Prevalence and correlates of ICD-11 adjustment disorder: Findings from the Zurich Adjustment Disorder Study

Background/Objective: The 11th revision of the International Classification of Diseases (ICD-11) will provide a new definition of adjustment disorder (AjD). The aim of the present study is to report on prevalence and correlates of ICD-11 AjD in a high-risk sample. Method: Three hundred thirty persons who had lost their job involuntarily were sampled by local job centres. The Munich Composite International Diagnostic Interview was administered with a new AjD module. Associations between AjD and correlates were investigated with logistic regression analyses. Results: 27.3% of the participants reported the AjD core symptom pattern. 13.8% men and 17.2% women met diagnostic guidelines of ICD-11 AjD. Prevalence increased with age and exposure to multiple stressors. The AjD core symptom pattern was associated with various sociodemographic correlates (e. g., lower financial household budget), whereas the full ICD-11 diagnosis including the exclusion algorithm was not. Regarding work-related factors, AjD occurred with a lower probability if the last job position had higher responsibilities and more general confidence for the future. Conclusions: ICD-11 AjD has a high prevalence among persons who lost their jobs involuntarily. Healthcare professionals should be aware of this problem. Research to investigate the ICD-11 AjD concept in the general populations and other subpopulations is needed.     

A case-controlled field study evaluating ICD-11 proposals for relational problems and intimate partner violence

Background/Objective: Intimate partner relationship problems and intimate partner abuse and neglect — referred to in this paper as “relational problems and maltreatment” — have substantial and well-documented impact on both physical and mental health. However, classification guidelines, such as those found in the International Classification of Diseases (ICD-10), are vague and unlikely to support consistent application. Revised guidelines proposed for ICD-11 are much more operationalized. We used standardized clinical vignette conditions with an international panel of clinicians to test if ICD-11 changes resulted in improved classification accuracy. Method: English-speaking mental health professionals (N = 738) from 65 nations applied ICD-10 or ICD-11 (proposed) guidelines with experimentally manipulated case presentations of presence or absence of (a) individual mental health diagnoses and (b) relational problems or maltreatment. Results: ICD-11, compared with ICD-10, guidelines resulted in significantly better classification accuracy, although only in the presence of co-morbid mental health problems. Clinician factors (e. g., gender, language, world region) largely did not impact classification performance. Conclusions: Despite being considerably more explicated, raters’ performance with ICD-11 guidelines reveals training issues that should be addressed prior to the release of ICD-11 in 2018 (e. g., overriding the guidelines with pre-existing archetypes for relationship problems and physical and psychological abuse).     

Validation of the Working Alliance Inventory–Observer Short Version with male intimate partner violence offenders

The working alliance is a key element to increase intimate partner violence (IPV) offenders’ motivation, adherence to treatment, and active participation in batterer intervention programs (BIPs). The objective of the present study is to assess the psychometric properties and factor structure of the Working Alliance Inventory–Observer Short Version (WAI-O-S) with a sample of IPV offenders. The sample was 140 men convicted for IPV and court-mandated to a community-based BIP. Inter-rater agreement and reliability were evaluated by computing the intraclass correlation coefficient. To test the latent structure a Bayesian confirmatory factor analysis approach was used. To test criterion-related validity, the WAI-O-S factorial scores were correlated to protherapeutic behavior, stage of change and motivation to change. The WAI-O-S showed an adequate reliability. Results from Bayesian confirmatory factor analyses showed two first-order factors (Bond and Agreement), and a second-order factor (General working alliance) explaining the relationship between the first-order factors. Results also support the validity of this instrument. The availability of reliable and valid observational measure of the working alliance provides a useful tool to overcome self-report measurement limitations such as social desirability, deception, and denial among IPV offenders.     

Depressive symptoms in Friedreich ataxiaSíntomas depresivos en la ataxia de Friedreich

Background/Objective: Almost no attention has been paid to depression in Friedreich ataxia (FRDA), a highly disabling cerebellar degenerative disease. Our aim was to study the presence and the profile of depressive symptoms in FRDA and their relationship with demographic-disease variables and cognitive processing speed. Method: The study groups consisted of 57 patients with a diagnosis of FRDA. The Beck Depression Inventory-II was used to assess symptoms of depression. Speed of information processing was measured with a Choice Reaction time task. Results: The mean BDI score for patients was significantly higher than the mean score in the general population. Twenty one percent of participants scored in the moderate/severe range. A Cognitive-Affective score and a Somatic-Motivational score was calculated for each patient. Patients’ scores in both dimensions were significantly higher than the scores in the general population. Demographic and disease variables were not related with symptoms of depression, except for severity of ataxia. Depressive symptoms predict cognitive reaction times. The greater proportion of variance was explained by the Cognitive-Affective dimension. Conclusions: Our data show that both somatic-motivational and cognitive affective symptoms of depression are frequent in individuals with FRDA. In addition, depressive symptoms may influence cognition, especially, the cognitive and affective symptoms.     

