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Michaelis R, Schiepek G, Heinen GM, Edelhäuser F, Viol K. Process-oriented and personalized psychotherapeutic care for epilepsy: Interim results of a feasibility study. Epilepsy Behav 2021; 124:108313. [PMID: 34560360 DOI: 10.1016/j.yebeh.2021.108313] [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: 07/23/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is great scientific and clinical interest in the effective integration of psychological treatments into comprehensive epilepsy care to optimize treatment outcomes and psychosocial functioning in people with epilepsy. Stepped care is a promising approach to accommodate personalized psychotherapeutic care in academic and regular outpatient settings. It aims at providing patients with the most adequate treatment duration, number of sessions, and treatment method while systematically monitoring their treatment processes. METHODS This is an uncontrolled feasibility study of process-oriented and personalized psychotherapeutic care for epilepsy in a naturalistic setting. The objective of this study was to evaluate individual changes of health-related quality of life (QOLIE-31) and psychiatric comorbidity (BDI-II, BSI) in participants by applying the concept of the reliable change index (RCI) to outcomes that were obtained at baseline and six months after the beginning of the intervention. Additionally, we assessed the relationship between outcome scores, the number of attended sessions, and history of childhood trauma by linear regression models. RESULTS Twenty patients [15 women/5 men, median age 48 years (range: 23-73 years)] were recruited. The median number of scheduled sessions was 11 (range: 6-22); there were no drop-outs. After psychotherapy quality of life (QOLIE-31), global distress (BSI) and depression (BDI-II) scores improved significantly (p-values: QOLIE-31: 0.03; BSI: 0.01; BDI-II: 0.01). The largest improvements were achieved for the emotional well-being subscale of the QOLIE-31 (47%, p-value: 0.02), the global severity index of the BSI (83%), and depression severity (BDI-II) (60%). Linear regression models did not reveal any significant association between interim changes, number of attended treatment sessions, and history of childhood trauma. CONCLUSION The results suggest that process-oriented and personalized psychotherapeutic has low attrition and results in improved quality of life and reduced psychiatric symptoms in people with epilepsy. Our findings indicate that responsiveness to psychotherapy is not dependent on the number of attended treatment sessions. Participants with childhood trauma did not need more treatment sessions to achieve an improvement. More research is needed to understand and address mechanisms and precursors of responsiveness to psychotherapy.
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Affiliation(s)
- Rosa Michaelis
- Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health, Witten/Herdecke University, Germany; Department of Neurology, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany; Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany.
| | - Günter Schiepek
- Faculty of Psychology and Educational Sciences, Ludwig-Maximilians-University Munich, Germany; Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University, Salzburg, Austria; University Hospital of Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | | | - Friedrich Edelhäuser
- Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health, Witten/Herdecke University, Germany; Department of Neurology, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany; Department of Early Rehabilitation, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
| | - Kathrin Viol
- Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University, Salzburg, Austria; University Hospital of Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
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Malpas CB, Wang AD, Leong M, Johnstone B, Rayner G, Kalincik T, Kwan P, O'Brien TJ, Velakoulis D. Abbreviated assessment of psychopathology in patients with suspected seizure disorders. Epilepsy Behav 2019; 100:106530. [PMID: 31665694 DOI: 10.1016/j.yebeh.2019.106530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/11/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE Psychopathology is common in patients undergoing investigation for seizure-related disorders. Psychometric examination using self-report instruments, such as the Symptom Checklist 90 - Revised (SCL-90-R), can assist diagnosis. The SCL-90-R, however, is a lengthy instrument and might not be tolerated by all patients. We assessed several abbreviated forms of the SCL-90-R in patients undergoing video encephalographic monitoring (VEM). METHOD Six hundred eighty-seven patients completed the SCL-90-R, and scores were computed for the full SCL-90-R and five abbreviated forms. Correlations and mean differences were computed between different forms. Classification accuracy was assessed via receiver operating characteristic (ROC) curves, and measurements models were examined using confirmatory factor analysis (CFA). RESULTS All abbreviated forms were strongly correlated with the SCL-90-R for general psychopathology (r = 0.93-0.99), depression (r = 0.89-0.95), anxiety (r = 0.97-0.98), psychosis (r = 0.95-0.99), and obsessive-compulsive symptoms (r = 0.97). Classification performance was similar across forms for depression and anxiety, with high negative predictive values (0.90-0.94) and lower positive predictive values (0.34-0.38). Classification performance for psychotic and obsessive-compulsive disorders was poor. Differences were observed between the full SCL-90-R and its abbreviated forms across most domains (d = 0.00-0.65). The published measurement model was most strongly validated for the SCL-27, SCL-14, and the SCL-K-9. CONCLUSIONS These five SCL-90-R abbreviated forms show high convergent validity with the full version. In patients undergoing investigation for seizure-related disorders, the Brief Symptom Inventory full form (BSI) or short form (BSI-18) is most appropriate where screening for both depression and anxiety is required. The SCL-K-9 is appropriate when only a single measure of global psychological distress is required. None of the instruments were able to detect psychotic or obsessive-compulsive symptoms with great accuracy. Caution should be exercised when making direct comparisons across the different forms.
