Integrating precision medicine in the study and clinical treatment of a severely mentally ill person

Directory of Open Access Journals (Sweden)

Jason A. O’Rawe

2013-10-01

carries the p.Glu429Ala allele in methylenetetrahydrofolate reductase (MTHFR and the p.Asp7Asn allele in ChAT, encoding choline O-acetyltransferase, with both alleles having been shown to confer an elevated susceptibility to psychoses. We have found thousands of other variants in his genome, including pharmacogenetic and copy number variants. This information has been archived and offered to this person alongside the clinical sequencing data, so that he and others can re-analyze his genome for years to come.Conclusions. To our knowledge, this is the first study in the clinical neurosciences that integrates detailed neuropsychiatric phenotyping, deep brain stimulation for OCD and clinical-grade WGS with management of genetic results in the medical treatment of one person with severe mental illness. We offer this as an example of precision medicine in neuropsychiatry including brain-implantable devices and genomics-guided preventive health care.

[DGPPN compass of participation for vocational integration of persons with mental illnesses].

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Stengler, K; Rauschenbach, J; Riedel-Heller, S G; Becker, T; Steinhart, I; Gerlinger, G; Hauth, I

2016-11-01

Working and living for persons with mental illnesses are a major concern of rehabilitative psychiatry. In Germany the definition of rehabilitation for persons with mental illnesses is closely linked to different sectors of social welfare and to the strongly organized supply chain of prevention, acute treatment, rehabilitation and care. In successfully supporting people with mental health problems in terms of vocational integration, professionals face various obstacles. Besides finding the correct content, structural and organizational difficulties can also arise. The welfare system with its specific institutions and settings is complicated which often leads to delays in the onset of rehabilitation. Some essential reasons are insufficient knowledge about established options of rehabilitative treatment and about responsibilities related to participation in specialized training and further education for professional caregivers. Also information and (positive) experiences from pilot projects working in an inclusive, cross-sectional way and across different settings are practically unavailable in Germany. The presented compass of participation from the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) for vocational integration of persons with mental illnesses starts at this point: it provides guidelines for psychiatric and psychotherapeutic practitioners, general practitioners as well as for physicians working in residential or day care institutions with a psychiatric and psychotherapeutic background. Both the paper and planned online versions should help professionals to help people, particularly those with severe mental illnesses to navigate the system of services for vocational integration in Germany.

Personalizing oncology treatments by predicting drug efficacy, side-effects, and improved therapy: mathematics, statistics, and their integration.

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Agur, Zvia; Elishmereni, Moran; Kheifetz, Yuri

2014-01-01

Despite its great promise, personalized oncology still faces many hurdles, and it is increasingly clear that targeted drugs and molecular biomarkers alone yield only modest clinical benefit. One reason is the complex relationships between biomarkers and the patient's response to drugs, obscuring the true weight of the biomarkers in the overall patient's response. This complexity can be disentangled by computational models that integrate the effects of personal biomarkers into a simulator of drug-patient dynamic interactions, for predicting the clinical outcomes. Several computational tools have been developed for personalized oncology, notably evidence-based tools for simulating pharmacokinetics, Bayesian-estimated tools for predicting survival, etc. We describe representative statistical and mathematical tools, and discuss their merits, shortcomings and preliminary clinical validation attesting to their potential. Yet, the individualization power of mathematical models alone, or statistical models alone, is limited. More accurate and versatile personalization tools can be constructed by a new application of the statistical/mathematical nonlinear mixed effects modeling (NLMEM) approach, which until recently has been used only in drug development. Using these advanced tools, clinical data from patient populations can be integrated with mechanistic models of disease and physiology, for generating personal mathematical models. Upon a more substantial validation in the clinic, this approach will hopefully be applied in personalized clinical trials, P-trials, hence aiding the establishment of personalized medicine within the main stream of clinical oncology. © 2014 Wiley Periodicals, Inc.

An Integrative Approach to Treatment-Resistant Obsessive-Compulsive Disorder.

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Woon, Luke Sy-Cherng; Kanapathy, Anita; Zakaria, Hazli; Alfonso, César A

2017-01-01

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy, concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

Using Images, Metaphor, and Hypnosis in Integrating Multiple Personality and Dissociative States: A Review of the Literature.

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Crawford, Carrie L.

1990-01-01

Reviews literature on hypnosis, imagery, and metaphor as applied to the treatment and integration of those with multiple personality disorder (MPD) and dissociative states. Considers diagnostic criteria of MPD; explores current theories of etiology and treatment; and suggests specific examples of various clinical methods of treatment using…

Integrating Personal and Professional Development.

Science.gov (United States)

Lippitt, Gordon L.

1980-01-01

The author outlines ways to integrate work identity and social identity in order to improve the quality of life. He presents a model for maintaining balance between personal and professional growth, which can stimulate achievement in six areas of human potential. (SK)

Work and personal life boundary management: boundary strength, work/personal life balance, and the segmentation-integration continuum.

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Bulger, Carrie A; Matthews, Russell A; Hoffman, Mark E

2007-10-01

While researchers are increasingly interested in understanding the boundaries surrounding the work and personal life domains, few have tested the propositions set forth by theory. Boundary theory proposes that individuals manage the boundaries between work and personal life through processes of segmenting and/or integrating the domains. The authors investigated boundary management profiles of 332 workers in an investigation of the segmentation-integration continuum. Cluster analysis indicated consistent clusters of boundary management practices related to varying segmentation and integration of the work and personal life domains. But, the authors suggest that the segmentation-integration continuum may be more complicated. Results also indicated relationships between boundary management practices and work-personal life interference and work-personal life enhancement. Less flexible and more permeable boundaries were related to more interference, while more flexible and more permeable boundaries were related to more enhancement.

What the patient wants: Addressing patients' treatment targets in an integrative group psychotherapy programme.

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Kealy, David; Joyce, Anthony S; Weber, Rainer; Ehrenthal, Johannes C; Ogrodniczuk, John S

2018-02-13

Limited empirical attention has been devoted to individualized treatment objectives in intensive group therapy for personality dysfunction. This study investigated patients' ratings of distress associated with individual therapy goals - referred to as target object severity - in an intensive Evening Treatment Programme for patients with personality dysfunction. Change in target objective severity was examined in a sample of 81 patients who completed treatment in an intensive, integrative group therapy programme. Correlation and regression analyses were used to examine associations between change in target object severity and patients' pre-treatment diagnosis, symptom distress, and treatment outcome expectancy, and between change in target objective severity and patients' ratings of group therapy process (group climate, therapeutic alliance, group cohesion). The relationship between change in target objective severity and longer-range life satisfaction was also examined in a subsample of patients who rated life satisfaction at follow-up. While change in target objective severity was not significantly related to pre-treatment variables, significant associations were found with several aspects of group therapy process. Patients' experience of a highly engaged group climate was uniquely associated with improvement in target object severity. Such improvement was significantly related to longer-term life satisfaction after controlling for general symptom change. The working atmosphere in group therapy contributes to patients' progress regarding individual treatment targets, and such progress is an important factor in later satisfaction. Attention to individualized treatment targets deserves further clinical and research attention in the context of integrative group therapy for personality dysfunction. This study found that patients attending an integrative group treatment programme for personality dysfunction experienced significant improvement in severity of distress

[Psychological Treatments for Borderline Personality Disorder: A Review of Cognitive-Behavioral Oriented Therapies].

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Marques, Sofia; Barrocas, Daniel; Rijo, Daniel

2017-04-28

Borderline personality disorder is the most common personality disorder, with a global prevalence rate between 1.6% and 6%. It is characterized by affective disturbance and impulsivity, which lead to a high number of self-harm behaviors and great amount of health services use. International guidelines recommend psychotherapy as the primary treatment for borderline personality disorder. This paper reviews evidence about the effects and efficacy of cognitive-behavioral oriented psychological treatments for borderline personality disorder. A literature review was conducted in Medline and PubMed databases, using the following keywords: borderline personality disorder, cognitive-behavioral psychotherapy and efficacy. Sixteen randomized clinical trials were evaluate in this review, which analyzed the effects of several cognitive-behavioral oriented psychotherapeutic interventions, namely dialectical behavioral therapy, cognitive behavioral therapy, schema-focused therapy and manual-assisted cognitive therapy. All above stated treatments showed clinical beneficial effects, by reducing borderline personality disorder core pathology and associated general psychopathology, as well as by reducing the severity and frequency of self-harm behaviors, and by improving the overall social, interpersonal and global adjustment. Dialectical behavioral therapy and schema-focused therapy also caused a soaring remission rate of diagnostic borderline personality disorder criteria of 57% and 94%, respectively. Although there were differences between the psychotherapeutic interventions analysed in this review, all showed clinical benefits in the treatment of borderline personality disorder. Dialectical behavioral therapy and schema-focused therapy presented the strongest scientific data documenting their efficacy, but both interventions are integrative cognitive-behavioral therapies which deviate from the traditional cognitive-behavioral model. In summary, the available studies support

A cost-effective technique for integrating personal radiation dose assessment with personal gravimetric sampling

International Nuclear Information System (INIS)

Strydom, R.; Rolle, R.; Van der Linde, A.

1992-01-01

During recent years there has been an increasing awareness internationally of radiation levels in the mining and milling of radioactive ores, including those from non-uranium mines. A major aspect of radiation control is concerned with the measurement of radiation levels and the assessment of radiation doses incurred by individual workers. Current techniques available internationally for personnel monitoring of radiation exposures are expensive and there is a particular need to reduce the cost of personal radiation monitoring in South African gold mines because of the large labour force employed. In this regard the obvious benefits of integrating personal radiation monitoring with existing personal monitoring systems already in place in South African gold mines should be exploited. A system which can be utilized for this purpose is personal gravimetric sampling. A new cost-effective technique for personal radiation monitoring, which can be fully integrated with the personal gravimetric sampling strategy being implemented on mines, has been developed in South Africa. The basic principles of this technique and its potential in South African mines are described. 9 refs., 7 figs

42 CFR 31.11 - Persons entitled to treatment.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Persons entitled to treatment. 31.11 Section 31.11... § 31.11 Persons entitled to treatment. To the extent and under the circumstances prescribed in this part, the following persons shall be entitled to medical, surgical, and dental treatment and...

Integrated EAP/Managed Behavioral Health Plan Utilization by Persons with Substance Use Disorders

Science.gov (United States)

Levy Merrick, Elizabeth S.; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Greenfield, Shelly F.; McCann, Bernard

2011-01-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral healthcare organization's integrated EAP/managed behavioral health care product (N=1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. PMID:21185684

Utilization Pattern and Drug Use of Traditional Chinese Medicine, Western Medicine, and Integrated Chinese-Western Medicine Treatments for Allergic Rhinitis Under the National Health Insurance Program in Taiwan.

Science.gov (United States)

Huang, Sheng-Kang; Lai, Chih-Sung; Chang, Yuan-Shiun; Ho, Yu-Ling

2016-10-01

Patients in Taiwan with allergic rhinitis seek not only Western medicine treatment but also Traditional Chinese Medicine treatment or integrated Chinese-Western medicine treatment. Various studies have conducted pairwise comparison on Traditional Chinese Medicine, Western medicine, and integrated Chinese-Western medicine treatments. However, none conducted simultaneous analysis of the three treatments. This study analyzed patients with allergic rhinitis receiving the three treatments to identify differences in demographic characteristic and medical use and thereby to determine drug use patterns of different treatments. The National Health Insurance Research Database was the data source, and included patients were those diagnosed with allergic rhinitis (International Classification of Diseases, Ninth Revision, Clinical Modification codes 470-478). Chi-square test and Tukey studentized range (honest significant difference) test were conducted to investigate the differences among the three treatments. Visit frequency for allergic rhinitis treatment was higher in female than male patients, regardless of treatment with Traditional Chinese Medicine, Western medicine, or integrated Chinese-Western medicine. Persons aged 0-19 years ranked the highest in proportion of visits for allergic rhinitis. Traditional Chinese Medicine treatment had more medical items per person-time and daily drug cost per person-time and had the lowest total expenditure per person-time. In contrast, Western medicine had the lowest daily drug cost per person-time and the highest total expenditure per person-time. The total expenditure per person-time, daily drug cost per person-time, and medical items per person-time of integrated Chinese-Western medicine treatment lay between those seen with Traditional Chinese Medicine and Western medicine treatments. Although only 6.82 % of patients with allergic rhinitis chose integrated Chinese-Western medicine treatment, the visit frequency per person-year of

Delineating the structure of normal and abnormal personality: an integrative hierarchical approach.

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Markon, Kristian E; Krueger, Robert F; Watson, David

2005-01-01

Increasing evidence indicates that normal and abnormal personality can be treated within a single structural framework. However, identification of a single integrated structure of normal and abnormal personality has remained elusive. Here, a constructive replication approach was used to delineate an integrative hierarchical account of the structure of normal and abnormal personality. This hierarchical structure, which integrates many Big Trait models proposed in the literature, replicated across a meta-analysis as well as an empirical study, and across samples of participants as well as measures. The proposed structure resembles previously suggested accounts of personality hierarchy and provides insight into the nature of personality hierarchy more generally. Potential directions for future research on personality and psychopathology are discussed.

Delineating the Structure of Normal and Abnormal Personality: An Integrative Hierarchical Approach

Science.gov (United States)

Markon, Kristian E.; Krueger, Robert F.; Watson, David

2008-01-01

Increasing evidence indicates that normal and abnormal personality can be treated within a single structural framework. However, identification of a single integrated structure of normal and abnormal personality has remained elusive. Here, a constructive replication approach was used to delineate an integrative hierarchical account of the structure of normal and abnormal personality. This hierarchical structure, which integrates many Big Trait models proposed in the literature, replicated across a meta-analysis as well as an empirical study, and across samples of participants as well as measures. The proposed structure resembles previously suggested accounts of personality hierarchy and provides insight into the nature of personality hierarchy more generally. Potential directions for future research on personality and psychopathology are discussed. PMID:15631580

Personality disorder and treatment outcome in alcohol use disorder.

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Newton-Howes, Giles; Foulds, James

2018-01-01

As personality disorder impacts the outcome of most major mental disorders, it would be consistent for it to impact negatively on the outcome of alcohol use disorders (AUDs). This update is to provide an up-to-date overview of the recent literature examining the impact of personality disorder and personality traits on the treatment outcome of AUDs. Comorbidity between personality disorder and AUD is significant and approaches 50%. Patients with AUD and comorbid personality disorder are substantially less likely to remain in treatment, drink more per drinking day and drink more frequently. If retained in treatment, comorbidity does not, however, lead to poorer outcomes. Relapse to drinking is more common in patient with high novelty seeking and lower reward dependence and persistence. Reporting from most studies is of moderate-to-poor quality and a single high-quality study may alter these findings. Landmark alcohol studies are notably quiet on the impact of personality on AUD treatment outcome. Both personality disorder and higher novelty seeking impact negatively on the treatment outcome of AUD. As personality disorder is common in this group, clinicians engaged in AUD treatment should screen for personality disturbance, either disorder or high novelty seeking.

The impact of personality and personality disorders on the treatment of depression

DEFF Research Database (Denmark)

Gabbard, Glen O.; Simonsen, Erik

2007-01-01

It is well known that the presence of personality disorder presents special challenges in the treatment of depression. In this clinical paper, we clarify the interrelationship between personality and depression; and suggest important implications for the psychotherapy and pharmacotherapy of patie...... of seeing them as treatment-refractory, they can be regarded as requiring longer duration and different treatment strategies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)...

[Role of contemporary pathological diagnostics in the personalized treatment of cancer].

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Tímár, József

2013-03-01

Due to the developments of pathology in the past decades (immunohistochemistry and molecular pathology) classification of cancers changed fundamentally, laying a ground for personalized management of cancer patients. Our picture of cancer is more complex today, identifying the genetic basis of the morphological variants. On the other hand, this picture has a much higher resolution enabling us to subclassify similar histological cancer types based on molecular markers. This redefined classification of cancers helps us to better predict the possible biological behavior of the disease and/or the therapeutic sensitivity, opening the way toward a more personalized treatment of this disease. The redefined molecular classification of cancer may affect the universal application of treatment protocols. To achieve this goal molecular diagnostics must be an integral and reimbursed part of the routine pathological diagnostics. On the other hand, it is time to extend the multidisciplinary team with molecular pathologist to improve the decision making process of the management of cancer patients.

Empirically derived personality subtyping for predicting clinical symptoms and treatment response in bulimia nervosa.

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Haynos, Ann F; Pearson, Carolyn M; Utzinger, Linsey M; Wonderlich, Stephen A; Crosby, Ross D; Mitchell, James E; Crow, Scott J; Peterson, Carol B

2017-05-01

Evidence suggests that eating disorder subtypes reflecting under-controlled, over-controlled, and low psychopathology personality traits constitute reliable phenotypes that differentiate treatment response. This study is the first to use statistical analyses to identify these subtypes within treatment-seeking individuals with bulimia nervosa (BN) and to use these statistically derived clusters to predict clinical outcomes. Using variables from the Dimensional Assessment of Personality Pathology-Basic Questionnaire, K-means cluster analyses identified under-controlled, over-controlled, and low psychopathology subtypes within BN patients (n = 80) enrolled in a treatment trial. Generalized linear models examined the impact of personality subtypes on Eating Disorder Examination global score, binge eating frequency, and purging frequency cross-sectionally at baseline and longitudinally at end of treatment (EOT) and follow-up. In the longitudinal models, secondary analyses were conducted to examine personality subtype as a potential moderator of response to Cognitive Behavioral Therapy-Enhanced (CBT-E) or Integrative Cognitive-Affective Therapy for BN (ICAT-BN). There were no baseline clinical differences between groups. In the longitudinal models, personality subtype predicted binge eating (p = 0.03) and purging (p = 0.01) frequency at EOT and binge eating frequency at follow-up (p = 0.045). The over-controlled group demonstrated the best outcomes on these variables. In secondary analyses, there was a treatment by subtype interaction for purging at follow-up (p = 0.04), which indicated a superiority of CBT-E over ICAT-BN for reducing purging among the over-controlled group. Empirically derived personality subtyping appears to be a valid classification system with potential to guide eating disorder treatment decisions. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:506-514). © 2016 Wiley Periodicals, Inc.

42 CFR 31.2 - Persons entitled to treatment.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Persons entitled to treatment. 31.2 Section 31.2... Public Health Service § 31.2 Persons entitled to treatment. To the extent and under the circumstances... treatment and hospitalization by the Service: (a) Coast Guard. (1) Commissioned officers, chief warrant...

Microblogging for Class: An Analysis of Affective, Cognitive, Personal Integrative, and Social Integrative Gratifications

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Gant, Camilla; Hadley, Patrick D.

2014-01-01

This study shows that undergraduate students can gratify cognitive, affective, social integrative, and personal integrative needs microblogging via a learning management system discussion tool. Moreover, the researchers find that microblogging about news regarding mass media events and issues via Blackboard heightened engagement, expanded…

Social exclusion, personal control, self-regulation, and stress among substance abuse treatment clients.

Science.gov (United States)

Cole, Jennifer; Logan, T K; Walker, Robert

2011-01-01

The purpose of this study was to examine the relationship of social exclusion, personal control, and self-regulation to perceived stress among individuals who participated in publicly funded substance abuse treatment. Participants entered treatment between June 2006 and July 2007 and completed a 12-month follow-up survey by telephone (n=787). The results of the OLS regression analysis indicate that individuals with greater social exclusion factors (e.g. greater economic hardship, lower subjective social standing, greater perceived discrimination), lower perceived control of one's life, and lower self-regulation had higher perceived stress. Furthermore, a significant interaction was found suggesting a stress-buffering effect of personal control between subjective social standing and perceived stress. Interestingly, income status was not significantly related to perceived stress, while economic hardship, which assesses participants' inability to meet basic expenses, was significantly associated with perceived stress. Future research should examine how to integrate the AA/NA teaching about powerlessness and its role in recovery with the importance of increased personal control and self-control in decreasing perceived stress. Implications for future research and substance abuse treatment are discussed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Change in Identity Diffusion and Psychopathology in a Specialized Inpatient Treatment for Borderline Personality Disorder.

Science.gov (United States)

Sollberger, Daniel; Gremaud-Heitz, Daniela; Riemenschneider, Anke; Agarwalla, Puspa; Benecke, Cord; Schwald, Oliver; Küchenhoff, Joachim; Walter, Marc; Dammann, Gerhard

2015-01-01

Patients with borderline personality disorder (BPD) show various psychopathological symptoms and suffer especially from disturbance in their identity. The purpose of the study was to investigate changes-particularly in affective BPD symptoms and identity diffusion-during a structured, disorder-specific inpatient treatment (DST) that combined a psychodynamic transference-focused psychotherapy approach with modules of dialectical behavioural skills training. In a prospective, two-group comparison trial, 44 patients with BPD were assessed with questionnaires addressing identity diffusion and state, as well as trait affective psychopathology, before and after 12 weeks of inpatient treatment. Thirty-two patients received DST, whereas 12 patients were given inpatient treatment-as-usual (TAU). The patients were allocated in a non-random procedure for two groups, in order of admission and availability of treatment options in the DST unit. In the pre-post-comparison, the DST group showed a significant decrease in identity diffusion (p borderline symptomatology and in the personality structure feature of identity diffusion. This highlights the significance of a short-term specific inpatient therapy for BPD. A structured, disorder-specific inpatient treatment of patients diagnosed with borderline personality disorder (BPD) combined a psychodynamic transference-focused psychotherapy treatment approach (focusing on pathological features in personality organization, particularly on non-integrated images of self and others) with modules of dialectical behavioural skills training. This treatment is associated with a decrease in identity diffusion of these patients after 12 weeks of treatment. The treatment is also related to a significant decrease in borderline typical psychopathological symptoms such as depressive symptoms, as well as an improvement in state anger. The outcomes of this structured, disorder-specific inpatient treatment of severely ill BPD patients indicated

Everyday Cyborgs: On Integrated Persons and Integrated Goods.

Science.gov (United States)

Quigley, Muireann; Ayihongbe, Semande

2018-05-01

Using the metaphor and actuality of the 'everyday cyborg', this article makes the case that the law is ill-equipped to deal with challenges raised by the linking of the organic, biological person with synthetic, inorganic parts and devices. For instance, should internal medical devices that keep the person alive be viewed as part of the person or mere objects (or something else)? Is damage to neuro-prostheses (eg nervous system integrated limb prostheses) personal injury or damage to property? Who ought to control/own the software in implanted medical devices? And how should the law deal with risks around third-party device access (including that of unauthorised access and hacking)? We argue that satisfactorily answering such questions will likely require a re-analysis of the conceptual and philosophical underpinnings of the law, as well as the law itself. To demonstrate this, we examine the uncharted terrain which everyday cyborgs pose for the law, looking in particular at five areas: (i) medical device regulation, safety, and product liability; (ii) damage to devices and liability; (iii) data and privacy; (iv) security and biohacking; and (v) intellectual property rights. The article highlights how advancing biotechnology continues to reveal, and prompts us to confront, lacunae within the law. Our analysis calls particular attention to law's boundary-work (how the law utilises and incorporates supposed ontological and moral boundaries) and the challenges which everyday cyborgs pose to this.

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

Science.gov (United States)

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

Personal Integration Resources of Mentally Handicapped Teenagers into Society

Science.gov (United States)

Konovalova, Natalia

2016-01-01

The paper deals with the issues concerning the study of mentally handicapped teenagers' integrative potential within modernisation of contemporary Russian education. The research is concentrated on the study of personal and social determinants influencing the readiness of mentally handicapped students to be integrated into the environment.…

Self-regulation underlies temperament and personality : An integrative developmental framework

NARCIS (Netherlands)

Denissen, J.J.A.; van Aken, M.A.G.; Penke, L.; Wood, D.

2013-01-01

In this article, we present an integrative perspective on temperament and personality development. Personality and temperament are conceptualized as regulatory systems that start as physiological reactivity to environmental features early in life, but are increasingly supplemented by regulation

Personality disorders and treatment drop out in the homeless

Directory of Open Access Journals (Sweden)

Salavera C

2013-03-01

Full Text Available Carlos Salavera,1 José M Tricás,2 Orosia Lucha21Faculty of Education, University of Zaragoza, Zaragoza, Spain; 2Physiotherapy Research Unit, University of Zaragoza, Zaragoza, SpainAbstract: The homeless drop out of treatment relatively frequently. Also, prevalence rates of personality disorders are much higher in the homeless group than in the general population. We hypothesize that when both variables coexist – homelessness and personality disorders – the possibility of treatment drop out grows. The aim of this study was to analyze the hypotheses, that is, to study how the existence of personality disorders affects the evolution of and permanence in treatment. One sample of homeless people in a therapeutic community (N = 89 was studied. The structured clinical interview for the diagnostic and statistical manual of mental disorders (DSM-IV-TR was administered and participants were asked to complete the Millon Clinical Multiaxial Inventory-II (MCMI-II. Cluster B personality disorders (antisocial, borderline, and narcissistic avoided permanence in the treatment process while cluster C disorders, as dependent, favored adhesion to the treatment and improved the prognosis. Knowledge of these personality characteristics should be used to advocate for better services to support homeless people and prevent their dropping out before completing treatment.Keywords: MCMI-II, abandonment, personality disorder, homeless

Personalized Network-Based Treatments in Oncology

DEFF Research Database (Denmark)

Robin, Xavier; Creixell, Pau; Radetskaya, Oxana

2013-01-01

Network medicine aims at unraveling cell signaling networks to propose personalized treatments for patients suffering from complex diseases. In this short review, we show the relevance of network medicine to cancer treatment by outlining the potential convergence points of the most recent technol...

Psychotherapeutic treatment levels of personality disorders in older adults

OpenAIRE

Videler, Arjan; Cornelis, Christina; Rossi, G.; van Royen, R.J.J.; Rosowsky, E.; van Alphen, S.P.J.

2015-01-01

Treatment of personality disorders (PDs) in older adults is a highly underexplored topic. In this article clinical applicability of the findings from a recent Delphi study regarding treatment aspects of PDs in older adults is explored. This concerns the relevance of three psychotherapeutic treatment levels for PDs in later life: (a) personality-changing treatment, (b) adaptation-enhancing treatment, and (c) supportive-structuring treatment. By means of three cases concerning the three levels,...

The Psychosocial Integration of Seropositive Persons

Directory of Open Access Journals (Sweden)

Matei Raluca

2017-05-01

Full Text Available We can assume without fail that the psychosocial implications in case of HIV/AIDS are as overwhelming as the medical aspects. For the positive person as well as for those who assist the seropositive people, the uncertainty frames the medical prognosis. All the effects that occur are entirely funded: the loss of self-trust as well as mistrusting others, stigmatization, isolation, getting abandoned by the family, friends, neighbors and school mates or coworkers. The current study aims to evaluate this aspect, the fact that the living environment of the seropositive person does not lead to significant differences as far as adjusting to HIV/AIDS diagnosis is concerned, but the adjusting differences are more related to the personality structure of the infected person, to the way this person identifies strategies of coping with the new situations he / she has to deal with (cognitive, emotional and behavioral strategies. In the applicative part of the study, we analyze the adjustment to the diagnosis, as well as the adherence to the treatment, by applying certain specific work instruments.

Assessment and Treatment of Personality Disorders: A Behavioral Perspective

Science.gov (United States)

Nelson-Gray, Rosemery O.; Lootens, Christopher M.; Mitchell, John T.; Robertson, Christopher D.; Hundt, Natalie E.; Kimbrel, Nathan A.

2009-01-01

Personality disorders are complex and highly challenging to treatment providers; yet, for clients with these problems, there exist very few treatment options that have been supported by research. Given the lack of empirically-supported therapies for personality disorders, it can be difficult to make treatment decisions for this population. The…

Personality does not predict treatment preference, treatment experience does: a study of four complementary pain treatments.

Science.gov (United States)

Blasche, Gerhard; Melchart, Herbert; Leitner, Daniela; Marktl, Wolfgang

2007-10-01

The aim of the present study was to determine the extent to which personality and treatment experience affect patients' appraisals of 4 complementary treatments for chronic pain. A total of 232 chronic pain patients (164 females, 68 males, average age 56.6 years) visiting a spa clinic in Austria returned a questionnaire on patient characteristics and personality (autonomy, depressiveness, assertiveness, self-control) as well as attitudes towards (i.e. appealing, effective, pleasant) and experience of the treatments. Results were analysed by use of linear regression analysis and confidence intervals. Although all treatments were appraised positively, the passive treatments (thermal water tub baths, classical massage) were favoured more than the active treatments (relaxation training or exercise therapy). Treatment appraisal was not predicted by any of the personality traits but to a large extent by treatment experience. Relaxing, not unpleasant treatments were the most highly esteemed treatments. How strenuous or tiring a treatment was only had a minor effect on its appraisal. Neither do dependent, passive patients prefer passive treatments, nor do conscientious patients prefer active treatments. Instead, the appraisal of treatments that induce specific somatosensory sensations is largely determined by treatment experiences, i.e. what the treatment feels like. Despite the popularity of CAM which encompasses many experientially intensive treatments, treatment experience has to date been a neglected topic of treatment research.

Comparing Effectiveness of Treatments for Borderline Personality Disorder in Communal Mental Health Care: The Oulu BPD Study.

Science.gov (United States)

Leppänen, V; Hakko, H; Sintonen, H; Lindeman, S

2016-02-01

The implementation of effective psychotherapies in community mental health care is challenging. This study aimed to create a well-structured and easily applicable treatment model for patients with severe borderline personality disorder (BPD). We integrated a schema therapy based psycho-educational group into an available individual therapy. Two groups were formed: (1) community treatment by experts (CTBE) patients (n = 24) receiving new treatment and (2) treatment as usual (TAU) patients (n = 47). Changes in symptoms were measured by Borderline Personality Disorder Severity Index-IV interview and quality of life by the 15D health-related quality of life questionnaire. After 1 year the CTBE patients showed a significant reduction in a wider range of BPD symptoms and better quality of life than TAU patients. The results of this study are encouraging. A well-structured treatment model was successfully implemented into community mental health care with improved patient adherence to treatment and superior treatment outcomes compared to TAU patients.

Advantages, Disadvantages, and Trend of Integrative Medicine in the Treatment of Heart Failure.

Science.gov (United States)

Zhang, PeiYing

2015-06-01

Integrative medicine therapy using traditional Chinese medicine (TCM) combined with western medicine has shown some advantages in treating heart failure (HF), such as holistic concept; multi-target treatment; dialectical logic; personalized therapy; formulae compatibility; and reduction of side effects of western medicine. However, problems still exist in TCM treatment of HF, including non-uniformed categorization of TCM, lack of standardized syndrome differentiation and lack of an evidence base. The future of treatment of HF seems to be focused on reversing ventricular remodeling, improving cardiac rehabilitation, and accelerating experimental research and drug discovery in TCM.

Treatment of borderline personality disorder and co-occurring anxiety disorders

Science.gov (United States)

Valenstein, Helen R.

2013-01-01

Anxiety disorders are highly prevalent among individuals with borderline personality disorder, with comorbidity rates of up to 90%. Anxiety disorders have been found to reduce the likelihood of achieving remission from borderline personality disorder over time and to increase the risk of suicide and self-injury in this population. Evidence-based treatments for borderline personality disorder have not sufficiently focused on targeting anxiety disorders, and their effects on these disorders are either limited or unknown. Conversely, evidence-based treatments for anxiety disorders typically exclude suicidal, self-injuring, and seriously comorbid patients, thereby limiting their generalizability to individuals with borderline personality disorder. To address these limitations, recent research has begun to emerge focused on developing and evaluating treatments for individuals with co-occurring borderline personality disorder and anxiety disorders, specifically posttraumatic stress disorder (PTSD), with promising initial results. However, there is a need for additional research in this area, particularly studies evaluating the treatment of anxiety disorders among high-risk and complex borderline personality disorder patients. PMID:23710329

A novel personal health system with integrated decision support and guidance for the management of chronic liver disease.

Science.gov (United States)

Kiefer, Stephan; Schäfer, Michael; Bransch, Marco; Brimmers, Peter; Bartolomé, Diego; Baños, Janie; Orr, James; Jones, Dave; Jara, Maximilian; Stockmann, Martin

2014-01-01

A personal health system platform for the management of patients with chronic liver disease that incorporates a novel approach to integrate decision support and guidance through care pathways for patients and their doctors is presented in this paper. The personal health system incorporates an integrated decision support engine that guides patients and doctors through the management of the disease by issuing tasks and providing recommendations to both the care team and the patient and by controlling the execution of a Care Flow Plan based on the results of tasks and the monitored health status of the patient. This Care Flow Plan represents a formal, business process based model of disease management designed off-line by domain experts on the basis of clinical guidelines, knowledge of care pathways and an organisational model for integrated, patient-centred care. In this way, remote monitoring and treatment are dynamically adapted to the patient's actual condition and clinical symptoms and allow flexible delivery of care with close integration of specialists, therapists and care-givers.

Integrated nonthermal treatment system study

International Nuclear Information System (INIS)

Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J.; Quapp, W.J.; Bechtold, T.; Brown, B.; Schwinkendorf, W.; Swartz, G.

1997-01-01

This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs

Integrated nonthermal treatment system study

Energy Technology Data Exchange (ETDEWEB)

Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J. [Morrison Knudsen Corp. (United States); Quapp, W.J. [Nuclear Metals (United States); Bechtold, T.; Brown, B.; Schwinkendorf, W. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States); Swartz, G. [Swartz and Associates (United States)

1997-01-01

This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

Comorbidity of Personality Disorders and Depression: Implications for Treatment.

Science.gov (United States)

Shea, M. Tracie; And Others

1992-01-01

Reviews studies of impact of comorbidity of personality disorders and depression on response to various forms of treatment. Notes that findings support belief that personality disorders are associated with poorer response to treatment for depression. Also notes that limited data available suggest that depression may be positive prognostic…

Integrating Dialectical Behavior Therapy and Prolonged Exposure to Treat Co-Occurring Borderline Personality Disorder and PTSD: Two Case Studies

Science.gov (United States)

Harned, Melanie S.; Linehan, Marsha M.

2008-01-01

Despite the high rate of trauma and PTSD among individuals with borderline personality disorder (BPD), no studies have specifically evaluated the treatment of PTSD in a BPD population. These case studies illustrate the use of a protocol based on prolonged exposure therapy that can be integrated into standard dialectical behavior therapy to treat…

Digital Technologies Supporting Person-Centered Integrated Care - A Perspective.

Science.gov (United States)

Øvretveit, John

2017-09-25

Shared electronic health and social care records in some service systems are already showing some of the benefits of digital technology and digital data for integrating health and social care. These records are one example of the beginning "digitalisation" of services that gives a glimpse of the potential of digital technology and systems for building coordinated and individualized integrated care. Yet the promise has been greater than the benefits, and progress has been slow compared to other industries. This paper describes for non-technical readers how information technology was used to support integrated care schemes in six EU services, and suggests practical ways forward to use the new opportunities to build person-centered integrated care.

A New Approach to Personalization: Integrating E-Learning and M-Learning

Science.gov (United States)

Nedungadi, Prema; Raman, Raghu

2012-01-01

Most personalized learning systems are designed for either personal computers (e-learning) or mobile devices (m-learning). Our research has resulted in a cloud-based adaptive learning system that incorporates mobile devices into a classroom setting. This system is fully integrated into the formative assessment process and, most importantly,…

Barriers to Implementing Treatment Integrity Procedures: Survey of Treatment Outcome Researchers

Science.gov (United States)

Perepletchikova, Francheska; Hilt, Lori M.; Chereji, Elizabeth; Kazdin, Alan E.

2009-01-01

Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity…

[Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy].

Science.gov (United States)

Taubner, Svenja; Volkert, Jana; Gablonski, Thorsten-Christian; Rossouw, Trudie

2017-07-01

Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy In recent years, the concept of mentalization has become increasingly important in practice and research. It describes the imaginative ability to understand human behavior in terms of mental states. Mentalization is a central component to understand the etiology and to treat patients with borderline personality disorder (BPD). Both adult and adolescent patients with BPD have limited mentalization abilities, which can be reliably assessed using the Reflective Functioning Scale. Mentalization-Based Treatment (MBT) was originally developed as an integrative approach for the treatment of adult patients with BPD. It is a manualized psychotherapy with psychodynamic roots with the aim to increase mentalizing abilities of patients. Since then, MBT has been further developed for other mental disorders as well as for the treatment of different age groups. One of these developments is MBT for Adolescents (MBT-A). MBT-A includes both individual as well as family sessions and the average duration of therapy is about twelve months. MBT-A can be applied in inpatient and outpatient settings and aims to improve mentalizing abilities in emotionally important relationships and the whole family system. First studies have found evidence for the efficacy of MBT-A. A randomized controlled trial (RCT) is currently being carried out to evaluate the efficacy of MBT-A for adolescents with conduct disorder. However, further evidence for efficacy and further conceptual development is needed.

Personality disorder features as predictors of symptoms five years post-treatment.

Science.gov (United States)

Jansson, Irene; Hesse, Morten; Fridell, Mats

2008-01-01

Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms.

Personalized Medicine: how to Switch from the Concept to the Integration into the Clinical Development Plan to Obtain Marketing Authorization.

Science.gov (United States)

Becquemont, Laurent; Bordet, Régis; Cellier, Dominic

2012-01-01

One of the challenges of the coming years is to personalize medicine in order to provide each patient with an individualized treatment plan. The three objectives of personalized medicine are to refine diagnosis, rationalize treatment and engage patients in a preventive approach. Personalization can be characterized by various descriptors whether related to the field, biology, imaging, type of lesion of the entity to be treated, comorbidity factors, coprescriptions or the environment As part of personalized medicine focused on biological markers including genetics or genomics, the integration of the clinical development plan to obtain marketing authorization may be segmented in 3 stages with a known descriptor identified before clinical development, a known descriptor discovered during clinical development or a known descriptor known after clinical development. For each stage, it is important to clearly define the technical optimization elements, to specify the expectations and objectives, to examine the methodological aspects of each clinical development phase and finally to consider the fast changing regulatory requirements in view of the few registered therapeutics complying with the definition of personalized medicine as well as the significant technological breakthroughs according to the screened and selected biomarkers. These considerations should be integrated in view of the time required for clinical development from early phase to MA, i.e. more than 10 years. Moreover, business models related to the economic environment should be taken into account when deciding whether or not to retain a biomarker allowing the selection of target populations in a general population. © 2012 Société Française de Pharmacologie et de Thérapeutique.

Association between personality traits and Escitalopram treatment efficacy in panic disorder.

Science.gov (United States)

Võhma, Ülle; Raag, Mait; Tõru, Innar; Aluoja, Anu; Maron, Eduard

2017-08-01

There is strong evidence to suggest that personality factors may interact with the development and clinical expression of panic disorder (PD). A greater understanding of these relationships may have important implications for clinical practice and implications for searching reliable predictors of treatment outcome. The study aimed to examine the effect of escitalopram treatment on personality traits in PD patients, and to identify whether the treatment outcome could be predicted by any personality trait. A study sample consisting of 110 outpatients with PD treated with 10-20 mg/day of escitalopram for 12 weeks. The personality traits were evaluated before and after 12 weeks of medication by using the Swedish universities Scales of Personality (SSP). Although almost all personality traits on the SSP measurement were improved after 12 weeks of medication in comparison with the baseline scores, none of these changes reached a statistically significant level. Only higher impulsivity at baseline SSP predicted non-remission to 12-weeks treatment with escitalopram; however, this association did not withstand the Bonferroni correction in multiple comparisons. All patients were treated in a naturalistic way using an open-label drug, so placebo responses cannot be excluded. The sample size can still be considered not large enough to reveal statistically significant findings. Maladaptive personality disposition in patients with PD seems to have a trait character and shows little trend toward normalization after 12-weeks treatment with the antidepressant, while the association between impulsivity and treatment response needs further investigation.

Personality, treatment choice and satisfaction in patients with localized prostate cancer

International Nuclear Information System (INIS)

Block, Craig A.; Erickson, Brad; Carney-Doebbling, Caroline; Gordon, Susanna; Fallon, Bernard; Konety, Badrinath R.

2007-01-01

Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction. From 1998 to 2002, 219 consecutive patients treated with RP (n=74), XRT (n=73), or BTX (n=72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient- and disease-related factors. Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P=NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P=NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients. There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI-measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision-making process. (author)

Personality, treatment choice and satisfaction in patients with localized prostate cancer.

Science.gov (United States)

Block, Craig A; Erickson, Brad; Carney-Doebbling, Caroline; Gordon, Susanna; Fallon, Bernard; Konety, Badrinath R

2007-11-01

Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction. From 1998 to 2002, 219 consecutive patients treated with RP (n = 74), XRT (n = 73), or BTX (n = 72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient- and disease-related factors. Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P = NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P = NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients. There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI-measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision-making process.

Treatment utilization among persons with opioid use disorder in the United States.

