; 15F, 1M, 18NBG) completed an online survey consisting of open-ended and Likert scale questions to assess the language, utility, transferability and therapeutic impact of the materials. Descriptive statistics and a Foucauldian-informed Narrative Analysis were employed to analyse responses, producing a summary of utility and two narrative chapters. The emergent chapters, 'Breaking the Stigma' and 'Recognising the Many', highlight the need for greater understanding and awareness of multiplicity, with psychoeducation materials viewed as helpful. Inclusive language can reduce stigma and normalise multiplicity as a response to trauma. With greater understanding, practitioners and researchers can collaborate with young people through trauma wise care, providing multiplicity sensitive language and support. Overall, the term 'parts' was viewed as problematic by the participants as it could imply the plural system is not coexisting as a whole. Additionally, opinions varied as to how much diagnostic language could and should be used to describe multiplicity; linguistically and conceptually. Importantly, compassion was seen as particularly essential for younger selves within the system; older in their years and presence, but often more vulnerable within the societies in which the system resides.
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Affiliation(s)
- Sarah Parry
- Department of Psychology, Manchester Metropolitan University, Brooks Building, Manchester, M15 6GX UK
| | - Zarah Eve
- Department of Psychology, Manchester Metropolitan University, Brooks Building, Manchester, M15 6GX UK
| | - Gemma Myers
- Department of Psychology, Manchester Metropolitan University, Brooks Building, Manchester, M15 6GX UK
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Ortelbach N, Rote J, Dingelstadt AML, Stolzenburg A, Koenig C, O'Malley G, Quinlivan E, Fiebig J, Pfeiffer S, König B, Simhandl C, Bauer M, Pfennig A, Stamm TJ. The big five model in bipolar disorder: a latent profile analysis and its impact on longterm illness severity. Int J Bipolar Disord 2022; 10:1. [PMID: 35041119 PMCID: PMC8766615 DOI: 10.1186/s40345-021-00248-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/16/2021] [Indexed: 12/12/2022] Open
Abstract
Background Using a personality typing approach, we investigated the relationship between personality profiles and the prediction of longterm illness severity in patients with bipolar disorder (BD). While previous research suggests associations between BD and traits from the NEO-FFI profiles, the current study firstly aimed to identify latent classes of NEO-FFI profiles, and, secondly, to examine their impact on the longterm prognosis of BD. Methods Based on the NEO-FFI profiles of 134 euthymic patients diagnosed with BD (64.2% female, mean age = 44.3 years), successive latent profile analyses were conducted. Subsequently, a subsample (n = 80) was examined prospectively by performing multiple regression analysis of the latent classes to evaluate the longitudinal course of the disease (mean: 54.7 weeks) measured using a modified Morbidity Index. Results The latent profile analyses suggested a 3-class model typifying in a resilient (n = 68, 51%), vulnerable (n = 55, 41%) and highly vulnerable (n = 11, 8%) class. In the regression analysis, higher vulnerability predicted a higher longterm Morbidity Index (R2 = 0.28). Conclusions Subgroups of patients with BD share a number of discrete personality features and their illness is characterized by a similar clinical course. This knowledge is valuable in a variety of clinical contexts including early detection, intervention planning and treatment process.
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Affiliation(s)
- Niklas Ortelbach
- Department of Educational Science and Psychology, Free University of Berlin, Berlin, Germany
| | - Jonas Rote
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Alice Mai Ly Dingelstadt
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Stolzenburg
- Department of Psychology, Brandenburg Medical School Theodor Fontane, Fehrbelliner Straße 38, 16816, Neuruppin, Germany
| | - Cornelia Koenig
- Department of Psychology, Brandenburg Medical School Theodor Fontane, Fehrbelliner Straße 38, 16816, Neuruppin, Germany
| | - Grace O'Malley
- Department of Psychology, Brandenburg Medical School Theodor Fontane, Fehrbelliner Straße 38, 16816, Neuruppin, Germany.,Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Esther Quinlivan
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jana Fiebig
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Steffi Pfeiffer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | | | - Christian Simhandl
- Bipolar Center, Wiener Neustadt, Austria.,Faculty of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Thomas J Stamm
- Department of Psychology, Brandenburg Medical School Theodor Fontane, Fehrbelliner Straße 38, 16816, Neuruppin, Germany. .,Schloss Luetgenhof Hospital, Centre for Personal Medicine, Psychosomatics and Psychotherapy, Dassow, Mecklenburg-Western Pomerania, Germany.