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Affiliation(s)
- Charles B Malpas
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia.
| | - Albert D Wang
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Michelle Leong
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Benjamin Johnstone
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Genevieve Rayner
- Department of Medicine (Austin Health), The University of Melbourne, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Tomas Kalincik
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia
| | - Patrick Kwan
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia
| | - Terence J O'Brien
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia
| | - Dennis Velakoulis
- Department of Psychiatry, Royal Melbourne Hospital, Australia; Department of Psychiatry, The University of Melbourne, Australia
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Adawi M, Zerbetto R, Re TS, Bisharat B, Mahamid M, Amital H, Del Puente G, Bragazzi NL. Psychometric properties of the Brief Symptom Inventory in nomophobic subjects: insights from preliminary confirmatory factor, exploratory factor, and clustering analyses in a sample of healthy Italian volunteers. Psychol Res Behav Manag 2019; 12:145-154. [PMID: 30881158 PMCID: PMC6419603 DOI: 10.2147/prbm.s173282] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background The Brief Symptom Inventory (BSI), developed by Derogatis in 1975, represents an important standardized screening instrument that enables one to quantitatively assess psychological distress and psychiatric disorders. The BSI is a 53-item self-report scale, measuring nine dimensions that can be summed up to reflect three global indices, including the General Severity Index (GSI). In the era of new information and communication technologies, nomophobia (“no mobile phobia”) is an emerging disorder, characterized by the fear of being out of mobile phone contact. Nothing is known, however, about the factor structure and reliability of the BSI in a population of nomophobic subjects. This study aimed at addressing this gap in knowledge. Methods A sample of 403 subjects aged 27.91±8.63 years (160 males, 39.7% of the entire sample, and 243 females, 60.3%), recruited via snowball sampling, volunteered to take part in the study. The Italian versions of the Nomophobia questionnaire and the BSI were administered. Exploratory factor analyses, confirmatory factor analyses, and clustering analysis were carried out together with correlation analysis, analysis of variance, and multivariate regression analysis. Results For each BSI subscale, scores were significantly higher than the norms. The nine subscales exhibited acceptable-to-good Cronbach’s alpha coefficients, varying from 0.733 for psychoticism to 0.875 for depression. Overall, the reliability of the entire instrument proved to be excellent (alpha coefficient=0.972). Furthermore, all BSI subscales as well as BSI synthetic indexes correlated with nomophobia in a significant way. Stratifying the population according to the severity of nomophobia (mild, 206 individuals, 51.1% of the sample; moderate, 167 subjects, 41.4%; and severe, 30 individuals, 7.4%), the GSI score could distinguish (P<0.001) between mild and moderate (0.99±0.71 vs 1.32±0.81) and between mild and severe (0.99±0.71 vs 1.54±0.79) nomophobia, although not between moderate and severe nomophobia (P>0.05). Similar patterns could be found for the other subscales of the BSI. Finally, looking at the fit indexes, the second-order 9-factor model best fit the data compared with the Derogatis 1-factor model. Conclusion The findings of our study show that the BSI is a reliable and valid instrument with acceptable psychometric properties, and can be administered to populations of nomophobic subjects.