Science.gov (United States)

Wu, Li-Tzy; Zhu, He; Swartz, Marvin S

2016-12-01

The United States is experiencing an opioid overdose epidemic. Treatment use data from diverse racial/ethnic groups with opioid use disorder (OUD) are needed to inform treatment expansion efforts. We examined demographic characteristics and behavioral health of persons aged ≥12 years that met criteria for past-year OUD (n=6,125) in the 2005-2013 National Surveys on Drug Use and Health (N=503,101). We determined the prevalence and correlates of past-year use of alcohol/drug use treatment and opioid-specific treatment to inform efforts for improving OUD treatment. Among persons with OUD, 81.93% had prescription (Rx) OUD only, 9.75% had heroin use disorder (HUD) only, and 8.32% had Rx OUD+HUD. Persons with Rx OUD+HUD tended to be white, adults aged 18-49, males, or uninsured. The majority (80.09%) of persons with OUD had another substance use disorder (SUD), and major depressive episode (MDE) was common (28.74%). Of persons with OUD, 26.19% used any alcohol or drug use treatment, and 19.44% used opioid-specific treatment. Adolescents, the uninsured, blacks, native-Hawaiians/Pacific-Islanders/Asian-Americans, persons with Rx OUD only, and persons without MDE or SUD particularly underutilized opioid-specific treatment. Among alcohol/drug use treatment users, self-help group and outpatient rehabilitation treatment were commonly used services. Most people with OUD report no use of OUD treatment. Multifaceted interventions, including efforts to access insurance coverage, are required to change attitudes and knowledge towards addiction treatment in order to develop a supportive culture and infrastructure to enable treatment-seeking. Outreach efforts could target adolescents, minority groups, and the uninsured to improve access to treatment. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

Towards personalizing treatment for depression : developing treatment values markers.

Science.gov (United States)

Wittink, Marsha N; Morales, Knashawn H; Cary, Mark; Gallo, Joseph J; Bartels, Stephen J

2013-01-01

While 'personalized medicine' commonly refers to genetic markers or profiles associated with pharmacological treatment response, tailoring treatments to patient preferences and values is equally important. To describe and demonstrate a method to develop 'values markers,' or profiles based on the relative importance of attributes of depression treatment. Discrete choice analysis was used to assess individuals' relative preferences for features of depression treatment. Preference profiles were developed using latent profile analysis. Eighty-six adults participating in an internet-based discrete choice questionnaire. Participants were presented with two depression scenarios representing mild and severe depression. For each scenario, they were asked to compare 18 choice sets based on the type of medication side effect (nausea, dizziness, and sexual dysfunction) and severity (mild, moderate, and severe); and for counseling frequency (once per week or every other week) and provider setting (the office of a mental health professional, primary care doctor, or spiritual counselor). Three profiles were identified: profile 1 was associated with a preference for counseling and an avoidance of medication side effects; profile 2 with an avoidance of strong medication side effects and for receiving counseling in medical settings; and profile 3 with a preference for medication over counseling. When presented with a severe depression scenario, there was a higher prevalence for profile 1 and patients were more likely to prefer mental health over primary care and spiritual settings. Values markers may provide a foundation for personalized medicine, and reflect current initiatives emphasizing patient-centered care. Next steps should assess whether values markers are predictive of treatment initiation and adherence.

The right to physical integrity and informed refusal: Just how far does a patient’s right to refuse medical treatment go?

Directory of Open Access Journals (Sweden)

Annelize Nienaber

2016-11-01

Full Text Available The article presents a legal analysis of the right to physical integrity as guaranteed by the South African Constitution, 1996, and the subsequent right of a competent adult person to refuse medical treatment under South African law. We consider whether the right to refuse treatment is an absolute right and very briefly reflect on the application of the constitutional limitations clause to this right. Instances in which patients’ right to physical integrity is limited by factors, which detract from (patient autonomy, are considered: these represent a limitation of their right to refuse medical treatment. We conclude that forced medical interventions, for the most part, are not desirable but, indeed, necessary in some narrowly defined circumstances. When a person makes a decision to refuse a medical intervention, which may seem unusual or may be perceived as irrational, it does not mean that person does not warrant the protection of the constitution and the courts. Provided that the patient makes an informed refusal while of sound mind, generally there is no reason to discredit his/her decision, difficult as it may be for others to accept. At all times the right to bodily integrity is pivotal in any health-related context and should not be lightly disregarded.

The Role of Personality Pathology in Depression Treatment Outcome With Psychotherapy and Pharmacotherapy

Science.gov (United States)

Levenson, Jessica C.; Wallace, Meredith L.; Fournier, Jay C.; Rucci, Paola; Frank, Ellen

2012-01-01

Background Depressed patients with comorbid personality pathology may fare worse in treatment for depression than those without this additional pathology, and comorbid personality pathology may be associated with superior response in one form of treatment relative to another, though recent findings have been mixed. We aimed to evaluate the effect of personality pathology on time to remission of patients randomly assigned to 1 of 2 treatment strategies for depression and to determine whether personality pathology moderated the effect of treatment assignment on outcome. Method Individuals undergoing an episode of unipolar major depression (n = 275) received interpersonal psychotherapy (Klerman, Weissman, Rounsaville, & Chevron, 1984) or selective serotonin reuptake inhibitor (SSRI) pharmacotherapy for depression. Depressive symptoms were measured with the HRSD-17. Remission was a mean HRSD-17 score of 7 or below over a period of 3 weeks. Personality disorders were measured according to SCID-II diagnoses, and personality pathology was measured dimensionally by summing the positive probes on the SCID-II. Results The presence of at least 1 personality disorder was not a significant predictor of time to remission, but a higher level of dimensionally measured personality pathology and the presence of borderline personality disorder were associated with a longer time to remission. Personality pathology did not moderate the effect of treatment assignment on time to remission. Conclusions The findings suggest that depressed individuals with comorbid personality pathology generally fare worse in treatment for depression, although in this report, the effect of personality pathology did not differ by the type of treatment received. PMID:22823857

Cultural Aspects in Symptomatology, Assessment, and Treatment of Personality Disorders.

Science.gov (United States)

Ronningstam, Elsa F; Keng, Shian-Ling; Ridolfi, Maria Elena; Arbabi, Mohammad; Grenyer, Brin F S

2018-03-26

This review discusses cultural trends, challenges, and approaches to assessment and treatment of personality traits and disorders. Specific focus include current developments in the Asian, Italian, Iranian, and Australian societies, as well as the process of acculturation, following moves between cultures with the impact on healthy and disordered personality function. Each culture with its specific history, dimensions, values, and practices influences and gears the individual and family or group in unique ways that affect personality functioning. Similarly, each culture provides means of protection and assimilation as well as norms for acceptance and denunciations of specific behaviors and personality traits. The diagnosis of personality disorders and their treatment need to take into consideration the individual in the context of the culture and society in which they live. Core personality problems, especially emotion dysregulation and interpersonal functioning are specifically influenced by cultural norms and context.

Personalized medicine: new genomics, old lessons

OpenAIRE

Offit, Kenneth

2011-01-01

Personalized medicine uses traditional, as well as emerging concepts of the genetic and environmental basis of disease to individualize prevention, diagnosis and treatment. Personalized genomics plays a vital, but not exclusive role in this evolving model of personalized medicine. The distinctions between genetic and genomic medicine are more quantitative than qualitative. Personalized genomics builds on principles established by the integration of genetics into medical practice. Principles s...

Introduction to the special series on "Narcissistic personality disorder--new perspectives on diagnosis and treatment".

Science.gov (United States)

Ronningstam, Elsa

2014-10-01

The first aim for this Special Series on "Narcissistic personality disorder--new perspecitves on diagnosis and treatment" is to further the dimensional self-regulatory diagnostic approach for identifying NPD by integrating range of functioning, co-occurring grandiosity and vulnerability, compromised empathic ability, self-enhancing interpersonal strategies and relatedness, and overt and covert expressions of pathological narcissism. A second aim is to broaden the conceptualization of pathological narcissism by identifying it in terms of attachment and mentalization/reflective function. The third aim is to apply the combined dimensional and trait diagnostic approach to clinical practice, both diagnostic evaluation and treatment. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Depressive personality and treatment outcome in major depressive disorder.

Science.gov (United States)

Ryder, Andrew G; Quilty, Lena C; Vachon, David D; Bagby, R Michael

2010-06-01

Depressive personality disorder (DPD) is currently included in the DSM-IV Appendix B, Criteria Sets and Axes Provided for Further Study. Evidence of the clinical utility of DPD will likely play an important role in the determination of whether it warrants inclusion in future editions of DSM. The current investigation examines the capacity of DPD traits to predict overall and preferential treatment outcome for patients with Major Depressive Disorder (MDD) (N = 120) using data from a randomized control trial, which included cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and antidepressant medication (ADM) treatment arms. Patients were treated for 16-20 weeks and completed the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Questionnaire (SCID-II/PQ) and the 17-item Hamilton Rating Scale for Depression immediately before and after treatment. Higher scores on a dimensionalized SCID-II/PQ subscale assessing DPD traits were associated with poor outcome for IPT, but not CBT or ADM. This result remained after accounting for variance associated with other personality disorder (PD) traits; none of the other 10 main text PDs predicted treatment outcome.

Research on Multi - Person Parallel Modeling Method Based on Integrated Model Persistent Storage

Science.gov (United States)

Qu, MingCheng; Wu, XiangHu; Tao, YongChao; Liu, Ying

2018-03-01

This paper mainly studies the multi-person parallel modeling method based on the integrated model persistence storage. The integrated model refers to a set of MDDT modeling graphics system, which can carry out multi-angle, multi-level and multi-stage description of aerospace general embedded software. Persistent storage refers to converting the data model in memory into a storage model and converting the storage model into a data model in memory, where the data model refers to the object model and the storage model is a binary stream. And multi-person parallel modeling refers to the need for multi-person collaboration, the role of separation, and even real-time remote synchronization modeling.

[The efficacy and tolerability of pericyazine in the treatment of patients with schizotypal disorder, organic personality disorders and pathocharacterological changes within personality disorders].

Science.gov (United States)

Danilov, D S

To assess the efficacy and tolerability of pericyazine in the treatment of patients with mental disorders manifesting with psychopathic-like symptoms and correction of pathocharacterological disorders in patients with personality disorders during the short-term admission to the hospital or the long-term outpatient treatment. Sixty-three patients with schizotypal personality disorder and organic personality disorder with psychopathic-like symptoms and pathocharacterological changes within the diagnosis of dissocial personality disorder and borderline personality disorder were examined. Patients received pericyazine during the short-term admission to the hospital (6 weeks) or the long-term outpatient treatment (6 month). Efficacy, tolerability and compliance were assessed in the study. Treatment with pricyazine was effective in all patients. The improvement was seen in patients with organic personality disorders and patients with personality disorders (psychopathy). The maximal effect was observed in inpatients and this effect remained during outpatient treatment. The improvement of mental state of patients with schizotypal personality disorder achieved during inpatient treatment with pericyazine continued during the long-term outpatient treatment. Side-effects were restricted to extrapyramidal symptoms, the frequency of metabolic syndrome was low. During outpatient treatment, the compliance was higher if the patient was managed by the same psychiatrist during inpatient- and outpatient treatment.

Digital Technologies Supporting Person-Centered Integrated Care – A Perspective

Directory of Open Access Journals (Sweden)

John Øvretveit

2017-09-01

Full Text Available Shared electronic health and social care records in some service systems are already showing some of the benefits of digital technology and digital data for integrating health and social care. These records are one example of the beginning “digitalisation” of services that gives a glimpse of the potential of digital technology and systems for building coordinated and individualized integrated care. Yet the promise has been greater than the benefits, and progress has been slow compared to other industries. This paper describes for non-technical readers how information technology was used to support integrated care schemes in six EU services, and suggests practical ways forward to use the new opportunities to build person-centered integrated care.

Digital Technologies Supporting Person-Centered Integrated Care – A Perspective

Science.gov (United States)

2017-01-01

Shared electronic health and social care records in some service systems are already showing some of the benefits of digital technology and digital data for integrating health and social care. These records are one example of the beginning “digitalisation” of services that gives a glimpse of the potential of digital technology and systems for building coordinated and individualized integrated care. Yet the promise has been greater than the benefits, and progress has been slow compared to other industries. This paper describes for non-technical readers how information technology was used to support integrated care schemes in six EU services, and suggests practical ways forward to use the new opportunities to build person-centered integrated care. PMID:29588629

Personalized Medicine: Matching Treatments to Your Genes

Science.gov (United States)

... Issues Subscribe December 2013 Print this issue Personalized Medicine Matching Treatments to Your Genes Send us your ... for disease, and the ways you respond to medicines are also unique. Medicines that work well for ...

Personality modulates the efficacy of treatment in patients with major depressive disorder.

Science.gov (United States)

Wardenaar, Klaas J; Conradi, Henk Jan; Bos, Elisabeth H; de Jonge, Peter

2014-09-01

Effects of depression treatment are obscured by heterogeneity among patients. Personality types could be one source of heterogeneity that explains variability in treatment response. Clinically meaningful variations in personality patterns could be captured with data-driven subgroups. The aim of this study was to identify such personality types and to explore their predictive value for treatment efficacy. Participants (N = 146) in the current exploratory study came from a randomized controlled trial in primary care depressed patients, conducted between January 1998 and June 2003, comparing different treatments. All participants were diagnosed with a major depressive disorder (MDD) according to the DSM-IV. Primary (care as usual [CAU] or CAU plus a psychoeducational prevention program [PEP]) and specialized (CAU + PEP + psychiatric consultation or cognitive-behavioral therapy) treatment were compared. Personality was assessed with the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI). Personality classes were identified with latent profile analysis (LPA). During 1 year, weekly depression ratings were obtained by trimonthly assessment with the Composite International Diagnostic Interview. Mixed models were used to analyze the effects of personality on treatment efficacy. A 2-class LPA solution fit best to the NEO-FFI data: Class 1 (vulnerable, n = 94) was characterized by high neuroticism, low extraversion, and low conscientiousness, and Class 2 (resilient, n = 52) by medium neuroticism and extraversion and higher agreeableness and conscientiousness. Recovery was quicker in the resilient class (class × time: P Personality profile may predict whether specialized clinical efforts have added value, showing potential implications for planning of treatments. © Copyright 2014 Physicians Postgraduate Press, Inc.

Psychotherapeutic treatment levels of personality disorders in older adults

NARCIS (Netherlands)

Videler, Arjan; Cornelis, Christina; Rossi, G.; van Royen, R.J.J.; Rosowsky, E.; van Alphen, S.P.J.

2015-01-01

Treatment of personality disorders (PDs) in older adults is a highly underexplored topic. In this article clinical applicability of the findings from a recent Delphi study regarding treatment aspects of PDs in older adults is explored. This concerns the relevance of three psychotherapeutic treatment

Short-Term Structured Treatment for Avoidant Personality Disorder.

Science.gov (United States)

Alden, Lynn

1989-01-01

Randomly assigned 42 men and 34 women classified as having avoidant personality disorder to one of three treatment conditions or to control group. Treatment subjects displayed significantly greater improvement on self-report and behavioral measures than did controls. Inclusion of skills-training procedures did not contribute to effects of…

Personality disorder and alcohol treatment outcome: systematic review and meta-analysis.

Science.gov (United States)

Newton-Howes, Giles M; Foulds, James A; Guy, Nicola H; Boden, Joseph M; Mulder, Roger T

2017-07-01

Background Personality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes. Aims To determine the size and direction of the association between personality disorder and the outcome of treatment for AUD. Method We conducted a systematic review and meta-analysis of randomised trials and longitudinal studies. Results Personality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall. Conclusions Current evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area. © The Royal College of Psychiatrists 2017.

Integrative medicine for cancer treatment

Science.gov (United States)

... gov/ency/patientinstructions/000932.htm Integrative medicine for cancer treatment To use the sharing features on this page, ... help relieve common side effects of cancer or cancer treatment, such as fatigue, anxiety, pain, and nausea. Some ...

Integrated Personal Health Records: Transformative Tools for Consumer-Centric Care

Directory of Open Access Journals (Sweden)

Raymond Brian

2008-10-01

Full Text Available Abstract Background Integrated personal health records (PHRs offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable. Discussion While there is a spectrum of dominant PHR models, (standalone, tethered, integrated, the authors state that only the integrated model has true transformative potential to strengthen consumers' ability to manage their own health care. Integrated PHRs improve the quality, completeness, depth, and accessibility of health information provided by patients; enable facile communication between patients and providers; provide access to health knowledge for patients; ensure portability of medical records and other personal health information; and incorporate auto-population of content. Numerous factors impede widespread adoption of integrated PHRs: obstacles in the health care system/culture; issues of consumer confidence and trust; lack of technical standards for interoperability; lack of HIT infrastructure; the digital divide; uncertain value realization/ROI; and uncertain market demand. Recent efforts have led to progress on standards for integrated PHRs, and government agencies and private companies are offering different models to consumers, but substantial obstacles remain to be addressed. Immediate steps to advance integrated PHRs should include sharing existing knowledge and expanding knowledge about them, building on existing efforts, and continuing dialogue among public and private sector stakeholders. Summary Integrated PHRs

Interpersonal impacts mediate the association between personality and treatment response in major depression.

Science.gov (United States)

Dermody, Sarah S; Quilty, Lena C; Bagby, R Michael

2016-07-01

Personality, as characterized by the Five-Factor Model, predicts response to psychotherapy for depression. To explain how personality impacts treatment response, the present study investigated patient and therapist interpersonal processes in treatment sessions as an explanatory pathway. A clinical trial was conducted in which 103 outpatients (mean age: 41.17 years, 65% female) with primary major depressive disorder completed 16-20 weeks of cognitive-behavioral or interpersonal therapy. Before treatment, patients completed the Revised NEO Personality Inventory to assess personality domains (neuroticism, extraversion, openness-to-experience, agreeableness, and conscientiousness). After 3 and 13 weeks, patient interpersonal behavior was rated by the therapist and vice versa to determine levels of patient and therapist communal and agentic behaviors. Depression levels were measured before and after treatment. Structural equation modeling supported that patients' interpersonal behavior during therapy mediated the associations between pretreatment personality and depression treatment outcome. Specifically, extraversion, conscientiousness, and neuroticism (inverse) predicted higher levels of patient communion throughout treatment, which was in turn associated with improved treatment outcomes. Furthermore, patient agreeableness was inversely associated with agency throughout treatment, which was linked to poorer treatment response. Therapist interpersonal behavior was not a significant mediator. Results suggest that patient interpersonal behavior during treatment may be one way that patient personality impacts clinical outcomes in depression. Results underscore the clinical utility of Five-Factor Model domains in treatment process and outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Professional formation through personal involvement and value integration.

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Haugland, Britt Øvrebø; Lassen, Rasmus M; Giske, Tove

2018-03-01

Formation is an important part of nursing education, and it is the responsibility of nurse educators to facilitate learning situations that provide students with opportunities for personal discovery. Studies have shown that awareness of one's own vulnerability can be a source of professional maturation and courageous action. The study setting is a Christian university that emphasises its value base through the perspective of diakonia in the nursing programme. Diakonia is understood as the provision of caring. Two hundred and forty-five pages of reflective journals from 124 third-year students were analysed with qualitative content analysis. The main theme of the study was Professional formation through personal involvement and value integration. Four categories emerged: 1) Diakonia as a guide to professional compassion; 2) Consciousness of one's own values; 3) The urge to act courageously; and 4) Choosing to spend the time available. The article discusses how students can integrate values in their professional lives by using all senses when learning in real-life situations and by using systematic reflection alone and together with others. Professional formation is an ongoing process, and we have found that mandatory participation, reiteration and progression are important conditions for such formation to occur. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Quality assurance of treatment for personality disorders - a web based solution

DEFF Research Database (Denmark)

Simonsen, Sebastian; Lau, Marianne Engelbrecht

We present data on approximately 200 patients treated for personality disorder at Stolpegaard Psychotherapeutic Centre in Denmark. The personality disorder clinic offers mentalization based treatment primarily delivered in groups. Patients have either been assigned to a standardized, time...... restricted treatment package or have been treated in the regional treatment program where duration is longer and individual psychotherapy is delivered in addition to group therapy. Data on symptom severity and interpersonal problems have been collected pre and post treatment. We discuss the implications...

Mechanisms of Change in Treatments of Personality Disorders: Commentary on the Special Section.

Science.gov (United States)

Kealy, David; Ogrodniczuk, John S

2018-01-01

Considerable progress has been made in the psychotherapeutic treatment of patients with personality disorders (PDs). Once engendering a pervasive therapeutic nihilism, PDs are starting to be viewed as treatable with a much better prognosis than previously thought. Evidence from several randomized controlled trials demonstrating the effectiveness of various forms of psychotherapy, coupled with findings from several longitudinal studies, suggests that such increased clinical optimism is warranted. However, the persistent focus on treatment brands obscures our understanding of the mechanisms through which benefits are actually realized. This article considers emerging trends in PD treatment research, exemplified by the series of articles contained within this special section, that attempt to identify more precisely the mechanisms of therapeutic change. It is only through such work that we will be able to accomplish further refinement of effective strategies, create possibilities for true integration of therapies, and achieve real progress in the field for the betterment of our patients.

28 CFR 43.2 - Obligations of persons receiving care and treatment.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Obligations of persons receiving care and treatment. 43.2 Section 43.2 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RECOVERY OF COST OF HOSPITAL AND MEDICAL CARE AND TREATMENT FURNISHED BY THE UNITED STATES § 43.2 Obligations of persons...

Neuroscience in Psychiatry towards an integrative and personalized medicine in the DSM-V: a proposal

Directory of Open Access Journals (Sweden)

Erick Emmanuel Pérez Solís

2009-05-01

Full Text Available In the last Century the concept of health and, with it, medical science, has suffered a profound, conceptual and ontological change. However, this revolution has not reached, in the same way the field of mental health. In the next pages it will be shown, taking Major Depressive Disorder as a model, how it is possible and necessary, for the field ofpsychopathology (behavior and “mental” functions: rational, executive, cognitive, emotional, etc. the return to its medical origins, which will allow it to respond how the brain functions and its interactions with the rest of the organism and the environment, with the goal of obtaining patterns that will help us to define disease from an etiopathogenic point of view, so it would be possible to provide therapeutic options to theorgan in question. The time has come to ask if we have invented a science (psychiatry that has little to do with reality, and to answer that, the creation of multicentric data bases is proposed, in which biological (not just brain based, social, personal, clinical, etc. variables are integrated, to finally obtain correlations that allow us a reclassification of brain pathology that would be useful to offer integral and personalized treatments.

Impact of Treatment Integrity on Intervention Effectiveness

Science.gov (United States)

Fryling, Mitch J.; Wallace, Michele D.; Yassine, Jordan N.

2012-01-01

Treatment integrity has cogent implications for intervention effectiveness. Understanding these implications is an important, but often neglected, undertaking in behavior analysis. This paper reviews current research on treatment integrity in applied behavior analysis. Specifically, we review research evaluating the relation between integrity…

Promotion of Well-Being in Person-Centered Mental Health Care

OpenAIRE

Cloninger, C. Robert; Zohar, Ada H.; Cloninger, Kevin M.

2010-01-01

An understanding of the mechanisms of personality development provides a systematic way to promote health as an integrated state of physical, mental, social, and spiritual well-being. Individual differences in personality are causal antecedents of the full range of psychopathology. The maturation with integration of personality appears to be an important mechanism by which diverse modalities of treatment promote wellness and reduce illness. First, the authors review the relationship between p...

The relation of ego integrity and despair to personality traits and mental health

NARCIS (Netherlands)

Westerhof, Gerben J.; Bohlmeijer, Ernst T.; McAdams, Dan P.

Objectives: Existing studies in the Eriksonian tradition found that ego integrity and despair are important indicators of life-span development. The present study relates ego integrity and despair to contemporary theories of personality and mental health. Method: A cross-sectional study of Dutch

Personality Modulates the Efficacy of Treatment in Patients With Major Depressive Disorder

NARCIS (Netherlands)

Wardenaar, Klaas J.; Conradi, Henk Jan; Bos, Elisabeth H.; de Jonge, Peter

OBJECTIVE: Effects of depression treatment are obscured by heterogeneity among patients. Personality types could be one source of heterogeneity that explains variability in treatment response. Clinically meaningful variations in personality patterns could be captured with data-driven subgroups. The

Meaning in life of older persons : An integrative literature review

NARCIS (Netherlands)

MSc S.H.A. Hupkens; Anja Machielse; Dr. M.J.B.M. Goumans; P. Derkx

2016-01-01

The aim of this integrative review for nurses is to synthesize knowledge from scholarly literature to provide insight into how older persons find meaning in life, what are influencing circumstances, and what are their sources of meaning. The review serves as a starting point for including meaning in

Integration of Multisensor Hybrid Reasoners to Support Personal Autonomy in the Smart Home

Directory of Open Access Journals (Sweden)

Miguel Ángel Valero

2014-09-01

Full Text Available The deployment of the Ambient Intelligence (AmI paradigm requires designing and integrating user-centered smart environments to assist people in their daily life activities. This research paper details an integration and validation of multiple heterogeneous sensors with hybrid reasoners that support decision making in order to monitor personal and environmental data at a smart home in a private way. The results innovate on knowledge-based platforms, distributed sensors, connected objects, accessibility and authentication methods to promote independent living for elderly people. TALISMAN+, the AmI framework deployed, integrates four subsystems in the smart home: (i a mobile biomedical telemonitoring platform to provide elderly patients with continuous disease management; (ii an integration middleware that allows context capture from heterogeneous sensors to program environment´s reaction; (iii a vision system for intelligent monitoring of daily activities in the home; and (iv an ontologies-based integrated reasoning platform to trigger local actions and manage private information in the smart home. The framework was integrated in two real running environments, the UPM Accessible Digital Home and MetalTIC house, and successfully validated by five experts in home care, elderly people and personal autonomy.

Integration of multisensor hybrid reasoners to support personal autonomy in the smart home.

Science.gov (United States)

Valero, Miguel Ángel; Bravo, José; Chamizo, Juan Manuel García; López-de-Ipiña, Diego

2014-09-17

The deployment of the Ambient Intelligence (AmI) paradigm requires designing and integrating user-centered smart environments to assist people in their daily life activities. This research paper details an integration and validation of multiple heterogeneous sensors with hybrid reasoners that support decision making in order to monitor personal and environmental data at a smart home in a private way. The results innovate on knowledge-based platforms, distributed sensors, connected objects, accessibility and authentication methods to promote independent living for elderly people. TALISMAN+, the AmI framework deployed, integrates four subsystems in the smart home: (i) a mobile biomedical telemonitoring platform to provide elderly patients with continuous disease management; (ii) an integration middleware that allows context capture from heterogeneous sensors to program environment's reaction; (iii) a vision system for intelligent monitoring of daily activities in the home; and (iv) an ontologies-based integrated reasoning platform to trigger local actions and manage private information in the smart home. The framework was integrated in two real running environments, the UPM Accessible Digital Home and MetalTIC house, and successfully validated by five experts in home care, elderly people and personal autonomy.

Integration of Multisensor Hybrid Reasoners to Support Personal Autonomy in the Smart Home

Science.gov (United States)

Valero, Miguel Ángel; Bravo, José; Chamizo, Juan Manuel García; López-de-Ipiña, Diego

2014-01-01

The deployment of the Ambient Intelligence (AmI) paradigm requires designing and integrating user-centered smart environments to assist people in their daily life activities. This research paper details an integration and validation of multiple heterogeneous sensors with hybrid reasoners that support decision making in order to monitor personal and environmental data at a smart home in a private way. The results innovate on knowledge-based platforms, distributed sensors, connected objects, accessibility and authentication methods to promote independent living for elderly people. TALISMAN+, the AmI framework deployed, integrates four subsystems in the smart home: (i) a mobile biomedical telemonitoring platform to provide elderly patients with continuous disease management; (ii) an integration middleware that allows context capture from heterogeneous sensors to program environment's reaction; (iii) a vision system for intelligent monitoring of daily activities in the home; and (iv) an ontologies-based integrated reasoning platform to trigger local actions and manage private information in the smart home. The framework was integrated in two real running environments, the UPM Accessible Digital Home and MetalTIC house, and successfully validated by five experts in home care, elderly people and personal autonomy. PMID:25232910

Increased Treatment Complexity for Major Depressive Disorder for Inpatients With Comorbid Personality Disorder.

Science.gov (United States)

Wiegand, Hauke F; Godemann, Frank

2017-05-01

The study examined inpatient treatment for major depressive disorder (MDD) when it is complicated by comorbid personality disorder. In this descriptive analysis of a large data sample from 2013 (German VIPP data set) of 58,913 cases from 75 hospitals, three groups were compared: patients with MDD, patients with MDD and a comorbid personality disorder, and patients with a main diagnosis of personality disorder. Compared with MDD patients, those with comorbid personality disorder had higher rates of recurrent depression and nearly twice as many readmissions within one year, despite longer mean length of stay. Records of patients with comorbidities more often indicated accounting codes for "complex diagnostic procedures," "crisis intervention," and "constant observation." Patients with comorbid disorders differed from patients with a main diagnosis of personality disorder in treatment indicator characteristics and distribution of personality disorder diagnoses. Personality disorder comorbidity made MDD treatment more complex, and recurrence of MDD episodes and hospital readmission occurred more often than if patients had a sole MDD diagnosis.

Integrating Personalized and Community Services for Mobile Travel Planning and Management

Science.gov (United States)

Yu, Chien-Chih

Personalized and community services have been noted as keys to enhance and facilitate e-tourism as well as mobile applications. This paper aims at proposing an integrated service framework for combining personalized and community functions to support mobile travel planning and management. Major mobile tourism related planning and decision support functions specified include personalized profile management, information search and notification, evaluation and recommendation, do-it-yourself planning and design, community and collaboration management, auction and negotiation, transaction and payment, as well as trip tracking and quality control. A system implementation process with an example prototype is also presented for illustrating the feasibility and effectiveness of the proposed system framework, process model, and development methodology.

Relating DSM-5 section II and section III personality disorder diagnostic classification systems to treatment planning.

Science.gov (United States)

Morey, Leslie C; Benson, Kathryn T

2016-07-01

Beginning with DSM-III, the inclusion of a "personality" axis was designed to encourage awareness of personality disorders and the treatment-related implications of individual differences, but since that time there is little accumulated evidence that the personality disorder categories provide substantial treatment-related guidance. The DSM-5 Personality and Personality Disorders Work Group sought to develop an Alternative Model for personality disorder, and this study examined whether this model is more closely related to clinicians' decision-making processes than the traditional categorical personality disorder diagnoses. A national sample of 337 clinicians provided complete personality disorder diagnostic information and several treatment-related clinical judgments about one of their patients. The dimensional concepts of the DSM-5 Alternative Model for personality disorders demonstrated stronger relationships than categorical DSM-IV/DSM-5 Section II diagnoses to 10 of 11 clinical judgments regarding differential treatment planning, optimal treatment intensity, and long-term prognosis. The constructs of the DSM-5 Alternative Model for personality disorders may provide more clinically useful information for treatment planning than the official categorical personality disorder diagnostic system retained in DSM-5 Section II. Copyright © 2016 Elsevier Inc. All rights reserved.

Optimization of personalized therapies for anticancer treatment.

Science.gov (United States)

Vazquez, Alexei

2013-04-12

As today, there are hundreds of targeted therapies for the treatment of cancer, many of which have companion biomarkers that are in use to inform treatment decisions. If we would consider this whole arsenal of targeted therapies as a treatment option for every patient, very soon we will reach a scenario where each patient is positive for several markers suggesting their treatment with several targeted therapies. Given the documented side effects of anticancer drugs, it is clear that such a strategy is unfeasible. Here, we propose a strategy that optimizes the design of combinatorial therapies to achieve the best response rates with the minimal toxicity. In this methodology markers are assigned to drugs such that we achieve a high overall response rate while using personalized combinations of minimal size. We tested this methodology in an in silico cancer patient cohort, constructed from in vitro data for 714 cell lines and 138 drugs reported by the Sanger Institute. Our analysis indicates that, even in the context of personalized medicine, combinations of three or more drugs are required to achieve high response rates. Furthermore, patient-to-patient variations in pharmacokinetics have a significant impact in the overall response rate. A 10 fold increase in the pharmacokinetics variations resulted in a significant drop the overall response rate. The design of optimal combinatorial therapy for anticancer treatment requires a transition from the one-drug/one-biomarker approach to global strategies that simultaneously assign makers to a catalog of drugs. The methodology reported here provides a framework to achieve this transition.

What Works in the Treatment of Borderline Personality Disorder

OpenAIRE

Choi-Kain, Lois W.; Finch, Ellen F.; Masland, Sara R.; Jenkins, James A.; Unruh, Brandon T.

2017-01-01

Purpose of the Review This review summarizes advances in treatments for adults with borderline personality disorder (BPD) in the last 5?years. Recent Findings Evidence-based advances in the treatment of BPD include a delineation of generalist models of care in contrast to specialist treatments, identification of essential effective elements of dialectical behavioral therapy (DBT), and the adaptation of DBT treatment to manage post-traumatic stress disorder (PTSD) and BPD. Studies on pharmacol...

Personality traits predict treatment outcome with an antidepressant in patients with functional gastrointestinal disorder.

Science.gov (United States)

Tanum, L; Malt, U F

2000-09-01

We investigated the relationship between personality traits and response to treatment with the tetracyclic antidepressant mianserin or placebo in patients with functional gastrointestinal disorder (FGD) without psychopathology. Forty-eight patients completed the Buss-Durkee Hostility Inventory, Neuroticism Extroversion Openness -Personality Inventory (NEO-PI), and Eysenck Personality Questionnaire (EPQ), neuroticism + lie subscales, before they were consecutively allocated to a 7-week double-blind treatment study with mianserin or placebo. Treatment response to pain and target symptoms were recorded daily with the Visual Analogue Scale and Clinical Global Improvement Scale at every visit. A low level of neuroticism and little concealed aggressiveness predicted treatment outcome with the antidepressant drug mianserin in non-psychiatric patients with FGD. Inversely, moderate to high neuroticism and marked concealed aggressiveness predicted poor response to treatment. These findings were most prominent in women. Personality traits were better predictors of treatment outcome than serotonergic sensitivity assessed with the fenfluramine test. Assessment of the personality traits negativism, irritability, aggression, and neuroticism may predict response to drug treatment of FGD even when serotonergic sensitivity is controlled for. If confirmed in future studies, the findings point towards a more differential psychopharmacologic treatment of FGD.

Pharmacogenomics of alcohol addiction: Personalizing pharmacologic treatment of alcohol dependence

Directory of Open Access Journals (Sweden)

Ragia Georgia

2014-01-01

Full Text Available Alcohol dependence is a serious psychiatric disorder with harmful physical, mental and social consequences, and a high probability of a chronic relapsing course. The field of pharmacologic treatment of alcohol dependence and craving is expanding rapidly; the drugs that have been found to reduce relapse rates or drinking in alcohol-dependent patients and are approved for treatment of alcohol dependence are naltrexone, acamprosate and disulfiram, whereas also topiramate appears as a promising therapy. For many patients, however, these treatments are not effective. Evidence from a number of different studies suggests that genetic variation is a significant contributor to interindividual variation of clinical presentation of alcohol problems and response to a given treatment. The aim of the present review is to summarize and discuss the findings on the association between gene polymorphisms and the response to alcohol dependence treatment medications. It is anticipated that future implementation of pharmacogenomics in clinical practice will help personalize alcohol dependence drug treatment, and development personalized hospital pharmacology.

Integrating the persons communicating

DEFF Research Database (Denmark)

Hermann, Jesper

2011-01-01

The paper presents some grounds for the working out of insights developed by Roy Harris and the fellow integrationalists, including the person-centered focus of Otto Jespersen when dealing with future communication studies. Whenever we are speaking of ‘something verbal’, immediately we are opening...... of ‘language’ evaporates, and we are left solely with persons and their understandings, actions and expressions to be investigated by us professionals, collaborating with the persons under scrutiny....

The development of an attachment-based treatment program for borderline personality disorder.

Science.gov (United States)

Bateman, Anthony W; Fonagy, Peter

2003-01-01

The treatment of borderline personality disorder (BPD) remains controversial. The authors have developed an evidence-based treatment program rooted in attachment theory that integrates research on constitutional factors with environmental influences. BPD is conceived of as a disorder in the self-structure brought about through environmentally induced distortion of psychological functioning, which decouples key mental processes necessary for interpersonal and social function. The primary mental function involved is mentalization, which is enfeebled by an absence of contingent and marked mirroring during development. Treatment strategies target mentalization in order to foster the development of stable internal representations, to aid the formation of a coherent sense of self, and to enable to borderline patient to form more secure relationships in which motivations of self and other are better understood. Destabilization of the self leads to emotional volatility, so treatment also needs to focus on identification and appropriate expression of affect. This article describes some of the techniques used to enhance mentalization within the context of group and individual psychotherapy. Targeting of current symptomatology and behavior is insufficient. Therapists need to retain their own ability to mentalize, maintain mental closeness, focus on current mental states, and avoid excessive use of conflict interpretation and metaphor while paying careful attention to the use of transference and countertransference.

Relationships of dissociative disorders and personality traits in opium addicts on methadone treatment.

Science.gov (United States)

Ghafarinezhad, Alireza; Rajabizadeh, Ghodratollah; Shahriari, Vahid

2013-01-01

Drug abuse is a major public health problem. Some believe that when dissociation fails to defend against emotional, physical, or sexual trauma, the person will find relief from unpleasant thoughts and emotions in opium use. On the other hand, personality disorders are considered as important predictors of treatment outcomes in drug abusers. Due to lack of adequate research in this regard, we evaluated dissociative disorders and personality traits of opium addicts on methadone treatment. This cross-sectional analytic study included 111 non-psychotic subjects on methadone treatment (case group) and 69 non-addicts (control group). After recording demographic characteristics, Dissociative Experiences Scale (DES) and Millon Multiaxial Inventory III were applied to assess dissociative symptoms and clinical personality patterns of all participants. Dissociative symptoms were significantly more common in the case group than in the control group (P = 0.044). While hysterionic personality disorder was more frequent in the control group (P = 0.008), sadistic, antisocial, and schizotypal personality disorders were significantly more common in the case group (P = 0.008, 0.002, and 0.023, respectively). We found relations between history of drug dependence, dissociative symptoms, and personality disorders. Therefore, the mentioned disorders need to be kept in mind while planning addiction treatment modalities and identifying high risk groups.

Psychopharmacologic treatment of borderline personality disorder

Science.gov (United States)

Ripoll, Luis H.

2013-01-01

The best available evidence for psychopharmacologic treatment of borderline personality disorder (BPD) is outlined here. BPD is defined by disturbances in identity and interpersonal functioning, and patients report potential medication treatment targets such as impulsivity, aggression, transient psychotic and dissociative symptoms, and refractory affective instability Few randomized controlled trials of psychopharmacological treatments for BPD have been published recently, although multiple reviews have converged on the effectiveness of specific anticonvulsants, atypical antipsychotic agents, and omega-3 fatty acid supplementation. Stronger evidence exists for medication providing significant improvements in impulsive aggression than in affective or other interpersonal symptoms. Future research strategies will focus on the potential role of neuropeptide agents and medications with greater specificity for 2A serotonin receptors, as well as optimizing concomitant implementation of evidence-based psychotherapy and psychopharmacology, in order to improve BPD patients' overall functioning. PMID:24174895

Dimensional personality traits and alcohol treatment outcome: a systematic review and meta-analysis.

Science.gov (United States)

Foulds, James; Newton-Howes, Giles; Guy, Nicola H; Boden, Joseph M; Mulder, Roger T

2017-08-01

To identify dimensional personality traits associated with treatment outcome for patients with an alcohol use disorder (AUD). Systematic review and meta-analysis of clinical trials and longitudinal studies of ≥ 8 weeks in patients receiving treatment for AUD, in which the association between personality dimensions and treatment outcome was reported. Primary outcomes were relapse and alcohol consumption measures. Treatment retention was a secondary outcome. Eighteen studies, including 4783 subjects, were identified. Twelve studies used Cloninger's Temperament and Personality Questionnaire (TPQ) or Temperament and Character Inventory (TCI). Remaining studies used a broad range of other personality measures. Compared with non-relapsers, patients who relapsed had higher novelty-seeking [standardized mean difference in novelty-seeking score 0.28; 95% confidence interval (CI) = 0.12, 0.44], lower persistence (-0.30, 95% = CI -0.48, -0.12), lower reward dependence (-0.16, 95% CI = -0.31, -0.01) and lower cooperativeness (-0.23, 95% CI = -0.41, -0.04). Few studies reported on alcohol consumption outcomes, therefore findings for those outcomes were inconclusive. Lower novelty-seeking predicted better retention in treatment in two of three studies. Most studies reported findings only for those retained in treatment, and did not attempt to account for missing data; therefore, findings for the primary outcomes cannot be generalized to patients who dropped out of treatment. Studies using personality instruments other than the TCI or TPQ reported no consistent findings on the association between personality variables and treatment outcome. Among patients receiving treatment for an alcohol use disorder, those who relapse during follow-up have higher novelty-seeking, lower persistence, lower reward dependence and lower cooperativeness than those who do not relapse. © 2017 Society for the Study of Addiction.

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

Directory of Open Access Journals (Sweden)

Carla Sabariego

2018-03-01

Full Text Available Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened.

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies.