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The role of personality traits in inpatient pulmonary rehabilitation response in patients with chronic obstructive pulmonary disease. Respir Med 2021; 190:106680. [PMID: 34768075 DOI: 10.1016/j.rmed.2021.106680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/04/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The effectiveness of pulmonary rehabilitation (PR) is a critical issue for chronic obstructive pulmonary disease (COPD) patients. However, PR response is marked by a strong heterogeneity, partially unexplained to date. We hypothesized that personality traits defined by the Five-Factor Model could modulate the effect of inpatient-PR. OBJECTIVE The aim was to assess the associations between these five personality traits and PR outcomes. METHODS 74 persons with COPD admitted for a 5-week inpatient PR program had a personality assessment at the start of the program (T1). Exercise capacity, quality of life, sensory and affective dyspnea dimensions were assessed at T1 and at the end of the program (T2). Their evolution was evaluated using the delta score between T2 and T1. PR response was defined using the minimal clinically important change score for each of them. A composite response was established distinguishing the poor responders' group, made of patients who responded to 0, 1 or 2 parameters and the good responders' group, with patients who responded on 3 or 4 indicators. RESULTS Logistic regressions analyses highlighted that those with a high level of openness [OR = 0.36, 95% CI = 0.15-0.74, p < 0.01] were less likely to respond on quality of life, controlling for socio-demographic factors and the severity of the disease. CONCLUSION This study shows that the investigation of the personality constitutes an interesting perspective for better understanding the interindividual differences observed between patients in the PR response. Tailoring clinical intervention to the patient's personality could be a promising prospect for optimizing PR effectiveness.
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Temporal and specific pathways of change in cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for depression. Behav Res Ther 2021; 151:104010. [DOI: 10.1016/j.brat.2021.104010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022]
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10
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Woods A, Solomonov N, Liles B, Guillod A, Kales HC, Sirey JA. Perceived Social Support and Interpersonal Functioning as Predictors of Treatment Response Among Depressed Older Adults. Am J Geriatr Psychiatry 2021; 29:843-852. [PMID: 33419660 PMCID: PMC8255325 DOI: 10.1016/j.jagp.2020.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Social isolation is highly common in late life and is associated with devastating mental health and physical outcomes. This study investigated whether components of social isolation (marital status, perceived social support, and interpersonal problems) predict change in depression severity over the course of a brief adherence intervention delivered in a primary care setting. METHOD A sample of 189 older adults with major depressive disorder were randomized to either an adherence intervention, "Treatment Initiation Program," or treatment as usual. Marital status, perceived social support and interpersonal problems were assessed at baseline. A mixed-effects regression was used to test whether these factors predicted the change trajectory in depression severity over 24 weeks. RESULTS Being married (F(2,176) = 6.60; p = 0.001), reporting higher perceived social support (F(2,177) = 4.70; p = 0.01), and fewer interpersonal problems (F(2, 176) = 4.34; p = 0.01) predicted lower depression severity on average over the course of 24 weeks. CONCLUSION Social variables such as living in partnership, perceiving others as supportive, and reporting few interpersonal problems may reduce older adults' vulnerability to depression and enhance their ability to benefit from treatment. These findings can guide development of interventions that will target these social factors early in treatment to increase efficacy.