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Affiliation(s)
- Mohammad Adawi
- Bar-Ilan Faculty of Medicine, Padeh and Ziv Hospitals, Zafat, Israel
| | | | - Tania Simona Re
- GESTALT Study Center (CSTG), Milan, Italy, .,UNESCO Chair "Health Anthropology, Biosphere and Healing Systems", University of Genoa, Genoa, Italy,
| | - Bishara Bisharat
- EMMS Nazareth Hospital, Nazareth, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,The Society for Health Promotion of the Arab Community, The Max Stern Yezreel Valley College, Nazareth, Israel
| | - Mahmud Mahamid
- EMMS Nazareth Hospital, Nazareth, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Howard Amital
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Zabludowicz Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Tel HaShomer, Israel
| | | | - Nicola Luigi Bragazzi
- GESTALT Study Center (CSTG), Milan, Italy, .,UNESCO Chair "Health Anthropology, Biosphere and Healing Systems", University of Genoa, Genoa, Italy, .,DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy, .,Department of Health Sciences, Postgraduate School of Public Health, University of Genoa, Genoa, Italy,
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Dean KE, Long ACJ, Matthews RA, Buckner JD. Willingness to Seek Treatment Among Black Students With Anxiety or Depression: The Synergistic Effect of Sociocultural Factors With Symptom Severity and Intolerance of Uncertainty. Behav Ther 2018; 49:691-701. [PMID: 30146137 DOI: 10.1016/j.beth.2017.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 11/17/2022]
Abstract
Anxiety and depressive disorders are among the most commonly diagnosed psychiatric disorders, yet they remain largely undertreated in the U.S. and Black adults are especially unlikely to seek or receive mental health services. Symptom severity has been found to impact treatment-seeking behaviors as have sociocultural factors. Yet no known research has tested whether these factors work synergistically to effect willingness to seek treatment. Further, emerging data point to the importance of transdiagnostic risk factors such as intolerance of uncertainty (IU). IU may be negatively related to seeking treatment given that Black adults may be uncertain whether treatment might benefit them. Thus, the current study examined the relations between symptom severity/IU and willingness to seek treatment for anxiety/depression problems and the impact of key sociocultural variables (i.e., cultural mistrust-interpersonal relations [CMI-IR], perceived discrimination [PED]) on these relations among 161 (85% female) Black undergraduates. Consistent with prediction, symptom severity was positively related to willingness, but unexpectedly, IU was positively related. There was a significant Symptom Severity × CMI-IR interaction such that severity was positively related to willingness among students with lower cultural mistrust, but not higher mistrust. There were also significant IU × PED interaction such that IU was positively related to willingness among students with lower PED, but not higher PED. Results highlight the importance of considering the interplay between symptom severity, transdiagnostic vulnerability factors, and sociocultural variables when striving to identify factors related to treatment seeking behaviors among anxious and/or depressed Black students.
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Abreu W, Tolson D, Jackson GA, Costa N. A cross-sectional study of family caregiver burden and psychological distress linked to frailty and functional dependency of a relative with advanced dementia. DEMENTIA 2018; 19:301-318. [DOI: 10.1177/1471301218773842] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Psychological health of caregivers of people with dementia is a major public concern. This study sought to determine the relationship between caregiver burden, psychological distress, frailty and functional dependency of a relative with advanced dementia. Persons with dementia and their caregivers (102 dyads) participated in this Portuguese community based cross-sectional study. Data were collected using the Clinical Dementia Rating Scale, a sociodemographic questionnaire, the Zarit Burden Interview, the Brief Symptoms Inventory and the Edmonton Frail Scale. Alzheimer's disease was the most common type of dementia among the recipients of care, who showed moderate (42.2%) to severe (52.9%) dementia. Among them 35.3% exhibited moderate and 45.1% severe frailty. Family caregivers reported moderate (76.5%) to severe burden (18.6%). Psychological distress was very high among family caregivers. Results show that people with dementia exhibited moderate (35.3%) or severe frailty (45.1%) and that a severe frailty was found in people with moderate dementia. A one-way ANOVA was conducted between the Global Severity Index and some sociodemographic variables. ANOVA reached p < .01 for employment status of the caregiver, assistance and professional support, and psychiatric history; and p = 0.01 for caregiver age and years of caregiving. Although caregivers reported benefit from the supportive approach offered by the multidisciplinary home care team, high levels of distress and associated burden were found, which might decrease their capacity to care for the person with dementia and their own health and well-being.