Science.gov (United States)

Sabariego, Carla; Coenen, Michaela; Ito, Elizabeth; Fheodoroff, Klemens; Scaratti, Chiara; Leonardi, Matilde; Vlachou, Anastasia; Stavroussi, Panayiota; Brecelj, Valentina; Kovačič, Dare S; Esteban, Eva

2018-03-19

Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits) and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened.

Borderline personality disorder and comorbid addiction: epidemiology and treatment.

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Kienast, Thorsten; Stoffers, Jutta; Bermpohl, Felix; Lieb, Klaus

2014-04-18

Borderline personality disorder (BPD) affects 2.7% of adults. About 78% of adults with BPD also develop a substance-related disorder or addiction at some time in their lives. These persons are more impulsive and clinically less stable than BPD patients without substance dependency. They display suicidal behavior to a greater extent, drop out of treatment more often, and have shorter abstinence phases. The combination of borderline personality disorder with addiction requires a special therapeutic approach. This review is based on a selective literature search about the treatment of patients with BPD and addiction, with particular attention to Cochrane Reviews and randomized controlled trials (RCT). The available evidence is scant. In two RCTs, Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD) was found to improve patients' overall functional level (standardized mean difference, 1.07-1.78) and to increase the number of abstinence days (effect strength [ES], 1.03) and negative urine samples (ES, 0.75). Dual focus schema therapy (DFST) was evaluated in three RCTs. Because of methodological problems, however, no useful quantitative comparison across trials is possible. In one RCT, dynamic deconstructive psychotherapy (DDP) was found to have only a moderate, statistically insignificant effect. Only a single study provides data about potentially helpful drug therapy over the intermediate term. Patients with borderline personality disorder and comorbid addiction should be treated as early as possible for both conditions in a thematically hierarchical manner. There is no evidence for any restriction on drug therapy to prevent recurrent addiction in these patients. The psychotherapeutic techniques that can be used (despite the currently inadequate evidence base) include DBT-SUD, DFST, and DDP. These patients need qualified expert counseling in choosing a suitable type of psychotherapy. Specific treatment is available in only a few places, and the relevant

16 CFR 312.8 - Confidentiality, security, and integrity of personal information collected from children.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Confidentiality, security, and integrity of... COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CHILDREN'S ONLINE PRIVACY PROTECTION RULE § 312.8 Confidentiality, security, and integrity of personal information collected from children. The operator must...

[Integrated intensive treatment of tinnitus: method and initial results].

Science.gov (United States)

Mazurek, B; Georgiewa, P; Seydel, C; Haupt, H; Scherer, H; Klapp, B F; Reisshauer, A

2005-07-01

In recent years, no major advances have been made in understanding the mechanisms underlying the development of tinnitus. Hence, the present therapeutic strategies aim at decoupling the subconscious from the perception of tinnitus. Mindful of the lessons drawn from existing tinnitus retraining and desensitisation therapies, a new integrated day hospital strategy of treatment lasting 7-14 days has been developed at the Charité Hospital and is presented in the present paper. The strategy for treating tinnitus in the proximity of patient domicile is designed for patients who feel disturbed in their world of perception and their efficiency due to tinnitus and give evidence of mental and physical strain. In view of the etiologically non-uniform and multiple events connected with tinnitus, consideration was also given to the fact that somatic and psychosocial factors are equally involved. Therefore, therapy should aim at diagnosing and therapeutically influencing those psychosocial factors that reduce the hearing impression to such an extent that the affected persons suffer from strain. The first results of therapy-dependent changes of 46 patients suffering from chronic tinnitus are presented. The data were evaluated before and after 7 days of treatment and 6 months after the end of treatment. Immediately after the treatment, the scores of both the tinnitus questionnaire (Goebel and Hiller) and the subscales improved significantly. These results were maintained during the 6-month post-treatment period and even improved.

A time series evaluation of the treatment of histrionic personality disorder with cognitive analytic therapy.

Science.gov (United States)

Kellett, Stephen

2007-09-01

The central aim of this study was to assess the effectiveness of cognitive analytic therapy (CAT) with a patient presenting with Histrionic Personality Disorder (HPD). The methodology employed an A/B single case time-series experimental design, with additionally 6 months of continuous follow-up in the experimental measures. Five HPD experimental variables were collected on a daily basis, creating 357 days of continual data for analysis, across various phases of assessment baseline (A), treatment (B) and follow-up. The therapy contract was 24 sessions of CAT, with 4 additional follow-up sessions, spread over the 6-month's post-therapy period. Three out of the five HPD experimental variables (focus on physical appearance, emptiness and child inside) displayed statistically significant phase of treatment effects. Graphing of such data indicated that a 'sudden deterioration' occurred at the point of termination, with eventual recovery and maintenance of the progress made during the intervention. A battery of validated clinical measures were also completed at assessment, termination and final follow-up sessions; analysis of the general measures illustrated clinically significant change, indexing personality integration and reductions to depression. The study is discussed in terms of methodological and clinical limitations, the central importance of process issues and effective termination in HPD, plus the potential utility of CAT in the treatment of HPD presentations.

Contemporary Directions in Theories and Psychotherapeutic Strategies in Treatment of Personality Disorders

DEFF Research Database (Denmark)

Simonsen, Sebastian; Simonsen, Erik

2014-01-01

and improved adaptation. Based on this finding, we argue that the Level of Personality Functioning could be a useful assessment method for improving treatment selection. Finally, we raise questions and offer considerations regarding the understanding of empathy, low motivation and autobiographical memory......In this commentary on treatment strategies for personality disorders, we analyze each of the cases and the problem of low motivation in terms of how they fit with the Level of Personality Functioning scale. We then show how patients vary in terms of both level and breadth of pathology. Three...

Day Hospital Mentalization-Based Treatment (MBT-DH) versus treatment as usual in the treatment of severe borderline personality disorder: protocol of a randomized controlled trial

Science.gov (United States)

2014-01-01

Background Severe borderline personality disorder is associated with a very high psychosocial and economic burden. Current treatment guidelines suggest that several manualized treatments, including day hospital Mentalization-Based Treatment (MBT-DH), are effective in these patients. However, only two randomized controlled trials have compared manualized MBT-DH with treatment as usual. Given the relative paucity of data supporting the efficacy and cost-effectiveness of MBT-DH, the possible influence of researcher allegiance in one of the trials, and potential problems with the generalization of findings to mental health systems in other countries, this multi-site randomized trial aims to investigate the efficacy and cost-effectiveness of manualized MBT-DH compared to manualized specialist treatment as usual in The Netherlands. Methods/design The trial is being conducted at two sites in The Netherlands. Patients with a DSM-IV-TR diagnosis of borderline personality disorder and a score of ≥ 20 on the Borderline Personality Disorder Severity Index were randomly allocated to MBT-DH or treatment as usual. The MBT-DH program consists of a maximum of 18 months’ intensive treatment, followed by a maximum of 18 months of maintenance therapy. Specialist treatment as usual is provided by the City Crisis Service in Amsterdam, a service that specializes in treating patients with personality disorders, offering manualized, non-MBT interventions including family interventions, Linehan training, social skills training, and pharmacotherapy, without a maximum time limit. Patients are assessed at baseline and subsequently every 6 months up to 36 months after the start of treatment. The primary outcome measure is the frequency and severity of manifestations of borderline personality disorder as assessed by the Borderline Personality Disorder Severity Index. Secondary outcome measures include parasuicidal behaviour, symptomatic distress, social and interpersonal functioning

Day Hospital Mentalization-Based Treatment (MBT-DH) versus treatment as usual in the treatment of severe borderline personality disorder: protocol of a randomized controlled trial.

Science.gov (United States)

Laurenssen, Elisabeth M P; Westra, Dieuwertje; Kikkert, Martijn J; Noom, Marc J; Eeren, Hester V; van Broekhuyzen, Anna J; Peen, Jaap; Luyten, Patrick; Busschbach, Jan J V; Dekker, Jack J M

2014-05-22

Severe borderline personality disorder is associated with a very high psychosocial and economic burden. Current treatment guidelines suggest that several manualized treatments, including day hospital Mentalization-Based Treatment (MBT-DH), are effective in these patients. However, only two randomized controlled trials have compared manualized MBT-DH with treatment as usual. Given the relative paucity of data supporting the efficacy and cost-effectiveness of MBT-DH, the possible influence of researcher allegiance in one of the trials, and potential problems with the generalization of findings to mental health systems in other countries, this multi-site randomized trial aims to investigate the efficacy and cost-effectiveness of manualized MBT-DH compared to manualized specialist treatment as usual in The Netherlands. The trial is being conducted at two sites in The Netherlands. Patients with a DSM-IV-TR diagnosis of borderline personality disorder and a score of ≥ 20 on the Borderline Personality Disorder Severity Index were randomly allocated to MBT-DH or treatment as usual. The MBT-DH program consists of a maximum of 18 months' intensive treatment, followed by a maximum of 18 months of maintenance therapy. Specialist treatment as usual is provided by the City Crisis Service in Amsterdam, a service that specializes in treating patients with personality disorders, offering manualized, non-MBT interventions including family interventions, Linehan training, social skills training, and pharmacotherapy, without a maximum time limit. Patients are assessed at baseline and subsequently every 6 months up to 36 months after the start of treatment. The primary outcome measure is the frequency and severity of manifestations of borderline personality disorder as assessed by the Borderline Personality Disorder Severity Index. Secondary outcome measures include parasuicidal behaviour, symptomatic distress, social and interpersonal functioning, personality functioning

The integrity of persons elected, appointed or exercising public functions

Directory of Open Access Journals (Sweden)

Agathi Nano

2017-07-01

On 17 December 2015, Members of the Albanian Parliament adopt by consensus the constitutional amendments and legislative framework which are necessary to introduce in our country a clear mechanism for the exclusion of criminal offenders from public offices. In this paper we examine regulatory issues relating to the legal framework necessary to guarantee the integrity of public officials, the verification and ascertainment of the prohibition of exercising public functions and the implementation of the prohibitive measures provided for by law no. 138/2015 “On guaranteeing the integrity of the persons elected and/or appointed to, or exercising public functions”, the so called “decriminalisation” law.

Role of personality traits in cocaine craving throughout an outpatient psychosocial treatment program

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Flávia Ismael

2014-03-01

Full Text Available Objective: Cocaine dependence is a major international public health concern. Its chronically relapsing nature is possibly related to craving intensity, which can be influenced by diverse biological and psychological aspects. This study aimed to evaluate the role of different personality traits in craving measured throughout a psychosocial treatment program. Method: The sample comprised 66 cocaine-dependent outpatients who were enrolled in an individual and manualized cognitive-behavioral therapy program. The influence of personality traits on craving intensity, frequency, and duration was analyzed using a generalized estimating equations model with an autoregressive correlation structure. Results: Craving varied during treatment. The personality traits of novelty seeking, reward dependence, and harm avoidance interacted with craving intensity, and the personality trait of persistence interacted with craving duration throughout the treatment period. Furthermore, there were significant interactions between drug use and craving intensity, and between different routes of administration and craving intensity. Participants who used cocaine/crack while in treatment and concurrent users of crack (i.e., freebase cocaine and powder cocaine also had a higher craving intensity. Conclusion: The extent of craving variation can depend on certain personality styles. This study shows that craving is influenced by personality traits, and this may presumably change clinical expression involved in disease.

Pre-treatment predictors and in-treatment factors associated with change in avoidant and dependent personality disorder traits among patients with social phobia.

Science.gov (United States)

Borge, Finn-Magnus; Hoffart, Asle; Sexton, Harold; Martinsen, Egil; Gude, Tore; Hedley, Liv Margaret; Abrahamsen, Gun

2010-01-01

We examined changes in avoidant and dependent personality disorder dimensions, and pre-treatment and in-treatment factors associated with such changes in 77 patients, randomized to medication-free residential cognitive (CT) or residential interpersonal therapy for social phobia. Personality disorders and personality dimensions according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were assessed at pre-treatment and at one-year post-treatment. Both treatments were associated with a decrease in avoidant and dependent personality dimensions; dependent dimension decreased more in CT. Changes in cognitive factors predicted changes in both personality dimensions, whereas changes in symptoms or interpersonal factors did not. Change in the cognitive factor estimated cost was the most powerful predictor in the avoidant dimension, as it was the only predictor that remained significant in the forward regression analyses. Change in the cognitive factor estimated cost, and treatment were the most powerful predictors of change in the dependent dimension. Pre-treatment use of anxiolytics predicted larger changes in both PD dimensions.

Personality disorder features as predictors of symptoms 5 years post-treatment

DEFF Research Database (Denmark)

Jansson, Irene; Hesse, Morten; Fridell, Mats

2008-01-01

disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms......Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality...... disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered...

'Old' and 'new' institutions for persons with mental illness: treatment, punishment or preventive confinement?

Science.gov (United States)

Gostin, Lawrence O

2008-09-01

Despite countless promises for a better life by national commissions, governments and the international community, there has evolved a vicious cycle of neglect, abandonment, indignity, cruel and inhuman treatment, and punishment of persons with mental illness. This shameful history of benign, and sometimes malignant, neglect of persons with mental illness is well understood, with the deep stigma and unredressed discrimination, the deplorable living conditions, and the physical and social barriers preventing their integration and full participation in society. The maltreatment of this vulnerable population has been reinforced by the hurtful stereotypes of incompetency and dangerousness. The belief that persons with mental illness are uniformly dangerous is an equally harmful myth. It provides policy makers with an ostensible justification to exercise control over persons with mental illness, even if they have not committed a violent offence. However, research demonstrates that the class of persons with most mental illnesses is no more dangerous than other populations, and that the vast majority of violence is committed by persons without mental illness. This article will show how this vulnerable population has been unconscionably treated. First, the gross violations of human rights that have occurred, and continue to occur, in 'old' psychiatric institutions will be examined. The deinstitutionalization movement, however, resulted in new places of confinement for this population, such as jails, prisons and homeless shelters. The second part of this paper will explore the new realities of criminal confinement of persons with mental illness. As we will see, incarceration of this vulnerable population in the criminal justice system has caused enormous suffering. If Dostoyevsky was correct that the 'degree of civilization... can be judged by entering its prisons', then by that measure, we are a deeply uncivilized society.

PERSONALIZED (LOCAL UV-CROSSLINKING AS A TREATMENT OF KERATOCONUS AND CORNEAL ECTASIA

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S. I. Anisimov

2017-01-01

Full Text Available There is no doubts that problem of keratoconus treatment is high relevant. The number of diagnosed ectasia, including iatrogenic ectasia, increased — in recent years. The amount of post-LASIK and ectasia after RK in late postoperative period multiplies significantly. It is associated not only with inception of new ways of treatment into practice, but also with the upgrade of diagnostic methods and equipment. A new method of local personalized crosslinking (LCXL was integrated into clinical practice using Laplace’s equation, pachymetry and topography maps data, It exceeds usual Dresden protocol on several parameters. This article shows the reaction of patients’ eyes on the treatment and the effectiveness of technique is provided. Materials and methods: topographic indications were evaluated (Orbscan II (B+L of 28 patients (40 eyes aged 18 — 44 with keratoconus stages I-IV (12 eyes — I stage; 16 eyes — II stage; 9 eyes — III stage; 3 eyes — IV stage classified by Abugova T.D., as well as UCVA, BCVA for 12 months after surgery. Normal values were estimated by characteristics of 30 eyes without any refractive errors. Results: LCXL is an effective way of treatment of corneal ectasia; it’s more effective in early stages. This technique has a strong controlled refractive impact and allows to reduce inflammatory after procedure. 

Personal networks of women in residential and outpatient substance abuse treatment.

Science.gov (United States)

Kim, HyunSoo; Tracy, Elizabeth; Brown, Suzanne; Jun, MinKyoung; Park, Hyunyong; Min, Meeyoung; McCarty, Chris

This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t -tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.

[Schema therapy: an integrative approach for personality disorders].

Science.gov (United States)

Roediger, Eckhard; Dieckmann, Eva

2012-01-01

Schema Therapy (ST) is a comprehensive approach deriving from cognitive behavioral therapy (CBT) for the treatment of chronic personality problems. ST extends CBT in 3 major issues: 1. The Schema-Mode-Model. 2. The therapeutic relationship. 3. The intensive use of experiential techniques. Schemas are persistent, rigid, and dysfunctional patterns preventing the patient from further personal emotive-interpersonal development. The central focus of the therapeutic process is the relationship between the therapist and the patient. Supported by the therapeutic relationship the patient gets in touch with painful childhood experiences. In ST, the core schemas are identified, put into a biographical context, and weakened by using several specific therapeutic techniques including experiential methods and strategies taken from Gestalt therapy that enrich traditional CBT techniques. © Georg Thieme Verlag KG Stuttgart · New York.

Questionnaire-based person trip visualization and its integration to quantitative measurements in Myanmar

Science.gov (United States)

Kimijiama, S.; Nagai, M.

2016-06-01

With telecommunication development in Myanmar, person trip survey is supposed to shift from conversational questionnaire to GPS survey. Integration of both historical questionnaire data to GPS survey and visualizing them are very important to evaluate chronological trip changes with socio-economic and environmental events. The objectives of this paper are to: (a) visualize questionnaire-based person trip data, (b) compare the errors between questionnaire and GPS data sets with respect to sex and age and (c) assess the trip behaviour in time-series. Totally, 345 individual respondents were selected through random stratification to assess person trip using a questionnaire and GPS survey for each. Conversion of trip information such as a destination from the questionnaires was conducted by using GIS. The results show that errors between the two data sets in the number of trips, total trip distance and total trip duration are 25.5%, 33.2% and 37.2%, respectively. The smaller errors are found among working-age females mainly employed with the project-related activities generated by foreign investment. The trip distant was yearly increased. The study concluded that visualization of questionnaire-based person trip data and integrating them to current quantitative measurements are very useful to explore historical trip changes and understand impacts from socio-economic events.

The Role of Personality Pathology in Depression Treatment Outcome with Psychotherapy and Pharmacotherapy

Science.gov (United States)

Levenson, Jessica C.; Wallace, Meredith L.; Fournier, Jay C.; Rucci, Paola; Frank, Ellen

2012-01-01

Background: Depressed patients with comorbid personality pathology may fare worse in treatment for depression than those without this additional pathology, and comorbid personality pathology may be associated with superior response in one form of treatment relative to another, though recent findings have been mixed. We aimed to evaluate the effect…

[Application of molecular diagnostic techniques in precision medicine of personalized treatment for colorectal cancer].

Science.gov (United States)

Fu, Ji; Lin, Guole

2016-01-01

Precision medicine is to customize the treatment options for individual patient based on the personal genome information. Colorectal cancer (CRC) is one of the most common cancer worldwide. Molecular heterogeneity of CRC, which includes the MSI phenotype, hypermutation phenotype, and their relationship with clinical preferences, is believed to be one of the main factors responsible for the considerable variability in treatment response. The development of powerful next-generation sequencing (NGS) technologies allows us to further understand the biological behavior of colorectal cancer, and to analyze the prognosis and chemotherapeutic drug reactions by molecular diagnostic techniques, which can guide the clinical treatment. This paper will introduce the new findings in this field. Meanwhile we integrate the new progress of key pathways including EGFR, RAS, PI3K/AKT and VEGF, and the experience in selective patients through associated molecular diagnostic screening who gain better efficacy after target therapy. The technique for detecting circulating tumor DNA (ctDNA) is introduced here as well, which can identify patients with high risk for recurrence, and demonstrate the risk of chemotherapy resistance. Mechanism of tumor drug resistance may be revealed by dynamic observation of gene alteration during treatment.

Contemporary Directions in Theories and Psychotherapeutic Strategies in Treatment of Personality Disorders: Relation to Level of Personality Functioning

DEFF Research Database (Denmark)

Simonsen, Sebastian; Simonsen, Erik

2014-01-01

In this commentary on treatment strategies for personality disorders, we analyze each of the cases and the problem of low motivation in terms of how they fit with the Level of Personality Functioning scale. We then show how patients vary in terms of both level and breadth of pathology. Three...

SOCIAL PHOBIA AND PERSONALITY-DISORDER - SEVERITY OF COMPLAINT AND TREATMENT EFFECTIVENESS

NARCIS (Netherlands)

MERSCH, PPA; JANSEN, MA; ARNTZ, A

1995-01-01

Thirty-four patients meeting the DSM-III-R criteria for social phobia participated in a study on the relationship between personality disorder, symptom pattern, and treatment outcome. Eight patients (23.5%) were diagnosed with a personality disorder; 26 patients did not receive an Axis II diagnosis.

Personalized neuromusculoskeletal modeling to improve treatment of mobility impairments: a perspective from European research sites

Directory of Open Access Journals (Sweden)

Fregly Benjamin J

2012-03-01

Full Text Available Abstract Mobility impairments due to injury or disease have a significant impact on quality of life. Consequently, development of effective treatments to restore or replace lost function is an important societal challenge. In current clinical practice, a treatment plan is often selected from a standard menu of options rather than customized to the unique characteristics of the patient. Furthermore, the treatment selection process is normally based on subjective clinical experience rather than objective prediction of post-treatment function. The net result is treatment methods that are less effective than desired at restoring lost function. This paper discusses the possible use of personalized neuromusculoskeletal computer models to improve customization, objectivity, and ultimately effectiveness of treatments for mobility impairments. The discussion is based on information gathered from academic and industrial research sites throughout Europe, and both clinical and technical aspects of personalized neuromusculoskeletal modeling are explored. On the clinical front, we discuss the purpose and process of personalized neuromusculoskeletal modeling, the application of personalized models to clinical problems, and gaps in clinical application. On the technical front, we discuss current capabilities of personalized neuromusculoskeletal models along with technical gaps that limit future clinical application. We conclude by summarizing recommendations for future research efforts that would allow personalized neuromusculoskeletal models to make the greatest impact possible on treatment design for mobility impairments.

Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

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Ruth Q. Wolever

2015-01-01

Full Text Available Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1 conventional tinnitus treatments and (2 promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs.

Available clinical markers of treatment outcome integrated in mathematical models to guide therapy in HIV infection.

Science.gov (United States)

Vergu, Elisabeta; Mallet, Alain; Golmard, Jean-Louis

2004-02-01

Because treatment failure in many HIV-infected persons may be due to multiple causes, including resistance to antiretroviral agents, it is important to better tailor drug therapy to individual patients. This improvement requires the prediction of treatment outcome from baseline immunological or virological factors, and from results of resistance tests. Here, we review briefly the available clinical factors that have an impact on therapy outcome, and discuss the role of a predictive modelling approach integrating these factors proposed in a previous work. Mathematical and statistical models could become essential tools to address questions that are difficult to study clinically and experimentally, thereby guiding decisions in the choice of individualized drug regimens.

Personality pathology in a forensic setting : prevalence, assessment, and prognostic value for treatment

NARCIS (Netherlands)

Spaans, M.A.

2016-01-01

Research on the prevalence, diagnostic and prognostic value for treatment of personality pathology – i.e., both personality disorders and problematic personality characteristics – was carried out within a mainly Dutch forensic mental health setting. Issues such as (dis)simulation and unintentional

Support Systems for Treatment Integrity

NARCIS (Netherlands)

Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately

Values and principles of person-centered integrated care: a systematic literature review (SIG meeting)

OpenAIRE

Zonneveld, Nick; Miller, Robin; Minkman, Mirella

2017-01-01

Introduction: In recent years many knowledge about integrated health services has been developed. So far research has focused on operational themes and interventions on the one side, which help decision makers in practice. On the other hand, a number of studies about generic elements of person-centered and integrated care have been published, resulting in valuable conceptual models and frameworks [1-9]. A third area of research is how to measure integrated care.However, if we want to further ...

Integrating Early Intervention for Borderline Personality Disorder and Mood Disorders.

Science.gov (United States)

Chanen, Andrew M; Berk, Michael; Thompson, Katherine

2016-01-01

Borderline personality disorder (BPD) has been demonstrated to be a reliable and valid construct in young people (adolescents and young adults). Both borderline- and mood-related psychopathology become clinically apparent from puberty through to young adulthood, frequently co-occur, can reinforce one another, and can be difficult to differentiate clinically. This Gordian knot of overlapping clinical features, common risk factors, and precursors to both BPD and mood disorders complicates clinical assessment, prevention, and treatment. Regardless of whether an individual crosses an arbitrary diagnostic threshold, a considerable proportion of young people with borderline- and mood-related psychopathology will develop significant and persistent functional, vocational, and interpersonal impairment and disability during this critical risk and developmental period. There is a clear need for early intervention, but spurious diagnostic certainty risks stigma, misapplication of diagnostic labels, inappropriate treatment, and unfavorable outcomes. This article aims to integrate early intervention for BPD and mood disorders in the clinical context of developmental and phenomenological change and evolution. "Clinical staging," similar to disease staging in general medicine, is presented as a pragmatic, heuristic, and trans-diagnostic framework to guide prevention and intervention. It acknowledges that the early stages of these disorders cannot be disentangled sufficiently to allow for disorder-specific preventive measures and early interventions. Clinical staging defines an individual's location along the continuum of the evolving temporal course of a disorder. Such staging aids differentiation of early or milder clinical phenomena from those that accompany illness progression and chronicity, and suggests the application of appropriate and proportionate intervention strategies.

The influence of comorbid personality disorder and neuroticism on treatment outcome in first episode depression

DEFF Research Database (Denmark)

Bock, Camilla; Bukh, Jens Drachmann; Vinberg, Maj

2010-01-01

setting were consecutively sampled from the Danish Psychiatric Central Research Register. The patients participated in an extensive interview including the Schedules for Clinical Assessment in Neuropsychiatry, the Structured Clinical Interview for DSM-IV Axis II Personality Disorders and a detailed...... of antidepressant treatment, and (2) 2 trials of antidepressant treatment. Further personality traits were assessed by means of the Eysenck Personality Questionnaire. RESULTS: Among a total of 301 patients with a single depressive episode, 31.9% fulfilled diagnostic criteria for at least 1 personality disorder......BACKGROUND: It has never been investigated whether comorbid personality disorder or neuroticism predicts a poor treatment outcome in first episode depression. METHODS: Medically treated patients discharged with a diagnosis of a single depressive episode from a psychiatric in- or outpatient hospital...

Treatment of antisocial personality disorder: Development of a practice focused framework.

Science.gov (United States)

van den Bosch, L M C; Rijckmans, M J N; Decoene, S; Chapman, A L

There is little to no evidence of effective treatment methods for patients with an antisocial personality disorder (ASPD). One of the reasons could be the fact that they are often excluded from mental healthcare and thus from studies. A treatment framework based on 'state of the art' methods and best practices, offering guidelines on the treatment of ASP and possibilities for more systematical research, is urgently needed. This research involved a literature search and an international Delphi-study (N = 61 experts in research, management and clinical practice focused on ASPD). The results suggested important preconditions with regard to organization of care, healthcare workers and therapy. Conclusions are that there are many ways to coordinate effective treatment and management and work toward the increased availability of evidence based care for persons with ASPD. Copyright © 2018 Elsevier Ltd. All rights reserved.

The thyroid function of Graves' disease patients is aggravated by depressive personality during antithyroid drug treatment.

Science.gov (United States)

Fukao, Atsushi; Takamatsu, Junta; Kubota, Sumihisa; Miyauchi, Akira; Hanafusa, Toshiaki

2011-08-09

We previously reported that depressive personality (the scores of hypochondriasis, depression and psychasthenia determined by the Minnesota Multiphasic Personality Inventory (MMPI)) and daily hassles of Graves' disease (GD) patients treated long trem with antithyroid drug (ATD) were significantly higher in a relapsed group than in a remitted group, even in the euthyroid state. The present study aims to examine the relationship among depressive personality, emotional stresses, thyroid function and the prognosis of hyperthyroidism in newly diagnosed GD patients. Sixty-four untreated GD patients responded to the MMPI for personality traits, the Natsume's Stress Inventory for major life events, and the Hayashi's Daily Life Stress Inventory for daily life stresses before and during ATD treatment. In the untreated thyrotoxic state, depressive personality (T-scores of hypochondriasis, depression or psychasthenia greater than 60 points in MMPI) were found for 44 patients (69%). For 15 (23%) of these patients, the scores decreased to the normal range after treatment. However, depressive personality persisted after treatment in the remaining 29 patients (46%). Normal scores before treatment were found for 20 patients (31%), and the scores were persistently normal for 15 patients (23%). The remaining 5 patients (8%) had higher depressive personality after treatment. Such depressive personality was not associated with the severity of hyperthyroidism. Serum TSH receptor antibody activity at three years after treatment was significantly (p = 0.0351) greater in the depression group than in the non- depression group. The remission rate at four years after treatment was significantly (p = 0.0305) lower in the depression group than in the non- depression group (22% vs 52%). The data indicate that in GD patients treated with ATD, depressive personality during treatment reflects the effect of emotional stress more than that of thyrotoxicosis and that it aggravates hyperthyroidism

Barriers to Implementing Treatment Integrity Procedures in School Psychology Research: Survey of Treatment Outcome Researchers

Science.gov (United States)

Sanetti, Lisa M. Hagermoser; DiGennaro Reed, Florence D.

2012-01-01

Treatment integrity data are essential to drawing valid conclusions in treatment outcome studies. Such data, however, are not always included in peer-reviewed research articles in school psychology or related fields. To gain a better understanding of why treatment integrity data are lacking in the school psychology research, we surveyed the…

Conjectures concerning cross-sex hormone treatment of aging transsexual persons.

Science.gov (United States)

Gooren, Louis; Lips, Paul

2014-08-01

Guidelines for cross-sex hormone treatment of transsexual people are now in place. However, little attention has been paid to the issue of treatment suitability for older people. Does existing treatment need to be adapted as subjects age, and does it make a difference if treatment is only started when the subject is already older? To assess the necessity of adapting cross-sex hormone administration for elderly transsexual people. Risks/benefits of continued use of cross-sex hormones with regard to bone health, cardiovascular risks, and malignancies. Due to lack of data on the subject population, sex hormone treatment of other conditions in older non-transsexual people has been taken as the best available analogy to determine the extent to which these might be applicable to comparable transsexual persons. Findings in transsexual people receiving cross-sex hormone treatment sometimes modified the above approach of applying guidelines for the elderly to the aging transsexual population. Testosterone administration to female-to-male transsexual persons (FtoM) carries little risk with regard to cardiovascular disease and cancer. For those with high hematocrit or cardiac insufficiency the dose can be reduced. Administration of estrogens to male-to-female transsexual persons (MtoF), particularly when combined with progestins, does significantly increase the risk of developing cardiovascular disease (almost a twofold incidence compared with the general population). This may require dose adjustment or changing from oral to safer transdermal estrogens. Tumors of the breasts, prostate and pituitary may occur. In FtoM, breast cancer can occur even after breast ablation. Older subjects can commence cross-sex hormone treatment without disproportionate risks. Cross-sex hormones may be continued into old age but monitoring for cardiovascular disease and malignancies, both of the old and new sex, is recommended. MtoF will have more health complications in old age than Fto

Personality, attrition and weight loss in treatment seeking women with obesity.

Science.gov (United States)

Dalle Grave, R; Calugi, S; Compare, A; El Ghoch, M; Petroni, M L; Colombari, S; Minniti, A; Marchesini, G

2015-10-01

Studies on small samples or in single units applying specific treatment programmes found an association between some personality traits and attrition and weight loss in individuals treated for obesity. We aimed to investigate whether pre-treatment personality traits were associated with weight loss outcomes in the general population of women with obesity. Attrition and weight loss outcomes after 12 months were measured in 634 women with obesity (mean age, 48; body mass index (BMI), 37.8 kg m(-2)) seeking treatment at eight Italian medical centres, applying different medical/cognitive behavioural programmes. Personality traits were assessed with the Temperament and Character Inventory (TCI), eating disorder features with the Binge Eating Scale (BES) and Night Eating Questionnaire (NEQ). Within the 12-month observation period, 32.3% of cases were lost to follow-up. After adjustment for demographic confounders and the severity of eating disorders, no TCI personality traits were significantly associated with attrition, while low scores of the novelty seeking temperament scale remained significantly associated with weight loss ≥ 10% (odds ratio, 0.983; 95% confidence interval, 0.975-0.992). Additional adjustment for education and job did not change the results. We conclude that personality does not systematically influence attrition in women with obesity enrolled into weight loss programmes in the community, whereas an association is maintained between novelty seeking and weight loss outcome. Studies adapting obesity interventions on the basis of individual novelty seeking scores might be warranted to maximize the results on body weight. © 2015 World Obesity.

An exploration of values among consumers seeking treatment for borderline personality disorder.

Science.gov (United States)

Mohi, Simone R; Deane, Frank P; Bailey, Anne; Mooney-Reh, Dianne; Ciaglia, Danielle

2018-01-01

Consumer feedback identifies a new challenge in the treatment of borderline personality disorder (BPD) is to address the discrepancy between clinical treatment targets and the more personally meaningful goals people are seeking in treatment. This highlights the need to increase clarification of people's values and link these to therapy goals. The current study explores ways in which individuals with BPD identify with values across key life domains. At initial assessment 106 consumer participants attending an outpatient clinic for the treatment of BPD completed the Personal Values Questionnaire by Blackledge and colleagues. This 90-item measure asks participants to respond to different value appraisals such as importance, commitment, desire to improve, success and, motivation across nine life domains. These included: relationships, health & wellbeing, education & personal development, work & career, spirituality, recreation & leisure, and community involvement. A consistent pattern of value appraisals was found across all life domains. Specifically, life domains were endorsed as highly important but participants reported significantly lower levels of value commitment, desire to improve and success. Successful value pursuit also related differentially to value motivations (internal vs. external) depending on the particular life domain. Relationships with family, friends and romantic partners, as well as health & wellbeing were most important compared to other life domains. The findings suggest that people with BPD identify with values and prioritise different life domains in terms of importance. Our results show discrepancies between higher importance and lower commitment, desire to improve and success at living in line with what is valued. Identification of such discrepancies provides opportunities to more effectively support consumers with BPD to prioritise goals that are consistent with valued domains. These findings offer new insights for cultivating the

Hanford Site waste treatment/storage/disposal integration

International Nuclear Information System (INIS)

MCDONALD, K.M.

1999-01-01

In 1998 Waste Management Federal Services of Hanford, Inc. began the integration of all low-level waste, mixed waste, and TRU waste-generating activities across the Hanford site. With seven contractors, dozens of generating units, and hundreds of waste streams, integration was necessary to provide acute waste forecasting and planning for future treatment activities. This integration effort provides disposition maps that account for waste from generation, through processing, treatment and final waste disposal. The integration effort covers generating facilities from the present through the life-cycle, including transition and deactivation. The effort is patterned after the very successful DOE Complex EM Integration effort. Although still in the preliminary stages, the comprehensive onsite integration effort has already reaped benefits. These include identifying significant waste streams that had not been forecast, identifying opportunities for consolidating activities and services to accelerate schedule or save money; and identifying waste streams which currently have no path forward in the planning baseline. Consolidation/integration of planned activities may also provide opportunities for pollution prevention and/or avoidance of secondary waste generation. A workshop was held to review the waste disposition maps, and to identify opportunities with potential cost or schedule savings. Another workshop may be held to follow up on some of the long-term integration opportunities. A change to the Hanford waste forecast data call would help to align the Solid Waste Forecast with the new disposition maps

How do intake clinicians use patient characteristics to select treatment for patients with personality disorders?

Science.gov (United States)

van Manen, Janine; Kamphuis, Jan Henk; Visbach, Geny; Ziegler, Uli; Gerritsen, Ad; Van Rossum, Bert; Rijnierse, Piet; Timman, Reinier; Verheul, Roel

2008-11-01

Treatment selection in clinical practice is a poorly understood, often largely implicit decision process, perhaps especially for patients with personality disorders. This study, therefore, investigated how intake clinicians use information about patient characteristics to select psychotherapeutic treatment for patients with personality disorder. A structured interview with a forced-choice format was administered to 27 experienced intake clinicians working in five specialist mental health care institutes in the Netherlands. Substantial consensus was evident among intake clinicians. The results revealed that none of the presented patient characteristics were deemed relevant for the selection of the suitable treatment setting. The appropriate duration and intensity are selected using severity or personal strength variables. The theoretical orientation is selected using personal strength variables.

[Home treatment--a treatment model of integrated care in Hamburg].

Science.gov (United States)

Schöttle, Daniel; Ruppelt, Friederike; Karow, Anne; Lambert, Martin

2015-03-01

Treatment models like "Crisis Resolution and Hometreatment (CRHT)" or "Assertive Community Treatment" (ACT), were found to be effective, enhancing the qualitative level of treatment for patients with severe mental disorders. In Germany, these are implemented only sporadically until today, often as part of a cross-sectoral Integrated Care (IC) treatment system. We will present the implementation of an "Assertive Community Treatment" embedded into an IC-treatment model in Hamburg and discuss the 3-year-outcomes. The IC-treatment model has been designed for severe mentally ill patients with psychotic disorders. Since May 2007 the model is financed by different health insurances as a managed-care "capitation-model" and its effectiveness gets continuously evaluated. The model proved to be effective in earlier studies were compared with standard care low rates of service disengagement were found as well as significantly improved psychopathology, psychosocial functioning, quality of life, satisfaction with care and adherence, while being cost effective. The rates of involuntary admissions declined to 10% in comparison to the years before. In 2011 the model was specified to the indication "first-episode adolescents and young adults in the age of 12-29" in a government-funded study "Integrated Care in Early Psychosis, ICEP Study". In this study an interdisciplinary team of child, adolescent and adult psychiatrists was implemented and since 2012 it is financed by the involved health insurances throughout an expansion of the §140 SGB V agreement. © Georg Thieme Verlag KG Stuttgart · New York.

Review of the integrated thermal and nonthermal treatment system studies

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-08-01

This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

Review of the integrated thermal and nonthermal treatment system studies

Energy Technology Data Exchange (ETDEWEB)

Durrani, H.A.; Schmidt, L.J.; Erickson, T.A.; Sondreal, E.A.; Erjavec, J.; Steadman, E.N.; Fabrycky, W.J.; Wilson, J.S.; Musich, M.A.

1996-07-01

This report analyzes three systems engineering (SE) studies performed on integrated thermal treatment systems (ITTSs) and integrated nonthermal treatment systems (INTSs) for the remediation of mixed low-level waste (MLLW) stored throughout the US Department of Energy (DOE) weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center (EERC), Science Applications International Corporation (SAIC), the Waste Policy Institute (WPI), and Virginia Tech (VT). The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions taken in the studies might bias the resulting economic evaluations of both thermal and nonthermal systems, (2) identify the critical areas of the studies that would benefit from further investigation, and (3) develop a standard template that could be used in future studies to produce sound SE applications.

Review of the integrated thermal and nonthermal treatment system studies

International Nuclear Information System (INIS)

1996-08-01

This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering

An integrative typology of personality assessment for aggression: implications for predicting counterproductive workplace behavior.