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Hemyari C, Zomorodian K, Shojaee M, Sahraian A, Dolatshahi B. The Effect of Personality Traits on Cognitive Behavioral Therapy Outcomes in Student Pharmacists with Rat Phobia: A Randomized Clinical Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES 2021; 46:23-31. [PMID: 33487789 PMCID: PMC7812500 DOI: 10.30476/ijms.2019.82341.1045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Little is known about which personality traits determine the effectiveness of various types of cognitive-behavioral therapy (CBT) on animal phobia. The objective of the present study was to investigate a possible association between personality traits and the outcome of single- and multi-session CBT. Methods: The present randomized clinical trial was conducted from November 2018 to May 2019 in Shiraz, Iran. Forty female students with rat phobia, who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria, were systematically allocated into a single- and a multi-session therapy group (odd numbers one-session treatment, even numbers multi-session treatment). In both groups, the students were gradually exposed to rats as part of the treatment. Psychological measures (state-anxiety, rat phobia, and disgust questionnaires) were used to compare pre- and post-intervention outcomes. Multivariate analysis of covariance was used to assess which personality traits influenced the intervention outcome. The statistical analysis was performed using SPSS (version 20.0) and P values<0.05 were considered statistically significant. Results: Rat phobia was positively and significantly affected by conscientiousness (P=0.001) and agreeableness (P=0.003). Of these personality traits, only a higher degree of conscientiousness resulted in a further reduction of state anxiety after the intervention (P=0.005). There were no significant differences between the pre- and post-intervention outcomes. Conclusion: The outcome of single- and multi-session rat phobia therapies was associated with specific personality traits of the participants, namely conscientiousness and agreeableness. Both intervention methods had an equal effect on reducing rat phobia.
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Affiliation(s)
- Camellia Hemyari
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kamiar Zomorodian
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Shojaee
- Central Research Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Sahraian
- Substance Abuse and Mental Health Research Center, Hafez Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behrooz Dolatshahi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Papamalis FE, Dritsas I, Knight K. The Role of Personality Functioning on Early Drop out in Outpatient Substance Misuse Treatment. Subst Use Misuse 2021; 56:1119-1136. [PMID: 33881361 DOI: 10.1080/10826084.2021.1908358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Treatment initiation is a major factor contributing to positive outcomes, but the supporting literature remains limited. It is difficult to draw conclusions regarding predictors of dropout, and there is a need to target clients' major early attrition vulnerabilities. Despite empirically validated models for assessing personality, little is known about its role in the treatment process. Studies that have been conducted in this area have focused mainly on stable personality traits and provide conflicting evidence. Aims: The aim of this study is to examine to what extent service users' personality functioning are potential determinants of early drop out. Methodology: A cross-sectional multi-site design examined the therapy process in a naturalistic setting in 5 outpatient preparation treatment centers with 210 service users. The current study adopts a contemporary dimensional-based framework, similar to the Alternative Model of Personality Disorder of the DSM-V and examines the role of characteristic adaptations (SIPP-118) on early drop out (CEST-Intake). Findings: From the broad spectrum of personality traits, only Depression remained significant predictor of drop out. Higher dysfunctional levels in Social Concordance [OR] = 1.85, Wald =19.87, p =.002, 95% CI [1.1, 1.9] as well as the facets Aggression Regulation, Respect and Purposefulness were also predictors of early drop out, while Treatment Readiness and Desire for Help accounted for a significant amount of variance. Conclusions: These findings extend our knowledge of the predictive role of characteristic adaptations in treatment and suggest it may be important to assess these individual differences early on and to design personalized-informed interventions.
