Lithiumtherapie bei älteren Patienten mit bipolarer Erkrankung

psychopraxis. neuropraxis - Die Behandlung psychiatrischer Erkrankungen mit Lithium bei älteren Patienten ist phasenprophylaktisch so wirksam wie in der Allgemeinbevölkerung und besitzt...     

Patients’ Views of Treatment-Focused Genetic Testing (TFGT): Some Lessons for the Mainstreaming of <Emphasis Type="Italic">BRCA1</Emphasis> and <Emphasis Type="Italic">BRCA2</Emphasis> Testing

This paper explores patients’ views and experiences of undergoing treatment-focused BRCA1 and BRCA2 genetic testing (TFGT), either offered following triaging to clinical genetics (breast cancer) or as part of a mainstreamed care pathway in oncology (ovarian cancer). Drawing on 26 in-depth interviews with patients with breast or ovarian cancer who had undergone TFGT, this retrospective study examines patients’ views of genetic testing at this point in their care pathway, focusing on issues, such as initial response to the offer of testing, motivations for undergoing testing, and views on care pathways. Patients were amenable to the incorporation of TFGT at an early stage in their cancer care irrespective of (any) prior anticipation of having a genetic test or family history. While patients were glad to have been offered TFGT as part of their care, some questioned the logic of the test’s timing in relation to their cancer treatment. Crucially, patients appeared unable to disentangle the treatment role of TFGT from its preventative function for self and other family members, suggesting that some may undergo TFGT to obtain information for others rather than for self.     

Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings

An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project’s success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.     

Parkinson’s Disease: Patients’ Knowledge,Attitudes, and Interest in Genetic Counseling

The objective of this study was to assess the genetics knowledge of patients with Parkinson’s disease (PD), and to explore their attitudes on genetic testing and interest in genetic counseling. We surveyed 158 patients from the University of Maryland Parkinson’s Disease and Movement Disorders Center. Patients averaged a score of 63% on general genetics knowledge and 73% on PD genetics knowledge. Participants had an overall positive attitude toward genetic testing: 80% believed that the use of genetic tests among people should be promoted, and 83% would undertake genetic test for PD if it was available. Patients reported a high interest to discuss the benefits, risks, and impacts of genetic testing for PD (mean sum score?=?26, range?=?9–35), and 43% patients expressed interest in meeting with a genetic counselor. Multivariate regression analysis showed that patients who had more positive attitudes toward genetic testing for PD were more interested in meeting with a genetic counselor (β?=?0.6, p?<?0.001). This study is the first to demonstrate an interest in genetic counseling among patients with PD. Our findings demonstrate a new niche for genetic counselors to support patients in clarifying gaps or misconceptions in knowledge about PD genetics as well as the possible risks, benefits, and limitations of genetic testing.     

Positive mental health moderates the association between depression and suicide ideation: A longitudinal study

Background/Objective: Depression and suicide ideation regularly occur together. Yet, little is known about factors that buffer individuals against the development of suicide ideation. The present study investigated, whether positive mental health buffers the association between depression and suicide ideation in a longitudinal study design. Methods: A total of 207 German students (70.3% female; age: M = 26.04, SD = 5.33) were assessed at a baseline evaluation and again twelve months later. Data were collected using self-report questionnaires. Linear hierarchical regression analysis was used to analyze the data. Positive mental health was considered to moderate the impact of depression on suicide ideation – controlling for age and gender. Results: Positive mental health was shown to moderate the impact of depression on suicide ideation: in those students who reported higher levels of positive mental health, depression severity showed no association with suicide ideation over time. Conclusion: Positive mental health seems to confer resilience and should be taken into account, when assessing individuals for suicide risk.     

Zukunftsperspektiven sexualforensischer Psychotherapie

There is a controversial discussion on to what extent sexual forensic psychotherapy has a positive influence on the legal probation of sexually delinquent people. From this the question arises on how treatment with a perspective for success could be structured. This article assumes that such a perspective can only succeed through close cooperation between science and psychotherapeutic practice. Through the analysis of a methodologically elaborate study, considerations on the motivation and the influence of empirically ascertained risk factors are developed and each placed in relation to scientific and therapeutic practice. In this way various problems are tackled, which range from insufficiently described interventions via too little therapeutic flexibility up to limitations in the scientific evaluation. Finally, possible barriers for the development of such a perspective are discussed and the connection to the so-called risk-need-responsivity (RNR) model is explored.     

Willingness to Seek Treatment Among Black Students With Anxiety or Depression: The Synergistic Effect of Sociocultural Factors With Symptom Severity and Intolerance of Uncertainty

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.     

Automated Item Generation with Recurrent Neural Networks

Utilizing technology for automated item generation is not a new idea. However, test items used in commercial testing programs or in research are still predominantly written by humans, in most cases by content experts or professional item writers. Human experts are a limited resource and testing agencies incur high costs in the process of continuous renewal of item banks to sustain testing programs. Using algorithms instead holds the promise of providing unlimited resources for this crucial part of assessment development. The approach presented here deviates in several ways from previous attempts to solve this problem. In the past, automatic item generation relied either on generating clones of narrowly defined item types such as those found in language free intelligence tests (e.g., Raven’s progressive matrices) or on an extensive analysis of task components and derivation of schemata to produce items with pre-specified variability that are hoped to have predictable levels of difficulty. It is somewhat unlikely that researchers utilizing these previous approaches would look at the proposed approach with favor; however, recent applications of machine learning show success in solving tasks that seemed impossible for machines not too long ago. The proposed approach uses deep learning to implement probabilistic language models, not unlike what Google brain and Amazon Alexa use for language processing and generation.     

An empirical solution to the puzzle of weakness of will

This paper presents an empirical solution to the puzzle of weakness of will. Specifically, it presents a theory of action, grounded in contemporary cognitive neuroscientific accounts of decision making, that explains the phenomenon of weakness of will without resulting in a puzzle.