Science.gov (United States)

Bing, Mark N; Stewart, Susan M; Davison, H Kristl; Green, Philip D; McIntyre, Michael D; James, Lawrence R

2007-05-01

This study presents an integrative typology of personality assessment for aggression. In this typology, self-report and conditional reasoning (L. R. James, 1998) methodologies are used to assess 2 separate, yet often congruent, components of aggressive personalities. Specifically, self-report is used to assess explicit components of aggressive tendencies, such as self-perceived aggression, whereas conditional reasoning is used to assess implicit components, in particular, the unconscious biases in reasoning that are used to justify aggressive acts. These 2 separate components are then integrated to form a new theoretical typology of personality assessment for aggression. Empirical tests of the typology were subsequently conducted using data gathered across 3 samples in laboratory and field settings and reveal that explicit and implicit components of aggression can interact in the prediction of counterproductive, deviant, and prosocial behaviors. These empirical tests also reveal that when either the self-report or conditional reasoning methodology is used in isolation, the resulting assessment of aggression may be incomplete. Implications for personnel selection, team composition, and executive coaching are discussed. 2007 APA, all rights reserved

Sojourners' second language learning and integration. The moderating effect of multicultural personality traits

NARCIS (Netherlands)

van Niejenhuis, Coby; Otten, Sabine; Flache, Andreas

This study examines the role of trainable intercultural personality traits in the widely assumed link between immigrants' second language (L2) learning and their cultural integration in the host country. The research was based on data of temporary immigrants (sojourners), being international

The thyroid function of Graves' disease patients is aggravated by depressive personality during antithyroid drug treatment

Directory of Open Access Journals (Sweden)

Miyauchi Akira

2011-08-01

Full Text Available Abstract Background We previously reported that depressive personality (the scores of hypochondriasis, depression and psychasthenia determined by the Minnesota Multiphasic Personality Inventory (MMPI and daily hassles of Graves' disease (GD patients treated long trem with antithyroid drug (ATD were significantly higher in a relapsed group than in a remitted group, even in the euthyroid state. The present study aims to examine the relationship among depressive personality, emotional stresses, thyroid function and the prognosis of hyperthyroidism in newly diagnosed GD patients. Methods Sixty-four untreated GD patients responded to the MMPI for personality traits, the Natsume's Stress Inventory for major life events, and the Hayashi's Daily Life Stress Inventory for daily life stresses before and during ATD treatment. Results In the untreated thyrotoxic state, depressive personality (T-scores of hypochondriasis, depression or psychasthenia greater than 60 points in MMPI were found for 44 patients (69%. For 15 (23% of these patients, the scores decreased to the normal range after treatment. However, depressive personality persisted after treatment in the remaining 29 patients (46%. Normal scores before treatment were found for 20 patients (31%, and the scores were persistently normal for 15 patients (23%. The remaining 5 patients (8% had higher depressive personality after treatment. Such depressive personality was not associated with the severity of hyperthyroidism. Serum TSH receptor antibody activity at three years after treatment was significantly (p = 0.0351 greater in the depression group than in the non- depression group. The remission rate at four years after treatment was significantly (p = 0.0305 lower in the depression group than in the non- depression group (22% vs 52%. Conclusion The data indicate that in GD patients treated with ATD, depressive personality during treatment reflects the effect of emotional stress more than that of

The thyroid function of Graves' disease patients is aggravated by depressive personality during antithyroid drug treatment

Science.gov (United States)

2011-01-01

Background We previously reported that depressive personality (the scores of hypochondriasis, depression and psychasthenia determined by the Minnesota Multiphasic Personality Inventory (MMPI)) and daily hassles of Graves' disease (GD) patients treated long trem with antithyroid drug (ATD) were significantly higher in a relapsed group than in a remitted group, even in the euthyroid state. The present study aims to examine the relationship among depressive personality, emotional stresses, thyroid function and the prognosis of hyperthyroidism in newly diagnosed GD patients. Methods Sixty-four untreated GD patients responded to the MMPI for personality traits, the Natsume's Stress Inventory for major life events, and the Hayashi's Daily Life Stress Inventory for daily life stresses before and during ATD treatment. Results In the untreated thyrotoxic state, depressive personality (T-scores of hypochondriasis, depression or psychasthenia greater than 60 points in MMPI) were found for 44 patients (69%). For 15 (23%) of these patients, the scores decreased to the normal range after treatment. However, depressive personality persisted after treatment in the remaining 29 patients (46%). Normal scores before treatment were found for 20 patients (31%), and the scores were persistently normal for 15 patients (23%). The remaining 5 patients (8%) had higher depressive personality after treatment. Such depressive personality was not associated with the severity of hyperthyroidism. Serum TSH receptor antibody activity at three years after treatment was significantly (p = 0.0351) greater in the depression group than in the non- depression group. The remission rate at four years after treatment was significantly (p = 0.0305) lower in the depression group than in the non- depression group (22% vs 52%). Conclusion The data indicate that in GD patients treated with ATD, depressive personality during treatment reflects the effect of emotional stress more than that of thyrotoxicosis and

Neither Right nor Wrong: How a Teacher Integrates Her Personal and Professional Life with Policy

Science.gov (United States)

Bunten, Bridget A.

2014-01-01

This article focuses on the importance of recognizing and appreciating the ways that a teacher integrates her personal and professional life with an English-only policy. Much can be learned from the ways in which she negotiates social forces and integrates them into her individual reality while making sense of the restrictive language policy.…

Personality factors versus expectations and self-reported symptoms among patients awaiting advanced prosthodontic treatment.

Science.gov (United States)

Hakestam, U; Söderfeldt, B; Rydén, O; Glantz, P O

1997-09-01

To assess simple questions for identifying patient personality traits among a normal Swedish population and to assess possible relationships between personality and symptoms, attitudes, dental problems, and received dental care, a questionnaire was sent to 489 subjects awaiting prosthodontic treatment (response rate 84.2%). Three personality traits could be identified: "Fearful-depressed" subjects consumed more tranquillisers, were worried and had many symptoms, whilst "Open-minded" were optimistic about treatment, had high expectations and few symptoms. "Control-minded" did not reveal worries and guarded their autonomy. It was concluded that personality indicators were related to clinically relevant factors: salience of teeth, perceptions of problems, dental attendance pattern, expectations and perceptions of symptoms.

Integrated treatment process of hazardous and mixed wastes

International Nuclear Information System (INIS)

Shibuya, M.; Suzuki, K.; Fujimura, Y.; Nakashima, T.; Moriya, Y.

1993-01-01

An integrated waste treatment system was studied based on technologies developed for the treatment of liquid radioactive, organic, and aqueous wastes containing hazardous materials and soils contaminated with heavy metals. The system consists of submerged incineration, metal ion fixing and stabilization, and soil washing treatments. Introduction of this system allows for the simultaneous processing of toxic waste and contaminated soils. Hazardous organic wastes can be decomposed into harmless gases, and aqueous wastes can be converted into a dischargeable effluent. The contaminated soil is backfilled after the removal of toxic materials. Experimental data show that the integration system is practical for complicated toxic wastes

Do people with borderline personality disorder complicated by antisocial personality disorder benefit from the STEPPS treatment program?

Science.gov (United States)

Black, Donald W; Simsek-Duran, Fatma; Blum, Nancee; McCormick, Brett; Allen, Jeff

2016-08-01

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment for persons with borderline personality disorder (BPD). We describe results from two data sets on outcome in persons who participated in STEPPS with BPD alone or BPD plus antisocial personality disorder (ASPD). In Study 1, we examined the effect of comorbid ASPD on outcome in 65 persons with BPD who participated in a randomized controlled trial at an academic medical centre. In Study 2, we examined the effect of comorbid ASPD on outcome in 64 offenders with BPD who participated in STEPPS in correctional settings. All subjects were assessed for the presence of BPD and ASPD. In Study 1, subjects with ASPD experienced greater improvement in BPD symptoms, impulsiveness and global symptoms. In Study 2, offenders with ASPD experienced greater improvement in positive and negative behaviours and positive affectivity. We conclude that persons with BPD plus ASPD benefit from STEPPS in community and correctional settings. The findings suggest that persons with BPD plus ASPD show greater improvement in some domains than persons with BPD only. People with ASPD should not be automatically excluded from participation in the program. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

An integrative view of mechanisms underlying generalized spike-and-wave epileptic seizures and its implication on optimal therapeutic treatments.

Directory of Open Access Journals (Sweden)

Boyuan Yan

Full Text Available Many types of epileptic seizures are characterized by generalized spike-and-wave discharges. In the past, notable effort has been devoted to understanding seizure dynamics and various hypotheses have been proposed to explain the underlying mechanisms. In this paper, by taking an integrative view of the underlying mechanisms, we demonstrate that epileptic seizures can be generated by many different combinations of synaptic strengths and intrinsic membrane properties. This integrative view has important medical implications: the specific state of a patient characterized by a set of biophysical characteristics ultimately determines the optimal therapeutic treatment. Through the same view, we further demonstrate the potentiation effect of rational polypharmacy in the treatment of epilepsy and provide a new angle to resolve the debate on polypharmacy. Our results underscore the need for personalized medicine and demonstrate that computer modeling and simulation may play an important role in assisting the clinicians in selecting the optimal treatment on an individual basis.

Personal and clinical social support and adherence to adjuvant endocrine therapy among hormone receptor-positive breast cancer patients in an integrated health care system.

Science.gov (United States)

Kroenke, Candyce H; Hershman, Dawn L; Gomez, Scarlett L; Adams, Sara R; Eldridge, Elizabeth H; Kwan, Marilyn L; Ergas, Isaac J; Kubo, Ai; Kushi, Lawrence H

2018-04-18

We evaluated associations between personal and clinical social support and non-adherence to adjuvant endocrine therapy (AET) in a large, Northern California breast cancer (BC) cohort from an integrated healthcare network. This study included 3382 women from the Pathways Study diagnosed from 2005 to 2013 with stages I-III hormone receptor-positive BC and who responded to the Medical Outcomes Study Social Support and Interpersonal Processes of Care surveys, approximately 2 months post-diagnosis. We used logistic regression to evaluate associations between tertiles of social support and non-initiation (social support (P trend = 0.02). Women with moderate (HR 1.20, 95% CI 0.99-1.45) or low (HR 1.32, 95% CI 1.09-1.60) personal social support were also more likely to discontinue treatment (P trend = 0.01). Furthermore, women with moderate (HR 1.25, 95% CI 1.02-1.53) or low (HR 1.38, 95% CI 1.12-1.70) personal social support had higher non-adherence (P trend = 0.007). Associations with clinical social support and outcomes were similar. Notably, high clinical social support mitigated the risk of discontinuation when patients' personal support was moderate or low (P value = 0.04). Women with low personal or clinical social support had higher AET non-adherence. Clinician teams may need to fill support gaps that compromise treatment adherence.

Assessing Instructional Modalities: Individualized Treatment Effects for Personalized Learning

Science.gov (United States)

Beemer, Joshua; Spoon, Kelly; Fan, Juanjuan; Stronach, Jeanne; Frazee, James P.; Bohonak, Andrew J.; Levine, Richard A.

2018-01-01

Estimating the efficacy of different instructional modalities, techniques, and interventions is challenging because teaching style covaries with instructor, and the typical student only takes a course once. We introduce the individualized treatment effect (ITE) from analyses of personalized medicine as a means to quantify individual student…

Personality and Euroscepticism

DEFF Research Database (Denmark)

Nielsen, Julie Hassing

2016-01-01

and openness positively correlate with positive EU attitudes, while people scoring high on neuroticism tend to support the EU less. Furthermore, I find that personality moderates different EU frames. Individuals with certain personality traits are more influenced by framing effects than others, while positive......Attitudes towards EU integration are widely studied, yet we know only little about the role of personality for EU attitudes. Utilizing a framing experiment encompassing positive and negative frames of EU integration, this article reports on how personality influences attitudes towards EU...... integration, and how personal predispositions moderate framing effects, impacting EU attitude formation. The study relies on Danish and Swedish data (N = 1808). I test both the direct impact of personality on EU attitudes and personality's moderating impact on framing effects. I find that extraversion...

Sexual desire in trans persons: associations with sex reassignment treatment.

Science.gov (United States)

Wierckx, Katrien; Elaut, Els; Van Hoorde, Birgit; Heylens, Gunter; De Cuypere, Griet; Monstrey, Stan; Weyers, Steven; Hoebeke, Piet; T'Sjoen, Guy

2014-01-01

Sex steroids and genital surgery are known to affect sexual desire, but little research has focused on the effects of cross-sex hormone therapy and sex reassignment surgery on sexual desire in trans persons. This study aims to explore associations between sex reassignment therapy (SRT) and sexual desire in a large cohort of trans persons. A cross-sectional single specialized center study including 214 trans women (male-to-female trans persons) and 138 trans men (female-to-male trans persons). Questionnaires assessing demographics, medical history, frequency of sexual desire, hypoactive sexual desire disorder (HSDD), and treatment satisfaction. In retrospect, 62.4% of trans women reported a decrease in sexual desire after SRT. Seventy-three percent of trans women never or rarely experienced spontaneous and responsive sexual desire. A third reported associated personal or relational distress resulting in a prevalence of HSDD of 22%. Respondents who had undergone vaginoplasty experienced more spontaneous sexual desire compared with those who planned this surgery but had not yet undergone it (P = 0.03). In retrospect, the majority of trans men (71.0%) reported an increase in sexual desire after SRT. Thirty percent of trans men never or rarely felt sexual desire; 39.7% from time to time, and 30.6% often or always. Five percent of trans men met the criteria for HSDD. Trans men who were less satisfied with the phalloplasty had a higher prevalence of HSDD (P = 0.02). Trans persons who were more satisfied with the hormonal therapy had a lower prevalence of HSDD (P = 0.02). HSDD was more prevalent in trans women compared with trans men. The majority of trans women reported a decrease in sexual desire after SRT, whereas the opposite was observed in trans men. Our results show a significant sexual impact of surgical interventions and both hormonal and surgical treatment satisfaction on the sexual desire in trans persons. © 2013 International Society for Sexual

Proposal of a service delivery integration index of home care for older persons: application in several European cities.

NARCIS (Netherlands)

Henrard, J.C.; Ankri, J.; Frijters, D.; Carpenter, I.; Topinkova, E.; Garms-Homolova, V.; Finne-Soveri, H.; Wergeland Sorbye, L.; Jonsson, P.V.; Ljunggren, G.; Schroll, M.; Wagner, C.; Bernabei, R.

2006-01-01

PURPOSE: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. THEORY: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure

Examining Acceptance of an Integrated Personal Health Record (PHR)

Science.gov (United States)

Morton, Alicia A.

2011-01-01

Objective: The purpose of this project was to examine the practice question, "What are the factors influencing acceptance of integrated PHRs for self-care management among the Howard University Hospital (HUH) Diabetes Treatment Clinic (DTC) patients?" These factors include a) demographic characteristics, b) computer…

Personality and mental health treatment: Traits as predictors of presentation, usage, and outcome.

Science.gov (United States)

Thalmayer, Amber Gayle

2018-03-08

Self-report scores on personality inventories predict important life outcomes, including health and longevity, marital outcomes, career success, and mental health problems, but the ways they predict mental health treatment have not been widely explored. Psychotherapy is sought for diverse problems, but about half of those who begin therapy drop out, and only about half who complete therapy experience lasting improvements. Several authors have argued that understanding how personality traits relate to treatment could lead to better targeted, more successful services. Here self-report scores on Big Five and Big Six personality dimensions are explored as predictors of therapy presentation, usage, and outcomes in a sample of community clinic clients (N = 306). Participants received evidence-based treatments in the context of individual-, couples-, or family-therapy sessions. One measure of initial functioning and three indicators of outcome were used. All personality trait scores except Openness associated with initial psychological functioning. Higher Conscientiousness scores predicted more sessions attended for family therapy but fewer for couples-therapy clients. Higher Honesty-Propriety and Extraversion scores predicted fewer sessions attended for family-therapy clients. Better termination outcome was predicted by higher Conscientiousness scores for family- and higher Extraversion scores for individual-therapy clients. Higher Honesty-Propriety and Neuroticism scores predicted more improvement in psychological functioning in terms of successive Outcome Questionnaire-45 administrations. Taken together, the results provide some support for the role of personality traits in predicting treatment usage and outcome and for the utility of a 6-factor model in this context. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Avoidant personality disorder as a social anxiety phenotype: risk factors, associations and treatment.

Science.gov (United States)

Lampe, Lisa

2016-01-01

This article identifies research trends and synthesizes information from recent studies of avoidant personality disorder (AVPD). AVPD and social anxiety disorder (SAD) share genetic vulnerability, but may have distinct environmental risk factors that shape qualitative differences. Negative self-concept, shame proneness, and interpersonal hypersensitivity are characteristic of AVPD and may be predisposed to by heritable traits of high negative affectivity and low positive affectivity, and experiences of neglectful or emotionless parents. The interpersonal difficulties of AVPD may be associated with both anxious and avoidant attachment. Most individuals with AVPD do not also meet criteria for SAD. Integrative treatments incorporating cognitive behavioral strategies effective in SAD but also targeting shame aversion and avoidance may be most helpful for AVPD. Therapy adapted to both anxious attachment, associated with heightened interpersonal sensitivity and distress, and avoidant attachment, associated with experiential avoidance, may be optimal, though this is yet to be tested. Effective treatment of AVPD may enhance the outcome of comorbid conditions. More research is needed which compares three social anxiety groups (SAD alone, AVPD alone, and SAD plus AVPD) to further explore these disorders which are highly related, but which may have differences that are clinically relevant for individuals.

Likelihood ratio-based integrated personal risk assessment of type 2 diabetes.

Science.gov (United States)

Sato, Noriko; Htun, Nay Chi; Daimon, Makoto; Tamiya, Gen; Kato, Takeo; Kubota, Isao; Ueno, Yoshiyuki; Yamashita, Hidetoshi; Fukao, Akira; Kayama, Takamasa; Muramatsu, Masaaki

2014-01-01

To facilitate personalized health care for multifactorial diseases, risks of genetic and clinical/environmental factors should be assessed together for each individual in an integrated fashion. This approach is possible with the likelihood ratio (LR)-based risk assessment system, as this system can incorporate manifold tests. We examined the usefulness of this system for assessing type 2 diabetes (T2D). Our system employed 29 genetic susceptibility variants, body mass index (BMI), and hypertension as risk factors whose LRs can be estimated from openly available T2D association data for the Japanese population. The pretest probability was set at a sex- and age-appropriate population average of diabetes prevalence. The classification performance of our LR-based risk assessment was compared to that of a non-invasive screening test for diabetes called TOPICS (with score based on age, sex, family history, smoking, BMI, and hypertension) using receiver operating characteristic analysis with a community cohort (n = 1263). The area under the receiver operating characteristic curve (AUC) for the LR-based assessment and TOPICS was 0.707 (95% CI 0.665-0.750) and 0.719 (0.675-0.762), respectively. These AUCs were much higher than that of a genetic risk score constructed using the same genetic susceptibility variants, 0.624 (0.574-0.674). The use of ethnically matched LRs is necessary for proper personal risk assessment. In conclusion, although LR-based integrated risk assessment for T2D still requires additional tests that evaluate other factors, such as risks involved in missing heritability, our results indicate the potential usability of LR-based assessment system and stress the importance of stratified epidemiological investigations in personalized medicine.

Traits and states: Integrating personality and affect into a model of criminal decision making

NARCIS (Netherlands)

van Gelder, J.L.; de Vries, R.E.

2012-01-01

We propose and test a model of criminal decision making that integrates the individual differences perspective with research and theorizing on proximal factors. The individual differences perspective is operationalized using the recent HEXACO personality structure. This structure incorporates the

Individual Music Therapy with Persons with Frontotemporal Dementia

DEFF Research Database (Denmark)

Ridder, Hanne Mette Ochsner

2007-01-01

It is possible to slow down the progression of Alzheimer's disease with pharmacological treatment. When this treatment is given to people with types of dementia that affect the frontal and temporal lobes (Frontotemporal Dementia) the results are discouraging. It is observed that the patients show...... is an integration of a relational music therapy approach and a more physiologically based arousal model, and is here illustrated in a case study that integrated both qualitative and quantitative data in a flexible research design1 ....... pronounced restlessness and mania. In this article we describe a nonpharmacological psychosocial approach, music therapy, and how it is possible to work with this method when constitutional, regulative, dialogical, and integrative aspects are included. The focus is on therapeutic singing where well......-known songs are applied in order to build up structure and stability and/or as means of arousal regulation. Songs with personal meaning make it possible to acknowledge the person's emotions, breaking the social isolation, and meeting the music therapy participant's psychosocial needs. The clinical approach...

Horticulture Therapy for Persons with Dementia; Effects on Engagement and Affect

OpenAIRE

Gigliotti, Christina Marie

2003-01-01

The purpose of this paper is to integrate and synthesize the literature from the fields of Horticulture Therapy (HT) and therapeutic activities for persons with dementia using the theory of environmental press Utilizing horticulture as a treatment modality, the therapist can either modify the environment or the personâ s competence level or both to assist persons to reach the desired Adaptation Level (AL). The AL represents an appropriate person-environment fit, and attainment of this zon...

The effect of sports on level of community integration as reported by persons with spinal cord injury.

Science.gov (United States)

Hanson, C S; Nabavi, D; Yuen, H K

2001-01-01

The purpose of this study was to determine whether participation in sports by persons with spinal cord injuries (SCIs) affected level of community integration as defined by the World Health Organization and as measured by the Craig Handicap Assessment and Reporting Technique (CHART). Forty-eight participants were recruited from a camp for persons with physical disabilities as well as from SCI support groups. Participants were divided into groups of athletes (n = 30) and nonathletes (n = 18) on the basis of their self-reported level of sports participation. Athletes scored significantly higher on four of five subsections of the CHART (physical independence, mobility, occupation, social integration), indicating greater levels of community integration than nonathletes. These findings extend the literature outlining the physical and psychological benefits of sports. Occupational therapists have a unique opportunity to use the occupation of sports to integrate the roots of the profession with the cultural demands of society.

Advance statements for borderline personality disorder: a qualitative study of future crisis treatment preferences.

Science.gov (United States)

Borschmann, Rohan; Trevillion, Kylee; Henderson, R Claire; Rose, Diana; Szmukler, George; Moran, Paul

2014-06-01

Little is known about the crisis treatment preferences of people with borderline personality disorder. Clinicians may also question service users' ability to make considered decisions about their treatment when in crisis. Therefore, this qualitative study aimed to investigate crisis treatment preferences of a sample of community-dwelling adults with borderline personality disorder. Participants were 41 adults with borderline personality disorder who had created joint crisis plans during a randomized controlled trial. Data from all 41 joint crisis plans were analyzed iteratively via a thematic analysis framework. Participants gave clear statements in their crisis plans relating to the desire to recover from the crisis and to improve their social functioning. Key themes included the desire to be treated with dignity and respect and to receive emotional and practical support from clinicians. Many participants spoke of the importance of connecting with others during periods of crisis, but several reported a clear desire to be left alone during a future crisis. Other themes concerned preferences for specific treatment refusals during crises, including particular types of psychotropic medication and involuntary treatment. The variation of participants' preferences underscores the importance of developing individually tailored crisis plans for people with borderline personality disorder. The need to be treated with dignity and respect and to be given autonomy in decision making--also identified in global surveys of people with severe mental illness--is important to people with borderline personality disorder. Key messages for clinicians, service users, and policy makers, in addition to staff training issues, are discussed.

Historical personalities of the Cuban education. A reflection necesary

Directory of Open Access Journals (Sweden)

Yordan Nápoles-Ramírez

2017-04-01

Full Text Available Along the History of the Cuban education, the teaching and the learning of the life and work of the historical personalities has constituted a priority. However, the tendency has prevailed to alone to approach in the different teaching levels the historical personalities from a political-military focus, without conceiving an integrative treatment that embraces other spheres of the social activity. Equal limitations exist in reconstructing the historical context where the same ones were developed and to analyze their narrow one with the diverse social sectors that accompanied her. The present article seeks to demonstrate the necessity to transform the treatment of the historical personalities at the present time. 

History of the treatment of persons with psychological difficulties and the abuse of their civil rights

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Petrović Nikola M.

2013-01-01

Full Text Available Treatment of persons with psychological difficulties varied in different historical periods, but in its essence remained similar until today. It included an inhumane relationship towards these persons, involuntary treatment through torture, and isolation from society as a kind of punishment for their diversity. It was not until the late 19th century that the relationship of society towards these individuals started to improve gradually, but in the 21st century isolation of these individuals still remained the dominant form of acceptable social solution for the “problem”, with a somewhat more humane attitude towards them and less cruel treatment. Serbia has followed the trends of treatment of the persons with psychological difficulties from the rest of Europe for centuries, but is still lagging behind the world in the introduction of new methods of treatment. Indeed the first legal solution to regulate the human rights of these people is currently in the process of implementation. The subject of this paper is the treatment of persons with psychological difficulties and the violation of their civil rights. In a subject specific context the goal of the analysis was the historical review of the treatment towards persons with psychological difficulties by doctors, other practicioners and the community in general, with reference to the current situation regarding their treatment within the psychiatric institutions, as well as the legal regulations and the protection of their civil rights.

Integrating Personal Development and Career Planning: The Outcomes for First Year Undergraduate Learning

Science.gov (United States)

Monks, Kathy; Conway, Edel; Dhuigneain, Muireann Ni

2006-01-01

This article describes the way in which colleagues from the Business faculty, the Careers Service and the Library at Dublin City University collaborated to design and deliver an integrated approach to personal development planning (PDP) with the aim of motivating first year undergraduate students to take greater responsibility for their own…

Relationship between personality traits and perceived internalized stigma in bipolar patients and their treatment partners.

Science.gov (United States)

Bassirnia, Anahita; Briggs, Jessica; Kopeykina, Irina; Mednick, Amy; Yaseen, Zimri; Galynker, Igor

2015-12-15

Internalized stigma of mental disorders has significant negative outcomes for patients with bipolar disorder and their families. The aim of this study is to evaluate the association between personality traits and internalized stigma of mental disorders in bipolar patients and their treatment partners. Five different questionnaires were utilized in this study: (1) Demographic data questionnaire, (2) Millon Clinical Multiaxial Inventory-III (MCMI-III) for personality traits, (3) Internalized Stigma of Mental Illness (ISMI) for stigma, (4) Self Report Manic Inventory (SRMI) for mania and (5) Center for Epidemiological Studies-Depression Scale (CES-D) for depression. The scores of personality traits were combined to create externalizing and internalizing personality trait scores. Results showed that patients with bipolar disorder and their treatment partners both experienced internalized stigma of mental health disorders. There was a significant positive correlation between internalized stigma and internalizing personality traits, but not externalizing traits. In a multi-variate regression analysis, internalizing personality trait score was found to be a significant predictor of internalized stigma. In conclusion, patients with bipolar disorder and their treatment partners perceive higher level of internalized stigma of mental disorders if they have internalizing personality traits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Integrating tuberculosis/HIV treatment: an evaluation of the ...

African Journals Online (AJOL)

Results: Seventy-four per cent of patients completed their treatment and 26% were cured, with no defaults or deaths, in the tubercuolosis/HIV integrated cohort. Thirty-eight per cent completed their treatment, 45% were cured, 9% died and another 9% defaulted in the cohort receiving their tuberculosis treatment at a local ...

Treatment Integrity in a Home-Based Pre-Reading Intervention Programme

Science.gov (United States)

van Otterloo, Sandra G.; van der Leij, Aryan; Veldkamp, Esther

2006-01-01

Treatment integrity is an underexposed issue in the phonological awareness intervention research. The current study assessed the integrity of treatment of the families (N = 32) participating in the experimental condition of a home-based pre-reading intervention study. The participating kindergartners were all genetically at risk for developing…

Integrating tuberculosis/HIV treatment: an evaluation of the ...

African Journals Online (AJOL)

2013-01-25

Jan 25, 2013 ... Scientific Letter: Integrating tuberculosis/HIV treatment: 479. Vol 55 No 5. SA Fam Pract 2013 treatment outcomes were applied where “cured” refers to patients with sputum conversion and “completed” to patients who completed treatment but did not meet the criteria for cure or failure – this includes patient ...

Medicolegal aspects of hospital treatment of violent mentally ill persons

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Jovanović Aleksandar

2009-01-01

Full Text Available Introduction. This paper deals with medicolegal aspects of the hospital treatment of patients suffering from severe mental disorders and who are prone to violent behavior, dangerous to self and others. Violent acts in this study were defined as deliberate and nonconsensual acts of actual, attempted or threatened harm to a person or persons, and classified into categories of any type of violence, physical violence and nonphysical violence, which is in accordance with approaches used in other risk assessment researches. Outline of Cases. The authors present four cases of mentally ill inpatients whose violent behavior toward self or other persons resulted in self-destruction and physical aggression against other persons. The presented cases involved: 1 selfinjury in a patient with acute organic mental disorder after jumping through a hospital window, 2 suicide by drowning of a patient with acute mental disorder after escaping from intensive care unit, 3 suicide in a depressive patient after escaping from a low-security psychiatry unit, 4 physical violence against body and life of other persons in a patient with chronic mental disorder. Conclusion. The presented cases are considered to be rare in clinical practice and risk of violent behavior and the consequent danger of mentally ill inpatients may be efficiently predicted and prevented with appropriate hospital management based on 1 repeated escalation of violent behavior and 2 protection of the patient and others. Hence, if the physician, in order to prevent harmful consequences, does not apply all the necessary measures, including appropriate diagnostic and therapeutic procedures, as well as treatment in an adequate setting, such act is against the Criminal Law of the Republic of Serbia which sanctions physician's negligence. Also, according to the Law on Obligations of the Republic of Serbia this presents a legal ground for damage claim and the requirement of liability for nonmaterial damage

Personality Development

Directory of Open Access Journals (Sweden)

Osman Ozdemir

2012-12-01

Full Text Available Personality is the integration of characteristics acquired or brought by birth which separate the individual from others. Personality involves aspects of the individual's mental, emotional, social, and physical features in continuum. Several theories were suggested to explain developmental processes of personality. Each theory concentrates on one feature of human development as the focal point, then integrates with other areas of development in general. Most theories assume that childhood, especially up to 5-6 years, has essential influence on development of personality. The interaction between genetic and environmental factors reveals a unique personality along growth and developmental process. It could be said that individual who does not have any conflict between his/her basic needs and society's, has well-developed and psychologically healthy personality.

Occlusal features and need for orthodontic treatment in persons with osteogenesis imperfecta

Science.gov (United States)

Binh, Ho Duy; Nguyen, Khac Minh; Maasalu, Katre; Kõks, Sulev; Märtson, Aare; Saag, Mare; Jagomägi, Triin

2017-01-01

Abstract The aim of the study was to (a) analyse dental occlusion and determine the need for orthodontic treatment of persons with osteogenesis imperfecta (OI) in comparison with the healthy population and (b) investigate the associations between OI and malocclusion. A case‐control study included 26 OI persons and 400 healthy participants (control group). Occlusal features and the need for orthodontic treatment were defined according to Dental Health Component‐Index of Orthodontic Treatment Need and Dental Aesthetic Index. Results showed that Angle Class I, II, and III relationship was found in 23.1%, 3.8%, and 73.1% of OI group, and in the control group, it was 67%, 17.5%, and 15.5%, respectively. OI group had significantly higher prevalence of reverse overjet >1 mm (76.9%), missing teeth (42.3%), posterior crossbite (34.6%), and open bite >2 mm (19.2%) compared to the control group (8.5%, 2.2%, 6.2%, and 3.5%, respectively). OI group had less incisal segment crowding and more incisal segment spacing than the control group (p  1 mm (OR = 13.3, 95% CI = 3.9–44.7, p < .001), Angle Class III malocclusion (OR = 8.0, 95% CI = 2.0–30.8, p = .003), and missing teeth (OR = 4.7, 95% CI = 1.0–22.4, p = .049). In conclusion, there is the high probability of malocclusion in OI persons. Persons with OI require early orthodontic treatment because of significant correlation of OI disease with Angle Class III malocclusion, reverse overjet, and missing teeth. PMID:29744175

Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study

Directory of Open Access Journals (Sweden)

Ethy Dorrepaal

2013-11-01

Full Text Available Background: In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD and personality disorders (PDs are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. Objective: In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. Method: In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive (N=14 with the non-adaptive patients (N=24 as revealed by a cluster analysis. Results: We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles “withdrawn” and “aggressive,” were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Conclusion: Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.

An integrative examination of general personality dysfunction in a large community sample.

Science.gov (United States)

Hengartner, Michael Pascal; De Fruyt, Filip; Rodgers, Stephanie; Müller, Mario; Rössler, Wulf; Ajdacic-Gross, Vladeta

2014-10-01

Recently, the severity of general personality dysfunction has gained broad interest in personality disorder (PD) research. We analysed data of 511 participants aged 20-41 years from a comprehensive psychiatric survey in the general population of Zurich, Switzerland. We added the trait-scores from all DSM-IV PDs, as assessed by a self-report questionnaire, to provide a measure of general personality dysfunction. Adjusting for the Big Five personality domains as a proxy for stylistic PD elements, this composite PD score exhibited strong associations with neuroticism and schizotypy. General personality dysfunction additionally revealed a moderate detrimental association with psychosocial functioning and a strong effect on coping resources, on heavy drinking and drug use and on most psychopathological syndromes. Of particular interest is the strong association with total psychopathological distress and co-occurrence of multiple disorders, suggesting that increasing PD severity relates to the degree of global impairment independent of specific PD traits. Discussed herein are implications for public mental health policies, classification, conceptualization and treatment of PDs. Copyright © 2014 John Wiley & Sons, Ltd.

Developing integrated health and social care services for older persons in Europe.

Science.gov (United States)

Leichsenring, Kai

2004-01-01

This paper is to distribute first results of the EU Fifth Framework Project 'Providing integrated health and social care for older persons-issues, problems and solutions' (PROCARE-http://www.euro.centre.org/procare/). The project's first phase was to identify different approaches to integration as well as structural, organisational, economic and social-cultural factors and actors that constitute integrated and sustainable care systems. It also served to retrieve a number of experiences, model ways of working and demonstration projects in the participating countries which are currently being analysed in order to learn from success-or failure-and to develop policy recommendations for the local, national and European level. The paper draws on existing definitions of integrated care in various countries and by various scholars. Given the context of an international comparative study it tries to avoid providing a single, ready-made definition but underlines the role of social care as part and parcel of this type of integrated care in the participating countries. The paper is based on national reports from researchers representing ten organisations (university institutes, consultancy firms, research institutes, the public and the NGO sector) from 9 European countries: Austria, Denmark, Finland, France, Germany, Greece, Italy, the Netherlands, and the UK. Literature reviews made intensive use of grey literature and evaluation studies in the context of at least five model ways of working in each country. As a result of the cross-national overview an attempt to classify different approaches and definitions is made and indicators of relative importance of the different instruments used in integrating health and social care services are provided. The cross-national overview shows that issues concerning co-ordination and integration of services are high on the agenda in most countries. Depending on the state of service development, various approaches and instruments can be

Internalizing and externalizing personality subtypes predict differences in functioning and outcomes among veterans in residential substance use disorder treatment.

Science.gov (United States)

Blonigen, Daniel M; Bui, Leena; Britt, Jessica Y; Thomas, Katherine M; Timko, Christine

2016-10-01

There is a long history of using personality to subtype patients in treatment for substance use disorders (SUD). However, no one has validated a typology of SUD patients using a structural model of normal-range personality, particularly indicating whether subtypes differ on treatment processes and outcomes. We developed a personality-based typology among 196 military veterans enrolled in residential SUD treatment at a Veterans Affairs medical center. Patients were assessed at treatment entry, 1 month into treatment, and at discharge from treatment. Personality was assessed using the Multidimensional Personality Questionnaire-Brief Form at treatment entry. Latent profile analyses identified a 3-group solution consisting of low pathology, internalizing, and externalizing groups. The internalizing group scored lowest on measures of functioning at treatment entry, whereas the externalizing group scored more poorly on treatment processes and outcomes over the course of their residential stay (e.g., more stressful relationships with other residents, lower program alliance). These findings support a clinically meaningful typology of SUD patients based on a 3-factor model of personality and can serve as a guide for future efforts aimed at developing targeted interventions that can address the individual differences of patients in this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Addressing narcissistic personality features in the context of medical care: integrating diverse perspectives to inform clinical practice.

Science.gov (United States)

Magidson, J F; Collado-Rodriguez, A; Madan, A; Perez-Camoirano, N A; Galloway, S K; Borckardt, J J; Campbell, W K; Miller, J D

2012-04-01

Narcissistic personality disorder (NPD) is characterized by an unrealistic need for admiration, lack of empathy toward others, and feelings of superiority. NPD presents a unique and significant challenge in clinical practice, particularly in medical settings with limited provider contact time, as health professionals treat individuals who often require excessive admiration and have competing treatment needs. This practice review highlights real case examples across three distinct medically oriented clinical settings (inpatient and outpatient behavioral medicine and a Level I trauma center) to demonstrate the difficult and compromising situations that providers face when treating patients with general medical conditions and comorbid narcissistic personality features. The main goal of this article is to discuss the various challenges and obstacles associated with these cases in medical settings and discuss some strategies that may prove successful. A second goal is to bridge diverse conceptualizations of narcissism/NPD through the discussion of theoretical and empirical perspectives that can inform understanding of the clinical examples. Despite differing perspectives regarding the underlying motivation of narcissistic behavior, this practice review highlights that these paradigms can be integrated when sharing the same ultimate goal: to improve delivery of care across medically oriented clinical settings for patients with narcissistic features.

Owning Up to Negative Ingroup Traits: How Personal Autonomy Promotes the Integration of Group Identity.

Science.gov (United States)

Legault, Lisa; Weinstein, Netta; Mitchell, Jahlil; Inzlicht, Michael; Pyke, Kristen; Upal, Afzal

2017-10-01

Our experiences, attributes, and behaviors are diverse, inconsistent, and often negative. Consequently, our capacity to assimilate divergent experiences-particularly negative aspects-is important to the development of a unified self. Whereas this process of integration has received attention at the level of personal identity, it has not been assessed at the level of group identity. We examined the mechanisms involved in integrating positive and negative ingroup identities, as well as related outcomes. In three experiments, participants (N = 332) high and low in autonomy identified either positive or negative aspects of their ingroup and then indicated the extent to which they integrated the attribute. Those high in personal autonomy integrated both positive and negative identities, whereas those low in autonomy acknowledged only positive identities. Study 2 showed that, regardless of identity valence, those high in autonomy felt satisfied and close with their group. Conversely, those low in autonomy felt less close and more dissatisfied with their group after reflecting on negative identities. Finally, reflecting on a negative identity reduced prejudice, but only for those high in autonomy. Owning up to negative group traits is facilitated by autonomy and demonstrates benefits for ingroup and intergroup processes. © 2016 Wiley Periodicals, Inc.

Becoming who you are: An integrative review of self-determination theory and personality systems interactions theory.

Science.gov (United States)

Koole, Sander L; Schlinkert, Caroline; Maldei, Tobias; Baumann, Nicola

2018-03-10

One of the enduring missions of personality science is to unravel what it takes to become a fully functioning person. In the present article, the authors address this matter from the perspectives of self-determination theory (SDT) and personality systems interactions (PSI) theory. SDT (a) is rooted in humanistic psychology; (b) has emphasized a first-person perspective on motivation and personality; (c) posits that the person, supported by the social environment, naturally moves toward growth through the satisfaction of basic psychological needs for autonomy, competence, and relatedness. PSI theory (a) is rooted in German volition psychology; (b) has emphasized a third-person perspective on motivation and personality; and (c) posits that a fully functioning person can form and enact difficult intentions and integrate new experiences, and that such competencies are facilitated by affect regulation. The authors review empirical support for SDT and PSI theory, their convergences and divergences, and how the theories bear on recent empirical research on internalization, vitality, and achievement flow. The authors conclude that SDT and PSI theory offer complementary insights into developing a person's full potential. © 2018 The Authors. Journal of Personality Published by Wiley Periodicals, Inc.

Personality, Stressful Life Events, and Treatment Response in Major Depression

Science.gov (United States)

Bulmash, Eric; Harkness, Kate L.; Stewart, Jeremy G.; Bagby, R. Michael

2009-01-01

The current study examined whether the personality traits of self-criticism or dependency moderated the effect of stressful life events on treatment response. Depressed outpatients (N = 113) were randomized to 16 weeks of cognitive-behavioral therapy, interpersonal psychotherapy, or antidepressant medication (ADM). Stressful life events were…

Integral treatment of children with dyslexia - 40 years experience

Directory of Open Access Journals (Sweden)

Stošljević Miodrag

2012-01-01

Full Text Available Introduction. Dyslexia represents a significant pediatric problem requiring prompt and appropriate treatment. Objective. The aim of this study was to examine the significance of integral rehabilitation approach in treating dyslexia of children. Methods. Objectives of the study were accomplished on a sample of 300 children, aged 11-15 years, with etiologically variable dyslexia. Results. The results gained from the integral treatment of children with dyslexia were more successful than those obtained from isolated logaoedic treatment, when compared in 10-15 examined variables; replacement of graphically similar letters (p=0.000, replacement of syllables (p=0.010, replacement of words - guessing (p=0.019, structural errors - displacement or insertion (p=0.038, adding letters and syllables (p=0.001, repeating of word parts (p=0.001, reading of a word in several wrong ways (p=0.001, omission of words and whole lines (p=0.000, returning to already read line (p=0.000, level of dyslexia (p=0.000. Conclusion. Dyslexia requires a multidisciplinary therapeutic approach in which integral rehabilitation treatment has an exceptionally large significance.

Integrated Risk Framework for Onsite Wastewater Treatment Systems

Science.gov (United States)

Carroll, Steven; Goonetilleke, Ashantha; Thomas, Evan; Hargreaves, Megan; Frost, Ray; Dawes, Les

2006-08-01

Onsite wastewater treatment systems (OWTS) are becoming increasingly important for the treatment and dispersal of effluent in new urbanised developments that are not serviced by centralised wastewater collection and treatment systems. However, the current standards and guidelines adopted by many local authorities for assessing suitable site and soil conditions for OWTS are increasingly coming under scrutiny due to the public health and environmental impacts caused by poorly performing systems, in particular septic tank-soil adsorption systems. In order to achieve sustainable onsite wastewater treatment with minimal impacts on the environment and public health, more appropriate means of assessment are required. This paper highlights an integrated risk based approach for assessing the inherent hazards associated with OWTS in order to manage and mitigate the environmental and public health risks inherent with onsite wastewater treatment. In developing a sound and cohesive integrated risk framework for OWTS, several key issues must be recognised. These include the inclusion of relevant stakeholders throughout framework development, the integration of scientific knowledge, data and analysis with risk assessment and management ideals, and identification of the appropriate performance goals for successful management and mitigation of associated risks. These issues were addressed in the development of the risk framework to provide a generic approach to assessing risk from OWTS. The utilisation of the developed risk framework for achieving more appropriate assessment and management techniques for OWTS is presented in a case study for the Gold Coast region, Queensland State, Australia.

Confidentiality and personal integrity.

Science.gov (United States)

Edgar, A

1994-06-01

This paper uses the social theory of Erving Goffman in order to argue that confidentiality should be understood in relation to the mundane social skills by which individuals present and respect specific self-images of themselves and others during social interaction. The breaching of confidentiality is analysed in terms of one person's capacity to embarrass another, and so to expose that person as incompetent. Respecting confidentiality may at once serve to protect the vulnerable from an unjust society, and yet also protect the guilty from just accusation. Ethical reasoning about confidentiality must therefore recognize the dangers of prejudice and violence inherent in decisions to breach or to respect confidentiality. Case studies are used to illustrate the efficacy of this account, culminating with analyses of three examples from the UKCC document Confidentiality.