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Affiliation(s)
- Fivos E Papamalis
- Psychology Department, University of Derby, SENSE - Centre for Translational Research on Public Health & Social Policy, Thessaloniki, Greece
| | - Ioannis Dritsas
- Greece Department of Education Sciences and Social Work, Clinical Observatory for the Diagnostic Evaluation of Addictions and Risky Behaviours in Adolescence, University Of Patras, Patras, Patra, Greece
| | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
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Baier AL, Kline AC, Feeny NC. Therapeutic alliance as a mediator of change: A systematic review and evaluation of research. Clin Psychol Rev 2020; 82:101921. [DOI: 10.1016/j.cpr.2020.101921] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 08/06/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023]
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14
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Innes S, Beynon A, Hodgetts C, Manassah R, Lim D, Walker BF. Predictors of instanteous relief from spinal manipulation for non-specific low back pain: a delphi study. Chiropr Man Therap 2020; 28:39. [PMID: 32611351 PMCID: PMC7331174 DOI: 10.1186/s12998-020-00324-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/04/2020] [Indexed: 11/25/2022] Open
Abstract
Background There is some evidence and anecdotal reports that high-velocity low-amplitude (HVLA) spinal manipulation therapy (SMT) for non-specific low back pain (NSLBP) may immediately reduce pain in some patients. The mechanism for such a change remains unclear and the evidence is conflicting. The aim of this study was to seek consensus among a sample of expert manual therapists as to the possible clinical predictors that could help identify patients who are most likely to receive instant relief from NSLBP with SMT intervention. Methods Thirty-seven expert chiropractors and manipulative physiotherapists from around the world were invited to participate in a three round online Delphi questionnaire during the second half of 2018. Participants were provided with a list of 55 potential signs and symptoms as well as offering them the option of suggesting other factors in the first round. The variables were rated using a 4-point Likert likelihood scale and a threshold of 75% agreement was required for any item to progress to the next round. Results Of these 37 experts, 19 agreed to participate. Agreement as to the proportion of patients who receive instantaneous relief was minimal (range 10–80%). A total of 62 items were ranked over the 3 rounds, with 18 of these retained following the third round. The highest rated of the 18 was ‘A history including a good response to previous spinal manipulation’. Discussion/conclusion Five categories; patient factors, practitioner factors, signs and symptoms of NSLBP presentation, an instrument of measurement (FABQ), and the presence of cavitation following SMT best describe the overall characteristics of the factors. The 18 factors identified in this study can potentially be used to create an instrument of measurement for further study to predict those patients with NSLBP who will receive instantaneous relief post-SMT.
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Affiliation(s)
- Stanley Innes
- Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Murdoch, Australia.
| | - Amber Beynon
- Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Murdoch, Australia
| | - Christopher Hodgetts
- Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Murdoch, Australia
| | - Rachel Manassah
- 5th Year student, Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Murdoch, Australia
| | - Denyse Lim
- 5th Year student, Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Murdoch, Australia
| | - Bruce F Walker
- Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Murdoch, Australia
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Ruggero CJ, Kotov R, Hopwood CJ, First M, Clark LA, Skodol AE, Mullins-Sweatt SN, Patrick CJ, Bach B, Cicero DC, Docherty A, Simms LJ, Bagby RM, Krueger RF, Callahan JL, Chmielewski M, Conway CC, De Clercq B, Dornbach-Bender A, Eaton NR, Forbes MK, Forbush KT, Haltigan JD, Miller JD, Morey LC, Patalay P, Regier DA, Reininghaus U, Shackman AJ, Waszczuk MA, Watson D, Wright AGC, Zimmermann J. Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice. J Consult Clin Psychol 2020; 87:1069-1084. [PMID: 31724426 DOI: 10.1037/ccp0000452] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alternative to traditional classifications that conceptualizes psychopathology as a set of dimensions organized into increasingly broad, transdiagnostic spectra. Prior work has shown that using a dimensional approach improves reliability and validity, but translating a model like HiTOP into a workable system that is useful for health care providers remains a major challenge. METHOD The present work outlines the HiTOP model and describes the core principles to guide its integration into clinical practice. RESULTS Potential advantages and limitations of the HiTOP model for clinical utility are reviewed, including with respect to case conceptualization and treatment planning. A HiTOP approach to practice is illustrated and contrasted with an approach based on traditional nosology. Common barriers to using HiTOP in real-world health care settings and solutions to these barriers are discussed. CONCLUSIONS HiTOP represents a viable alternative to classifying mental illness that can be integrated into practice today, although research is needed to further establish its utility. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University
