A double-blind,sham-controlled,trial of home-administered rhythmic 10-Hz median nerve stimulation for the reduction of tics,and suppression of the urge-to-tic,in individuals with Tourette syndrome and chronic tic disorder

Tourette syndrome (TS) and chronic tic disorder (CTD) are neurological disorders of childhood onset characterized by the occurrence of tics; repetitive, purposeless, movements or vocalizations of short duration which can occur many times throughout a day. Currently, effective treatment for tic disorders is an area of considerable unmet clinical need. We aimed to evaluate the efficacy of a home-administered neuromodulation treatment for tics involving the delivery of rhythmic pulse trains of median nerve stimulation (MNS) delivered via a wearable ‘watch-like’ device worn at the wrist. We conducted a UK-wide parallel double-blind sham-controlled trial for the reduction of tics in individuals with tic disorder. The device was programmed to deliver rhythmic (10 Hz) trains of low-intensity (1–19 mA) electrical stimulation to the median nerve for a pre-determined duration each day, and was intended to be used by each participant in their home once each day, 5 days each week, for a period of 4 weeks. Between 18th March 2022 and 26th September 2022, 135 participants (45 per group) were initially allocated, using stratified randomization, to one of the following groups; active stimulation; sham stimulation or to a waitlist (i.e. treatment as usual) control group. Recruited participants were individuals with confirmed or suspected TS/CTD aged 12 years of age or upward with moderate to severe tics. Researchers involved in the collection or processing of measurement outcomes and assessing the outcomes, as well as participants in the active and sham groups and their legal guardians were all blind to the group allocation. The primary outcome measure used to assess the ‘offline’ or treatment effect of stimulation was the Yale Global Tic Severity Scale–Total Tic Severity Score (YGTSS–TTSS) assessed at the conclusion of 4 weeks of stimulation. The primary outcome measure used to assess the ‘online’ effects of stimulation was tic frequency, measured as the number of tics per minute (TPM) observed, based upon blind analysis of daily video recordings obtained while stimulation was delivered. The results demonstrated that after 4-week stimulation, tic severity (YGTSS-TTSS) had reduced by 7.1 points (35 percentile reduction) for the active stimulation group compared to 2.13/2.11 points for the sham stimulation and waitlist control groups. The reduction in YGTSS–TTSS for the active stimulation group was substantially larger, clinically meaningful (effect size = .5) and statistically significant (p = .02) compared to both the sham stimulation and waitlist control groups, which did not differ from one another (effect size = −.03). Furthermore, blind analyses of video recordings demonstrated that tic frequency (tics per minute) reduced substantially (−15.6 TPM) during active stimulation compared to sham stimulation (−7.7 TPM). This difference represents a statistically significant (p < .03) and clinically meaningful reduction in tic frequency (>25 percentile reduction: effect size = .3). These findings indicate that home-administered rhythmic MNS delivered through a wearable wrist-worn device has the potential to be an effective community-based treatment for tic disorders.     

Validity of self-efficacy scale scores for a Spanish sample

This study analyzed the validity of the Sherer, et al. Self-efficacy Scale for a Spanish sample of 555 subjects, 257 men and 298 women. 415 were from the general population; 34 schizophrenics and 45 with eating disorders were from a clinic, plus 61 drug addicts from two centers. All met DSM-IV-R criteria. The Eysenck Personality Questionnaire, State-Trait Anxiety Inventory, Assertiveness Inventory, and the Self-control Questionnaire were administered. The reliability for total scores, general factor were high even when social self-efficacy was low. A bidimensional factor structure seemed more acceptable. The Self-efficacy scale scores correlated with those on the Self-control Questionnaire and the Assertiveness Inventory. Extraversion scores on the Sincerity dimension of the Eysenck Personality Questionnaire correlated with scores on the State-Trait Anxiety Inventory and Eysenck's Neuroticism and Psychoticism scales. Significant mean differences appeared between the general population group and the three clinical groups. These analyses support the usefulness of the scale for clinical practice and research with Spanish samples.     