[Reflections on mentalization-based treatment and its adaptation for men presenting a narcissistic personality disorder and a not otherwise specified personality disorder].

Science.gov (United States)

Cherrier, Jean-François

2013-01-01

Narcissistic personality disorder (NPD) and not otherwise specified personality disorder (borderline and narcissistic) are major mental health problems for men. These pathologies predispose patients to significant relational difficulties which are characterised by intense reactions to perceived threats to the self-esteem and an impaired empathic ability. Understanding these disorders as affect dysregulation stimulated by shame, the author presents how patients in this context are prone to lose their capacity to mentalize. This article describes a specific individual and group mentalization-based treatment and its implementation for treating narcissistic men. Different reflections on the treatment, on empathy, as well as on the adaptation of this treatment for NPD patients are presented and illustrated with clinical vignettes.

Participation and integration from the perspective of persons with spinal cord injury from five European countries.

Science.gov (United States)

Ruoranen, Kaisa; Post, Marcel W M; Juvalta, Sibylle; Reinhardt, Jan D

2015-03-01

To examine the subjective understanding of participation and integration of persons with spinal cord injuries from 5 European countries and to compare these findings with the International Classification of Functioning, Disability and Health (ICF)'s conceptualization of participation. Semi-structured interviews with 54 persons with acquired spinal cord injuries and 3 with spina bifida from 5 countries were examined using qualitative content analysis. Integration was most often associated with social acceptance and, furthermore, with ordinary performance, equality and freedom of choice. Participation was most often described as ordinary performance, with less emphasis on social acceptance and equality. However, participation and integration overlapped in people's narratives and were difficult to separate. The perception of participation and integration was largely similar across countries. In contrast to others, however, Finnish interviewees were more likely to associate participation with contributing to society. A variety of life domains was identified, of which recreation and leisure, work life, sports and going out were the most prevalent. While participation domains are well covered by the ICF, as is the notion of ordinary performance, interviewees also referred to a rights (e.g. acceptance) and duties (e.g. contribution) perspective.

Evaluation of changes in prescription medication use after a residential treatment programme for borderline personality disorder.

Science.gov (United States)

Broadbear, Jillian H; Nesci, Julian; Thomas, Rosemary; Thompson, Katherine; Beatson, Josephine; Rao, Sathya

2016-12-01

Residential patients diagnosed with borderline personality disorder were evaluated to determine whether borderline personality disorder-focused psychotherapy reduced prescribing, personality disorder and co-morbid symptom severity. Psychotropic prescriptions were measured at admission, discharge and 1 year later in 74 female participants with one or more personality disorder diagnosis and co-morbid mood disorders. Changes in pharmacotherapy were examined in the context of improvements in borderline personality disorder and/or co-morbid disorder symptom severity. Residential treatment included individual and group psychotherapy for borderline personality disorder. The Structured Clinical Interview for DSM-IV was used to confirm the borderline personality disorder diagnosis and associated co-morbid conditions. The Beck Depression Inventory was completed at each time point. A significant reduction in the incidence and severity of self-rated depression as well as clinician assessed personality disorder, including borderline personality disorder, was accompanied by a reduction in prescription of psychoactive medications. Three to six months of intensive borderline personality disorder-specific psychotherapy showed lasting benefit with regard to symptom severity of personality disorders (borderline personality disorder in particular) as well as depressive symptoms. This improvement corresponded with a reduction in prescriptions for psychoactive medications, which is consistent with current thinking regarding treatment for borderline personality disorder. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Evaluation of person-level heterogeneity of treatment effects in published multiperson N-of-1 studies: systematic review and reanalysis.

Science.gov (United States)

Raman, Gowri; Balk, Ethan M; Lai, Lana; Shi, Jennifer; Chan, Jeffrey; Lutz, Jennifer S; Dubois, Robert W; Kravitz, Richard L; Kent, David M

2018-05-26

Individual patients with the same condition may respond differently to similar treatments. Our aim is to summarise the reporting of person-level heterogeneity of treatment effects (HTE) in multiperson N-of-1 studies and to examine the evidence for person-level HTE through reanalysis. Systematic review and reanalysis of multiperson N-of-1 studies. Medline, Cochrane Controlled Trials, EMBASE, Web of Science and review of references through August 2017 for N-of-1 studies published in English. N-of-1 studies of pharmacological interventions with at least two subjects. Citation screening and data extractions were performed in duplicate. We performed statistical reanalysis testing for person-level HTE on all studies presenting person-level data. We identified 62 multiperson N-of-1 studies with at least two subjects. Statistical tests examining HTE were described in only 13 (21%), of which only two (3%) tested person-level HTE. Only 25 studies (40%) provided person-level data sufficient to reanalyse person-level HTE. Reanalysis using a fixed effect linear model identified statistically significant person-level HTE in 8 of the 13 studies (62%) reporting person-level treatment effects and in 8 of the 14 studies (57%) reporting person-level outcomes. Our analysis suggests that person-level HTE is common and often substantial. Reviewed studies had incomplete information on person-level treatment effects and their variation. Improved assessment and reporting of person-level treatment effects in multiperson N-of-1 studies are needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Summary of comparative results integrated nonthermal treatment and integrated thermal treatment systems studies

International Nuclear Information System (INIS)

1996-12-01

In July 1994, the Idaho National Engineering Laboratory (INEL), under a contract from U.S. Department of Energy's (DOE) Environment Management Office of Science and Technology (OST, EM-50) published a report entitled open-quotes Integrated Thermal Treatment System Study - Phase 1 Resultsclose quotes (EGG-MS-11211). This report was the culmination of over a year of analysis involving scientists and engineers within the DOE complex and from private industry. The purpose of that study was open-quotes to conduct a systematic engineering evaluation of a variety of mixed low level waste (MLLW) treatment system alternatives.close quotes The study also open-quotes identified the research and development, demonstrations, and testing and evaluation needed to assure unit operability in the most promising alternative system.close quotes This study evaluated ten primary thermal treatment technologies, organized into complete open-quotes cradle-to-graveclose quotes systems (including complete engineering flow sheets), to treat DOE MLLW and calculated mass balances and 20-year total life cycle costs (TLCC) for all systems. The waste input used was a representative heterogenous mixture of typical DOE MLLW. An additional study was conducted, and then, based on response to these studies, additional work was started to investigate and evaluate non-thermal treatment options on a footing comparable to the effort devoted to thermal options. This report attempts to present a summary overview of the thermal and non-thermal treatment technologies which were examined in detail in the process of the above mentioned reviews

Integrating the Differentiated: A Review of the Personal Construct Approach to Cognitive Complexity

OpenAIRE

Kovářová, M. (Marie); Filip, M. (Miroslav)

2015-01-01

This article reviews personal construct psychology (PCP) research on cognitive complexity. It examines conceptual foundations, measures of cognitive complexity, and a large body of empirical findings. It identifies several ambiguities in the conceptualization of the two components of cognitive complexity: differentiation and integration. These ambiguities lead to inconsistent interpretations of indexes proposed for their measurement and consequently to an inconsistent interpretation of em...

Modified Therapeutic Community Treatment for Offenders with MICA Disorders: Antisocial Personality Disorder and Treatment Outcomes

Science.gov (United States)

McKendrick, Karen; Sullivan, Christopher; Banks, Steven; Sacks, Stanley

2006-01-01

Treatment outcomes 1 year after release from prison were compared for two subgroups of male inmates with co-occurring serious mental illness and chemical abuse (MICA) disorders, those with a diagnosis for Antisocial Personality Disorder (APD), and those without a diagnosis of APD. The foundation study had randomly assigned inmates to either…

The treatment of personality disorder in Jamaica with psychohistoriographic brief psychotherapy.

Science.gov (United States)

Hickling, F W

2013-01-01

To assess the clinical outcome of patients with personality disorder, receiving treatment with psychohistoriographic brief psychotherapy (PBP). Patients seen in the author's private practice from 1974-2010 with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) personality disorder diagnosis were treated with PBP. Demographic, clinical responses and one-year clinical outcome measures were disaggregated and analysed, using SPSS, version 17. One hundred patients completed treatment with PBP, male:female 34:64; mean age of 35.86 ± 10.28 (range 16 - 66) years. Forty-five per cent were married, 73% were of predominantly African racial origin, with 59% from socio-economic class (SEC) I and 39% from SEC II and III. The presenting complaints were interpersonal conflict (35%), anxiety (21%) and depressed mood (20%). Major depression (30%), substance abuse disorder (18%) and generalized anxiety disorder (13%) were the most common Axis I diagnoses. Histrionic personality disorder (39%) and avoidant personality disorder (35%) were the main Axis II diagnoses. Psychohistoriography was completed with all patients, and charted by 96%. Transference variants were experienced by all patients and worked through with 87%. The quadranting process was completed by 42% with goal setting instituted by 96% and actualization scoring fully completed by 34%. A continuous exercise programme was instituted by all patients, and was maintained by 56% at one-year follow-up. Ninety-four per cent reported fair (10%), good (68%) to very good/excellent (16%) improvement on completion of PBP, with 72% assessed as maintaining fair to good clinical improvement by the therapist at one-year follow-up. Patients with personality disorders showed clinical improvement one year after being treated with psychohistoriographic brief psychotherapy.

A Test of an Integrative Model Using Social Factors and Personality Traits: Prediction on the Delinquency of South Korean Youth.

Science.gov (United States)

Yun, Minwoo; Kim, Eunyoung; Park, Woong-Sub

2017-08-01

To more fully comprehend juvenile delinquency, it is necessary to take an integrative approach, with consideration of both personality traits of social risk factors. Many scholars argue the necessity and strength of integrative approach on the ground that juvenile delinquency is an outcome of interplay of individual and social factors. The present study examines the general applicability of an integrative model of personal traits and social risk factors to youth delinquency in the South Korean context. The empirical results show that the delinquency predictors in the current South Korean sample are closely aligned to Loeber and Farrington's theoretical propositions and that found in Western nations. Perhaps this is because South Korea has undergone rapid Westernization for the last decades. Because the correlates in this sample and Western theoretical propositions and studies overlap, an integrative model of personality trait and social risk factors is indeed generally applicable to South Korea. This finding also depicts the extent of Westernization in the South Korean society at least among adolescents. Limitations of the present study and directions for the future study are discussed.

Treatment of pathological gambling - integrative systemic model.

Science.gov (United States)

Mladenović, Ivica; Lažetić, Goran; Lečić-Toševski, Dušica; Dimitrijević, Ivan

2015-03-01

Pathological gambling was classified under impulse control disorders within the International Classification of Diseases (ICD-10) (WHO 1992), but the most recent Diagnostic and Statistical Manual, 5th edition (DSM-V), (APA 2013), has recognized pathological gambling as a first disorder within a new diagnostic category of behavioral addictions - Gambling disorder. Pathological gambling is a disorder in progression, and we hope that our experience in the treatment of pathological gambling in the Daily Hospital for Addictions at The Institute of Mental Health, through the original "Integrative - systemic model" would be of use to colleagues, dealing with this pathology. This model of treatment of pathological gambling is based on multi-systemic approach and it primarily represents an integration of family and cognitive-behavioral therapy, with traces of psychodynamic, existential and pharmacotherapy. The model is based on the book "Pathological gambling - with self-help manual" by Dr Mladenovic and Dr Lazetic, and has been designed in the form of a program that lasts 10 weeks in the intensive phase, and then continues for two years in the form of "extended treatment" ("After care"). The intensive phase is divided into three segments: educational, insight with initial changes and analysis of the achieved changes with the definition of plans and areas that need to be addressed in the extended treatment. "Extended treatment" lasts for two years in the form of group therapy, during which there is a second order change of the identified patient, but also of other family members. Pathological gambling has been treated in the form of systemic-family therapy for more than 10 years at the Institute of Mental Health (IMH), in Belgrade. For second year in a row the treatment is carried out by the modern "Integrative-systemic model". If abstinence from gambling witihin the period of one year after completion of the intensive phase of treatment is taken as the main criterion of

The 'antisocial' person: an insight in to biology, classification and current evidence on treatment

Directory of Open Access Journals (Sweden)

Rajapakse Senaka

2010-07-01

Full Text Available Abstract Background This review analyses and summarises the recent advances in understanding the neurobiology of violence and empathy, taxonomical issues on defining personality disorders characterised by disregard for social norms, evidence for efficacy of different treatment modalities and ethical implications in defining 'at-risk' individuals for preventive interventions. Methods PubMed was searched with the keywords 'antisocial personality disorder', 'dissocial personality disorder' and 'psychopathy'. The search was limited to articles published in English over the last 10 years (1999 to 2009 Results Both diagnostic manuals used in modern psychiatry, the Diagnostic and Statistical Manual published by the American Psychiatric Association and the International Classification of Diseases published by the World Health Organization, identify a personality disorder sharing similar traits. It is termed antisocial personality disorder in the diagnostic and statistical manual and dissocial personality disorder in the International Classification of Diseases. However, some authors query the ability of the existing manuals to identify a special category termed 'psychopathy', which in their opinion deserves special attention. On treatment-related issues, many psychological and behavioural therapies have shown success rates ranging from 25% to 62% in different cohorts. Multisystemic therapy and cognitive behaviour therapy have been proven efficacious in many trials. There is no substantial evidence for the efficacy of pharmacological therapy. Currently, the emphasis is on early identification and prevention of antisocial behaviour despite the ethical implications of defining at-risk children. Conclusions Further research is needed in the areas of neuroendocrinological associations of violent behaviour, taxonomic existence of psychopathy and efficacy of treatment modalities.

Arts Integration: A Strategy to Improve Teaching and Learning, Promote Personal Competencies, and Turn Around Low-Performing Schools

Science.gov (United States)

Biscoe, Belinda; Wilson, Kirk

2015-01-01

This paper connects the dots between arts integration, students' personal competencies, and school turnaround. Its thesis is that by intertwining art forms and methods with content in all subject areas, students learn more about art and the other subjects and build their personal competencies for learning. The paper includes the story of an…

A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

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Tillman, Jane G

2008-01-01

Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach.

Motivation for treatment in patients with substance use disorder: personal volunteering versus legal/familial enforcement

Directory of Open Access Journals (Sweden)

Bilici R

2014-08-01

Full Text Available Rabia Bilici,1 Esra Yazici,2 Ali Evren Tufan,3 Elif Mutlu,4 Filiz İzci,1 Görkem Karakas Ugurlu5 1Erenkoy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul; 2Sakarya University, Medical Faculty, Department of Psychiatry, Sakarya, 3Abant Izzet Baysal University, Medical Faculty, Department of Child and Adolescent Psychiatry, Bolu, 4Bakirköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, 5Yildirim Beyazit University, Medical Faculty, Department of Psychiatry, Ankara, Turkey Background: Motivation for treatment on the part of patients with addictive disorders is known to affect their prognosis, and lack thereof is reported to be among the most common reasons for failed treatment adherence and relapse after treatment. This study evaluated the relationship between volunteering, personality, demographic factors, and motivation for treatment. Methods: The study was conducted at a substance dependence center in the eastern part of Turkey. Forty-five patients (mean age 37.9±11.2 years with a substance use disorder were included. They were assessed using the Structured Clinical Interview for DSM (Diagnostic and Statistical Manual of Mental Disorders Axis II disorders. Depression and anxiety were evaluated using the Beck depression and anxiety inventories, and motivation for treatment was measured using the Turkish version of the Texas Christian University Motivation for Treatment scale. Results: All patients had been using substances daily and 41 (88.9% had been using multiple drugs. The most commonly used substance was heroin (n=18, 40%. Voluntary admission was a predictor of motivation for treatment (P<0.05. Having a personality disorder and higher depression scores were related to less motivation for treatment. Conclusion: Motivation for treatment is affected by external factors such as type of admission and internal factors such as personality disorder and

Incorporating Applied Behavior Analysis to Assess and Support Educators' Treatment Integrity

Science.gov (United States)

Collier-Meek, Melissa A.; Sanetti, Lisa M. H.; Fallon, Lindsay M.

2017-01-01

For evidence-based interventions to be effective for students they must be consistently implemented, however, many teachers struggle with treatment integrity and require support. Although many implementation support strategies are research based, there is little empirical guidance about the types of treatment integrity, implementers, and contexts…

Removal of Pharmaceutical and Personal Care Products (PPCPs) from Municipal Waste Water with Integrated Membrane Systems, MBR-RO/NF.

Science.gov (United States)

Wang, Yonggang; Wang, Xu; Li, Mingwei; Dong, Jing; Sun, Changhong; Chen, Guanyi

2018-02-05

This study focuses on the application of combining membrane bioreactor (MBR) treatment with reverse osmosis (RO) or nanofiltration (NF) membrane treatment for removal of pharmaceuticals and personal care products (PPCPs) in municipal wastewater. Twenty-seven PPCPs were measured in real influent with lowest average concentration being trimethoprim (7.12 ng/L) and the highest being caffeine (18.4 ng/L). The results suggest that the MBR system effectively removes the PPCPs with an efficiency of between 41.08% and 95.41%, and that the integrated membrane systems, MBR-RO/NF, can achieve even higher removal rates of above 95% for most of them. The results also suggest that, due to the differences in removal mechanisms of NF/RO membrane, differences of removal rates exist. In this study, the combination of MBR-NF resulted in the removal of 13 compounds to below detection limits and MBR-RO achieved even better results with removal of 20 compounds to below detection limits.

[Integrity].

Science.gov (United States)

Gómez Rodríguez, Rafael Ángel

2014-01-01

To say that someone possesses integrity is to claim that that person is almost predictable about responses to specific situations, that he or she can prudentially judge and to act correctly. There is a closed interrelationship between integrity and autonomy, and the autonomy rests on the deeper moral claim of all humans to integrity of the person. Integrity has two senses of significance for medical ethic: one sense refers to the integrity of the person in the bodily, psychosocial and intellectual elements; and in the second sense, the integrity is the virtue. Another facet of integrity of the person is la integrity of values we cherish and espouse. The physician must be a person of integrity if the integrity of the patient is to be safeguarded. The autonomy has reduced the violations in the past, but the character and virtues of the physician are the ultimate safeguard of autonomy of patient. A field very important in medicine is the scientific research. It is the character of the investigator that determines the moral quality of research. The problem arises when legitimate self-interests are replaced by selfish, particularly when human subjects are involved. The final safeguard of moral quality of research is the character and conscience of the investigator. Teaching must be relevant in the scientific field, but the most effective way to teach virtue ethics is through the example of the a respected scientist.

Review of the integrated thermal and nonthermal treatment system studies. Final report

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-10-01

This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1 -- issued July 1994; Integrated Thermal Treatment System Study, Phase 2 -- issued February 1996; and Integrated Nonthermal Treatment System Study -- drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

Review of the integrated thermal and nonthermal treatment system studies. Topical Report

International Nuclear Information System (INIS)

Durrani, H.A.; Schmidt, L.J.; Erickson, T.A.; Sondreal, E.A.; Erjavec, J.; Steadman, E.N.; Fabrycky, W.J.; Wilson, J.S.; Musich, M.A.

1996-07-01

This report analyzes three systems engineering (SE) studies performed on integrated thermal treatment systems (ITTSs) and integrated nonthermal treatment systems (INTSs) for the remediation of mixed low-level waste (MLLW) stored throughout the US Department of Energy (DOE) weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center (EERC), Science Applications International Corporation (SAIC), the Waste Policy Institute (WPI), and Virginia Tech (VT). The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions taken in the studies might bias the resulting economic evaluations of both thermal and nonthermal systems, (2) identify the critical areas of the studies that would benefit from further investigation, and (3) develop a standard template that could be used in future studies to produce sound SE applications

Review of the integrated thermal and nonthermal treatment system studies. Final report

International Nuclear Information System (INIS)

1996-10-01

This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1 -- issued July 1994; Integrated Thermal Treatment System Study, Phase 2 -- issued February 1996; and Integrated Nonthermal Treatment System Study -- drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering

Dimensions of personality structure among patients with substance use disorders and co-occurring personality disorders: a comparison with psychiatric outpatients and healthy controls.

Science.gov (United States)

Di Pierro, Rossella; Preti, Emanuele; Vurro, Nicoletta; Madeddu, Fabio

2014-08-01

Although dual diagnosis has been a topic of great scientific interest for a long time, few studies have investigated the personality traits that characterize patients suffering from substance use disorders and co-occurring personality disorders through a dimensional approach. The present study aimed to evaluate structural personality profiles among dual-diagnosis inpatients to identify specific personality impairments associated with dual diagnosis. The present study involved 97 participants divided into three groups: 37 dual-diagnosis inpatients, 30 psychiatric outpatients and 30 nonclinical controls. Dimensions of personality functioning were assessed and differences between groups were tested using Kernberg's dimensional model of personality. Results showed that dual diagnosis was associated with the presence of difficulties in three main dimensions of personality functioning. Dual-diagnosis inpatients reported a poorly integrated identity with difficulties in the capacity to invest, poorly integrated moral values, and high levels of self-direct and other-direct aggression. The present study highlighted that a dimensional approach to the study of dual diagnosis may clarify the personality functioning of patients suffering from this pathological condition. The use of the dimensional approach could help to advance research on dual diagnosis, and it could have important implications on clinical treatment programs for dual-diagnosis inpatients. Copyright © 2014 Elsevier Inc. All rights reserved.

Research on monitoring and management information integration technique in waste treatment and management

International Nuclear Information System (INIS)

Kong Jinsong; Yu Ren; Mao Wei

2013-01-01

The integration of the waste treatment process and the device status monitoring information and management information is a key problem required to be solved in the information integration of the waste treatment and management. The main content of the monitoring and management information integration is discussed in the paper. The data exchange techniques, which are based on the OPC, FTP and data push technology, are applied to the different monitoring system respectively, according to their development platform, to realize the integration of the waste treatment process and device status monitoring information and management information in a waste treatment center. (authors)

Personality and Differential Treatment Response in Major Depression: A Randomized Controlled Trial Comparing Cognitive-Behavioural Therapy and Pharmacotherapy

Science.gov (United States)

Bagby, R Michael; Quilty, Lena C; Segal, Zindel V; McBride, Carolina C; Kennedy, Sidney H; Costa, Paul T

2008-01-01

Objective Effective treatments for major depressive disorder exist, yet some patients fail to respond, or achieve only partial response. One approach to optimizing treatment success is to identify which patients are more likely to respond best to which treatments. The objective of this investigation was to determine if patient personality characteristics are predictive of response to either cognitive-behavioural therapy (CBT) or pharmacotherapy (PHT). Method Depressed patients completed the Revised NEO Personality Inventory, which measures the higher-order domain and lower-order facet traits of the Five-Factor Model of Personality, and were randomized to receive either CBT or PHT. Result Four personality traits—the higher-order domain neuroticism and 3 lower-order facet traits: trust, straightforwardness, and tendermindedness—were able to distinguish a differential response rate to CBT, compared with PHT. Conclusion The assessment of patient dimensional personality traits can assist in the selection and optimization of treatment response for depressed patients. PMID:18616856

Process-integrated slag treatment; Prozessintegrierte Schlackebehandlung

Energy Technology Data Exchange (ETDEWEB)

Koralewska, R.; Faulstich, M. [Technische Univ., Garching (Germany). Lehrstuhl fuer Wasserguete- und Abfallwirtschaft

1998-09-01

The present study compares two methods of washing waste incineration slag, one with water only, and one which uses additives during wet deslagging. The presented aggregate offers ideal conditions for process-integrated slag treatment. The paper gives a schematic description of the integrated slag washing process. The washing liquid serves to wash out the readily soluble constituents and remove the fines, while the additives are for immobilising heavy metals in the slag material. The study is based on laboratory and semi-technical trials on the wet chemical treatment of grate slag with addition of carbon dioxide and phosphoric acid. [Deutsch] Die dargestellten Untersuchungen beziehen sich auf den Vergleich zwischen einer Waesche der Muellverbrennungsschlacke mit Wasser und unter Zugabe von Additiven im Nassentschlacker. In diesem Aggregat bieten sich optimale Voraussetzungen fuer eine prozessintegrierte Schlackebehandlung. Die Durchfuehrung der integrierten Schlackewaesche wird schematisch gezeigt. Durch die Waschfluessigkeit sollen die leichtloeslichen Bestandteile ausgewaschen und die Feinanteile ausgetragen sowie durch die Additive zusaetzlich die Schwermetalle im Schlackematerial immobilisiert werden. Dazu erfolgten Labor- und halbtechnische Versuche zur nasschemischen Behandlung der Rostschlacken unter Zugabe von Kohlendioxid und Phosphorsaeure. (orig./SR)

A randomised controlled trial of mentalization-based treatment versus structured clinical management for patients with comorbid borderline personality disorder and antisocial personality disorder.

Science.gov (United States)

Bateman, Anthony; O'Connell, Jennifer; Lorenzini, Nicolas; Gardner, Tessa; Fonagy, Peter

2016-08-30

Antisocial personality disorder (ASPD) is an under-researched mental disorder. Systematic reviews and policy documents identify ASPD as a priority area for further treatment research because of the scarcity of available evidence to guide clinicians and policymakers; no intervention has been established as the treatment of choice for this disorder. Mentalization-based treatment (MBT) is a psychotherapeutic treatment which specifically targets the ability to recognise and understand the mental states of oneself and others, an ability shown to be compromised in people with ASPD. The aim of the study discussed in this paper is to investigate whether MBT can be an effective treatment for alleviating symptoms of ASPD. This paper reports on a sub-sample of patients from a randomised controlled trial of individuals recruited for treatment of suicidality, self-harm, and borderline personality disorder. The study investigates whether outpatients with comorbid borderline personality disorder and ASPD receiving MBT were more likely to show improvements in symptoms related to aggression than those offered a structured protocol of similar intensity but excluding MBT components. The study found benefits from MBT for ASPD-associated behaviours in patients with comorbid BPD and ASPD, including the reduction of anger, hostility, paranoia, and frequency of self-harm and suicide attempts, as well as the improvement of negative mood, general psychiatric symptoms, interpersonal problems, and social adjustment. MBT appears to be a potential treatment of consideration for ASPD in terms of relatively high level of acceptability and promising treatment effects. ISRCTN ISRCTN27660668 , Retrospectively registered 21 October 2008.

The Prevalence of Comorbid Personality Disorders in Treatment-Seeking Problem Gamblers: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Dowling, Nicki A; Cowlishaw, S; Jackson, A C; Merkouris, S S; Francis, K L; Christensen, D R

2015-12-01

The aim of this study was to systematically review and meta-analyze the prevalence of comorbid personality disorders among treatment-seeking problem gamblers. Almost one half (47.9%) of problem gamblers displayed comorbid personality disorders. They were most likely to display Cluster B disorders (17.6%), with smaller proportions reporting Cluster C disorders (12.6%) and Cluster A disorders (6.1%). The most prevalent personality disorders were narcissistic (16.6%), antisocial (14.0%), avoidant (13.4%), obsessive-compulsive (13.4%), and borderline (13.1%) personality disorders. Sensitivity analyses suggested that these prevalence estimates were robust to the inclusion of clinical trials and self-selected samples. Although there was significant variability in reported rates, subgroup analyses revealed no significant differences in estimates of antisocial personality disorder according to problem gambling severity, measure of comorbidity employed, and study jurisdiction. The findings highlight the need for gambling treatment services to conduct routine screening and assessment of co-occurring personality disorders and to provide treatment approaches that adequately address these comorbid conditions.

Pathological gambling and age: differences in personality, psychopathology, and response to treatment variables.

Science.gov (United States)

González-Ibáñez, A; Mora, M; Gutiérrez-Maldonado, J; Ariza, A; Lourido-Ferreira, M R

2005-02-01

The aim of this study was to ascertain the possible differences in personality, psychopathology, and response to treatment in pathological gambling according to age. The sample, comprising 67 participants, was divided into three groups: 32.6% with ages ranging between 17 and 26 years, 31.3% between 27 and 43 years, and 35.8% over 44 years of age. The participants were administered the following tests, Minnesota Multiphasic Personality Inventory [MMPI; Hathaway, S.R. & McKinley, J.C. (1943, 1961). Cuestionario de personalidad MMPI. Madrid Seccion de Estudios de TEA ed. 1970, 1975], sensation-seeking questionnaire [SSS; Zuckerman, M. (1979). Sensation seeking; beyond the optimal level of arousal. Hillsdale, NJ: Lawrence Erlbaum Associates], and the Symptom Check List Revised [SCL-90-R; Derogatis, L.R. (1977). Symptom check list-90 revised. Administration scoring and procedures manual. Baltimore]. All underwent a group treatment programme that was carried out in the Pathological Gambling Unit at Ciutat Sanitaria i Universitaria de Bellvitge (CSUB), Teaching hospital, Barcelona, Spain. The findings show differences depending on age in the participants' personality and in psychopathology and in their response to treatment.

Treatment outcomes for inpatients with obsessive-compulsive personality disorder: An open comparison trial.

Science.gov (United States)

Smith, Ryan; Shepard, Christopher; Wiltgen, Anika; Rufino, Katrina; Fowler, J Christopher

2017-02-01

The current case-control study compared rates of clinically significant and reliable change in psychopathology and global functioning, prevalence of clinical deterioration, and rates of symptom remission among adult patients with obsessive compulsive personality disorder OCPD (n=52) and well-matched inpatients with any other personality disorder (n=56) and no personality disorder (n=53). Propensity score matching (PSM) was utilized to select patients matched on specific criteria present in the OCPD group. Multivariate analysis of variance models measured differences in admission functioning and RCI change across depression and anxiety severity, emotion dysregulation and suicidal ideation. Patients diagnosed with OCPD admit to treatment with higher rates of depression, anxiety, difficulty with emotion regulation and non-acceptance of emotional experience than inpatient controls. Furthermore, OCPD patients respond to treatment at a similar rate to inpatient controls, but experience lower rates of anxiety remission upon discharge. Post-hoc analyses indicate individuals meeting stubbornness and rigidity (OCPD Criteria 8) were nine times more likely to report moderate to severe anxiety at point of discharge. Limitations include a predominantly Caucasian, inpatient sample, use of self-report measures and a non-manualized treatment approach. Overall, OCPD inpatients benefit from an intensive multimodal psychiatric treatment, but experience more anxiety than non-PD patients upon discharge. Copyright © 2016 Elsevier B.V. All rights reserved.

The relation between antisocial and borderline personality symptoms and early maladaptive schemas in a treatment seeking sample of male substance users.

Science.gov (United States)

Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L

2014-01-01

Individuals with substance use disorders are more likely to have antisocial and borderline personality disorder than non-substance abusers. Recently, research has examined the relations between early maladaptive schemas and personality disorders, as early maladaptive schemas are believed to underlie personality disorders. However, there is a dearth of research on the relations between early maladaptive schemas and personality disorders among individuals seeking treatment for substance abuse. The current study examined the relations among early maladaptive schemas and antisocial and borderline personality within in a sample of men seeking substance abuse treatment (n = 98). Results demonstrated that early maladaptive schema domains were associated with antisocial and borderline personality symptoms. Implications of these findings for substance use treatment and research are discussed. Antisocial (ASPD) and Borderline (BPD) personality disorder symptoms are prevalence among individuals seeking substance abuse treatment. Early maladaptive schemas are believed to underlie the development of ASPD and BPD symptoms, and are also prevalence among individuals seeking substance use treatment. Findings from the current study suggest that specific early maladaptive schema domains predict ASPD and BPD symptoms in a substance abuse treatment seeking sample of adult males. The treatment of ASPD and BPD among men seeking substance use treatment may want to focus on early maladaptive schemas. Copyright © 2013 John Wiley & Sons, Ltd.

Awareness and treatment of alcohol dependence in Japan: results from internet-based surveys in persons, family, physicians and society.

Science.gov (United States)

Taguchi, Yurie; Takei, Yoshiyuki; Sasai, Ryoko; Murteira, Susana

2014-01-01

To understand current awareness of, and views on, treatment of alcohol dependence in Japan. (a) Nationwide internet-based survey of 520 individuals, consisting of 52 diagnosed alcohol-dependent (AD) persons, 154 potentially alcohol-dependent (ADP) persons, 104 family members and 106 friends/colleagues of AD persons, and 104 general individuals, derived from a consumer panel where the response rate was 64.3%. We enquired into awareness about the treatment of alcohol dependence and patient pathways through the healthcare network. (b) Nationwide internet-based survey of physicians (response rate 10.1% (2395/23,695) to ask 200 physicians about their management of alcohol use disorders). We deduced that 10% of alcohol-dependent Japanese persons had ever been diagnosed with alcohol dependence, with only 3% ever treated. Regarding putative treatment goals, 20-25% of the AD and ADP persons would prefer to attempt to abstain, while 60-75% preferred 'reduced drinking.' A half of the responding physicians considered abstinence as the primary treatment goal in alcohol dependence, while 76% considered reduced drinking as an acceptable goal. AD and ADP persons in Japan have low 'disease awareness' defined as 'understanding of signs, symptoms and consequences of alcohol use disorders,' which is in line with the overseas situation. The Japanese drinking culture and stigma toward alcohol dependence may contribute to such low disease awareness and current challenging treatment environment. While abstinence remains the preferred treatment goal among physicians, reduced drinking seems to be an acceptable alternative treatment goal to many persons and physicians in Japan. © The Author 2014. Medical Council on Alcohol and Oxford University Press.

Maternal personality and psychopathology as determinants of parenting behavior: a quantitative integration of two parenting literatures.

Science.gov (United States)

McCabe, Jennifer E

2014-05-01

A substantial literature has examined the association between parenting behavior and maternal psychological characteristics (i.e., personality and psychopathology). Although research has provided evidence indicating that personality and psychopathology are not independent of one another, parenting research has mainly focused on these characteristics separately. In the present study, I quantitatively integrated these literatures through meta-analytic path analysis. First, meta-analyses were conducted on articles, book chapters, and dissertations that examined associations between personality or psychopathology and warmth or control in mothers of children age 12 months or older. Using mixed-effects regression, meta-analyses revealed significant, small effect sizes suggesting that low levels of neuroticism and psychopathology and high levels of agreeableness, extraversion, and conscientiousness were associated with adaptive parenting. Moderator analyses indicated that variability among individual studies was partially explained by report method, study design, and conceptualizations of parenting behavior. Meta-analytic path analyses showed that the observed associations between maternal personality/psychopathology and parenting behaviors as reported in the literature may be explained by variance shared among these psychological characteristics. Furthermore, some maternal psychological characteristics explained a significantly larger portion of variance in parenting behavior than others. Findings supported the proposal that maternal personality and psychopathology are not independent in the associations they demonstrate with parenting behaviors and that these areas of research can be integrated. The present study is limited by including only mothers, excluding infants, and using cross-sectional analyses. However, results have implications for future conceptualizations of maternal psychological characteristics as determinants of parenting behaviors and for the refinement

Narcissistic personality disorder: a current review.

Science.gov (United States)

Ronningstam, Elsa

2010-02-01

The diagnosis of narcissistic personality disorder in the DSM-IV has been criticized foremost for its limitations in capturing the range and complexity of narcissistic pathology. The attention to the narcissistic individual's external, symptomatic, or social interpersonal patterns--at the expense of his or her internal complexity and individual suffering--has also added to the diagnosis' low clinical utility and limited guidance for treatment. Recent studies and reviews have pointed to the need for change in the diagnostic approach to and formulation of narcissism. This review focuses specifically on studies of features that add to the identification, understanding, and treatment of patients with pathological narcissistic functioning and narcissistic personality disorder. They have been integrated into a regulatory model that includes the functions and fluctuations of internal control, self-esteem, perfectionism with accompanying self-criticism, shame, and empathic ability and functioning.

Influence of personality on the outcome of treatment in depression: systematic review and meta-analysis.

Science.gov (United States)

Newton-Howes, Giles; Tyrer, Peter; Johnson, Tony; Mulder, Roger; Kool, Simone; Dekker, Jack; Schoevers, Robert

2014-08-01

There continues to be debate about the influence of personality disorder on the outcome of depressive disorders and is relative interactions with treatment. To determine whether personality disorder, both generically and in terms of individual clusters, leads to a worse outcome in patients with depressive disorders and whether this is influenced by type of treatment, a systematic electronic search of MEDLINE, CINAHL, and PsycINFO from 1966, 1982, and 1882, respectively, until February 2007 was undertaken. The keyword terms depression, mental illness, and personality disorder were used. All references were reviewed and personal correspondence was undertaken. Only English language papers were considered. Any English language paper studying a depressed adult population was considered for inclusion. Studies needed to clearly define depression and personality disorder using peer-reviewed instruments or International Classification of Disease/Diagnostic Statistical Manual criteria. Outcome assessment at greater than 3 weeks was necessary. Final inclusion papers were agreed on by consensus by at least two reviewers. All data were extracted using predetermined criteria for depression by at least two reviewers in parallel. Disagreement was settled by consensus. Complex data extraction was confirmed within the study group. Data were synthesized using log odds ratios in the Cochrane RevMan 5 program. The finding of comorbid personality disorder and depression was associated with a more than double the odds of a poor outcome for depression compared with those with no personality disorder (OR 2.16, CI 1.83-2.56). This effect was not ameliorated by the treatment modality used for the depressive disorder. This finding led to the conclusion that personality disorder has a negative impact on the outcome of depression. This finding is important in considering prognosis in depressive disorders.

Integrated anaerobic/aerobic biological treatment for intensive swine production.

Science.gov (United States)

Bortone, Giuseppe

2009-11-01

Manure processing could help farmers to effectively manage nitrogen (N) surplus load. Many pig farms have to treat wastewater. Piggery wastewater treatment is a complex challenge, due to the high COD and N concentrations and low C/N ratio. Anaerobic digestion (AD) could be a convenient pre-treatment, particularly from the energetic view point and farm income, but this causes further reduction of C/N ratio and makes denitrification difficult. N removal can only be obtained integrating anaerobic/aerobic treatment by taking into account the best use of electron donors. Experiences gained in Italy during development of integrated biological treatment approaches for swine manure, from bench to full scale, are reported in this paper. Solid/liquid separation as pre-treatment of raw manure is an efficient strategy to facilitate liquid fraction treatment without significantly lowering C/N ratio. In Italy, two full scale SBRs showed excellent efficiency and reliability. Current renewable energy policy and incentives makes economically attractive the application of AD to the separated solid fraction using high solid anaerobic digester (HSAD) technology. Economic evaluation showed that energy production can reduce costs up to 60%, making sustainable the overall treatment.

The costs and cost-effectiveness of an integrated sepsis treatment protocol.

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Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

2008-04-01

Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

Integrated Personal Health and Care Services deployment: Experiences in eight European countries

DEFF Research Database (Denmark)

Villalba, Elena; Casas, Isabel; Abadie, Fabienne

2013-01-01

conditions for mainstreaming these services into care provision. Methods: We conducted a qualitative analysis of 27 Telehealth, Telecare and Integrated Personal Health System projects, implemented across 20 regions in eight European countries. The analysis was based on Suter’s ten key principles...... mechanisms, interoperable information systems, policy commitment, engaged professionals, national investments and funding programmes, and incentives and financing. Conclusion: In those cases which provided evidence of success beyond the pilot stage, we observed a promising trend: awareness and introduction...

SSRI treatment of borderline personality disorder: A randomized, placebo-controlled clinical trial for female patients with borderline personality disorder

NARCIS (Netherlands)

Rinne, Thomas; van den Brink, Wim; Wouters, Luuk; van Dyck, Richard

2002-01-01

Objective: Selective serotonin reuptake inhibitors (SSRIs) are recommended for treatment of affect lability, impulsivity, and aggression in patients with borderline personality disorder. This recommendation is based on positive findings in at least 10 open studies and one small double-blind study of

Do personality traits predict outcome of psychodynamically oriented psychosomatic inpatient treatment beyond initial symptoms?

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Steinert, Christiane; Klein, Susanne; Leweke, Frank; Leichsenring, Falk

2015-03-01

Whether personality characteristics have an impact on treatment outcome is an important question in psychotherapy research. One of the most common approaches for the description of personality is the five-factor model of personality. Only few studies investigated whether patient personality as measured with the NEO-Five-Factor Inventory (NEO-FFI, Costa & McCrae [1992b]. Revised NEO-PI-R and NEO-FFI. Professional manual. Odessa, FL: Psychological Assessment Recources) predicts outcome. Results were inconsistent. Studies reporting personality to be predictive of outcome did not control for baseline symptoms, while studies controlling initial symptoms could not support these findings. We hypothesized that after taking into account baseline symptoms, the NEO-FFI would not predict outcome and tested this in a large sample of inpatients at a psychosomatic clinic. Naturalistic, non-controlled study using patients' data for multiple regression analysis to identify predictors of outcome. Data of 254 inpatients suffering primarily from depressive, anxiety, stress, and somatoform disorders were analysed. Personality was assessed at the beginning of therapy. For psychotherapy outcome, changes in anxiety and depression (Hospital Anxiety and Depression Scale; HADS), overall psychopathology (Symptom Checklist-90-R Global Severity Index [GSI]), and interpersonal problems (Inventory of Interpersonal Problems; IIP) were measured. The treatment resulted in significant decreases on all outcome measures corresponding to moderate to large effect sizes (HADS: d = 1.03; GSI: d = 0.90; IIP: d = 0.38). Consistent with our hypothesis, none of the personality domains predicted outcome when baseline symptoms were controlled for. Personality assessment at baseline does not seem to have an added value in the prediction of inpatient psychotherapy outcome beyond initial symptoms. Clinical implications Personality dimensions overlap with symptomatic distress. Rather than serve as predictors of

Changes in neurotic personality profile associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

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Rodziński, Paweł; Rutkowski, Krzysztof; Sobański, Jerzy A; Mielimąka, Michał; Murzyn, Agnieszka; Cyranka, Katarzyna; Dembińska, Edyta; Grządziel, Karolina; Klasa, Katarzyna; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna

2015-01-01

Analysis of associations between changes in neurotic personality profile and reductionof suicidal ideation (SI) - or lack of such reduction - defined as its elimination or reduction of its intensity in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men treated due to neurotic, behavioral or personality disorders in a day hospital between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. Patients who improved in terms of SI obtained significantly greater reduction of global neurotic personality disintegration (neuroticism) than others (ppsychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism) and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.