| | | | - Michael First
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University
| | | | | | | | | | - Bo Bach
- Psychiatric Research Unit, Slagelse Psychiatric Hospital
| | | | | | - Leonard J Simms
- Department of Psychology, University at Buffalo, The State University of New York
| | - R Michael Bagby
- Departments of Psychology and Psychiatry, University of Toronto
| | | | | | | | | | - Barbara De Clercq
- Department of Developmental, Personality, and Social Psychology, Ghent University
| | | | | | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University
| | | | | | | | | | - Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing, University College London
| | - Darrel A Regier
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University
| | | | | | | | - David Watson
- Department of Psychology, University of Notre Dame
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A meta-analytic review of personality traits and their associations with mental health treatment outcomes. Clin Psychol Rev 2019; 70:51-63. [DOI: 10.1016/j.cpr.2019.04.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 03/23/2019] [Accepted: 04/03/2019] [Indexed: 12/14/2022]
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Kealy D, McCloskey KD, Cox DW, Ogrodniczuk JS, Joyce AS. Getting absorbed in group therapy: Absorption and cohesion in integrative group treatment. COUNSELLING & PSYCHOTHERAPY RESEARCH 2019. [DOI: 10.1002/capr.12226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- David Kealy
- Department of Psychiatry University of British Columbia Vancouver British Columbia Canada
| | - Katharine D. McCloskey
- Department of Psychiatry University of British Columbia Vancouver British Columbia Canada
- Educational and Counselling Psychology University of British Columbia Vancouver British Columbia Canada
| | - Daniel W. Cox
- Educational and Counselling Psychology University of British Columbia Vancouver British Columbia Canada
| | - John S. Ogrodniczuk
- Department of Psychiatry University of British Columbia Vancouver British Columbia Canada
| | - Anthony S. Joyce
- Department of Psychiatry University of Alberta Edmonton Alberta Canada
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18
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Treatment of Clients with Anxious and Over-controlled Personality Disorders: An International Accord. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2019. [DOI: 10.1007/s10879-018-9403-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Thomson L, Barker M, Kaylor-Hughes C, Garland A, Ramana R, Morriss R, Hammond E, Hopkins G, Simpson S. How is a specialist depression service effective for persistent moderate to severe depressive disorder?: a qualitative study of service user experience. BMC Psychiatry 2018; 18:194. [PMID: 29902995 PMCID: PMC6003097 DOI: 10.1186/s12888-018-1708-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A specialist depression service (SDS) offering collaborative pharmacological and cognitive behaviour therapy treatment for persistent depressive disorder showed effectiveness against depression symptoms versus usual community based multidisciplinary care in a randomised controlled trial (RCT) in specialist mental health services in England. However, there is uncertainty concerning how specialist depression services effect such change. The current study aimed to evaluate the factors which may explain the greater effectiveness of SDS compared to Treatment as Usual (TAU) by exploring the experience of the RCT participants. METHODS Qualitative audiotaped and transcribed semi-structured interviews were conducted 12-18 months after baseline with 21 service users (12 SDS, 9 TAU arms) drawn from all three sites. Inductive thematic analysis using a grounded approach contrasted the experiences of SDS with TAU participants. RESULTS Four themes emerged in relation to service user experience: 1. Specific treatment components of the SDS: which included sub-themes of the management of medication change, explaining and developing treatment strategies, setting realistic expectations, and person-centred and holistic approach; 2. Individual qualities of SDS clinicians; 3. Collaborative team context in SDS: which included sub-themes of communication between healthcare professionals, and continuity of team members; 4. Accessibility to SDS: which included sub-themes of flexibility of locations, frequent consultation as reinforcement, gradual pace of treatment, and challenges of returning to usual care. CONCLUSIONS The study uncovered important mechanisms and contextual factors in the SDS that service users experience as different from TAU, and which may explain the greater effectiveness of the SDS: the technical expertise of the healthcare professionals, personal qualities of clinicians, teamwork, gradual pace of care, accessibility and managing service transitions. Usual care in other specialist mental health services may share many of the features from the SDS. TRIAL REGISTRATION "Trial of the Clinical and Cost Effectiveness of a Specialist Expert Mood Disorder Team for Refractory Unipolar Depressive Disorder" was registered in www.ClinicalTrials.gov ( NCT01047124 ) on 12-01-2010 and the ISRCTN registry was registered in www.isrctn.com ( ISRCTN10963342 ) on 25-11-2015 (retrospectively registered).
