Performance monitoring in obsessive–compulsive disorder: A temporo-spatial principal component analysis

Hyperactive performance monitoring is a robust finding in obsessive–compulsive disorder (OCD). Patients show increased amplitudes of the error-related negativity (ERN) and correct-related negativity (CRN). Recently, two temporo-spatial factors were shown to contribute to both ERPs in healthy individuals. In the present study, it was investigated whether the factor structure underlying ERN and CRN is similar in OCD and which factors differ between groups. A principal component analysis (PCA) was employed to investigate the temporo-spatial factor structure of ERN and CRN. Twenty-six OCD patients and 26 healthy controls conducted a flanker task. EEG data were analyzed as conventional ERP components and as factor scores derived from temporo-spatial PCA. ERP results showed expected increases in ERN and CRN amplitudes in OCD patients. For both groups, the PCA confirmed the assumed factor structure of a central and a fronto-parietal factor contributing to ERN and CRN. Factor scores of both factors were differently affected by response correctness in OCD. Alterations in factor scores indicate increased activity in both an outcome-independent monitoring process and an error-sensitive process, contributing to overactive performance monitoring in OCD.     

Quality of Life of the Hidden Youth in Hong Kong

Hidden youth was a phenomenon which originated in Japan and later spread to Hong Kong. The youth were described as being in a state of social isolation, marginalization, and prone to emotional disturbances. This may imply that they were suffering from a poor quality of life. However, direct contact with the hidden youth found that some of them are satisfied with their lives. The present study aims to investigate the relationship between the hidden youth’s quality of life and their period and level of social withdrawal. A total of 588 of the hidden youth took part in the study. With the use of mean plots in ANOVA, correlation analysis, regression analysis, and mediation analysis, it was found that the longer the period of social withdrawal, the better the quality of life. The positive correlation between the two variables was mediated by positive emotions derived from social support. On the other hand, as the level of social withdrawal increased, the quality of life decreased. The negative association between the two variables was mediated by negative emotions caused by low levels of social support and a high sense of loneliness. These findings suggest that being “hidden” is the preferred lifestyle of young people and it should not be regarded as a problem that undermines their quality of life.     

Not all phonological awareness deficits are created equal: evidence from a comparison between children with Otitis Media and poor readers

Children with reading difficulties and children with a history of repeated ear infections (Otitis Media, OM) are both thought to have phonological impairments, but for quite different reasons. This paper examines the profile of phonological and morphological awareness in poor readers and children with OM. Thirty‐three poor readers were compared to individually matched chronological age and reading age controls. Their phonological awareness and morphological awareness skills were consistently at the level of reading age matched controls. Unexpectedly, a significant minority (25%) of the poor readers had some degree of undiagnosed mild or very mild hearing loss. Twenty‐nine children with a history of OM and their matched controls completed the same battery of tasks. They showed relatively small delays in their literacy and showed no impairment in morphological awareness but had phonological awareness scores below the level of reading age matched controls. Further analysis suggested that this weakness in phonological awareness was carried by a specific weakness in segmenting and blending phonemes, with relatively good performance on phoneme manipulation tasks. Results suggest that children with OM show a circumscribed deficit in phoneme segmentation and blending, while poor readers show a broader metalinguistic impairment which is more closely associated with reading difficulties.     

Virtual Reality and Cognitive-Behavioral Therapy for Driving Anxiety and Aggression in Veterans: A Pilot Study

Within the U.S. military, motor vehicle accidents (MVAs) are the leading cause of preventable morbidity and mortality. Prior combat exposure and anxiety symptoms are associated with risky and aggressive driving, which is responsible for over half of MVA fatalities. Therefore, interventions are needed to reduce driving anxiety and aggression in veterans in order to mitigate the public health impact of MVAs. Virtual reality exposure therapy (VRET) offers safe, controlled exposure to distressing stimuli. The current study piloted a novel virtual reality and cognitive behavioral intervention (VRET + CBT) for veterans that integrated both anxiety and anger management components. Virtual reality driving scenarios were delivered in a driving simulator and tailored for the military population. Six previously deployed veterans completed eight intervention sessions, as well as pre/post, one month follow-up and six to nine month follow-up assessments. Repeated measures ANOVAs demonstrated significant decline and large effect sizes for PTSD symptoms, driving phobia, hyperarousal in driving situations, anxiety/anger-related thoughts and behaviors, and risky driving. Hyperarousal in driving situations declined by 69%, aggressive driving declined by 29%, and risky driving declined by 21%. Treatment gains were maintained at follow-up. Recruitment, retention, immersion, simulator sickness scores, and qualitative feedback demonstrated feasibility of the intervention. Implications for future research and adaptation are discussed.     

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.     

Youth Subgroups who Receive John F. Chafee Foster Care Independence Program Services

To date over two billion dollars have been invested in the John F. Chafee Foster Care Independence Program (CFCIP) to help youth who are transitioning out of foster care to achieve self-sufficiency through an array of independent living services. Although states are required to report CFCIP service provision to the National Youth in Transition Database (NYTD), the degree of heterogeneity of the aging out population from the service receipt perspective and state implementation is unknown. The CFCIP calls for a deeper understanding of the underlying patterns of services receipt to prepare for youth’s successful transition to adulthood. Based on the population of 68,057 first-time youth who received CFCIP services in FY2011-FY2013 from the NYTD, we used multi-level latent class analysis (MLCA) to identify underlying combinations of service receipt that may be influenced by youth-level and state-level characteristics. We identified the most preferred model based on interpretability, fit statistics, and split-half replication. The optimal model was a three-class, MLCA solution characterized by a high-service receipt profile, an independent living assessment and academic support receipt profile, and a limited service receipt profile. Among male and female youth, age, education level, and whether states serve youth aged 18 or above were significant characteristics associated with LCA profile membership. States could benefit from understanding existing service receipt patterns and gaps to optimize decisions on service delivery in order to meet youth needs and to identify specific services that may prepare youth aging out of foster care towards positive outcomes.     

Parental Involvement in Primary School Education: its Relationship with Children’s Academic Performance and Psychosocial Competence through Engaging Children with School

The benefits of parental involvement in children’s education have been well established but increasing evidence suggests that overparenting may have adverse effects on children. The question of whether excessive parental involvement hinders children’s academic and psychosocial development warrants further investigations. This study examined the associations of parental educational involvement at home and in school with academic performance and psychological health of 507 Chinese Grade 3 schoolchildren in Hong Kong. Parents reported on their level of involvement in children’s schooling and their children’s psychosocial issues. Children were surveyed to determine their school engagement, and their Chinese language and mathematics attainment was assessed. We also explored the underlying mechanism by testing children’s engagement with school as a mediator of the relationships. Our results showed that home-based parental educational involvement was positively associated with children’s language competence and psychosocial wellbeing, and the associations were linked through engaging children with school. However, the benefits reached a plateau at higher level of parental involvement in children’s learning at home. School-based parental involvement had an indirect effect on children’s prosocial behavior through school engagement. These findings highlight the significance of optimal level of parental involvement in children’s education at home for children’s development.