大动脉炎的影像学诊断比较探讨

探讨大动脉炎的多层螺旋CT血管成像表现及其临床应用价值。回顾分析大动脉炎的多层螺旋CT血管成像表现并结合大量文献进行分析讨论。3例大动脉炎患者血管成像表现为动脉管腔狭窄、扩张及管壁增厚。多层螺旋CT血管成像可同时显示大动脉炎的管壁改变和管腔情况,对大动脉炎早期诊断、治疗方法选择有重要意义。     

Dreaming and cognition in patients with frontotemporal dysfunction

Individuals with Parkinson’s disease (PD) and temporal lobe epilepsy (TLE) have hallucinations and mild cognitive dysfunction. The objective of this work was to study dreams in PD and TLE patients using a common functional model of dream production involving the limbic and paralimbic structures.Dreams were characterised in early-stage PD (19 males) and TLE patients (52) with dream diaries classified by the Hall van de Castle system and were compared with matched controls.In PD, there were significant differences between patients’ dreams and those of controls: animals, physical aggression, and a befriender were more common in patients, and aggressor and bodily misfortunes were less common. The dreams of patients with frontal dysfunction showed more aggressive features.TLE patients had lower recall than PD patients and a higher proportion of dreams involving family and familiar settings, lower proportions involving success, and a higher incidence of frontal dysfunction.The dreams of PD and TLE patients share important features.     

Loss of emotional insight in behavioral variant frontotemporal dementia or "frontal anosodiaphoria"

Loss of insight is a prominent clinical manifestation of behavioral variant frontotemporal dementia (bvFTD), but its characteristics are poorly understood. Twelve bvFTD patients were compared with 12 Alzheimer’s disease (AD) patients on a structured insight interview of cognitive insight (awareness of having a disorder) and emotional insight (concern over having a disorder). Compared to the AD patients, the bvFTD patients were less aware and less concerned about their disorder, and they had less appreciation of its effects on themselves and on others. After corrective feedback (“updating”), the bvFTD patients were just as aware of their disorder as the AD patients but remained unconcerned and unappreciative of its effects. These findings suggest that lack of insight in bvFTD is not due to “anosognosia,” or impaired cognitive and executive awareness of disease, but to “frontal anosodiaphoria,” or lack of emotional concern over having bvFTD and its impact on themselves and others.     

Gami-Chunghyuldan ameliorates memory impairment and neurodegeneration induced by intrahippocampal Aβ 1-42 oligomer injection

Soluble oligomeric forms of amyloid beta (AβO) are regarded as a main cause of synaptic and cognitive dysfunction in Alzheimer’s disease (AD) and have been a primary target in the development of drug treatments for AD. The present study utilized a mouse model of AD induced by intrahippocampal injection of AβO (10 μM) to investigate the effects of Gami-Chunghyuldan (GCD), a standardized multi-herbal medicinal formula, on the presentation of memory deficits and neurohistological pathogenesis. GCD (10 and 50 mg/kg/day, 5 days, p.o.) improved AβO-induced memory impairment as well as reduced neuronal cell death, astrogliosis, and microgliosis in the hippocampus. In addition, GCD prevented AβO-triggered synaptic disruption and cholinergic fiber loss. These results suggest that GCD may be useful in the prevention and treatment of AD.     

La valorisation professionnelle des caractéristiques de personnalité masculines,féminines et androgynes

This article examines the professional valorisation of gender-typed traits. In the study, participants should assess masculine, feminine and androgynous profiles in a set of professional contexts obtained by the crossing of social status (high versus low), gender (masculine versus feminine) and sector (production versus maintenance) of occupations. Consistent with a gender- typed trait matching model, the results showed that masculine profiles were the most valued ones in the most masculine occupations, feminine profiles were mostly valued in the most feminine occupations while androgynous profiles were the most valued in gender ambiguous occupations. Of particular interest was the fact that the perception of occupations’ gender was a function of the interaction between the gender and the sector of occupations (i.e.: the most masculine occupations were those that were stereotypically masculine and belonging to the production sector; the most feminine were those that were stereotypically feminine and belonging to the maintenance sector; the stereotypically masculine and maintenance occupations as the stereotypically feminine and production occupations were perceived as less gender typed).