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Affiliation(s)
- Wilson Abreu
- Porto School of Nursing/CINTESIS (Center for Research in Health Technologies and Services), Portugal
| | | | | | - Nilza Costa
- University of Aveiro - Campus Universitário de Santiago, Portugal
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Abreu W, Rodrigues T, Sequeira C, Pires R, Sanhudo A. The experience of psychological distress in family caregivers of people with dementia: A cross-sectional study. Perspect Psychiatr Care 2018; 54:317-323. [PMID: 29077985 DOI: 10.1111/ppc.12240] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 06/22/2017] [Accepted: 08/06/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To evaluate the degree of psychological distress in family caregivers of people with dementia. DESIGN AND METHODS A nonprobabilistic sample of 54 dyads (people with dementia and family caregivers) was recruited. A sociodemographic questionnaire, the Brief Symptom Inventory (BSI), and the Barthel Index were used for data collection. FINDINGS About half of the caregivers had significant levels of psychological distress. Caregivers showed high scores in some BSI dimensions: somatization, obsessive-compulsion, interpersonal sensitivity, anxiety, and paranoid ideation. PRACTICE IMPLICATIONS Alleviating the caregivers' distress is likely to have positive effects on the overall health and capacity to care. Frameworks for providing palliative care to people with advanced dementia and support the caregivers would enhance the quality of care provided and may reduce the distress on the caregiver.
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Affiliation(s)
- Wilson Abreu
- Center for Health Technology and Services Research (CINTESIS), Porto School of Nursing, Porto, Portugal
| | | | - Carlos Sequeira
- Center for Health Technology and Services Research (CINTESIS), Porto School of Nursing, Porto, Portugal
| | | | - Ana Sanhudo
- Hospital Magalhães Lemos, Rua Professor Álvaro Rodrigues, Porto, Portugal
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Franklin RA, Butler MP, Bentley JA. The physical postures of yoga practices may protect against depressive symptoms, even as life stressors increase: a moderation analysis. PSYCHOL HEALTH MED 2018; 23:870-879. [PMID: 29308657 DOI: 10.1080/13548506.2017.1420206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Yoga contains sub-components related to its physical postures (asana), breathing methods (pranayama), and meditation (dhyana). To test the hypothesis that specific yoga practices are associated with reduced psychological distress, 186 adults completed questionnaires assessing life stressors, symptom severity, and experience with each of these aspects of yoga. Each yoga sub-component was found to be negatively correlated with psychological distress indices. However, differing patterns of relationship to psychological distress symptoms were found for each yoga sub-component. Experience with asana was negatively correlated with global psychological distress (r = -.21, p < .01), and symptoms of anxiety (r = -.18, p = .01) and depression (r = -.17, p = .02). These relationships remained statistically significant after accounting for variance attributable to Social Readjustment Rating Scale scores (GSI: r = -.19, p = .01; BSI Anxiety: r = -.16, p = .04; BSI Depression: r = -.14, p = .05). By contrast, the correlations between other yoga sub-components and symptom subscales became non-significant after accounting for exposure to life stressors. Moreover, stressful life events moderated the predictive relationship between amount of asana experience and depressive symptoms. Asana was not related to depressive symptoms at low levels of life stressors, but became associated at mean (t[182] = -2.73, p < .01) and high levels (t[182] = -3.56, p < .001). Findings suggest asana may possess depressive symptom reduction benefits, particularly as life stressors increase. Additional research is needed to differentiate whether asana has an effect on psychological distress, and to better understand potential psychophysiological mechanisms of action.
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Affiliation(s)
- Rebecca A Franklin
- a Department of Clinical Psychology , Seattle Pacific University , Seattle , WA , USA
| | - Michael P Butler
- b Department of Psychology , Saint Martin's University , Lacey , WA , USA
| | - Jacob A Bentley
- a Department of Clinical Psychology , Seattle Pacific University , Seattle , WA , USA
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Lopes A, Fonseca I, Sousa A, Branco M, Rodrigues C, Coelho T, Sequeiros J, Freitas P. Psychopathological Dimensions in Portuguese Subjects with Transthyretin Familial Amyloid Polyneuropathy. Biomed Hub 2017; 2:1-14. [PMID: 31988916 PMCID: PMC6945894 DOI: 10.1159/000485118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 11/09/2017] [Indexed: 11/21/2022] Open
Abstract
Background Transthyretin familial amyloid polyneuropathy (TTR-FAP) is a fatal, chronic, progressive disease. It is a rare hereditary amyloidosis, which manifests as a sensorimotor neuropathy and autonomic dysfunction. It begins during adulthood. Aims and Methods Our aim is to evaluate psychopathological dimensions in a population attending a consultation center for TTR-FAP. Two hundred and nine subjects (symptomatic and asymptomatic carriers), 84 men and 127, women participated in the study. Most subjects were married (67.1%) and most of them were still working; 33% were retired from work or on a sick leave. A sociodemographic questionnaire and The Brief Symptom Inventory (BSI) were applied. Statistical analysis was performed (descriptive analysis, Mann-Whitney, Wilcoxon, and Spearman tests). Results The Global Symptom Index (GSI) was significantly higher in patients (p = 0.001). Considering GSI, 32.7% of total subjects were above the median for general population. When subgroups were evaluated, 25.6% of symptomatic carriers, 26.3% of subjects without established diagnosis, and 39.1% of patients were above median. GSI was significantly higher in patients (p = 0.001). Some BSI dimensions were also significantly higher in the patient group (somatization, depression, anxiety, and psychoticism) when compared with carriers. Women scored higher than men. Sick women scored higher for all dimensions except somatization. Asymptomatic carriers scored statistically higher for phobic anxiety (p = 0.01), interpersonal sensitivity, anxiety, and depression. In patients, most dimensions and GSI (rho = 0.33, p = 0.002) had positive correlations with years of disease. Conclusions TTR-FAP patients and carriers are a very vulnerable group for psychological distress and psychopathological problems. Women and patients are at higher risk.