Personalized treatment for advanced colorectal cancer: KRAS and beyond

International Nuclear Information System (INIS)

Patel, Gargi Surendra; Karapetis, Christos S

2013-01-01

Targeted therapies have improved the survival of patients with advanced colorectal cancer (CRC). However, further improvements in patient outcomes may be gained by the development of predictive biomarkers in order to select individuals who are most likely to benefit from treatment, thus personalizing treatment. Using the epidermal growth-factor receptor (EGFR) pathway, we discuss the existing and potential predictive biomarkers in clinical development for use with EGFR-targeted agents in metastatic CRC. The data and technological issues surrounding such biomarkers as expression of EGFR or its family members or ligands, KRAS-, NRAS-, and BRAF-mutation status, PI3K/PTEN expression, and imaging and clinical biomarkers, such as rash and hypomagnesemia, are summarized. Although the discovery of KRAS mutations has improved patient selection for EGFR-targeted treatments, further biomarkers are required, especially for those patients who exhibit KRAS mutations rather than the wild-type gene

Personality and recovery: integrating personality assessment data to facilitate the recovery process.

Science.gov (United States)

Donat, D C

2001-01-01

The relatively enduring and persistent nature of personality traits means that they will likely continue to impact the course of psychiatric recovery after Axis I symptoms are stabilized. These traits can significantly impact the choices that recovering persons make and the quality of interpersonal relationships with care providers who are trying to facilitate the recovery process. Despite this, they are often inadequately assessed and considered in providing psychiatric care. This manuscript reviews the common combinations of personality traits that have emerged across a variety of clinical samples. The implications of these personality features for the provision of care in an inpatient setting to facilitate recovery are discussed.

Mentalization-based treatment in groups for adolescents with borderline personality disorder (BPD) or subthreshold BPD versus treatment as usual (M-GAB)

DEFF Research Database (Denmark)

Beck, Emma; Bo, Sune; Gondan, Matthias

2016-01-01

Background Evidence-based outpatient psychotherapeutic programs are first-line treatment of borderline personality disorder (BPD). Early and effective treatment of BPD is crucial to the prevention of its individual, psychosocial, and economic consequences. However, in spite of recent advantages...

Personality traits and emotional patterns in irritable bowel syndrome.

Science.gov (United States)

Muscatello, Maria Rosaria A; Bruno, Antonio; Mento, Carmela; Pandolfo, Gianluca; Zoccali, Rocco A

2016-07-28

The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.

Effect of the personality traits of the patient on pain perception and attitude toward orthodontic treatment

Directory of Open Access Journals (Sweden)

Abhijeet Kadu

2015-01-01

Full Text Available Objective: The objective was to evaluate the relationship between personality traits, pain perception, and person′s attitude toward orthodontic treatment. Materials and Methods: The sample comprised of two groups: Group 1 consisted of 100 treated subjects (50 males, 50 females; average age, 16.07 ± 1.36 years, and Group 2 consisted of 100 untreated subjects (50 males, 50 females; average age, 16.07 ± 1.41 years. The instrument for data collection was a questionnaire that included an assessment of patients′ personality profiles, pain expectation for untreated subjects, pain experience for treated subjects, and attitude toward orthodontic treatment. Results: Gender and treatment status did not affect pain perception and attitude of a person toward orthodontic treatment. There was a strong relationship between pain perception and attitude with Pearson′s correlation of 0.367 and P ≤ 0.0001. With one unit increase in attitude there was 0.43 units increase in pain. Patients with high levels of trait neuroticism (P = 0.01 and low levels of trait conscientiousness (P = 0.02 experienced more pain. Patients with high levels of trait conscientiousness showed better attitude (P = 0.01. Conclusion: Personality traits, neuroticism, and conscientiousness have effect on pain perception and attitude of patients toward orthodontic treatment. Patients with better attitude experienced less pain and patients with less pain exhibited better attitude.

Personalized medicine and treatment approaches in non-small-cell lung carcinoma

Directory of Open Access Journals (Sweden)

Vadakara J

2012-09-01

Full Text Available Joseph Vadakara, Hossein BorghaeiFox Chase Cancer Center, Philadelphia, PA, USAAbstract: Chemotherapy has been the traditional backbone for the management of metastatic lung cancer. Multiple trials have shown the benefits of treatment with platinum doublets in lung cancer. This “one treatment fits all” approach was further refined by the introduction of targeted agents and discovery of subpopulations of patients who benefited from treatment with these agents. It has also become evident that certain histologic subtypes of non-small-cell lung cancer respond better to one cytotoxic chemotherapy versus others. This has led to the concept of using histology to guide therapy. With the introduction of epidermal growth factor receptor (EGFR tyrosine kinase inhibitors and the discovery of activating mutations in the EGFR gene, further personalization of treatment for subgroups of patients has become a reality. More recently, the presence of a fusion gene, echinoderm microtubule-associated protein-like 4 – anaplastic lymphoma kinase (EML4-ALK, was identified as the driver mutation in yet another subgroup of patients, and subsequent studies have led to approval of crizotinib in this group of patients. In this article, efforts in personalizing delivery of care based on the histological subtypes of lung cancer and the role of K-RAS and EGFR mutations, EML4/ALK translocation, and ERCC1 (excision repair cross-complementing 1 and EGFR expression in choosing appropriate treatments for patients with advanced lung cancer are discussed. This article also reviews the problem of resistance to EGFR tyrosine kinase inhibitors and the ongoing trials that target novel pathways and mechanisms that are implicated in resistance.Keywords: NSCLC, EGFR, cancer treatment

INFLUENCE OF PERSONALITY ON THE OUTCOME OF TREATMENT IN DEPRESSION : SYSTEMATIC REVIEW AND META-ANALYSIS

NARCIS (Netherlands)

Newton-Howes, Giles; Tyrer, Peter; Johnson, Tony; Mulder, Roger; Kool, Simone; Dekker, Jack; Schoevers, Robert

There continues to be debate about the influence of personality disorder on the outcome of depressive disorders and is relative interactions with treatment. To determine whether personality disorder, both generically and in terms of individual clusters, leads to a worse outcome in patients with

[Relationship between cocaine dependence treatment and personal values of openness to change and conservation].

Science.gov (United States)

Galdós, Jesús Saiz; Sánchez, Isabel Martínez

2010-01-01

To analyze the relationship between participation in a drug addiction treatment program and Schwartz's values of Openness to change (Self-direction, Stimulation and Hedonism) and Conservation (Tradition, Conformity and Security) in cocaine users. The present quasi-experimental study was carried out on a sample of 411 adult cocaine users, grouped according to whether they had begun treatment more than three months earlier or less than three months earlier or they were not receiving any treatment. Using Schwartz's Personal Values Questionnaire (PVQ), we measured the priority given by each of these groups to the values of Conservation and Openness to change. Participants who had initiated the treatment more than three months earlier tended to score lower in the values of Openness to change than those who were not in treatment, though there were no significant differences in these values between those who were not in treatment and those who had been in treatment for less than three months. On the other hand, it was observed that participants in treatment, regardless of the time spent in treatment, scored higher in values of Conservation than the cocaine users who were not in treatment. These results reveal the relationship between attendance on a cocaine-dependence treatment program and personal values, together with their potential importance in treatment and rehabilitation programs for cocaine users.

The mean and the individual: Integrating variable-centered and person-centered analyses of cognitive recovery in patients with substance use disorders

Directory of Open Access Journals (Sweden)

Marsha E. Bates

2013-12-01

Full Text Available Neuropsychological and cognitive deficits are observed in the majority of persons with alcohol and drug use disorders and may interfere with treatment processes and outcomes. Although, on average, the brain and cognition improve with abstinence or markedly reduced substance use, better understanding of the heterogeneity in the time-course and extent of cognitive recovery at the individual level is useful to promote bench-to-bedside translation and inform clinical decision making. This study integrated a variable-centered and a person-centered approach to characterize diversity in cognitive recovery in 197 patients in treatment for a substance use disorder. We assessed executive function, verbal ability, memory, and complex information processing speed at treatment entry, and then 6, 26, and 52 weeks later. Structural equation modeling was used to define underlying ability constructs and determine the mean level of cognitive changes in the sample while minimizing measurement error and practice effects on specific tests. Individual-level empirical growth plots of latent factor scores were used to explore prototypical trajectories of cognitive change. At the level of the mean, small to medium effect size gains in cognitive abilities were observed over one year. At the level of the individual, the mean trajectory of change was also the modal individual recovery trajectory shown by about half the sample. Other prototypical cognitive change trajectories observed in all four cognitive domains included Delayed Gain, Loss of Gain, and Continuous Gain. Together these trajectories encompassed between 86% and 94% of individual growth plots across the four latent abilities. Further research is needed to replicate and predict trajectory membership. Replication of the present findings would have useful implications for targeted treatment planning and the new cognitive interventions being developed to enhance treatment outcomes.

An integrated treatment model for dual diagnosis of psychosis and addiction.

Science.gov (United States)

Minkoff, K

1989-10-01

A model that integrates the treatment of patients with a dual diagnosis of psychosis and addiction has been developed on a general hospital psychiatric unit. The model emphasizes the parallels between the standard biopsychosocial illness-and-rehabilitation model for treatment of serious psychiatric disorders and the 12-step disease-and-recovery model of Alcoholics Anonymous for treatment of addiction. Dual-diagnosis patients are viewed as having two primary, chronic, biologic mental illnesses, each requiring specific treatment to stabilize acute symptoms and engage the patient in a recovery process. An integrated treatment program is described, as are the steps taken to alleviate psychiatric clinicians' concerns about patient involvement in AA and addiction clinicians' discomfort with patients' use of medication.

Personalized Monte Carlo dosimetry for the planning and evaluation of internal radiotherapy treatments: development and application to selective internal radiotherapy (SIRT)

International Nuclear Information System (INIS)

Petitguillaume, Alice

2014-01-01

Medical techniques in full expansion arousing high therapeutic expectations, targeted radionuclide therapies (TRT) consist of administering a radiopharmaceutical to selectively treat tumors. Nowadays, the activity injected to the patient is generally standardized. However, in order to establish robust dose-effect relationships and to optimize treatments while sparing healthy tissues at best, a personalized dosimetry must be performed, just like actual clinical practice in external beam radiotherapy. In that context, this PhD main objective was to develop, using the OEDIPE software, a methodology for personalized dosimetry based on direct Monte Carlo calculations. The developed method enables to calculate the tridimensional distribution of absorbed doses depending on the patient anatomy, defined from CT or MRI data, and on the patient-specific activity biodistribution, defined from SPECT or PET data. Radiobiological aspects, such as differences in radiosensitivities and repair time constants between tumoral and healthy tissues, have also been integrated through the linear-quadratic model. This methodology has been applied to the selective internal radiation therapy (SIRT) which consists in the injection of 90 Y-microspheres to selectively treat unresectable hepatic cancers. Distributions of absorbed doses and biologically effective doses (BED) along with the equivalent uniform biologically effective doses (EUD) to hepatic lesions have been calculated from 99m Tc-MAA activity distributions obtained during the evaluation step for 18 patients treated at Hopital Europeen Georges Pompidou. Those results have been compared to classical methods used in clinics and the interest of accurate and personalized dosimetry for treatment planning has been investigated. On the one hand, the possibility to increase the activity in a personalized way has been highlighted with the calculation of the maximal activity that could be injected to the patient while meeting tolerance criteria

Marital and Family Therapy in the Treatment of Multiple Personality Disorder.

Science.gov (United States)

Sachs, Roberta G.; And Others

1988-01-01

Explores marital and family therapy in treatment of Multiple Personality Disorder (MPD), discussing role of family of origin in MPD development and role of nuclear family in its perpetuation. Suggests family and marital interventions, illustrating them with case examples. Proposes involving MPD client in marital or family therapy, in addition to…

Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders.

Science.gov (United States)

Prasko, Jan; Grambal, Ales; Kasalova, Petra; Kamardova, Dana; Ociskova, Marie; Holubova, Michaela; Vrbova, Kristyna; Sigmundova, Zuzana; Latalova, Klara; Slepecky, Milos; Zatkova, Marta

2016-01-01

The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders. The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety-depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program - Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale. A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86%) patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the questionnaires). The patients' mean ratings on all measurements were significantly reduced during the treatment. Also, 67.5% reached at least minimal improvement (42.4% showed moderate and more improvement, 35.3% of the patients reached remission). The patients without comorbid personality disorder improved more significantly in the reduction of depressive symptoms than those with comorbid personality disorder. However, there were no significant differences in change in anxiety levels and severity of the mental issues between the patients with and without personality disorders. Higher

Brand Personality Creation through Advertising

OpenAIRE

Ouwersloot Hans; Tudorica Anamaria

2001-01-01

Brand Personality is one of the core dimensions of brand equity. Brand personality refers to the emotional side of a brand image. It is created by all experiences of consumers with a brand, but advertising plays a dominant role in personality creation. In this paper we explore the mechanism that builds brand personality with the help of advertising. We integrate advertising models with the theory of brand personality. Our integrated framework leads to a number of propositions that set an agen...

Prevalence, Awareness, Treatment and Control of Diabetes Among Elderly Persons in an Urban Slum of Delhi

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Arvind Kumar Singh

2012-01-01

Full Text Available Background : The increasing proportion of elderly persons is contributing to an increase in the prevalence of diabetes. The residents of urban slums are more vulnerable due to poverty and lack of access to health care. Objective: To estimate the prevalence of diabetes in elderly persons in an urban slum and to assess their awareness, treatment and control of this condition. Materials and Methods : All persons aged 60 years and above, residing in an urban slum of Delhi, were included in this cross-sectional community- based study. Data were collected on sociodemographic variables. The participants′ awareness and treatment of diabetes was recorded. Their fasting blood sugar was estimated using an automated glucometer. Diabetes was diagnosed if fasting blood glucose was ≥126 mg/dL, or if the participant was taking treatment for diabetes. Impaired fasting blood glucose was diagnosed if fasting blood glucose was 110-125 mg/dL. Results: Among the 474 participants studied, the prevalence of diabetes was estimated to be 18.8% (95% CI 15.3-21.5. It decreased with increasing age, and was higher among women. The prevalence of impaired fasting blood glucose was 19.8% (95% CI 16.3-23.7. It was higher among women. One-third of the diabetic participants were aware of their condition; two-thirds of these were on treatment and three-fourths of those on treatment had controlled fasting blood sugar level. The awareness, treatment and control were better among women. Conclusions : Diabetes is common among elderly persons in urban slums. Its magnitude and low awareness warrant effective public health interventions for their treatment and control.

Process modeling for the Integrated Nonthermal Treatment System (INTS) study

Energy Technology Data Exchange (ETDEWEB)

Brown, B.W.

1997-04-01

This report describes the process modeling done in support of the Integrated Nonthermal Treatment System (INTS) study. This study was performed to supplement the Integrated Thermal Treatment System (ITTS) study and comprises five conceptual treatment systems that treat DOE contract-handled mixed low-level wastes (MLLW) at temperatures of less than 350{degrees}F. ASPEN PLUS, a chemical process simulator, was used to model the systems. Nonthermal treatment systems were developed as part of the INTS study and include sufficient processing steps to treat the entire inventory of MLLW. The final result of the modeling is a process flowsheet with a detailed mass and energy balance. In contrast to the ITTS study, which modeled only the main treatment system, the INTS study modeled each of the various processing steps with ASPEN PLUS, release 9.1-1. Trace constituents, such as radionuclides and minor pollutant species, were not included in the calculations.

Viewpoint Integration for Hand-Based Recognition of Social Interactions from a First-Person View.

Science.gov (United States)

Bambach, Sven; Crandall, David J; Yu, Chen

2015-11-01

Wearable devices are becoming part of everyday life, from first-person cameras (GoPro, Google Glass), to smart watches (Apple Watch), to activity trackers (FitBit). These devices are often equipped with advanced sensors that gather data about the wearer and the environment. These sensors enable new ways of recognizing and analyzing the wearer's everyday personal activities, which could be used for intelligent human-computer interfaces and other applications. We explore one possible application by investigating how egocentric video data collected from head-mounted cameras can be used to recognize social activities between two interacting partners (e.g. playing chess or cards). In particular, we demonstrate that just the positions and poses of hands within the first-person view are highly informative for activity recognition, and present a computer vision approach that detects hands to automatically estimate activities. While hand pose detection is imperfect, we show that combining evidence across first-person views from the two social partners significantly improves activity recognition accuracy. This result highlights how integrating weak but complimentary sources of evidence from social partners engaged in the same task can help to recognize the nature of their interaction.

Step-down versus outpatient psychotherapeutic treatment for personality disorders: 6-year follow-up of the Ullevål personality project

Science.gov (United States)

2014-01-01

Background Although psychotherapy is considered the treatment of choice for patients with personality disorders (PDs), there is no consensus about the optimal level of care for this group of patients. This study reports the results from the 6-year follow-up of the Ullevål Personality Project (UPP), a randomized clinical trial comparing outpatient individual psychotherapy with a long-term step-down treatment program that included a short-term day hospital treatment followed by combined group and individual psychotherapy. Methods The UPP included 113 patients with PDs. Outcome was evaluated after 8 months, 18 months, 3 years and 6 years and was based on a wide range of clinical measures, such as psychosocial functioning, interpersonal problems, symptom severity, and axis I and II diagnoses. Results At the 6-year follow-up, there were no statistically significant differences in outcome between the treatment groups. Effect sizes ranged from medium to large for all outcome variables in both treatment arms. However, patients in the outpatient group had a marked decline in psychosocial functioning during the period between the 3- and 6-year follow-ups; while psychosocial functioning continued to improve in the step-down group during the same period. This difference between groups was statistically significant. Conclusions The findings suggest that both hospital-based long-term step-down treatment and long-term outpatient individual psychotherapy may improve symptoms and psychosocial functioning in poorly functioning PD patients. Social and interpersonal functioning continued to improve in the step-down group during the post-treatment phase, indicating that longer-term changes were stimulated during treatment. Trial registration NCT00378248. PMID:24758722

Social function of persons with schizophrenia.

Science.gov (United States)

McDonald, Jennifer; Badger, Terry A

2002-06-01

1. The social function needs of persons with schizophrenia are similar to those of all individuals and include typical social roles, integration and contacts, and intimacy and sexual function. 2. Social function is essential to QOL, and aspects of social function are determinants of mental health and mental health outcomes. 3. Although intimacy and sexual function is found to be an important aspect of social function and QOL, health care workers neglect to discuss these issues with patients with schizophrenia. 4. Education, support, counseling, adequate transportation, safe environments, and treatment plans that include appropriate activities are important treatment interventions.

TREATMENT OF CANCER IN THE OLDER AGED PERSON

Directory of Open Access Journals (Sweden)

Lodovico Balducci

2010-05-01

Full Text Available

 Cancer is a disease of aging .  Currently 50% of all malignancies occur in individuals 65 and over and by the year 2030 older individuals will account for 70% of all neoplasms.

 With the aging of the population the management of cancer in the older person with chemotherapy is beoming increasingly common. This treatment may be  safe and effective if some appropriate measures are taken, including, an assessment of the physiologic age of each patient, modification of doses according to the renal function, use of meyelopoietic growth factors prophylactically in presence of moderately toxic chemotherapy, and provision of an adequate caregiver. Cure, prolongation of survival, and symptom palliation are universal goals of medical treatment.   Prolongation of active life expectancy  should be added to the treatment goal of the older aged person .

Integrating the context-appropriate balanced attention model and reinforcement sensitivity theory: Towards a domain-general personality process model.

Science.gov (United States)

Collins, Michael D; Jackson, Chris J; Walker, Benjamin R; O'Connor, Peter J; Gardiner, Elliroma

2017-01-01

Over the last 40 years or more the personality literature has been dominated by trait models based on the Big Five (B5). Trait-based models describe personality at the between-person level but cannot explain the within-person mental mechanisms responsible for personality. Nor can they adequately account for variations in emotion and behavior experienced by individuals across different situations and over time. An alternative, yet understated, approach to personality architecture can be found in neurobiological theories of personality, most notably reinforcement sensitivity theory (RST). In contrast to static trait-based personality models like the B5, RST provides a more plausible basis for a personality process model, namely, one that explains how emotions and behavior arise from the dynamic interaction between contextual factors and within-person mental mechanisms. In this article, the authors review the evolution of a neurobiologically based personality process model based on RST, the response modulation model and the context-appropriate balanced attention model. They argue that by integrating this complex literature, and by incorporating evidence from personality neuroscience, one can meaningfully explain personality at both the within- and between-person levels. This approach achieves a domain-general architecture based on RST and self-regulation that can be used to align within-person mental mechanisms, neurobiological systems and between-person measurement models. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

An integral approach to town planning: lessons from personal construct theory, part 1

OpenAIRE

A Jackson

1986-01-01

Personal construct theory is introduced as an all-embracing philosophy which provides a consistent framework for integrating different notions about the planning process. The implication is that 'man-the-planner' does not necessarily have constructs which are better, more accurate, or more predictive than his subject, 'man-the-planned'. Policies can be seen as theories, in which case they should be clearly expressed as such. The theory and its methodology have been used in an empirical invest...

Integration of second cancer risk calculations in a radiotherapy treatment planning system

International Nuclear Information System (INIS)

Hartmann, M; Schneider, U

2014-01-01

Second cancer risk in patients, in particular in children, who were treated with radiotherapy is an important side effect. It should be minimized by selecting an appropriate treatment plan for the patient. The objectives of this study were to integrate a risk model for radiation induced cancer into a treatment planning system which allows to judge different treatment plans with regard to second cancer induction and to quantify the potential reduction in predicted risk. A model for radiation induced cancer including fractionation effects which is valid for doses in the radiotherapy range was integrated into a treatment planning system. From the three-dimensional (3D) dose distribution the 3D-risk equivalent dose (RED) was calculated on an organ specific basis. In addition to RED further risk coefficients like OED (organ equivalent dose), EAR (excess absolute risk) and LAR (lifetime attributable risk) are computed. A risk model for radiation induced cancer was successfully integrated in a treatment planning system. Several risk coefficients can be viewed and used to obtain critical situations were a plan can be optimised. Risk-volume-histograms and organ specific risks were calculated for different treatment plans and were used in combination with NTCP estimates for plan evaluation. It is concluded that the integration of second cancer risk estimates in a commercial treatment planning system is feasible. It can be used in addition to NTCP modelling for optimising treatment plans which result in the lowest possible second cancer risk for a patient.

Integrated ecotechnology approach towards treatment of complex wastewater with simultaneous bioenergy production.

Science.gov (United States)

Hemalatha, Manupati; Sravan, J Shanthi; Yeruva, Dileep Kumar; Venkata Mohan, S

2017-10-01

Sequential integration of three stage diverse biological processes was studied by exploiting the individual process advantage towards enhanced treatment of complex chemical based wastewater. A successful attempt to integrate sequence batch reactor (SBR) with bioelectrochemical treatment (BET) and finally with microalgae treatment was studied. The sequential integration has showed individual substrate degradation (COD) of 55% in SBR, 49% in BET and 56% in microalgae, accounting for a consolidated treatment efficiency of 90%. Nitrates removal efficiency of 25% was observed in SBR, 31% in BET and 44% in microalgae, with a total efficiency of 72%. The SBR treated effluents fed to BET with the electrode intervention showed TDS removal. BET exhibited relatively higher process performance than SBR. The integration approach significantly overcame the individual process limitations along with value addition as biomass (1.75g/L), carbohydrates (640mg/g), lipids (15%) and bioelectricity. The study resulted in providing a strategy of combining SBR as pretreatment step to BET process and finally polishing with microalgae cultivation achieving the benefits of enhanced wastewater treatment along with value addition. Copyright © 2017 Elsevier Ltd. All rights reserved.

Life after unsuccessful IVF treatment in an assisted reproduction unit: a qualitative analysis of gains through loss among Chinese persons in Hong Kong.

Science.gov (United States)

Lee, Geok Ling; Hui Choi, W H; Chan, Celia H Y; Chan, Cecilia L W; Ng, Ernest H Y

2009-08-01

Previous studies examining experiences of infertility focused mainly on the aspect of loss but neglected the possible gains realized through surviving the experience of infertility. The success rate of IVF remains relatively low, and we used the strengths perspective to examine adjustment after unsuccessful treatment. This study aims to provide an in-depth description of the gains perceived by Chinese men and women and how they re-constructed their lives after unsuccessful IVF treatment. Four couples and another six women who experienced unsuccessful IVF treatment were recruited from an assisted reproduction clinic. Data were collected through in-depth interviews, using a grounded theory constructivist approach. Of the 10 women and 4 men interviewed, 9 remained childless, 3 had adopted a child and 2 had conceived naturally. They reported gains on a personal level, interpersonal level and transpersonal level through surviving the experience of infertility. All, regardless of the eventual outcome, reported at least one form of personal gain: in personality or knowledge gain. Interpersonal gains were perceived in relationships with their spouses, children, parents, friends, colleagues and fellow IVF service users. More than half of them reported spiritual growth and a change in identity through integrating their experiences and offering help to others. Despite the small sample size, this study makes a significant contribution by suggesting that while negative feelings provoked by the failure to conceive should be acknowledged, people in this situation should also be enabled to consolidate their negative experiences of IVF constructively, helping them to move on with their lives.

Integrated modeling of ozonation for optimization of drinking water treatment

NARCIS (Netherlands)

van der Helm, A.W.C.

2007-01-01

Drinking water treatment plants automation becomes more sophisticated, more on-line monitoring systems become available and integration of modeling environments with control systems becomes easier. This gives possibilities for model-based optimization. In operation of drinking water treatment

The Relation Between Antisocial and Borderline Personality Symptoms and Early Maladaptive Schemas in a Treatment Seeking Sample of Male Substance Users

Science.gov (United States)

Shorey, Ryan C.; Anderson, Scott; Stuart, Gregory L.

2014-01-01

Individuals with substance use disorders are more likely to have antisocial and borderline personality disorder than non-substance abusers. Recently, research has examined the relations between early maladaptive schemas and personality disorders, as early maladaptive schemas are believed to underlie personality disorders. However, there is a dearth of research on the relations between early maladaptive schemas and personality disorders among individuals seeking treatment for substance abuse. The current study examined the relations among early maladaptive schemas and antisocial and borderline personality within in a sample of men seeking substance abuse treatment (n = 98). Results demonstrated that early maladaptive schema domains were associated with antisocial and borderline personality symptoms. Implications of these findings for substance use treatment and research are discussed. PMID:23650153

Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment.

Science.gov (United States)

Cooperman, Nina A; Lu, Shou-En; Richter, Kimber P; Bernstein, Steven L; Williams, Jill M

2016-01-01

attempt or not (C-statistic of .79, 95% CI [0.70, 0.88]). Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking.

Influence of Psychiatric and Personality Disorders on Smoking Cessation among Individuals in Opiate Dependence Treatment

Science.gov (United States)

Cooperman, Nina A.; Lu, Shou-En; Richter, Kimber P.; Bernstein, Steven L.; Williams, Jill M.

2016-01-01

.85]) and ever making a quit attempt or not (C-statistic of .79, 95% CI[0.70, 0.88]). Conclusions Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking. PMID:27064523

Getting personal: can systems medicine integrate scientific and humanistic conceptions of the patient?

Science.gov (United States)

Vogt, Henrik; Ulvestad, Elling; Eriksen, Thor Eirik; Getz, Linn

2014-12-01

The practicing doctor, and most obviously the primary care clinician who encounters the full complexity of patients, faces several fundamental but intrinsically related theoretical and practical challenges - strongly actualized by so-called medically unexplained symptoms (MUS) and multi-morbidity. Systems medicine, which is the emerging application of systems biology to medicine and a merger of molecular biomedicine, systems theory and mathematical modelling, has recently been proposed as a primary care-centered strategy for medicine that promises to meet these challenges. Significantly, it has been proposed to do so in a way that at first glance may seem compatible with humanistic medicine. More specifically, it is promoted as an integrative, holistic, personalized and patient-centered approach. In this article, we ask whether and to what extent systems medicine can provide a comprehensive conceptual account of and approach to the patient and the root causes of health problems that can be reconciled with the concept of the patient as a person, which is an essential theoretical element in humanistic medicine. We answer this question through a comparative analysis of the theories of primary care doctor Eric Cassell and systems biologist Denis Noble. We argue that, although systems biological concepts, notably Noble's theory of biological relativity and downward causation, are highly relevant for understanding human beings and health problems, they are nevertheless insufficient in fully bridging the gap to humanistic medicine. Systems biologists are currently unable to conceptualize living wholes, and seem unable to account for meaning, value and symbolic interaction, which are central concepts in humanistic medicine, as constraints on human health. Accordingly, systems medicine as currently envisioned cannot be said to be integrative, holistic, personalized or patient-centered in a humanistic medical sense. © 2014 The Authors. Journal of Evaluation in Clinical

Independent peer review panel report on the integrated nonthermal treatment systems study and the comparison of integrated thermal and integrated nonthermal treatment systems for mixed low level waste

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-08-01

The US Department of Energy`s (DOE) Office of Environmental Management (EM) Office of Science and Technology (OST) has conducted studies of integrated thermal treatment systems and integrated nonthermal treatment systems (INTS) for treating contact handled, alpha and non-alpha mixed low level radioactive waste (MLLW). The MLLW in the DOE complex consists of a wide variety of organic and inorganic solids and liquids contaminated with radioactive substances. Treatment systems are needed to destroy organic material and stabilize residues prior to land disposal. In May 1996 the Deputy Assistant Secretary for OST appointed an Independent Peer Review Panel to: (1) review and comment on the INTS Study; (2) make recommendations on the most promising thermal and nonthermal treatment systems; (3) make recommendations on research and development necessary to prove the performance of nonthermal and thermal technologies; and (4) review and comment on the preliminary draft of the ITTS/INTS Comparison Report. This report presents the primary conclusions and recommendations based on the review of the INTS study and the comparison report. System selection, overviews, comparisons, cost estimations and sensitivity analyses, and recommended R and D engineering needs are then described and discussed.

Independent peer review panel report on the integrated nonthermal treatment systems study and the comparison of integrated thermal and integrated nonthermal treatment systems for mixed low level waste

International Nuclear Information System (INIS)

1996-08-01

The US Department of Energy's (DOE) Office of Environmental Management (EM) Office of Science and Technology (OST) has conducted studies of integrated thermal treatment systems and integrated nonthermal treatment systems (INTS) for treating contact handled, alpha and non-alpha mixed low level radioactive waste (MLLW). The MLLW in the DOE complex consists of a wide variety of organic and inorganic solids and liquids contaminated with radioactive substances. Treatment systems are needed to destroy organic material and stabilize residues prior to land disposal. In May 1996 the Deputy Assistant Secretary for OST appointed an Independent Peer Review Panel to: (1) review and comment on the INTS Study; (2) make recommendations on the most promising thermal and nonthermal treatment systems; (3) make recommendations on research and development necessary to prove the performance of nonthermal and thermal technologies; and (4) review and comment on the preliminary draft of the ITTS/INTS Comparison Report. This report presents the primary conclusions and recommendations based on the review of the INTS study and the comparison report. System selection, overviews, comparisons, cost estimations and sensitivity analyses, and recommended R and D engineering needs are then described and discussed

[Guideline-adherent inpatient psychiatric psychotherapeutic treatment of borderline personality disorder : Normative definition of personnel requirements].

Science.gov (United States)

Bohus, M; Schmahl, C; Herpertz, S C; Lieb, K; Berger, M; Roepke, S; Heinz, A; Gallinat, J; Lyssenko, L

2016-07-01

Borderline personality disorders (BPD) are severe mental diseases which place high pressure on the psychiatric healthcare system. Nowadays, well-tested, disorder-specific treatment concepts are available also for inpatient treatment in Germany. These show very good and long-term improvements in the psychopathology as well as posttreatment social participation; however, prerequisites for the implementation of these evidence-based inpatient psychotherapy programs are well-trained treatment teams and appropriate financing of resource expenditure. The aim was to formulate a definition of normative needs for treatment duration and intensity for a guideline-conform, empirically proven and effective inpatient treatment of borderline personality disorder as well as the derived personnel requirements in comparison to the currently available resources within the framework of the Psychiatry Personnel Act (Psych-PV). The resource requirements were established based on evaluated hospital ward models, the recommendations of the S2 guidelines and the criteria of specialist societies and compared with the personnel stipulations according to the Psych-PV. The results for a normatively established treatment program showed a pronounced deficit in the financing of the evaluated resource requirements, even when the stipulations laid down in the Psych-PV were implemented to 100 %. Disorder-specific inpatient treatment programs for borderline personality disorder have been scientifically proven to be highly effective; however, resource analyses show that the personnel requirements necessary for effective implementation of these programs are much higher than those allocated by the funding according to the Pysch-PV. The current underfunding leads to inadequate treatment outcomes with high readmission rates and as a result high direct and indirect costs of illness.

An integrated Ka/Ku-band payload for personal, mobile and private business communications

Science.gov (United States)

Hayes, Edward J.; Keelty, J. Malcolm

1991-01-01

The Canadian Department of Communications has been studying options for a government-sponsored demonstration payload to be launched before the end of the century. A summary of the proposed system concepts and network architectures for providing an advanced private business network service at Ku-band and personal and mobile communications at Ka-band is presented. The system aspects addressed include coverage patterns, traffic capacity, and grade of service, multiple access options as well as special problems, such as Doppler in mobile applications. Earth terminal types and the advanced payload concept proposed in a feasibility study for the demonstration mission are described. This concept is a combined Ka-band/Ku-band payload which incorporates a number of advanced satellite technologies including a group demodulator to convert single-channel-per-carrier frequency division multiple access uplink signals to a time division multiplex downlink, on-board signal regeneration, and baseband switching to support packet switched data operation. The on-board processing capability of the payload provides a hubless VSAT architecture which permits single-hop full mesh interconnectivity. The Ka-band and Ku-band portions of the payload are fully integrated through an on-board switch, thereby providing the capability for fully integrated services, such as using the Ku-band VSAT terminals as gateway stations for the Ka-band personal and mobile communications services.

Using pilot data to size a two-arm randomized trial to find a nearly optimal personalized treatment strategy.

Science.gov (United States)

Laber, Eric B; Zhao, Ying-Qi; Regh, Todd; Davidian, Marie; Tsiatis, Anastasios; Stanford, Joseph B; Zeng, Donglin; Song, Rui; Kosorok, Michael R

2016-04-15

A personalized treatment strategy formalizes evidence-based treatment selection by mapping patient information to a recommended treatment. Personalized treatment strategies can produce better patient outcomes while reducing cost and treatment burden. Thus, among clinical and intervention scientists, there is a growing interest in conducting randomized clinical trials when one of the primary aims is estimation of a personalized treatment strategy. However, at present, there are no appropriate sample size formulae to assist in the design of such a trial. Furthermore, because the sampling distribution of the estimated outcome under an estimated optimal treatment strategy can be highly sensitive to small perturbations in the underlying generative model, sample size calculations based on standard (uncorrected) asymptotic approximations or computer simulations may not be reliable. We offer a simple and robust method for powering a single stage, two-armed randomized clinical trial when the primary aim is estimating the optimal single stage personalized treatment strategy. The proposed method is based on inverting a plugin projection confidence interval and is thereby regular and robust to small perturbations of the underlying generative model. The proposed method requires elicitation of two clinically meaningful parameters from clinical scientists and uses data from a small pilot study to estimate nuisance parameters, which are not easily elicited. The method performs well in simulated experiments and is illustrated using data from a pilot study of time to conception and fertility awareness. Copyright © 2015 John Wiley & Sons, Ltd.

Treatment of upper gastrointestinal fistula and leakage with personal stage nutrition support

Institute of Scientific and Technical Information of China (English)

Qun Wang; Zhi-Su Liu; Qun Qian; Quan Sun; Ding-Yu Pan; Yue-Ming He

2008-01-01

AIM: To investigate the feasibility of treatment for upper gastrointestinal fistula and leakage with personal stage nutrition support.METHODS: Forty-three patients with upper gastrointestinal fistula and leakage were randomly divided into two groups. Patients in group A were treated with personal stage nutrition support and patients in group B were treated with total parental nutrition (TPN) in combination with operation.Nutritional states of the candidates were evaluated by detecting albumin (Alb) and pre-Alb. The balance between nutrition and hepatic function was evaluated by measurement of aspartate aminotransferase (AST),alanine aminotransferase (ALT) and total bilirubin (Tbill) before and after operation. At the same time their complications and hospitalized time were surveyed.RESULTS: Personal stage nutrition support improved upper gastrointestinal fistula and leakage. The nutrition state and hepatic function were better in patients who received personal stage nutrition support than in those who did not receive TPN. There was no significant difference in the complication and hospitalized time in the two groups of patients.CONCLUSION: Upper gastrointestinal fistula and leakage can be treated with personal stage nutrition support which is more beneficial for the post-operation recovery and more economic than surgical operation.

Content-Based Personalization Services Integrating Folksonomies

Science.gov (United States)

Musto, Cataldo; Narducci, Fedelucio; Lops, Pasquale; de Gemmis, Marco; Semeraro, Giovanni

Basic content-based personalization consists in matching up the attributes of a user profile, in which preferences and interests are stored, with the attributes of a content object. The Web 2.0 (r)evolution has changed the game for personalization, from ‘elitary’ Web 1.0, written by few and read by many, to web content generated by everyone (user-generated content - UGC), since the role of people has evolved from passive consumers of information to that of active contributors.

Personal Calendar: Treatment and Physical Tracking

Science.gov (United States)

... Policy Ways to Give to DBSA Individual Giving Memorials & Tributes Bequests & Planned Giving Matching Gifts & Foundation Giving ... of Personal Stories Peers Celebrating Art Peers Celebrating Music Be Vocal Support Locator DBSA In-Person Support ...

Perspectives on the prevalence and treatment of personality disorder.

Science.gov (United States)

Winship, G; Hardy, S

2007-04-01

Personality disorder (PD) is the most prevalent psychiatric disorder. A methodical literature search identified that PD is under researched compared with other mental health problems such as depression or schizophrenia. Social and psychotherapeutic approaches emerge as dominant treatment approaches with PD where there is good evidence of efficacy. Collaborative group-based therapeutic approaches appear to offer a therapeutic counterpoise to the anti-social traits often prevalent in PD. A retrospective analysis of formal group therapy on acute inpatient units (treating PD patients among other mental health disorders) reveals only one violent incident in over 40,000 treatment hours of formal group therapy. It is argued that group-based and social therapy should be the recommended treatment approach because these approaches have been shown to create a safe and contained milieu, establishing a good base for therapeutic gain with PD patients. The case for widening the scope of collaborative group and community-based therapies is considered and the merits and shortcomings of a key worker system with PD patients are critiqued.

Integrated ultrasonic/microbiological treatment of toxic and refractory pollutants

Energy Technology Data Exchange (ETDEWEB)

Tiehm, A. [Water Technology Center, Karlsruhe (Germany)

2002-07-01

The elimination of environmental pollutants by biodegradation in many cases represents an efficient and reliable method, e.g. in waste waster treatment, treatment of solid wastes, and in the remediation of contaminated soil. Nevertheless, there are situations where biological treatment alone does not result in a successful elimination of the target pollutants. For example, the presence of toxic compounds, an insufficient period of adaptation or a low bioavailability of the pollutants hinder a rapid biodegradation. Physico-chemical techniques, e.g. sonochemical degradation, provide an alternative to eliminate pollutants that are poorly biodegradable. It is the aim of this paper to demonstrate the potential of integrated ultrasound/biodegradation processes in the light of the underlying mechanisms. Optimisation of sonication is discussed with respect to ultrasound frequency and pH of the aqueous phase. Examplarily, two successful combinations of the integrated process are presented: (i) Application of ultrasound to reduce the toxicity of chlorophenols and (ii) ultrasonic irradiation to increase mass transfer and biodegradation of polyaromatic hydrocarbons. (orig.)

Intensive Evening Outpatient Treatment for Patients With Personality Dysfunction: Early Group Process, Change in Interpersonal Distress, and Longer-Term Social Functioning.