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Affiliation(s)
- Louise Thomson
- Division of Psychiatry and Applied Psychology, Institute of Mental Health, School of Medicine, University of Nottingham, Yang Fujia Building, Nottingham, NG8 1BB, UK.
| | - Marcus Barker
- 0000 0004 1936 8868grid.4563.4CLAHRC-EM, School of Medicine, University of Nottingham, Nottingham, UK
| | - Catherine Kaylor-Hughes
- 0000 0004 1936 8868grid.4563.4CLAHRC-EM, School of Medicine, University of Nottingham, Nottingham, UK
| | - Anne Garland
- Adult Mental Health Directorate, Nottinghamshire Healthcare Trust, Nottingham, UK
| | - Rajini Ramana
- Cambridge and Peterborough Partnership NHS Foundation Trust, Cambridge, UK
| | - Richard Morriss
- 0000 0004 1936 8868grid.4563.4CLAHRC-EM, School of Medicine, University of Nottingham, Nottingham, UK
| | - Emily Hammond
- Cambridge and Peterborough Partnership NHS Foundation Trust, Cambridge, UK
| | - Gail Hopkins
- 0000 0004 1936 8868grid.4563.4Faculty of Science, University of Nottingham, Nottingham, UK
| | - Sandra Simpson
- Clinical Research Network, Nottinghamshire Healthcare Trust, Nottingham, UK
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Affiliation(s)
- Kate Sheppard
- Kate Sheppard is the specialty coordinator and clinical associate professor at the University of Arizona, College of Nursing, Psychiatric Mental Health NP Program, Tucson, Ariz. Cameron Duncan is a CEO and APRN at Duncan Family Healthcare PLLC, Reno, Nev. and an assistant professor at the University of Nevada, Reno, Nev
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21
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Cohen JN, Drabick DAG, Blanco C, Schneier FR, Liebowitz MR, Heimberg RG. Pharmacotherapy for social anxiety disorder: Interpersonal predictors of outcome and the mediating role of the working alliance. J Anxiety Disord 2017; 52:79-87. [PMID: 29102818 PMCID: PMC5689479 DOI: 10.1016/j.janxdis.2017.10.004] [Citation(s) in RCA: 6] [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: 06/22/2017] [Revised: 10/13/2017] [Accepted: 10/18/2017] [Indexed: 12/27/2022]
Abstract
Social anxiety disorder (SAD) is highly prevalent and associated with high levels of impairment and distress. Therapies for SAD leave many patients symptomatic at the end of treatment, and little is known about predictors or mechanisms of treatment outcome. Given the interpersonal dysfunction fundamental to SAD, this study investigated whether prominent interpersonal features of SAD (submissive behavior, childhood maltreatment, suppression of anger, and depression) predicted attrition and response to pharmacotherapy and whether the working alliance mediated these relationships. This is the first study to examine the role of the working alliance in pharmacotherapy for SAD. One hundred thirty-eight treatment-seeking individuals with a primary diagnosis of SAD received 12 weeks of open treatment with paroxetine. Higher levels of depression predicted greater severity of SAD at the end of treatment, and higher levels of submissive behavior and childhood emotional maltreatment predicted a greater probability of attrition from treatment. The psychiatrist-assessed working alliance mediated response to pharmacotherapy for individuals who reported a history of emotional maltreatment. These results identify variables that predict pharmacotherapy outcome and emphasize the importance of the working alliance as a mechanism of treatment response for those with a history of emotional maltreatment. Implications for person-specific treatment selection are discussed.