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Affiliation(s)
- Alice Lopes
- Unidade Corino de Andrade, Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar do Porto, Porto, Portugal.,ICBAS - Instituto de Ciências Biomédicos Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Isabel Fonseca
- Unidade Corino de Andrade, Centro Hospitalar do Porto, Porto, Portugal.,EPIUnit and Instituto de Saúde Pública da Universidade do Porto (ISPUP), Porto, Portugal
| | - Alexandra Sousa
- Unidade Corino de Andrade, Centro Hospitalar do Porto, Porto, Portugal
| | - Margarida Branco
- Unidade Corino de Andrade, Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar do Porto, Porto, Portugal
| | - Carla Rodrigues
- Unidade Corino de Andrade, Centro Hospitalar do Porto, Porto, Portugal
| | - Teresa Coelho
- Unidade Corino de Andrade, Serviço de Neurofisiologia, Centro Hospitalar do Porto, Porto, Portugal
| | - Jorge Sequeiros
- ICBAS - Instituto de Ciências Biomédicos Abel Salazar, Universidade do Porto, Porto, Portugal.,IBMC - Institute for Molecular and Cell Biology and i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Paula Freitas
- ICBAS - Instituto de Ciências Biomédicos Abel Salazar, Universidade do Porto, Porto, Portugal
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Recklitis CJ, Blackmon JE, Chang G. Validity of the Brief Symptom Inventory-18 (BSI-18) for identifying depression and anxiety in young adult cancer survivors: Comparison with a Structured Clinical Diagnostic Interview. Psychol Assess 2017; 29:1189-1200. [PMID: 28080106 DOI: 10.1037/pas0000427] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The Brief Symptom Inventory-18 (BSI-18) is widely used to assess psychological symptoms in cancer survivors, but the validity of conventional BSI-18 cut-off scores in this population has been questioned. This study assessed the accuracy of the BSI-18 for identifying significant anxiety and depression in young adult cancer survivors (YACS), by comparing it with a "gold standard" diagnostic interview measure. Two hundred fifty YACS, age 18-40 completed the BSI-18 and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; SCID) interview assessing anxiety and depressive disorders. BSI-18 results were compared with SCID criteria using receiver operating characteristics (ROC) analyses. Forty four participants (17.7%) met criteria for ≥1 SCID diagnoses, and an additional 20 (8.0%) met criteria for clinically significant SCID symptoms without a diagnosis. General concordance between the BSI-18 GSI scale and SCID diagnosis was good (AUC = 0.848), but the 2 most widely used BSI-18 case rules failed to identify a majority of survivors with SCID diagnoses, and no alternative BSI-18 cut-off scores met study criteria for clinical screening. Analyses aimed at identifying survivors with significant SCID symptoms or a SCID diagnosis had similar results, as did analyses examining depression and anxiety separately. The BSI-18 shows good overall concordance with a psychiatric interview, but recommended cut-off scores fail to identify a majority of YACS with psychiatric diagnosis. Clinicians should not rely on the BSI-18 alone as a screening measure for YACS. Alternative BSI-18 scoring algorithms optimized for detecting psychiatric symptoms in YACS may be an important step to address this limitation. (PsycINFO Database Record
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Affiliation(s)
| | | | - Grace Chang
- Department of Psychiatry, VA Boston Healthcare System
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10
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Gender differences in outpatients with anxiety disorders: the Leiden Routine Outcome Monitoring Study. Epidemiol Psychiatr Sci 2016; 25:278-87. [PMID: 25989916 PMCID: PMC6998770 DOI: 10.1017/s2045796015000414] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Data from the general population show higher prevalence of different anxiety disorders in women as compared with men. We analysed gender differences in a naturalistic sample of outpatients with anxiety disorders in a mental healthcare setting. METHOD Routine outcome monitoring data were collected from 1333 patients (age: 18-65; 63.3% women) fulfilling Diagnostic and Statistical Manual of Mental Disorders IV criteria of current anxiety disorder according to the Mini-International Neuropsychiatric Interview between 2004 through 2006. Data included Comprehensive Psychopathological Rating Scale, Brief Symptom Inventory (BSI), Short Form Health Survey (SF-36), Mood and Anxiety Symptom Questionnaire (MASQ). Chi-squared test and t-test were used to compare women with men for variables with parametric distributions, and Mann-Whitney test for non-parametric distribution. Adjustments for potential confounders (age, level of education, ethnicity and comorbidites) were made by logistic regression models (for discrete variables) or analysis of