Science.gov (United States)

Joyce, Anthony S; Ogrodniczuk, John S; Kealy, David

2017-01-01

Entrenched interpersonal difficulties are a defining feature of those with personality dysfunction. Evening treatment-a comprehensive and intensive group-oriented outpatient therapy program-offers a unique approach to delivering mental health services to patients with chronic personality dysfunction. This study assessed change in interpersonal problems as a key outcome, the relevance of such change to future social functioning, and the influence of early group processes on this change. Consecutively admitted patients (N = 75) to a group-oriented evening treatment program were recruited; the majority were diagnosed with personality disorder. Therapy outcome was represented by scores on the Inventory of Interpersonal Problems. Follow-up outcome was represented by the global score of the Social Adjustment Scale. Group climate, group cohesion, and the therapeutic alliance were examined as process variables. Patients experienced substantial reduction in distress associated with interpersonal problems; early process factors that reflected a cohesive and engaged group climate and stronger therapeutic alliance were predictive of this outcome. Improvement in interpersonal distress was predictive of global social functioning six months later. The therapeutic alliance most strongly accounted for change in interpersonal problems at posttreatment and social functioning at follow-up. A comprehensive and integrated outpatient group therapy program, offered in the evening to accommodate patients' real-life demands, can facilitate considerable improvement in interpersonal problems, which in turn influences later social functioning. The intensity and intimacy of peer interactions in the therapy groups, and a strong alliance with the program therapists, are likely interacting factors that are particularly important to facilitate such change.

The impact of personality disorders on behavioral treatment outcome for social phobia

NARCIS (Netherlands)

van Velzen, C.J.M.; Emmelkamp, P.M.G.; Scholing, A.

1997-01-01

The impact of personality disorders (PDs) on exposure in pipe treatment for social phobia was investigated in three groups of social phobics: social phobia without any PD (n = 30), social phobia with a single diagnosis of avoidant PD (n = 18) and social phobia with multiple PDs (n = 13). We

WPA ISSPD educational program: Module II. Advances in research and understanding of personality disorders

DEFF Research Database (Denmark)

Ronningstam, Elsa; Simonsen, Erik; Millon, Theodore

2009-01-01

of their heritability and aetiological origin, variability over time and between cultures, and change and remission. A curriculum suggesting different educational approaches to the programme, now available on the Internet, aims at promoting integrative learning and discussion among clinicians and educators in study......Recent advances in research, clinical observations and treatment have contributed to several major changes in the conceptualization of personality disorders. Featured in an educational programme on personality disorders prepared by the World Psychiatric Association (WPA) Section on Personality...

Nonverbal interpersonal attunement and extravert personality predict outcome of light treatment in seasonal affective disorder

NARCIS (Netherlands)

Geerts, E; Kouwert, E; Bouhuys, N; Meesters, Y; Jansen, J

We investigated whether personality and nonverbal interpersonal processes can predict the subsequent response to light treatment in seasonal affective disorder (SAD) patients. In 60 SAD patients, Neuroticism and Extraversion were assessed prior to light treatment (4 days with 30 min of 10.000 lux).

Personality disorders

DEFF Research Database (Denmark)

Simonsen, Sebastian; Heinskou, Torben; Sørensen, Per

2017-01-01

BACKGROUND: In this naturalistic study, patients with personality disorders (N = 388) treated at Stolpegaard Psychotherapy Center, Mental Health Services, Capital Region of Denmark were allocated to two different kinds of treatment: a standardized treatment package with a preset number of treatment...... characteristics associated with clinicians' allocation of patients to the two different personality disorder services. METHODS: Patient characteristics across eight domains were collected in order to study whether there were systematic differences between patients allocated to the two different treatments....... Patient characteristics included measures of symptom severity, personality pathology, trauma and socio-demographic characteristics. Significance testing and binary regression analysis were applied to identify important predictors. RESULTS: Patient characteristics on fifteen variables differed...

[Power of personal goal sharing--treatment plan using personal goal maps for patients with mental disorders].

Science.gov (United States)

Zhao, Yueren

2011-01-01

A female patient in her sixties with schizophrenia had secretly disposed of all her medication and was not cooperating with hospital staff for about four months. During one of our consultations she mentioned that she wanted to be out of hospital by a certain date. That date happened to be her grandchild's birthday. It was at this point that she shared her goals with us, and voluntarily started having treatment. She was able to return home three months later, just in time to celebrate her grandchild's birthday with her family. A male patient in his sixties was able to leave the seclusion room after 10 years. The first doctor in charge and other hospital staff had firmly believed that releasing him from the seclusion room wasn't a possibility. However the patient decided he wanted to be discharged and was interested in finding out how to go about it. The moment he realized it was possible, his outlook changed immensely. He gradually started to open up and communicate better with his new doctor in charge, and was able to work towards his newly found goals. Staff members were also surprised when he was able to leave the seclusion room. They realized this patient was another person like them who had dreams and goals, and stopped stereotyping patients who seemed to be 'difficult to handle'. I have always experienced the power of goal sharing at clinical scenes, and have noticed its importance for patients making a start on the road to recovery. In order to discuss goals and the way to go about achieving them, I use a simple drawing of a mountain. I call this mountain 'A Personal Goal Map'. I like to think of myself (the doctor) as the mountain guide, and my patient as the mountain climber. The three key philosophies are acknowledging individuality, diversity and freedom. These are important when we think about where we are now, where we are going, and where we want to be. Firstly at the start point, we need to define the patient's problem and discuss ideas and goals

Assessing treatment integrity in cognitive-behavioral therapy: comparing session segments with entire sessions.

Science.gov (United States)

Weck, Florian; Grikscheit, Florian; Höfling, Volkmar; Stangier, Ulrich

2014-07-01

The evaluation of treatment integrity (therapist adherence and competence) is a necessary condition to ensure the internal and external validity of psychotherapy research. However, the evaluation process is associated with high costs, because therapy sessions must be rated by experienced clinicians. It is debatable whether rating session segments is an adequate alternative to rating entire sessions. Four judges evaluated treatment integrity (i.e., therapist adherence and competence) in 84 randomly selected videotapes of cognitive-behavioral therapy for major depressive disorder, social anxiety disorder, and hypochondriasis (from three different treatment outcome studies). In each case, two judges provided ratings based on entire therapy sessions and two on session segments only (i.e., the middle third of the entire sessions). Interrater reliability of adherence and competence evaluations proved satisfactory for ratings based on segments and the level of reliability did not differ from ratings based on entire sessions. Ratings of treatment integrity that were based on entire sessions and session segments were strongly correlated (r=.62 for adherence and r=.73 for competence). The relationship between treatment integrity and outcome was comparable for ratings based on session segments and those based on entire sessions. However, significant relationships between therapist competence and therapy outcome were only found in the treatment of social anxiety disorder. Ratings based on segments proved to be adequate for the evaluation of treatment integrity. The findings demonstrate that session segments are an adequate and cost-effective alternative to entire sessions for the evaluation of therapist adherence and competence. Copyright © 2014. Published by Elsevier Ltd.

Mixed Waste Treatment Project: Computer simulations of integrated flowsheets

International Nuclear Information System (INIS)

Dietsche, L.J.

1993-12-01

The disposal of mixed waste, that is waste containing both hazardous and radioactive components, is a challenging waste management problem of particular concern to DOE sites throughout the United States. Traditional technologies used for the destruction of hazardous wastes need to be re-evaluated for their ability to handle mixed wastes, and in some cases new technologies need to be developed. The Mixed Waste Treatment Project (MWTP) was set up by DOE's Waste Operations Program (EM30) to provide guidance on mixed waste treatment options. One of MWTP's charters is to develop flowsheets for prototype integrated mixed waste treatment facilities which can serve as models for sites developing their own treatment strategies. Evaluation of these flowsheets is being facilitated through the use of computer modelling. The objective of the flowsheet simulations is to provide mass and energy balances, product compositions, and equipment sizing (leading to cost) information. The modelled flowsheets need to be easily modified to examine how alternative technologies and varying feed streams effect the overall integrated process. One such commercially available simulation program is ASPEN PLUS. This report contains details of the Aspen Plus program

What it takes to get proactive: An integrative multilevel model of the antecedents of personal initiative.

Science.gov (United States)

Hong, Ying; Liao, Hui; Raub, Steffen; Han, Joo Hun

2016-05-01

Building upon and extending Parker, Bindl, and Strauss's (2010) theory of proactive motivation, we develop an integrated, multilevel model to examine how contextual factors shape employees' proactive motivational states and, through these proactive motivational states, influence their personal initiative behavior. Using data from a sample of hotels collected from 3 sources and over 2 time periods, we show that establishment-level initiative-enhancing human resource management (HRM) systems were positively related to departmental initiative climate, which was positively related to employee personal initiative through employee role-breadth self-efficacy. Further, department-level empowering leadership was positively related to initiative climate only when initiative-enhancing HRM systems were low. These findings offer interesting implications for research on personal initiative and for the management of employee proactivity in organizations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Personality Patterns of Physicians in Person-Oriented and Technique-Oriented Specialties

Science.gov (United States)

Borges, Nicole J.; Gibson, Denise D.

2005-01-01

This study investigated differences in personality patterns between person-oriented and technique-oriented physicians. It tested an integrative framework by converting the scores on the Personality Research Form (PRF) to the Big-Five factors and built a predictive model of group membership in clinical specialty area. PRF scores from 238 physicians…

Personality Facets and RIASEC Interests: An Integrated Model

Science.gov (United States)

Armstrong, Patrick Ian; Anthoney, Sarah Fetter

2009-01-01

Research examining links between personality and interest have typically focused on links between measures of the five factor model and Holland's RIASEC types. However, the five factor model of personality can be divided in to a larger set of narrow domain personality scales measuring facets of the "big five" traits. Research in a number of fields…

The BraveNet prospective observational study on integrative medicine treatment approaches for pain.

Science.gov (United States)

Abrams, Donald I; Dolor, Rowena; Roberts, Rhonda; Pechura, Constance; Dusek, Jeffery; Amoils, Sandi; Amoils, Steven; Barrows, Kevin; Edman, Joel S; Frye, Joyce; Guarneri, Erminia; Kligler, Ben; Monti, Daniel; Spar, Myles; Wolever, Ruth Q

2013-06-24

Chronic pain affects nearly 116 million American adults at an estimated cost of up to $635 billion annually and is the No. 1 condition for which patients seek care at integrative medicine clinics. In our Study on Integrative Medicine Treatment Approaches for Pain (SIMTAP), we observed the impact of an integrative approach on chronic pain and a number of other related patient-reported outcome measures. Our prospective, non-randomized, open-label observational evaluation was conducted over six months, at nine clinical sites. Participants received a non-standardized, personalized, multimodal approach to chronic pain. Validated instruments for pain (severity and interference levels), quality of life, mood, stress, sleep, fatigue, sense of control, overall well-being, and work productivity were completed at baseline and at six, 12, and 24 weeks. Blood was collected at baseline and week 12 for analysis of high-sensitivity C-reactive protein and 25-hydroxyvitamin D levels. Repeated-measures analysis was performed on data to assess change from baseline at 24 weeks. Of 409 participants initially enrolled, 252 completed all follow-up visits during the 6 month evaluation. Participants were predominantly white (81%) and female (73%), with a mean age of 49.1 years (15.44) and an average of 8.0 (9.26) years of chronic pain. At baseline, 52% of patients reported symptoms consistent with depression. At 24 weeks, significantly decreased pain severity (-23%) and interference (-28%) were seen. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed. Mean 25-hydroxyvitamin D levels increased from 33.4 (17.05) ng/mL at baseline to 39.6 (16.68) ng/mL at week 12. Among participants completing an integrative medicine program for chronic pain, significant improvements were seen in pain as well as other relevant patient-reported outcome measures. ClinicalTrials.gov, NCT01186341.

From genomic variation to personalized medicine

DEFF Research Database (Denmark)

Wesolowska, Agata; Schmiegelow, Kjeld

Genomic variation is the basis of interindividual differences in observable traits and disease susceptibility. Genetic studies are the driving force of personalized medicine, as many of the differences in treatment efficacy can be attributed to our genomic background. The rapid development...... a considerable amount of the phenotype variability, hence the major difficulty of interpretation lies in the complexity of molecular interactions. This PhD thesis describes the state-of-art of the functional human variation research (Chapter 1) and introduces childhood acute lymphoblastic leukaemia (ALL...... the thesis and includes some final remarks on the perspectives of genomic variation research and personalized medicine. In summary, this thesis demonstrates the feasibility of integrative analyses of genomic variations and introduces large-scale hypothesis-driven SNP exploration studies as an emerging...

Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders

Directory of Open Access Journals (Sweden)

Prasko J

2016-10-01

Full Text Available Jan Prasko,1 Ales Grambal,1 Petra Kasalova,1 Dana Kamardova,1 Marie Ociskova,1 Michaela Holubova,1,2 Kristyna Vrbova,1 Zuzana Sigmundova,1 Klara Latalova,1 Milos Slepecky,3 Marta Zatkova3 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital Olomouc, Olomouc, 2Psychiatric Department, Hospital Liberec, Liberec, Czech Republic; 3Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic Objective: The central goal of the study was to analyze the impact of dissociation on the treatment effectiveness in patients with anxiety/neurotic spectrum and depressive disorders with or without comorbid personality disorders.Methods: The research sample consisted of inpatients who were hospitalized in the psychiatric department and met the ICD-10 criteria for diagnosis of depressive disorder, panic disorder, generalized anxiety disorder, mixed anxiety–depressive disorder, agoraphobia, social phobia, obsessive compulsive disorder, posttraumatic stress disorder, adjustment disorders, dissociative/conversion disorders, somatoform disorder, or other anxiety/neurotic spectrum disorder. The participants completed these measures at the start and end of the therapeutic program – Beck Depression Inventory, Beck Anxiety Inventory, a subjective version of Clinical Global Impression-Severity, Sheehan Patient-Related Anxiety Scale, and Dissociative Experience Scale.Results: A total of 840 patients with anxiety or depressive spectrum disorders, who were resistant to pharmacological treatment on an outpatient basis and were referred for hospitalization for the 6-week complex therapeutic program, were enrolled in this study. Of them, 606 were statistically analyzed. Data from the remaining 234 (27.86% patients were not used because of various reasons (103 prematurely finished the program, 131 did not fill in most of the

Neurofeedback Treatment of College Students' Test on Anxiety, Depression, Personality, and Mood

Institute of Scientific and Technical Information of China (English)

Dan Zhu; Yuan Li; Jin Yang

2009-01-01

Biofeedback is used to treat the mental diseases of college students, such as test anxiety, depression, personality, and mood. Anxiety of the colleague students was first tested by test anxiety scale (TAS) and then treated by biofeedback. After getting the biofeedback treatment, the students' TAS scores, blood volume pulse, and skin conductance were decreased, especially, their TAS scores dropped markedly. Meanwhile, the level of EEG ((1 rhythm/( rhythm) and peripheral temperature increased observably. Then, neurofeedback ((1 rhythm/( rhythm) was applied to treat students' depression, personality, and mood. As a result, these three kinds of symptoms got alleviated. And their therapeutic effects based on neurofeedback were more stable, durative and less recrudescent.

Systems biology technologies enable personalized traditional Chinese medicine: a systematic review.

Science.gov (United States)

Wang, Xijun; Zhang, Aihua; Sun, Hui; Wang, Ping

2012-01-01

Traditional Chinese medicine (TCM), an alternative medicine, focuses on the treatment of human disease via the integrity of the close relationship between body and syndrome analysis. It remains a form of primary care in most Asian countries and its characteristics showcase the great advantages of personalized medicine. Although this approach to disease diagnosis, prognosis and treatment has served the medical establishment well for thousands of years, it has serious shortcomings in the era of modern medicine that stem from its reliance on reductionist principles of experimentation and analysis. In this way, systems biology offers the potential to personalize medicine, facilitating the provision of the right care to the right patient at the right time. We expect that systems biology will have a major impact on future personalized therapeutic approaches which herald the future of medicine. Here we summarize current trends and critically review the potential limitations and future prospects of such treatments. Some characteristic examples are presented to highlight the application of this groundbreaking platform to personalized TCM as well as some of the necessary milestones for moving systems biology of a state-of-the-art nature into mainstream health care.

The access of the homeless persons with tuberculosis to the health care: an integrative review

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Annelissa Andrade Virgínio de Oliveira

2017-04-01

Full Text Available Introduction: The Tuberculosis (TB keeps being a big public health problem in the world, having the poverty, the bad life condition, the bad income distribution, the social iniquity and the disability on the health system as a substrate to its maintenance. Objective: To identify the scientific knowledge produced under the access to the health service of the homeless person sick by TB. Method: Integrative literature review conducted from April to June, 2016, having as inclusion criteria: publications written in Portuguese, English or Spanish, published from 1990 to 2015, indexed on the data basis: LILACS, SciELO, MEDLINE and Web of Science and portals Virtual Health Library (VHL and MEDLINE/PubMed, that had the text completely available online. As searching strategy was used the Boolean operator AND, with the descriptors: Tuberculosis, health services accessibility; homeless persons. To obtain the information that answered the research guideline question was elaborated a form that contemplated the following items: identification, theme, descriptors or key-words, abstract, introduction, method, results, discussion, conclusions and references. The search resulted in 51 articles that, observed with the inclusion and exclusion criteria, resulted in 10 complete articles. The data analyzes was made in qualitative terms, summarized in three categories: I Specific characteristics of the homeless people access to the health services to tuberculosis diagnostic and treatment; II Access difficulty to the health care: factors related to homeless people and factors related to health services; III Strategies to overcome the access difficulties of the homeless person (HLP  to the health care. Results: pointed that the homeless people have a higher risk to get sick by TB, presenting TB incidence rate 10 to 20 times higher than the general population. Many obstacles that limited those people access to the health services were identified. Many times they presented

Data-Driven Markov Decision Process Approximations for Personalized Hypertension Treatment Planning

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Greggory J. Schell PhD

2016-10-01

Full Text Available Background: Markov decision process (MDP models are powerful tools. They enable the derivation of optimal treatment policies but may incur long computational times and generate decision rules that are challenging to interpret by physicians. Methods: In an effort to improve usability and interpretability, we examined whether Poisson regression can approximate optimal hypertension treatment policies derived by an MDP for maximizing a patient’s expected discounted quality-adjusted life years. Results: We found that our Poisson approximation to the optimal treatment policy matched the optimal policy in 99% of cases. This high accuracy translates to nearly identical health outcomes for patients. Furthermore, the Poisson approximation results in 104 additional quality-adjusted life years per 1000 patients compared to the Seventh Joint National Committee’s treatment guidelines for hypertension. The comparative health performance of the Poisson approximation was robust to the cardiovascular disease risk calculator used and calculator calibration error. Limitations: Our results are based on Markov chain modeling. Conclusions: Poisson model approximation for blood pressure treatment planning has high fidelity to optimal MDP treatment policies, which can improve usability and enhance transparency of more personalized treatment policies.

Response to "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study"

NARCIS (Netherlands)

de Jongh, A.; ten Broeke, E.

2014-01-01

Last November, the European Journal of Psychotraumatology published an interesting paper entitled "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study". This article

The effects of comorbid personality disorders on cognitive behavioral treatment for panic disorder

NARCIS (Netherlands)

Telch, M.J.; Kamphuis, J.H.; Schmidt, N.B.

2011-01-01

The present study investigated the influence of personality pathology assessed both dimensionally and categorically on acute clinical response to group cognitive-behavioral treatment in a large sample of panic disorder patients (N = 173) meeting DSMIII-R criteria for panic disorder with or without

Personality and Sexual Orientation

Science.gov (United States)

Harris, Charles M.

2004-01-01

Bases for individual acceptance and cultural integration of gays and lesbians were investigated by assessing qualities of personality among four participant groups: Heterosexual females, heterosexual males, homosexual females, and homosexual males. Personality was operationally defined as personal qualities and characteristics associated with…

An Integrated Framework to Achieve Interoperability in Person-Centric Health Management

Directory of Open Access Journals (Sweden)

Fabio Vergari

2011-01-01

Full Text Available The need for high-quality out-of-hospital healthcare is a known socioeconomic problem. Exploiting ICT's evolution, ad-hoc telemedicine solutions have been proposed in the past. Integrating such ad-hoc solutions in order to cost-effectively support the entire healthcare cycle is still a research challenge. In order to handle the heterogeneity of relevant information and to overcome the fragmentation of out-of-hospital instrumentation in person-centric healthcare systems, a shared and open source interoperability component can be adopted, which is ontology driven and based on the semantic web data model. The feasibility and the advantages of the proposed approach are demonstrated by presenting the use case of real-time monitoring of patients' health and their environmental context.

Personalized Medicine: New Perspectives for the Diagnosis and the Treatment of Renal Diseases

Directory of Open Access Journals (Sweden)

Anna Gluba-Brzózka

2017-06-01

Full Text Available The prevalence of renal diseases is rising and reaching 5–15% of the adult population. Renal damage is associated with disturbances of body homeostasis and the loss of equilibrium between exogenous and endogenous elements including drugs and metabolites. Studies indicate that renal diseases are influenced not only by environmental but also by genetic factors. In some cases the disease is caused by mutation in a single gene and at that time severity depends on the presence of one or two mutated alleles. In other cases, renal disease is associated with the presence of alteration within a gene or genes, but environmental factors are also necessary for the development of disease. Therefore, it seems that the analysis of genetic aspects should be a natural component of clinical and experimental studies. The goal of personalized medicine is to determine the right drug, for the right patient, at the right time. Whole-genome examinations may help to change the approach to the disease and the patient resulting in the creation of “personalized medicine” with new diagnostic and treatment strategies designed on the basis of genetic background of each individual. The identification of high-risk patients in pharmacogenomics analyses will help to avoid many unwarranted side effects while optimizing treatment efficacy for individual patients. Personalized therapies for kidney diseases are still at the preliminary stage mainly due to high costs of such analyses and the complex nature of human genome. This review will focus on several areas of interest: renal disease pathogenesis, diagnosis, treatment, rate of progression and the prediction of prognosis.

Groups as a part of integrated treatment plans : Inpatient psychotherapy for outpatients?

NARCIS (Netherlands)

Staats, H

2005-01-01

Group psychotherapy in Germany is well established as part of an integrative treatment plan in inpatient treatment. Outpatient group psychotherapy, however, is conceptualized as a separate treatment option in competition with individual therapy. German guidelines for outpatient psychotherapy exclude

[Mentalization based treatment and borderline personality disorder].

Science.gov (United States)

De Oliveira, C; Rahioui, H; Smadja, M; Gorsane, M A; Louppe, F

2017-08-01

Relationship Scales Questionnaire. During the second phase, which includes individual and group therapy, the aim is to stimulate the capacity of mentalization through different techniques according to the patient's attachment style. These include therapeutic relationship, empathy, affect clarification and elaboration, positive and negative reinforcement. The final phase serves to review the patient's improvement and to prepare him progressively for the end of the therapy which can be experienced as an abandonment. Effectiveness of MBT in treating borderline disorder has been shown in several studies with short and long term benefits. It can be adapted for other personality disorders and specific populations such as adolescents. This article introduces the key concepts and aims of mentalization based treatment. The therapy is briefly described in its different phases and the various techniques are discussed. Clinical trials have shown that MBT is effective in treating borderline disorder in adolescent and adult populations. Despite the effectiveness of this therapy, it is difficult to set up and requires substantial resources. Interpersonal therapy based on attachment provides a therapeutic model focused on problematic areas which can offer an alternative therapy and reduce the fields of investigations. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

[M. Linehan dialectic behavioral psychotherapy. A new concept in the treatment of borderline personality disorders].

Science.gov (United States)

Bohus, M; Berger, M

1996-11-01

M. Linehan developed "dialectical behavioral therapy" specifically to treat chronically suicidal borderline patients. It rests on a biosocial model that assumes a disorder in the regulation of emotions and in tolerance of stress. The numerous dysfunctional patterns of behavior such as self-destructive behavior, inability to govern impulses or severe dissociative phenomena are regarded as attempts at problem-solving. This concept of therapy focuses on the continuing balance between the necessity of accepting maladaptive behavior patterns in both an intrapsychic and an interactional context while still working to change them. A comprehensive manual outlines the clearly structured therapy and integrates a wide choice of therapeutic strategies. Parallel to development of the therapy itself, a method also was developed for testing therapist adherence to the manual's guidelines, thus providing a basis for empirical evaluation. An initial controlled, randomized study demonstrated the significant superiority of this method to methods of unspecific psychotherapy at various levels. In the current endeavor to develop disorder-specific approaches to the treatment of personality disorders, "dialectical behavioral therapy" is a noteworthy model.

Integrating Neuroscience Knowledge and Neuropsychiatric Skills Into Psychiatry: The Way Forward.

Science.gov (United States)

Schildkrout, Barbara; Benjamin, Sheldon; Lauterbach, Margo D

2016-05-01

Increasing the integration of neuroscience knowledge and neuropsychiatric skills into general psychiatric practice would facilitate expanded approaches to diagnosis, formulation, and treatment while positioning practitioners to utilize findings from emerging brain research. There is growing consensus that the field of psychiatry would benefit from more familiarity with neuroscience and neuropsychiatry. Yet there remain numerous factors impeding the integration of these domains of knowledge into general psychiatry.The authors make recommendations to move the field forward, focusing on the need for advocacy by psychiatry and medical organizations and changes in psychiatry education at all levels. For individual psychiatrists, the recommendations target obstacles to attaining expanded neuroscience and neuropsychiatry education and barriers stemming from widely held, often unspoken beliefs. For the system of psychiatric care, recommendations address the conceptual and physical separation of psychiatry from medicine, overemphasis on the Diagnostic and Statistical Manual of Mental Disorders and on psychopharmacology, and different systems in medicine and psychiatry for handling reimbursement and patient records. For psychiatry residency training, recommendations focus on expanding neuroscience/neuropsychiatry faculty and integrating neuroscience education throughout the curriculum.Psychiatry traditionally concerns itself with helping individuals construct meaningful life narratives. Brain function is one of the fundamental determinants of individuality. It is now possible for psychiatrists to integrate knowledge of neuroscience into understanding the whole person by asking, What person has this brain? How does this brain make this person unique? How does this brain make this disorder unique? What treatment will help this disorder in this person with this brain?

Using personality neuroscience to study personality disorder.

Science.gov (United States)

Abram, Samantha V; DeYoung, Colin G

2017-01-01

Personality neuroscience integrates techniques from personality psychology and neuroscience to elucidate the neural basis of individual differences in cognition, emotion, motivation, and behavior. This endeavor is pertinent not only to our understanding of healthy personality variation, but also to the aberrant trait manifestations present in personality disorders and severe psychopathology. In the current review, we focus on the advances and limitations of neuroimaging methods with respect to personality neuroscience. We discuss the value of personality theory as a means to link specific neural mechanisms with various traits (e.g., the neural basis of the "Big Five"). Given the overlap between dimensional models of normal personality and psychopathology, we also describe how researchers can reconceptualize psychopathological disorders along key dimensions, and, in turn, formulate specific neural hypotheses, extended from personality theory. Examples from the borderline personality disorder literature are used to illustrate this approach. We provide recommendations for utilizing neuroimaging methods to capture the neural mechanisms that underlie continuous traits across the spectrum from healthy to maladaptive. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Personality characteristics of children in an orphanage as criteria for the developing of proactive attitude and successful social integration

Directory of Open Access Journals (Sweden)

Larin A.N.

2016-06-01

Full Text Available The article presents the results of a personality characteristics study of orphans and children left without parental care growing up in an orphanage. It is assumed that examined personality characteristics have an effect on the socialization and integration processes after graduating from the orphanage. The paper gives a comparative analysis of personality characteristics in 18 boys and 14 girls aged from 12 to 17 years in orphanages, as well as finds out the personality characteristics undermining the developing of child’s proactive attitude. The study used a children's version of "Individual typological questionnaire" by L.N. Sobchik and Cattell 14 PF method of multivariate personality study. Statistical significance of the results is due to Mann–Whitney U test and Student t-test for nonrandom access. Cattell 14PF study shows that boys and girls in the test groups have personality differences (p≤0.05. A pattern of the results may indicate a general trend of personal characteristics negatively affecting the success of adaptation after graduating from the orphanage.

Narcissistic personality disorder: a clinical perspective.

Science.gov (United States)

Ronningstam, Elsa

2011-03-01

Narcissistic traits and narcissistic personality disorder (NPD) present specific diagnostic challenges. While they are often readily and straightforwardly identified, their presentation in some patients and the reasons for which such patients seek treatment may conceal significant narcissistic pathology. Recently, several empirical studies have confirmed that the phenotypic range of people with NPD includes individuals with insecure, shy, and hypersensitive traits with prominent internalized narcissistic features and functioning. Other studies have confirmed that internal emotional distress, interpersonal vulnerability, fear, pain, anxiety, a sense of inadequacy, and depressivity can also co-occur with narcissistic personality functioning. This paper focuses on integrating these findings into the diagnostic evaluation and initial negotiation of treatment for NPD. In patients with narcissistic traits or NPD, it is important to give attention to the two sides of character functioning, which include both self-serving and self-enhancing manifestations as well as hypersensitivity, fluctuations in self-esteem, and internal pain and fragility. This article highlights some of these seemingly incompatible clinical presentations of narcissistic traits and NPD, especially as they co-occur with depressivity and perfectionism, and it discusses implications for building a treatment alliance with a patient with such a predominant disorder of character functioning. The article also discusses the importance of retaining the NPD diagnosis as a separate type of personality disorder, with this range of features, in the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS-5).

Perceptions of a Person with Mental Retardation as a Function of Participation in Integrated versus Segregated Recreation/Sport Activities: An Experimental Analysis

Science.gov (United States)

Kellow, J. Thomas; Frey, Georgia C.; Sandt, Dawn Rosser

2007-01-01

This study is a conceptual replication of previous work by Storey, Stern, & Parker (1990) that examined the influence of participation in integrated vs. segregated recreation/sports activities on evaluations of a person with mental retardation by persons without a disability. The Storey et al., (1990) study observed that people with mental…

K West integrated water treatment system subproject safety analysis document

International Nuclear Information System (INIS)

SEMMENS, L.S.

1999-01-01

This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System

K West integrated water treatment system subproject safety analysis document

Energy Technology Data Exchange (ETDEWEB)

SEMMENS, L.S.

1999-02-24

This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System.

Condom use assessment of persons in drug abuse treatment.

Science.gov (United States)

Ross, Dana; Schumacher, Joseph E

2004-12-01

The purpose of this study was to objectively and quantitatively assess individual skill level of male condom use. This study developed a reliable and face valid assessment of correct male condom use based on Centers for Disease Control and Prevention criteria. Participants (N= 163) were recruited from persons in treatment for cocaine addiction. Condom use was assessed on the basis of correct completion of eight discrete steps. An overall score of 40% correct condom use indicated the need for training in this sample. Assessment showed training needs especially related to steps involving reduction of ejaculate leakage and steps related to potential hazards of nonoxynol-9 use. Frequency of condom use was also assessed; there was no correlation between frequency of condom use and condom use skill. Drug addiction treatment programs are encouraged to incorporate HIV risk reduction programs that teach condom use skills and use the CUDOS as an empirical measure of condom skill acquisition.

Breast cancer patients' satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service.

Science.gov (United States)

Hack, Carolin C; Antoniadis, Sophia; Hackl, Janina; Langemann, Hanna; Schwitulla, Judith; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

2018-04-27

Complementary medicine services are nowadays usually quite heterogeneous, and little information is available on standards for running an integrative medicine consultancy service. This study aimed to assess patients' satisfaction with a standardized treatment service on integrative medicine. Using a cross-sectional design, 75 breast cancer patients from the integrative medicine consultancy service at the University Breast Center for Franconia were evaluated between January 2016 and March 2017. At primary consultation, patients answered a standardized questionnaire on their medical history and treatment goals regarding integrative medicine. In a subsequent interview, patients evaluated their satisfaction with the treatment service and individual treatment goals. 72% of the patients (n = 54) reported high satisfaction with the overall approach of the treatment service. 76% of the patients (n = 57) were very satisfied or satisfied with their individual treatment plans. The most frequently reported goals were to slow tumor progression (n = 64, 85.3%), reducing the side effects of conventional cancer treatments (n = 60, 80%), and a desire to participate actively in the treatment of breast cancer (n = 64, 85.3%). Using a standardized procedure in integrative medicine allows a high quality level to be offered to patients. Overall, breast cancer patients report very high satisfaction with the integrative medicine consultancy service and state long-term treatment goals. Hence, long-term treatment with integrative medicine methods should be taken into consideration.

The addition of a goal-based motivational interview to treatment as usual to enhance engagement and reduce dropouts in a personality disorder treatment service: results of a feasibility study for a randomized controlled trial.

Science.gov (United States)

McMurran, Mary; Cox, W Miles; Whitham, Diane; Hedges, Lucy

2013-02-17

There are high rates of treatment non-completion for personality disorder and those who do not complete treatment have poorer outcomes. A goal-based motivational interview may increase service users' readiness to engage with therapy and so enhance treatment retention. We conducted a feasibility study to inform the design of a randomized controlled trial. The aims were to test the feasibility of recruitment, randomization and follow-up, and to conduct a preliminary evaluation of the effectiveness of the motivational interview. Patients in an outpatient personality disorder service were randomized to receive the Personal Concerns Inventory plus treatment as usual or treatment as usual only. The main randomized controlled trial feasibility criteria were recruitment of 54% of referrals, and 80% of clients and therapists finding the intervention acceptable. Information was collected on treatment attendance, the clarity of therapy goals and treatment engagement. The recruitment rate was 29% (76 of 258). Of 12 interviewed at follow-up, eight (67%) were positive about the Personal Concerns Inventory. Pre-intervention interviews were conducted with 61% (23 out of 38) of the Personal Concerns Inventory group and 74% (28 out of 38) of the treatment as usual group. Participants' therapy goals were blind-rated for clarity on a scale of 0 to 10. The mean score for the Personal Concerns Inventory group was 6.64 (SD = 2.28) and for the treatment as usual group 2.94 (SD = 1.71). Over 12 weeks, the median percentage session attendance was 83.33% for the Personal Concerns Inventory group (N = 17) and 66.67% for the treatment as usual group (N = 24). Of 59 eligible participants at follow-up, the Treatment Engagement Rating scale was completed for 40 (68%). The mean Treatment Engagement Rating scale score for the Personal Concerns Inventory group was 6.64 (SD = 2.28) and for the treatment as usual group 2.94 (SD = 1.71). Of the 76 participants, 63 (83%) completed the Client Service

Treatment for Chronic Depression Using Schema Therapy

NARCIS (Netherlands)

Renner, F.; Arntz, A.; Leeuw, I.; Huibers, M.J.H.

2013-01-01

Schema therapy (ST) is an integrative treatment approach to chronic lifelong problems with an established effectiveness for treating personality disorders. This article describes the adaptation of ST to chronic depression by reviewing the literature on the underlying risk factors to chronic

Adverse events and treatment completion for latent tuberculosis in jail inmates and homeless persons.

Science.gov (United States)

Lobato, Mark N; Reves, Randall R; Jasmer, Robert M; Grabau, John C; Bock, Naomi N; Shang, Nong

2005-04-01

Recently, a short-course treatment using 60 daily doses of rifampin and pyrazinamide was recommended for latent tuberculosis (TB) infection (LTBI). To determine the acceptability, tolerability, and completion of treatment. Observational cohort study. Five county jails and TB outreach clinics for homeless populations in three cities. Study staff enrolled 1,211 patients (844 inmates and 367 homeless persons). Sites used 60 daily doses of rifampin and pyrazinamide, an approved treatment regimen for LTBI. Types and frequency of drug-related adverse events and outcomes of treatment. Prior to treatment, 25 of 1,178 patients (2.1%) had a serum aminotransferase measurement at least 2.5 times the upper limit of normal. Patients who reported excess alcohol use in the past 12 months were more likely than other patients to have an elevated pretreatment serum aminotransferase level (odds ratio, 2.1; 95% confidence interval, 1.1 to 6.1; p = 0.03). Treatment was stopped in 66 of 162 patients (13.4%) who had a drug-related adverse event. Among 715 patients who had serum aminotransferase measured during treatment, 43 patients (6.0%) had an elevation > 5 times the upper limits of normal, including one patient who died of liver failure attributed to treatment. In multivariate analyses, increasing age, an abnormal baseline aspartate aminotransferase level, and unemployment within the past 24 months were independent risk factors for hepatotoxicity. Completion rates were similar in jail inmates (47.5%) and homeless persons (43.6%). This study detected the first treatment-associated fatality with the rifampin and pyrazinamide regimen, prompting surveillance that detected unacceptable levels of hepatotoxicity and retraction of recommendations for its routine use. Completion rates for LTBI treatment using a short-course regimen exceeds historical rates using isoniazid. Efforts to identify an effective short-course treatment for LTBI should be given a high priority.

The shorter the better? A follow-up analysis of 10-session psychiatric treatment including the motive-oriented therapeutic relationship for borderline personality disorder.

Science.gov (United States)

Kramer, Ueli; Stulz, Niklaus; Berthoud, Laurent; Caspar, Franz; Marquet, Pierre; Kolly, Stéphane; De Roten, Yves; Despland, Jean-Nicolas

2017-05-01

There is little research on short-term treatments for borderline personality disorder (BPD). While the core changes may occur only in long-term treatments, short-term treatments may enable the study of early generic processes of engagement in therapy and thus inform about effective treatment components. It was shown that a 10-session version of a psychiatric treatment was effective in reducing borderline symptoms at the end of this treatment [Kramer, U., Kolly, S., Berthoud, L., Keller, S., Preisig, M., Caspar, F., … Despland, J.-N. (2014). Effects of motive-oriented therapeutic relationship in a ten-session general psychiatric treatment for borderline personality disorder: A randomized controlled trial. Psychotherapy and Psychosomatics, 83, 176-186.]. Also, it was demonstrated in a randomized design that adding the motive-oriented therapeutic relationship (MOTR), following an individualized case formulation based on Plan Analysis, further increased general outcome after session 10 and had a positive effect on the early changes in self-esteem and alliance. The present study focuses on the follow-up period after this initial treatment, examining treatment density and outcomes after 6 months and service utilization after 12 months. Outcome was measured using the OQ-45. Results on a sub-sample of N = 40 patients with available OQ-45 data at follow-up (n = 21 for MOTR-treatment, n = 19 for comparison treatment) showed maintenance of gains over the follow-up period, which did not differ between both conditions. It appeared for this sample that MOTR treatments, while using the same number of sessions, lasted more weeks (i.e., lower treatment density, defined as the number of sessions per week), when compared to the treatments without MOTR. Density marginally predicted symptom reduction at follow-up. Patients in MOTR treatments had a greater likelihood of entering structured psychotherapy after the initial sessions than patients in the comparison

Comparing perceived public stigma and personal stigma of mental health treatment seeking in a young adult sample

OpenAIRE

Pedersen, Eric R.; Paves, Andrew P.

2014-01-01

Perceived public stigma regarding seeking mental health treatment seeking can be a barrier to accessing services for young adults. While factors associating with personal stigma regarding how one would view and treat others have been identified, the discrepancies between perceived and personal stigma has received less research attention. We designed the current study to expand on previous research and examine the discrepancies between perceived public stigma and personal stigma among a sample...

Organization of setting-up sanitary pass-control regime and sanitary treatment of injured persons in case of radiation accidents

International Nuclear Information System (INIS)

Korostin, A.S.; Klochkov, V.N.; Yatsenko, V.N.

1995-01-01

The main aim of sanitary pass-control regime is to prevent propagation of radioactive contamination outside the area of emergency-rescue works and guarantee of sanitary treatment of all persons having radioactive contamination. The paper has studied the questions of organization of sanitary pass-control regime, arrangement of sanitary treatment of the injured persons and rendering first aid in case of radioactive contamination of wounds. 5 refs

Psychological Treatments for Borderline Personality Disorder: A Review of Cognitive-Behavioral Oriented Therapies

Directory of Open Access Journals (Sweden)

Sofia Marques

2017-04-01

Conclusion: In summary, the available studies support cognitive-behavioral psychological treatments as an efficacious intervention in borderline personality disorder. However, the existing scientific literature on this topic is still scarce and there is need for more studies, with higher methodological rigor, that should validate these results.

Treatment decision-making by men with localized prostate cancer: the influence of personal factors.

Science.gov (United States)

Berry, Donna L; Ellis, William J; Woods, Nancy Fugate; Schwien, Christina; Mullen, Kristin H; Yang, Claire

2003-01-01

For many men with localized prostate cancer, there is no definite answer or unequivocal choice regarding treatment modality. This high-stakes treatment decision is made in the context of great uncertainty. The purpose of this study is to systematically document meaningful and relevant aspects of treatment decision-making reported by men with localized prostate cancer. Focus groups and individual interviews were conducted with 44 men who were within 6 months of a diagnosis of localized prostate cancer. Using content analysis and grounded theory analytic techniques, major aspects and processes of men's treatment decision making are identified and described. The participants reported their experiences beginning with influential personal history factors, followed by detailed descriptions of information gathering and the important influence of expected treatment outcomes and other individuals' cancer histories and/or shared opinions. Twenty of the 44 (45%) participants relied heavily on the influence of another's opinion or history to finalize a decision, yet only 10 of the 44 (22.7%) reported this individual to be their physician. A common process, "making the best choice for me" was explicated. Clinicians assume that men are making rational treatment decisions based on reliable information, yet this study documents a different reality. Patient education about medical therapies and the patients' own medical factors is not enough. A clinic visit dialogue that brings personal factors to the conversation along with medical factors can guide a man to making his "best choice" for localized prostate cancer.