Transposed-letter and laterality effects in lexical decision

Two divided visual field lexical decision experiments were conducted to examine the role of the cerebral hemispheres in transposed-letter similarity effects. In Experiment 1, we created two types of nonwords: nonadjacent transposed-letter nonwords (TRADEGIA; the base word was TRAGEDIA, the Spanish for TRAGEDY) and two-letter different nonwords (orthographic controls: TRATEPIA). In Experiment 2, the controls were one-letter different nonwords (TRAGEPIA) instead of two-letter different nonwords (TRATEPIA). The effect of transposed-letter similarity was substantially greater in the right visual field (left hemisphere) than in the left visual field. Furthermore, nonwords created by transposing two letters were more competitive than the nonwords created by substituting one or two letters of a target word. We examine the implications of these findings for the models of visual word recognition.     

A pragmatic guideline for evaluation of social intervention

Considering the many theoretical and methodological viewpoints in the field of evaluation, a guideline was established to facilitate the evaluation of social intervention programs. For this purpose, the goals of the evaluation were taken into account: (a) planning interventions, (b) learning and continuous improvement of interventions, (c) programming policies, and (d) transformation of society. These goals will determine the perspective of the analysis selected (focusing on the evaluand or the context) and the strategies for change employed (focusing on processes or results). The elements that, according to Shadish, Cook, and Levinton (1991), constitute the theory of evaluation (evaluand, value, building of knowledge, and uses) have also been considered. The analysis of all these components led to the elaboration of a guideline to orient the practice of evaluation from a pragmatic perspective, in accordance with the demands and needs of a certain social context.     

Victim’s innocence, social categorization, and the threat to the belief in a just world

This research studies people’s reactions to the suffering of victims, examining the hypothesis of the belief in a just world (BJW) (Lerner, 1980) according to which the awareness of innocent victims threatens people’s BJW, and extending the scope of BJW theory to intergroup contexts. An implicit measure of the threat to the BJW (Hafer, 2000a) is used in this research. After participants viewed a videotaped film containing the victimization story they performed an emotional modified Stroop task. Study 1 examined the threat to the BJW as function of the innocence of the victim at an interpersonal level of analysis. Results show that only the innocent victim threatens the observer’s BJW. Study 2 examined the threat to the BJW as function of the victim’s group and of the victim’s innocence. Results show that an ingroup victim threatens the participant’s BJW more than a victim belonging to an outgroup.     

Psychometric properties of the Adolescent Sexism Detection (ASD) scale

In this article, it is assumed that gender violence, or violence against women, has mainly a sociocultural basis. A scale (Adolescent Sexism Detection; ASD) to detect sexism in adolescents was developed and its psychometric properties were analysed. 245 adolescents between 14 and 17 years of age participated in the study. As a result of the factor analyses carried out, the hostile and benevolent dimensions of sexism were clearly differentiated. Convergent validity of the scale was confirmed by its high correlations with the Ambivalent Sexism Inventory (ASI). Participants scored higher in benevolent than in hostile sexism, an effect even stronger in female participants. These findings suggest that the ASD scale is a valid instrument to measure sexism among adolescents. The main findings of this study are compared to those obtained in other studies using the ASI. The potential of this scale to appropriately detect sexism among adolescents is discussed.     

History of the Hospital Real y General de Nuestra Señora de Gracia in Saragossa: Occupational Therapy Pioneer in Neurology and Psychiatry in Spain

In this article the authors describe the program of the Hospital Real y General de Nuestra Señora de Gracia in Saragossa (Spain) and its importance in the history of occupational therapy. It is believed to be the first hospital in the world to use occupations as therapy for psychiatric patients. Pinel knew about this new trend through a report by Iberti and wrote about it in his book Medico-Philosophical Treatise on Mental Alienation.