covariance. RESULTS The female-to-male ratio (i.e., 844 women, 489 men) for any anxiety disorder was 1.73 : 1 (95% confidence interval [CI]: 1.63-1.83), with the strongest skewness for post-traumatic stress disorder (2.80 : 1) and the smallest one for social phobia (1.18 : 1). Compared with men, women reported more severe self-rating scores on the BSI (on average, the scores were 12.3% higher on 3 of 9 subscales: somatisation, interpersonal sensitivity and anxiety), SF-36 (self-reported generic health status was lower on 5 of 8 subscales: physical functioning, social functioning, physical problems, vitality and bodily pain) and MASQ (on average, the scores were 6.6% higher on 4 of 5 subscales: anxious arousal, general distress, general distress depression, general distress anxiety). On the contrary, no gender difference was found in the severity of anxiety symptoms measured by the Brief Anxiety Scale. Women were more likely to suffer from comorbid depression and bulimia nervosa, and less likely from substance abuse. CONCLUSIONS In a treatment-seeking population the prevalence rate of anxiety disorders was 1.7 times higher in female compared with men. Female outpatients were more severely affected on self-rated but not on observer-rated scales.
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Valera P, Fullilove R, Cali S, Nunes E, Chiongbian V, Clark W, Covey L. The Psychometric Properties of the Brief Symptom Inventory in Men under Criminal Justice Involvement: Implications for Forensic Social Workers in Practice Settings. BRITISH JOURNAL OF SOCIAL WORK 2015; 45:2210-2223. [PMID: 27516643 PMCID: PMC4975521 DOI: 10.1093/bjsw/bcu074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to assess the factor structure and psychometric properties of the original and a revised modification of the Brief Symptom Inventory (BSI) in 259 black and Latino males, aged thirty-five to sixty-seven, who had been released from a New York state prison or a New York City jail. The data were analysed using exploratory factor analysis, principal axis factoring and confirmatory factor analysis. Standardised factor loadings were evaluated at 0.05, model fit was evaluated using the chi-square statistic, and fit indices were examined. Items whose communalities fell below 0.30 were eliminated from the procedure. The findings did not yield the same number of factors as the original BSI, but the revised BSI model fitted the current data better. This modified factor structure reduced the BSI to the nineteen most appropriate items to assess five key common psychiatric symptoms affecting men under community supervision. The results of the current factor structure suggest that the psychiatric disorders experienced by men under community supervision may differ from the populations studied by the original BSI factor structure. Forensic social work ought to examine the psychometric properties of standardised measures for different populations such that appropriate instruments may be specifically targeted and maximised.
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Affiliation(s)
- Pamela Valera
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Robert Fullilove
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Shae Cali
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Edward Nunes
- New York State Psychiatric Institute, New York, NY 10032, USA
| | | | | | - Lirio Covey
- New York State Psychiatric Institute, New York, NY 10032, USA
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Dunlop WL, Tracy JL. The autobiography of addiction: autobiographical reasoning and psychological adjustment in abstinent alcoholics. Memory 2012; 21:64-78. [PMID: 22943450 DOI: 10.1080/09658211.2012.713970] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The narration of drinking experiences plays a central role in many alcohol rehabilitation programmes, yet few researchers have considered whether alcoholics' stories about such experiences relate to their psychological adjustment. Here we examine the extent to which drinking stories of abstinent alcoholics reflect autobiographical reasoning processes denoting self-change and self-stability, and whether these processes are associated with adjustment. Participants who revealed a positive self-change in their narratives about drinking demonstrated higher levels of self-esteem, authentic pride, and mental health compared to those who did not. In contrast, those who implied a sense of self-stability in their narratives demonstrated higher levels of hubristic pride and aggression, and poorer mental health. These results suggest that narrating positive self-change in the wake of substance abuse may underlie psychological adjustment, whereas establishing self-stability in these experiences may impede adjustment. More broadly, these findings underscore the importance of recognising the multi-dimensional nature of autobiographical reasoning.