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Affiliation(s)
- Jonah N Cohen
- Department of Psychology, 1701 North 13th Street, Weiss Hall, Temple University, Philadelphia, PA, 19122, USA
| | - Deborah A G Drabick
- Department of Psychology, 1701 North 13th Street, Weiss Hall, Temple University, Philadelphia, PA, 19122, USA
| | - Carlos Blanco
- Department of Psychiatry, Columbia University Medical Center, Harkness Pavilion, 180 Ft. Washington Avenue, New York, NY, 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Franklin R Schneier
- Department of Psychiatry, Columbia University Medical Center, Harkness Pavilion, 180 Ft. Washington Avenue, New York, NY, 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Michael R Liebowitz
- Department of Psychiatry, Columbia University Medical Center, Harkness Pavilion, 180 Ft. Washington Avenue, New York, NY, 10032, USA
| | - Richard G Heimberg
- Department of Psychology, 1701 North 13th Street, Weiss Hall, Temple University, Philadelphia, PA, 19122, USA.
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Kudo Y, Nakagawa A, Wake T, Ishikawa N, Kurata C, Nakahara M, Nojima T, Mimura M. Temperament, personality, and treatment outcome in major depression: a 6-month preliminary prospective study. Neuropsychiatr Dis Treat 2017; 13:17-24. [PMID: 28031714 PMCID: PMC5182045 DOI: 10.2147/ndt.s123788] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite available treatments, major depression is a highly heterogeneous disorder, which leads to problems in classification and treatment specificity. Previous studies have reported that personality traits predict and influence the course and treatment response of depression. The Temperament and Personality Questionnaire (T&P) assesses eight major constructs of personality traits observed in those who develop depression. The aim of this study was to investigate the influence of T&P's eight constructs on the treatment outcome of depressed patients. PATIENTS AND METHODS A preliminary 6-month prospective study was conducted with a sample of 51 adult patients with a diagnosis of major depressive disorder (MDD) without remarkable psychomotor disturbance using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. All patients received comprehensive assessment including the T&P at baseline. We compared each T&P construct score between patients who achieved remission and those who did not achieve remission after 6 months of treatment for depression using both subjective and objective measures. All 51 (100%) patients received the 6-month follow-up assessment. RESULTS This study demonstrated that higher scores on T&P personal reserve predicted poorer treatment outcome in patients with MDD. Higher levels of personal reserve, rejection sensitivity, and self-criticism correlated with higher levels of depression. Higher levels of rejection sensitivity and self-criticism were associated with non-remitters; however, when we controlled for baseline depression severity, this relationship did not show significance. CONCLUSION Although the results are preliminary, this study suggests that high scores on T&P personal reserve predict poorer treatment outcome and T&P rejection sensitivity and self-criticism correlate with the severity of depression. Longer follow-up studies with large sample sizes are required to improve the understanding of these relationships.
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Affiliation(s)
- Yuka Kudo
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo; Department of Psychiatry, Gunma Hospital, Gunma
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo; Clinical and Translational Research Center, Keio University School of Medicine, Tokyo
| | - Taisei Wake
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo
| | - Natsumi Ishikawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo
| | - Chika Kurata
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo
| | - Mizuki Nakahara
- Graduate School, Tokyo University of Social Welfare, Gunma, Japan
| | | | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo
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Bagby RM, Gralnick TM, Al‐Dajani N, Uliaszek AA. The role of the five‐factor model in personality assessment and treatment planning. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2016. [DOI: 10.1111/cpsp.12175] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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