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Affiliation(s)
- William L Dunlop
- Department of Psychology , The University of British Columbia, Vancouver, BC, Canada.
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Wieland J, Wardenaar KJ, Fontein E, Zitman FG. Utility of the Brief Symptom Inventory (BSI) in psychiatric outpatients with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2012; 56:843-853. [PMID: 21726320 DOI: 10.1111/j.1365-2788.2011.01440.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Diagnostics and care for people with intellectual disabilities (ID) and psychiatric disorders need to be improved. This can be done by using assessment instruments to routinely measure the nature and severity of psychiatric symptoms. Up until now, in the Netherlands, assessment measures are seldom used in the psychiatric care for this population. The objective of the present paper is to evaluate the use of the Brief Symptom Inventory (BSI), a widely used standardised questionnaire in general psychiatry, in a well-defined sample of people with borderline intellectual functioning or mild ID diagnosed with one or more psychiatric disorders. METHODS A total of 224 psychiatric outpatients with either borderline intellectual functioning or mild ID participated in this study. All participants were new patients of Kristal, Centre for Psychiatry and Intellectual Disability in the Netherlands, in the period between 1 April 2008 and 1 October 2009. All participants were assessed by a multidisciplinary team, including a certified psychiatrist. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria were applied. The mean total intelligence quotient was measured with the Wechsler Adult Intelligence Scale (WAIS-III). The BSI was administered in an assisted fashion. Utility and psychometric properties of the BSI were investigated. Internal consistency coefficients (Cronbach's alphas) were computed. Bivariate correlations between the sub-scales were computed to assess differentiation between the scales. Mean sub-scale scores were compared between different DSM-IV-TR subgroups to investigate the discriminant abilities of the scales. A confirmatory factor analysis was conducted. RESULTS The results suggest that the BSI is practically useful. Internal consistencies ranged from 0.70 to 0.96 and thus are considered good to adequate. Sub-scale inter-correlations showed there is a degree of differentiation between the sub-scales. Discriminant validity was shown for the sub-scales depression, anxiety and phobic anxiety. Confirmatory factor analysis showed that the underlying structure of the BSI could be described by the same nine-factor model as reported in previous studies. CONCLUSIONS As a result of the psychometric properties illustrated, this study supports the use of the BSI as a screener for psychopathology and a general outcome measure in people with ID.
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Affiliation(s)
- J Wieland
- Kristal, Centre for Psychiatry and Intellectual Disability, Leiden, The Netherlands.
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Khalil AA, Hall LA, Moser DK, Lennie TA, Frazier SK. The psychometric properties of the Brief Symptom Inventory depression and anxiety subscales in patients with heart failure and with or without renal dysfunction. Arch Psychiatr Nurs 2011; 25:419-29. [PMID: 22114796 DOI: 10.1016/j.apnu.2010.12.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 12/24/2010] [Accepted: 12/31/2010] [Indexed: 11/30/2022]
Abstract
More than 5 million Americans have heart failure (HF); approximately one third have concomitant renal dysfunction. Anxiety and depressive symptoms are the most common psychological responses of these individuals and may influences outcomes; thus a reliable valid instrument to measure these is needed. This article reports a psychometric evaluation of the Brief Symptom Inventory (BSI) depression and anxiety subscales in patients with HF and with or without renal dysfunction, as these scales are commonly used in this population for research studies. This rigorous psychometric analysis used existing data from 590 patients with HF with an average ejection fraction of 35% ± 15% and average age of 63 ± 13 years. Patients were categorized as normal renal function (n = 495) or renal dysfunction (n = 95), and groups were compared and analyzed separately. Cronbach's alpha for the BSI subscales was .82 for those with normal renal function and .88 for those with renal dysfunction. Factor analysis determined that the subscales evaluated one dimension, psychological distress, in both groups. Construct validity was examined using hypothesis testing, and construct validity was supported in patients with HF and with normal renal function by significant associations of the BSI subscales with another measure of depression and a measure of perceived control. Construct validity in patients with HF and renal dysfunction was not strongly supported. Only the BSI depression subscale predicted poorer outcomes in patients with HF and with normal renal function; neither subscale was associated with event-free survival at 12 months in those with renal dysfunction. The BSI anxiety and depression subscales provide reliable and valid data in patients HF and normal renal function. Although reliability is excellent, construct validity was weak in those patients with HF and with concomitant renal dysfunction, which may reduce the validity of those data.
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Affiliation(s)
- Amani A Khalil
- College of Nursing-University of Jordan Amman, Jordan; and University of Kentucky College of, Nursing Lexington, KY, USA.
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Pasieczny N, Connor J. The effectiveness of dialectical behaviour therapy in routine public mental health settings: An Australian controlled trial. Behav Res Ther 2011; 49:4-10. [DOI: 10.1016/j.brat.2010.09.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 09/20/2010] [Accepted: 09/24/2010] [Indexed: 10/19/2022]
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Endermann M, Zimmermann F. Factors associated with health-related quality of life, anxiety and depression among young adults with epilepsy and mild cognitive impairments in short-term residential care. Seizure 2009; 18:167-75. [DOI: 10.1016/j.seizure.2008.08.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Revised: 06/11/2008] [Accepted: 08/22/2008] [Indexed: 10/21/2022] Open
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Endermann M. Quality of life among people with epilepsy and mild intellectual disabilities in residential care. Epilepsy Behav 2006; 8:703-12. [PMID: 16621722 DOI: 10.1016/j.yebeh.2006.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2005] [Revised: 02/17/2006] [Accepted: 02/23/2006] [Indexed: 10/24/2022]
Abstract
This study examined quality-of-life (QOL) evaluations among people with epilepsy and mild intellectual disabilities in residential care to determine their covariation and potential determinants. Participants were 111 clients of the Bethel Institute, Bielefeld, Germany. They completed questionnaires on their overall QOL and life satisfaction, the PESOS scales on epilepsy-related QOL, the Brief Symptom Inventory (BSI), and scales on activities of daily life and work-related problems in face-to-face-interviews. QOL evaluations differed in the various domains and tended to be better on more concrete items. Correlations of generic QOL parameters with scales on epilepsy-related QOL were only weak. BSI scores reflecting the current emotional state were identified as the most influential predictors of all QOL measures. The weak relationship between non-health-related parameters of subjective QOL and epilepsy-related QOL requires further investigation and theoretical explanation, whereas the influence of negative affect on different QOL dimensions is in line with previous QOL findings.
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Affiliation(s)
- Michael Endermann
- von Bodelschwinghsche Anstalten Bethel, Psychosozialer Dienst im Stiftungsbereich Behindertenhilfe Bielefeld, Remterweg 58, 33617 Bielefeld, Germany.
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Schneider G, Nabavi D, Heuft G. Eye movement desensitization and reprocessing in the treatment of posttraumatic stress disorder in a patient with comorbid epilepsy. Epilepsy Behav 2005; 7:715-8. [PMID: 16246634 DOI: 10.1016/j.yebeh.2005.08.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Revised: 08/17/2005] [Accepted: 08/20/2005] [Indexed: 11/28/2022]
Abstract
Whether eye movement desensitization and reprocessing (EMDR) treatment of posttraumatic stress disorder (PTSD) causes reactivation of epilepsy is as yet unclear. A 34-year-old woman was treated in an inpatient multimodal psychotherapeutic setting with EMDR for PTSD resulting from sexual harassment and for a moderate depressive episode. She had been diagnosed with idiopathic generalized absence epilepsy in childhood, but had experienced no seizures under lamotrigine medication since 1999. After the second EMDR session, clinical seizures in the form of absences occurred, and were validated by electroencephalography. The seizures ceased after medication with benzodiazepines and an increase in the lamotrigine level. She underwent four more sessions of EMDR treatment successfully without further seizures. Possible triggers are discussed, especially as to whether EMDR treatment played a role in reactivating epilepsy. Further research and publications on the application of EMDR in epilepsy patients are needed.
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Affiliation(s)
- Gudrun Schneider
- Department of Psychosomatics and Psychotherapy, University of Münster, Domagkstrasse 22, D-48149 Münster, Germany.
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