Reduction of suicidal ideation in patients undergoing psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders and their neurotic personality traits measured before the hospitalization.

Science.gov (United States)

Rodziński, Paweł; Rutkowski, Krzysztof; Sobański, Jerzy A; Murzyn, Agnieszka; Mielimąka, Michał; Smiatek-Mazgaj, Bogna; Cyranka, Katarzyna; Dembińska, Edyta; Grządziel, Karolina; Klasa, Katarzyna; Müldner-Nieckowski, Łukasz

2015-01-01

Analysis of associations between initial neurotic personality traits and subsequent reduction of suicidal ideation (SI) - or lack of such reduction - obtained until the end of hospitalization in patients who underwent the course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men hospitalized in the day-hospital due to neurotic, behavioral and personality disorders between 2005-2013. At the stage of qualification 134 women and 80 men reported SI, of whom subsequently 84.3% and 77.5% respectively improved. Women with prominent Tendency to risk-taking (p=0.002) and Impulsiveness (p=0.038) constituted subgroups with decreased chances of improvement in terms of SI, while men with prominently elevated level of Envy (p=0.041) and women who seemed to have difficulties in expressing anger adequately (ppsychotherapy. Thus, those subgroups require special attention and diligent selection of therapeutic methods. Also, it is probable that focusing therapy at the above-mentioned personality components may increase effectiveness of SI treatment. Reducing SI during psychotherapy appears to be highly effective especially in women with difficulties in expressing anger adequately and in men with prominently elevated level of Envy, which suggests adequacy of this treatment choice and of targeting those difficulties during psychotherapy.

Environmental integrated impact assessment for waste treatment activity: methodology and case-study application

International Nuclear Information System (INIS)

Lonati, G.; Panzeri, A.

2008-01-01

A literature method for the environmental integrated impact assessment, according to the IPPC Directive, has been critically analysed and adjusted in order to be used for the environmental performance assessment of waste treatment activities. The assessment parameters, sorted in eight treatment and combined pollution categories, have been partly redefined and re balanced. The adjusted methodology has been applied to a real case-study, a chemical- physical waste treatment plant, in order to calculate the current performance (Actual Integrated Index) and the ideal performance (Actual Integrated Index) achievable by technical and operational improvements. The adjusted methodology has also been used as a decision support system, in order to estimate the value of the expected environmental performances improvement after the execution achievable from the introduction of a single one or a set of improvement actions. The valuation of the Integrated Index percentage reduction, along with the action achievable, made the best actions able to be identified, both in comparative way and in the cost-effective one. The results, 50 as Effective Integrated Index and 42 as Ideal Integrated Index, in a 10-100 scale, show a medium impact level and point out an appreciable improvement margin on all the environmental performances, especially in air emission control and water consumption [it

Process modeling for the Integrated Thermal Treatment System (ITTS) study

Energy Technology Data Exchange (ETDEWEB)

Liebelt, K.H.; Brown, B.W.; Quapp, W.J.

1995-09-01

This report describes the process modeling done in support of the integrated thermal treatment system (ITTS) study, Phases 1 and 2. ITTS consists of an integrated systems engineering approach for uniform comparison of widely varying thermal treatment technologies proposed for treatment of the contact-handled mixed low-level wastes (MLLW) currently stored in the U.S. Department of Energy complex. In the overall study, 19 systems were evaluated. Preconceptual designs were developed that included all of the various subsystems necessary for a complete installation, from waste receiving through to primary and secondary stabilization and disposal of the processed wastes. Each system included the necessary auxiliary treatment subsystems so that all of the waste categories in the complex were fully processed. The objective of the modeling task was to perform mass and energy balances of the major material components in each system. Modeling of trace materials, such as pollutants and radioactive isotopes, were beyond the present scope. The modeling of the main and secondary thermal treatment, air pollution control, and metal melting subsystems was done using the ASPEN PLUS process simulation code, Version 9.1-3. These results were combined with calculations for the remainder of the subsystems to achieve the final results, which included offgas volumes, and mass and volume waste reduction ratios.

Process modeling for the Integrated Thermal Treatment System (ITTS) study

International Nuclear Information System (INIS)

Liebelt, K.H.; Brown, B.W.; Quapp, W.J.

1995-09-01

This report describes the process modeling done in support of the integrated thermal treatment system (ITTS) study, Phases 1 and 2. ITTS consists of an integrated systems engineering approach for uniform comparison of widely varying thermal treatment technologies proposed for treatment of the contact-handled mixed low-level wastes (MLLW) currently stored in the U.S. Department of Energy complex. In the overall study, 19 systems were evaluated. Preconceptual designs were developed that included all of the various subsystems necessary for a complete installation, from waste receiving through to primary and secondary stabilization and disposal of the processed wastes. Each system included the necessary auxiliary treatment subsystems so that all of the waste categories in the complex were fully processed. The objective of the modeling task was to perform mass and energy balances of the major material components in each system. Modeling of trace materials, such as pollutants and radioactive isotopes, were beyond the present scope. The modeling of the main and secondary thermal treatment, air pollution control, and metal melting subsystems was done using the ASPEN PLUS process simulation code, Version 9.1-3. These results were combined with calculations for the remainder of the subsystems to achieve the final results, which included offgas volumes, and mass and volume waste reduction ratios

Emotion detection deficits and changes in personality traits linked to loss of white matter integrity in primary progressive aphasia

Directory of Open Access Journals (Sweden)

Namita Multani

2017-01-01

Full Text Available Non-cognitive features including personality changes are increasingly recognized in the three PPA variants (semantic-svPPA, non fluent-nfvPPA, and logopenic-lvPPA. However, differences in emotion processing among the PPA variants and its association with white matter tracts are unknown. We compared emotion detection across the three PPA variants and healthy controls (HC, and related them to white matter tract integrity and cortical degeneration. Personality traits in the PPA group were also examined in relation to white matter tracts. Thirty-three patients with svPPA, nfvPPA, lvPPA, and 32 HC underwent neuropsychological assessment, emotion evaluation task (EET, and MRI scan. Patients' study partners were interviewed on the Clinical Dementia Rating Scale (CDR and completed an interpersonal traits assessment, the Interpersonal Adjective Scale (IAS. Diffusion tensor imaging of uncinate fasciculus (UF, superior longitudinal fasciculus (SLF and inferior longitudinal fasciculus (ILF, and voxel-based morphometry to derive gray matter volumes for orbitofrontal cortex (OFC, anterior temporal lobe (ATL regions were performed. In addition, gray matter volumes of white matter tract-associated regions were also calculated: inferior frontal gyrus (IFG, posterior temporal lobe (PTL, inferior parietal lobe (IPL and occipital lobe (OL. ANCOVA was used to compare EET performance. Partial correlation and multivariate linear regression were conducted to examine association between EET and neuroanatomical regions affected in PPA. All three variants of PPA performed significantly worse than HC on EET, and the svPPA group was least accurate at recognizing emotions. Performance on EET was related to the right UF, SLF, and ILF integrity. Regression analysis revealed EET performance primarily relates to the right UF integrity. The IAS subdomain, cold-hearted, was also associated with right UF integrity. Disease-specific emotion recognition and personality changes occur

A systematic review of personality disorder, race and ethnicity: prevalence, aetiology and treatment

Directory of Open Access Journals (Sweden)

Lee Tennyson

2010-05-01

Full Text Available Abstract Background Although psychoses and ethnicity are well researched, the importance of culture, race and ethnicity has been overlooked in Personality Disorders (PD research. This study aimed to review the published literature on ethnic variations of prevalence, aetiology and treatment of PD. Method A systematic review of studies of PD and race, culture and ethnicity including a narrative synthesis of observational data and meta-analyses of prevalence data with tests for heterogeneity. Results There were few studies with original data on personality disorder and ethnicity. Studies varied in their classification of ethnic group, and few studies defined a specific type of personality disorder. Overall, meta-analyses revealed significant differences in prevalence between black and white groups (OR 0.476, CIs 0.248 - 0.915, p = 0.026 but no differences between Asian or Hispanic groups compared with white groups. Meta-regression analyses found that heterogeneity was explained by some study characteristics: a lower prevalence of PD was reported among black compared with white patients in UK studies, studies using case-note diagnoses rather than structured diagnostic interviews, studies of borderline PD compared with the other PD, studies in secure and inpatient compared with community settings, and among subjects with co-morbid disorders compared to the rest. The evidence base on aetiology and treatment was small. Conclusion There is some evidence of ethnic variations in prevalence of personality disorder but methodological characteristics are likely to account for some of the variation. The findings may indicate neglect of PD diagnosis among ethnic groups, or a true lower prevalence amongst black patients. Further studies are required using more precise cultural and ethnic groups.

A systematic review of personality disorder, race and ethnicity: prevalence, aetiology and treatment.

Science.gov (United States)

McGilloway, Angela; Hall, Ruth E; Lee, Tennyson; Bhui, Kamaldeep S

2010-05-11

Although psychoses and ethnicity are well researched, the importance of culture, race and ethnicity has been overlooked in Personality Disorders (PD) research. This study aimed to review the published literature on ethnic variations of prevalence, aetiology and treatment of PD. A systematic review of studies of PD and race, culture and ethnicity including a narrative synthesis of observational data and meta-analyses of prevalence data with tests for heterogeneity. There were few studies with original data on personality disorder and ethnicity. Studies varied in their classification of ethnic group, and few studies defined a specific type of personality disorder. Overall, meta-analyses revealed significant differences in prevalence between black and white groups (OR 0.476, CIs 0.248 - 0.915, p = 0.026) but no differences between Asian or Hispanic groups compared with white groups. Meta-regression analyses found that heterogeneity was explained by some study characteristics: a lower prevalence of PD was reported among black compared with white patients in UK studies, studies using case-note diagnoses rather than structured diagnostic interviews, studies of borderline PD compared with the other PD, studies in secure and inpatient compared with community settings, and among subjects with co-morbid disorders compared to the rest. The evidence base on aetiology and treatment was small. There is some evidence of ethnic variations in prevalence of personality disorder but methodological characteristics are likely to account for some of the variation. The findings may indicate neglect of PD diagnosis among ethnic groups, or a true lower prevalence amongst black patients. Further studies are required using more precise cultural and ethnic groups.

DeepSurv: personalized treatment recommender system using a Cox proportional hazards deep neural network.

Science.gov (United States)

Katzman, Jared L; Shaham, Uri; Cloninger, Alexander; Bates, Jonathan; Jiang, Tingting; Kluger, Yuval

2018-02-26

Medical practitioners use survival models to explore and understand the relationships between patients' covariates (e.g. clinical and genetic features) and the effectiveness of various treatment options. Standard survival models like the linear Cox proportional hazards model require extensive feature engineering or prior medical knowledge to model treatment interaction at an individual level. While nonlinear survival methods, such as neural networks and survival forests, can inherently model these high-level interaction terms, they have yet to be shown as effective treatment recommender systems. We introduce DeepSurv, a Cox proportional hazards deep neural network and state-of-the-art survival method for modeling interactions between a patient's covariates and treatment effectiveness in order to provide personalized treatment recommendations. We perform a number of experiments training DeepSurv on simulated and real survival data. We demonstrate that DeepSurv performs as well as or better than other state-of-the-art survival models and validate that DeepSurv successfully models increasingly complex relationships between a patient's covariates and their risk of failure. We then show how DeepSurv models the relationship between a patient's features and effectiveness of different treatment options to show how DeepSurv can be used to provide individual treatment recommendations. Finally, we train DeepSurv on real clinical studies to demonstrate how it's personalized treatment recommendations would increase the survival time of a set of patients. The predictive and modeling capabilities of DeepSurv will enable medical researchers to use deep neural networks as a tool in their exploration, understanding, and prediction of the effects of a patient's characteristics on their risk of failure.

Individual Music Therapy with Persons with Frontotemporal Dementia

DEFF Research Database (Denmark)

Ridder, Hanne Mette Ochsner; Aldridge, David

2005-01-01

It is possible to slow down the progression of Alzheimer’s disease with pharmacological treatment. When this treatment is given to people with types of dementia that affect the frontal and temporal lobes (Frontotemporal Dementia) the results are discouraging. It is observed that the patients show...... is an integration of a relational music therapy approach and a more physiologically based arousal model, and is here illustrated in a case study research that integrated both qualitative and quantitative data in a flexible research design....... pronounced restlessness and mania. In this article we describe a non-pharmacological psychosocial approach, music therapy, and how it is possible to work with this method when constitutional, regulative, dialogical, and integrative aspects are included. The focus is on therapeutic singing where well known...... songs are applied in order to build up structure and stability and/or as means of arousal regulation. Songs with personal meaning make it possible to acknowledge the person’s emotions, breaking the social isolation, and meeting the music therapy participant’s psychosocial needs. The clinical approach...

A microbial fuel cell–membrane bioreactor integrated system for cost-effective wastewater treatment

International Nuclear Information System (INIS)

Wang, Yong-Peng; Liu, Xian-Wei; Li, Wen-Wei; Li, Feng; Wang, Yun-Kun; Sheng, Guo-Ping; Zeng, Raymond J.; Yu, Han-Qing

2012-01-01

Highlights: ► An MFC–MBR integrated system for wastewater treatment and electricity generation. ► Stable electricity generation during 1000-h continuous operation. ► Low-cost electrode, separator and filter materials were adopted. -- Abstract: Microbial fuel cell (MFC) and membrane bioreactor (MBR) are both promising technologies for wastewater treatment, but both with limitations. In this study, a novel MFC–MBR integrated system, which combines the advantages of the individual systems, was proposed for simultaneous wastewater treatment and energy recovery. The system favored a better utilization of the oxygen in the aeration tank of MBR by the MFC biocathode, and enabled a high effluent quality. Continuous and stable electricity generation, with the average current of 1.9 ± 0.4 mA, was achieved over a long period of about 40 days. The maximum power density reached 6.0 W m −3 . Moreover, low-cost materials were used for the reactor construction. This integrated system shows great promise for practical wastewater treatment application.

Integrated treatment ameliorates negative symptoms in first episode psychosis--results from the Danish OPUS trial

DEFF Research Database (Denmark)

Thorup, Anne Amalie Elgaard; Petersen, L; Jeppesen, P

2005-01-01

To investigate the effect of integrated treatment on negative, psychotic and disorganised symptoms in patients with first episode psychosis.......To investigate the effect of integrated treatment on negative, psychotic and disorganised symptoms in patients with first episode psychosis....

An integrated anaerobic digestion and UV photocatalytic treatment of distillery wastewater

Energy Technology Data Exchange (ETDEWEB)

Apollo, Seth [Department of Chemical Engineering, Vaal University of Technology, Private Bag X021, Vanderbijlpark 1900 (South Africa); Onyango, Maurice S. [Department of Chemical and Metallurgical Engineering, Tshwane University of Technology, Pretoria, Private Bag X680, Pretoria 0001 (South Africa); Ochieng, Aoyi, E-mail: ochienga@vut.ac.za [Department of Chemical Engineering, Vaal University of Technology, Private Bag X021, Vanderbijlpark 1900 (South Africa)

2013-10-15

Highlights: • Integrated AD and photodegradation is suitable for treatment of distillery effluent. • AD process is effective in COD and BOD reduction but not colour removal. • UV photodegradation is efficient in colour and DON removal. • UV photodegradation as a post treatment technique achieved high efficiencies. • UV pre-treatment inhibited biogas production in the succeeding anaerobic process. -- Abstract: Anaerobic up-flow fixed bed reactor and annular photocatalytic reactor were used to study the efficiency of integrated anaerobic digestion (AD) and ultraviolet (UV) photodegradation of real distillery effluent and raw molasses wastewater (MWW). It was found that UV photodegradation as a stand-alone technique achieved colour removal of 54% and 69% for the distillery and MWW, respectively, with a COD reduction of <20% and a negligible BOD reduction. On the other hand, AD as a single treatment technique was found to be effective in COD and BOD reduction with efficiencies of above 75% and 85%, respectively, for both wastewater samples. However, the AD achieved low colour removal efficiency, with an increase in colour intensity of 13% recorded when treating MWW while a colour removal of 51% was achieved for the distillery effluent. The application of UV photodegradation as a pre-treatment method to the AD process reduced the COD removal and biogas production efficiency. However, an integration in which UV photodegradation was employed as a post-treatment to the AD process achieved high COD removal of above 85% for both wastewater samples, and colour removal of 88% for the distillery effluent. Thus, photodegradation can be employed as a post-treatment technique to an AD system treating distillery effluent for complete removal of the biorecalcitrant and colour imparting compounds.

An integrated anaerobic digestion and UV photocatalytic treatment of distillery wastewater

International Nuclear Information System (INIS)

Apollo, Seth; Onyango, Maurice S.; Ochieng, Aoyi

2013-01-01

Highlights: • Integrated AD and photodegradation is suitable for treatment of distillery effluent. • AD process is effective in COD and BOD reduction but not colour removal. • UV photodegradation is efficient in colour and DON removal. • UV photodegradation as a post treatment technique achieved high efficiencies. • UV pre-treatment inhibited biogas production in the succeeding anaerobic process. -- Abstract: Anaerobic up-flow fixed bed reactor and annular photocatalytic reactor were used to study the efficiency of integrated anaerobic digestion (AD) and ultraviolet (UV) photodegradation of real distillery effluent and raw molasses wastewater (MWW). It was found that UV photodegradation as a stand-alone technique achieved colour removal of 54% and 69% for the distillery and MWW, respectively, with a COD reduction of <20% and a negligible BOD reduction. On the other hand, AD as a single treatment technique was found to be effective in COD and BOD reduction with efficiencies of above 75% and 85%, respectively, for both wastewater samples. However, the AD achieved low colour removal efficiency, with an increase in colour intensity of 13% recorded when treating MWW while a colour removal of 51% was achieved for the distillery effluent. The application of UV photodegradation as a pre-treatment method to the AD process reduced the COD removal and biogas production efficiency. However, an integration in which UV photodegradation was employed as a post-treatment to the AD process achieved high COD removal of above 85% for both wastewater samples, and colour removal of 88% for the distillery effluent. Thus, photodegradation can be employed as a post-treatment technique to an AD system treating distillery effluent for complete removal of the biorecalcitrant and colour imparting compounds

The effectiveness and cost-effectiveness of an integrated cardiometabolic risk assessment and treatment program in primary care (the INTEGRATE study).

NARCIS (Netherlands)

Stol, D.; Badenbroek, I.; Hollander, M.; Nielen, M.; Schellevis, F.; Wit, N. de

2014-01-01

The effectiveness and cost-effectiveness of an integrated cardiometabolic risk assessment and treatment program in primary care (the INTEGRATE study): a stepped-wedge randomized controlled trial protocol. Rationale: The increasing prevalence of cardiometabolic disease (CMD), including cardiovascular

Personality Disorder and Changes in Affect Consciousness: A 3-Year Follow-Up Study of Patients with Avoidant and Borderline Personality Disorder.

Science.gov (United States)

Normann-Eide, Eivind; Johansen, Merete Selsbakk; Normann-Eide, Tone; Egeland, Jens; Wilberg, Theresa

2015-01-01

Personality disorders (PDs) are highly prevalent in patients receiving psychiatric services, and are associated with significant personal and social costs. Over the past two decades, an increasing number of treatment studies have documented the effectiveness of treatment for patients with PDs, especially when it comes to reduction of symptom distress, risk taking behavior, self-harm, or suicide attempts. However, less is known about the more complex aims of improving the personality structure itself, such as identity- and interpersonal disturbances. Emotional dysfunction is closely associated with PD pathology. The present study investigated changes in affect consciousness (AC) in patients with avoidant or borderline PD, and how these changes were associated with clinical status after 3 years of follow-up. The study included 52 individuals; 79 percent were females, and mean age was 30 years. The evaluations included the Affect Consciousness Interview, Symptom Checklist-90-R, Circumplex of Interpersonal Problems, the Index of Self-Esteem, and three domains (Identity Integration, Relational Capacities, and Self-Control) of the Severity Indices of Personality Problems (SIPP-118). There was a significant increase in the Global AC and AC scores for most of the specific affects from baseline to follow-up. As the present study did not include a control group, it cannot be concluded that changes in AC are effects of psychotherapy, and the possibility of age-related maturation processes cannot be excluded. The change in Global AC contributed significantly to explained variance in the follow-up levels of Circumplex of Interpersonal Problems, and the two SIPP-118 domains Relational Capacities and Identity Integration. Improved AC was not associated with change in the Self-Control domain or the Global Severity Index of Symptom Checklist-90-R. The results suggest that AC may be altered for patients with borderline and avoidant PDs, and this is the first study to report that

Personality Disorder and Changes in Affect Consciousness: A 3-Year Follow-Up Study of Patients with Avoidant and Borderline Personality Disorder.

Directory of Open Access Journals (Sweden)

Eivind Normann-Eide

Full Text Available Personality disorders (PDs are highly prevalent in patients receiving psychiatric services, and are associated with significant personal and social costs. Over the past two decades, an increasing number of treatment studies have documented the effectiveness of treatment for patients with PDs, especially when it comes to reduction of symptom distress, risk taking behavior, self-harm, or suicide attempts. However, less is known about the more complex aims of improving the personality structure itself, such as identity- and interpersonal disturbances. Emotional dysfunction is closely associated with PD pathology. The present study investigated changes in affect consciousness (AC in patients with avoidant or borderline PD, and how these changes were associated with clinical status after 3 years of follow-up. The study included 52 individuals; 79 percent were females, and mean age was 30 years. The evaluations included the Affect Consciousness Interview, Symptom Checklist-90-R, Circumplex of Interpersonal Problems, the Index of Self-Esteem, and three domains (Identity Integration, Relational Capacities, and Self-Control of the Severity Indices of Personality Problems (SIPP-118. There was a significant increase in the Global AC and AC scores for most of the specific affects from baseline to follow-up. As the present study did not include a control group, it cannot be concluded that changes in AC are effects of psychotherapy, and the possibility of age-related maturation processes cannot be excluded. The change in Global AC contributed significantly to explained variance in the follow-up levels of Circumplex of Interpersonal Problems, and the two SIPP-118 domains Relational Capacities and Identity Integration. Improved AC was not associated with change in the Self-Control domain or the Global Severity Index of Symptom Checklist-90-R. The results suggest that AC may be altered for patients with borderline and avoidant PDs, and this is the first study to

Personality Disorder and Changes in Affect Consciousness: A 3-Year Follow-Up Study of Patients with Avoidant and Borderline Personality Disorder

Science.gov (United States)

Johansen, Merete Selsbakk; Normann-Eide, Tone; Egeland, Jens

2015-01-01

Personality disorders (PDs) are highly prevalent in patients receiving psychiatric services, and are associated with significant personal and social costs. Over the past two decades, an increasing number of treatment studies have documented the effectiveness of treatment for patients with PDs, especially when it comes to reduction of symptom distress, risk taking behavior, self-harm, or suicide attempts. However, less is known about the more complex aims of improving the personality structure itself, such as identity- and interpersonal disturbances. Emotional dysfunction is closely associated with PD pathology. The present study investigated changes in affect consciousness (AC) in patients with avoidant or borderline PD, and how these changes were associated with clinical status after 3 years of follow-up. The study included 52 individuals; 79 percent were females, and mean age was 30 years. The evaluations included the Affect Consciousness Interview, Symptom Checklist-90-R, Circumplex of Interpersonal Problems, the Index of Self-Esteem, and three domains (Identity Integration, Relational Capacities, and Self-Control) of the Severity Indices of Personality Problems (SIPP-118). There was a significant increase in the Global AC and AC scores for most of the specific affects from baseline to follow-up. As the present study did not include a control group, it cannot be concluded that changes in AC are effects of psychotherapy, and the possibility of age-related maturation processes cannot be excluded. The change in Global AC contributed significantly to explained variance in the follow-up levels of Circumplex of Interpersonal Problems, and the two SIPP-118 domains Relational Capacities and Identity Integration. Improved AC was not associated with change in the Self-Control domain or the Global Severity Index of Symptom Checklist-90-R. The results suggest that AC may be altered for patients with borderline and avoidant PDs, and this is the first study to report that

Integration of TB and ART services fails to improve TB treatment ...

African Journals Online (AJOL)

The median CD4+ count of HIV-positive patients was 152 cells/μl (interquartile range (IQR) 71 - 277) for integrated facilities and 148 cells/μl (IQR 67 - 260) for single-service facilities. There was no statistical difference in the TB treatment outcome profile between integrated and single-service facilities for all TB patients (p=0.

MRI-Guided Regional Personalized Electrical Stimulation in Multisession and Home Treatments

Directory of Open Access Journals (Sweden)

Andrea Cancelli

2018-05-01

Full Text Available The shape and position of the electrodes is a key factor for the efficacy of transcranial electrical stimulations (tES. We have recently introduced the Regional Personalized Electrode (RePE, a tES electrode fitting the personal cortical folding, that has been able to differentiate the stimulation of close by regions, in particular the primary sensory (S1 and motor (M1 cortices, and to personalize tES onto such an extended cortical district. However, neuronavigation on individual brain was compulsory for the correct montage. Here, we aimed at developing and testing a neuronavigation-free procedure for easy and quick positioning RePE, enabling multisession RePE-tES at home. We used off-line individual MRI to shape RePE via an ad-hoc computerized procedure, while an ad-hoc developed Adjustable Helmet Frame (AHF was used to properly position it in multisession treatments, even at home. We used neuronavigation to test the RePE shape and position obtained by the new computerized procedure and the re-positioning obtained via the AHF. Using Finite Element Method (FEM model, we also estimated the intra-cerebral current distribution induced by transcranial direct current stimulation (tDCS comparing RePE vs. non-RePE with fixed reference. Additionally, we tested, using FEM, various shapes, and positions of the reference electrode taking into account possible small displacements of RePE, to test feasibility of RePE-tES sessions at home. The new RePE neuronavigation-free positioning relies on brain MRI space distances, and produced a mean displacement of 3.5 ± 0.8 mm, and the re-positioning of 4.8 ± 1.1 mm. Higher electric field in S1 than in M1 was best obtained with the occipital reference electrode, a montage that proved to feature low sensitivity to typical RePE millimetric displacements. Additionally, a new tES accessory was developed to enable repositioning the electrodes over the scalp also at home, with a precision which is acceptable according to

Therapeutic assessment promotes treatment readiness but does not affect symptom change in patients with personality disorders: Findings from a randomized clinical trial

NARCIS (Netherlands)

de Saeger, H.; Kamphuis, J.H.; Finn, S.E.; Smith, J.D.; Verheul, R.; van Busschbach, J.J.; Feenstra, D.J.; Dine, J.; Horn, E.K.

2014-01-01

The field of clinical personality assessment is lacking in published empirical evidence regarding its treatment and clinical utility. This article reports on a randomized controlled clinical trial (N = 74) allocating patients awaiting treatment in a specialized clinic for personality disorders to

Structural Relation Pattern between Deviant Personality Traits, Risk Perception and Treatment Motivation in People with Substance Dependency: The Mediating Role of Risk Perception

Directory of Open Access Journals (Sweden)

S Basharpoor

2016-02-01

Full Text Available Objective: The current study was conducted to investigate the pattern of structural relations between deviant personality traits, risk perception and treatment motivation in people with substance dependency. Method: A descriptive- correlational method was used in this study. All the drug addicts referring to Ardabil centers of addiction treatment in second half of 2014 constituted the statistical population of this study. The number of 140 individuals from this population was selected via cluster sampling and responded to stages of change readiness and treatment eagerness scale, personality deviance scale, and cognitive appraisal of risky events (CARE questionnaire. Results: The results showed that risk perception and three components of treatment motivation are negatively correlated with hostile thoughts, denigration of others, low self-confidence, dependency, submissiveness; however, risk perception was positively associated with the three components of treatment motivation. The results of regression analyses also revealed that 53% variance of recognition, 44 % variance of ambivalence, and 47 % of variance of step taking were explained by deviant personality traits. Model fitness indexed confirmed the path of deviant personality traits to treatment motivation via the mediating role of risk perception. Conclusion: The findings of this study suggest that low risk perception is one of the explanatory pathways for the relationship between deviant personality traits and treatment motivation.

Changes in Personality Disorder Traits Following 2 Years of Treatment in a Secure Therapeutic Community Milieu

Science.gov (United States)

Morrissey, Catrin; Taylor, Jon

2014-01-01

Therapeutic community treatment models have not previously been applied to forensic patients with mild intellectual disabilities (IDs) with a comorbid diagnosis of personality disorder. Thirteen patients with mild IDs were allocated to a unit within a high secure psychiatric service operating a model of treatment based on the principles and…

MMPI-2 Personality Psychopathology Five (PSY-5) and prediction of treatment outcome for patients with chronic back pain

NARCIS (Netherlands)

Vendrig, A.A.; Derksen, J.J.L.; Mey, H.R.A. De

2000-01-01

This study investigated the utility of the MMPI-2-based Personality Psychopathology Five (PSY-5) scales (Harkness, McNulty, & Ben-Porath, 1995) in the outcome prediction of behaviorally oriented chronic-pain treatment. The PSY-5 is a dimensional descriptive system for personality and its disorders.

Need of integrated dietary therapy for persons with diabetes mellitus and "unhealthy" body constitution presentations.

Science.gov (United States)

Wong, Yee Chi Peggy

2016-07-01

From a perspective of Chinese medicine (CM), persons with unregulated "unhealthy" body constitution (BC) will further develop chronic diseases, such as diabetes mellitus (DM). Conventional dietary therapy with nutrition component has its limitations in the regulation of "unhealthy" BC. However, empirical evidence supports that "unhealthy" BC can be regulated with food natures and flavors from a perspective of CM. Presentations of "unhealthy" BC types, such as Yin-deficiency, Yang-deficiency and Yin-Yang-deficiency were found in persons with DM. It would be necessary to regulate the "unhealthy" BC presentations with integration of conventional dietary therapy and Chinese food therapy. The ultimate goal is to either stabilize glycaemic control or prevent the development of other chronic diseases leading to reduction of disease burden, such as disease-related poor quality of life, stress of healthcare professionals and the rising of healthcare cost.

Nursing interventions for promoting self-care of persons with type 2 diabetes: an integrative review

Directory of Open Access Journals (Sweden)

Glória Yanne Martins de Oliveira

2016-12-01

Full Text Available This is an integrative review aiming at analyzing and identifying the evidence available in the literature on nursing interventions to promote self-care for persons with type 2 diabetes mellitus. Data collection occurred in the Latin American and Caribbean Health Sciences (LILACS, MEDLINE (via EBSCO, Cumulative Index to Nursing and Allied Health Literature (CINAHL and SCOPUS. The survey of articles occurred in July and August 2015 by two independent reviewers. The initial search identified 239 articles and eight of them met the selection criteria. Health education has emerged as a strategic field for implementing nursing interventions. Interventions with patient monitoring and that provided more care time were more satisfactory regarding self-care practices. The Orem's Self-Care Deficit Theory is indicated as a guide to direct the educator in self-care of diabetic persons.

Psychological treatment of depression and anxiety in patients with co-morbid personality disorder: A scoping study of trial evidence.

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French, L R M; Turner, K M; Dawson, S; Moran, P

2017-05-01

It is unclear what the best psychological treatment is for depression and anxiety in people with co-morbid personality disorder. Trials of different psychological treatment options for this patient group have been conducted, but this evidence has not previously been systematically reviewed or critically appraised. We set out to conduct a scoping review in order to describe which psychological therapies appear most effective in treating depression and/or anxiety in patients with co-morbid personality disorder. PsycINFO, Cochrane library trials, Medline and Embase databases were searched for studies involving randomized, controlled, experimental, parallel-arm comparisons, examining any well-defined, psychotherapeutic intervention for adults, in an outpatient setting, with a clearly defined diagnosis of depression and/or anxiety, and co-morbid personality disorder. A total of 1662 papers were identified. Fifteen met criteria for inclusion and were reviewed. There was weak evidence to support the use of cognitive behavioural therapy as a psychological treatment for depression in patients with co-morbid personality disorder. However, the literature is characterized by considerable methodological heterogeneity, and further research is needed before there is sufficient evidence to indicate which psychological treatment would be most effective in treating anxiety and/or depression in this patient group. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

The feasibility of cognitive adaptation training for outpatients with schizophrenia in integrated treatment

DEFF Research Database (Denmark)

Hansen, Jens Peter; Østergaard, Birte; Nordentoft, Merete

2013-01-01

Cognitive adaptation training (CAT) has been tested as a psychosocial treatment, showing promising results. To date there are no reported tests of CAT treatment outside the United States. Thus, we decided to adjust CAT treatment and apply it to an Integrated Treatment setting in Denmark. In this ...

Impact of health education on home treatment and prevention

African Journals Online (AJOL)

Emmanuel Ameh

effect on perception (P < .001), knowledge (P < .001), malaria prevention practice ... Caregivers should also be integrated into malaria ... intention (p=0,031) et le type de traitement administré pour fièvre chez l'enfant (p=0,048). .... person consulting and cost of treatment. .... may play a greater role in the choice of treatment.

Personal Inquiry Manager

NARCIS (Netherlands)

Suarez, Angel; Ternier, Stefaan; Specht, Marcus

2014-01-01

The Personal Inquiry Manager (PIM) is an integration approach based on a mobile application, based on Android, to support the IBL process and gives users mobile access to their inquiries. Moreover it facilitates a more self-directed approach as it enables to set up their own personal inquiries. The

Use of dialectical behavior therapy in inpatient treatment of borderline personality disorder: a systematic review.

Science.gov (United States)

Bloom, Jill Myerow; Woodward, Eva N; Susmaras, Teresa; Pantalone, David W

2012-09-01

Dialectical behavior therapy (DBT) is an empirically supported treatment for outpatients with borderline personality disorder. However, the utility of DBT strategies for inpatients with the disorder is unclear. This review summarizes and synthesizes findings from trials of DBT in inpatient settings. Multiple research databases were searched for articles published through June 2011 that reported on any implementation of DBT in an inpatient setting to address symptoms related to borderline personality disorder, including suicidal and self-injurious behavior. Eleven studies that reported pre- and posttreatment symptoms related to borderline personality disorder were evaluated. Studies indicated that many variations of standard DBT have been used in inpatient settings, including approaches that do not include phone consultation, that include group therapy only, and that vary in treatment duration (from two weeks to three months). Most studies reported reductions in suicidal ideation, self-injurious behaviors, and symptoms of depression and anxiety, whereas results for reducing anger and violent behaviors were mixed. Follow-up data indicated that symptom reduction was often maintained between one and 21 months posttreatment. On the basis of the evidence, the authors identify essential components of an inpatient DBT package and discuss its potential function as an "intensive orientation" to outpatient DBT services. There is considerable variation in the configuration and duration of DBT implementation for inpatients with borderline personality disorder. However, findings suggest that DBT may be effective in reducing symptoms related to borderline personality disorder in inpatient settings. Future research should standardize and systematically test inpatient DBT. (Psychiatric Services 63:881-888, 2012; doi: 10.1176/appi.ps.201100311).

Case study: centralized wastewater treatment plant at Rawang Integrated Industrial Park

International Nuclear Information System (INIS)

Ting Teo Ming; Khomsaton Abu Bakar; Zulkafli Ghazali; Khairul Zaman Mohd Dahlan

2006-01-01

Survey has been conducted at Rawang Integrated Industrial Park (RIIP) to investigate the possibility of setting up centralized industrial wastewater treatment plant. Rawang integrated industrial park is selected based on suggestion from department of environment. RIIP consists of about 150 industries with various type of activities operated in the area. Only 9 out of estimated 150 industries have individual wastewater treatment plant. The business activities of the 9 industries include food processing, textile, welding rods manufacturing, steel galvanizing and battery manufacturing. Wastewater generated by the industries are characterized by high oil and grease, cod, bod, organic matter, metal hydroxide and acidic. Besides that most of industries do the monitoring only once a month. This paper will also discuss the advantages of setting up of centralized industrial wastewater treatment plant to the government authorities, industries, people and environment. (Author)

Metacognition moderates the relationship of disturbances in attachment with severity of borderline personality disorder among persons in treatment of substance use disorders.

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Outcalt, Jared; Dimaggio, Giancarlo; Popolo, Raffaele; Buck, Kelly; Chaudoin-Patzoldt, Kelly A; Kukla, Marina; Olesek, Kyle L; Lysaker, Paul H

2016-01-01

Borderline personality disorder traits have been observed to be linked with both insecure attachment styles as well as deficits in mentalizing and metacognition. Less is known, however, about how attachment style does or does not interact with deficits in mentalizing and metacognition to create, sustain, or influence levels of borderline personality disorder traits. In this study, we examined the hypothesis that metacognitive mastery, which is the ability to use knowledge about mental states of self and others to cope with distress and solve social problems, moderates the relationship of anxious attachment style with the severity of borderline personality disorder traits. Concurrent assessments were gathered of metacognitive mastery using the Metacognitive Assessment Scale Abbreviated, anxious attachment style using the Experiences of in Close Relationships Scale, and borderline personality disorder traits using the Structured Clinical Interview for DSM-IV Axis II Disorders. Participants were 59 adults in an early phase of recovery from substance use disorders in a residential setting. Multiple regression revealed that metacognitive mastery moderated the relationship of anxious attachment style with the number of borderline personality disorder traits. A median split of the anxious attachment and metacognitive mastery scores was performed yielding 4 groups. An analysis of covariance revealed that participants with higher levels of anxious attachment and poorer metacognitive mastery had more borderline personality disorder traits did than the other groups after controlling for levels of psychopathology. Insecure attachment may be associated with higher number of borderline personality disorder traits in the presence of deficits in metacognitive mastery. Patients with substance use and borderline personality disorder traits may benefit from treatment which addresses metacognitive mastery. Published by Elsevier Inc.

Generalizability of Multiple Measures of Treatment Integrity: Comparisons among Direct Observation, Permanent Products, and Self-Report

Science.gov (United States)

Gresham, Frank M.; Dart, Evan H.; Collins, Tai A.

2017-01-01

The concept of treatment integrity is an essential component to databased decision making within a response-to-intervention model. Although treatment integrity is a topic receiving increased attention in the school-based intervention literature, relatively few studies have been conducted regarding the technical adequacy of treatment integrity…

[Personalized molecular medicine: new paradigms in the treatment of cochlear implant and cancer patients].

Science.gov (United States)

Zenner, H P; Pfister, M; Friese, N; Zrenner, E; Röcken, M

2014-07-01

To evaluate present options for the indication of cochlear implants (CI) and new forms of treatment for head and neck cancer, melanomas and basal cell carcinomas, with emphasis on future perspectives. A literature search was performed in the PubMed database. Search parameters were "personalized medicine", "individualized medicine" and "molecular medicine". Personalized medicine based on molecular-genetic evaluation of functional proteins such as otoferlin, connexin 26 and KCNQ4 or the Usher gene is becoming increasingly important for the indication of CI in the context of infant deafness. Determination of HER2/EGFR mutations in the epithelial growth factor receptor (EGFR) gene may be an important prognostic parameter for therapeutic decisions in head and neck cancer patients. In basal cell carcinoma therapy, mutations in the Hedgehog (PCTH1) and Smoothened (SMO) pathways strongly influence the indication of therapeutic Hedgehog inhibition, e.g. using small molecules. Analyses of c-Kit receptor, BRAF-600E and NRAS mutations are required for specific molecular therapy of metastasizing melanomas. The significant advances in the field of specific molecular therapy are best illustrated by the availability of the first gene therapeutic procedures for treatment of RPE65-induced infantile retinal degradation. The aim of personalized molecular medicine is to identify patients who will respond particularly positively or negatively (e.g. in terms of adverse side effects) to a therapy using the methods of molecular medicine. This should allow a specific therapy to be successfully applied or preclude its indication in order to avoid serious adverse side effects. This approach serves to stratify patients for adequate treatment.

The adjustments experienced by persons with an ostomy: an integrative review of the literature.

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Torquato Lopes, Ana Patrícia Araujo; Decesaro, Maria das Neves

2014-10-01

The person with an ostomy may focus on the negative aspects of the stoma rather than its function to the detriment of self-image, acceptance of a new lifestyle, and ability to self-care. The purpose of this integrative literature review was to explore factors involved in the adaption process of persons with a gastrointestinal stoma with a focus on the role of nonspecialist professional nurses in the process. The authors searched the databases of the Virtual Health Library, the Latin American and Caribbean of Health Sciences Information System, the Scientific Electronic Library Online, the Spanish Bibliographic Index of Health Sciences, International Literature on Health Sciences (MEDLINE), and the Cochrane Library using the keywords ostomy, adaption, and nursing for full text articles in all languages published between 2008 and 2013. Of the 612 articles identified, 21 were not duplicates and met the inclusion criteria of availability of full text, published in the past 5 years, indexed, and covering the topic of stoma adaption; this literature was analyzed using Bardin's thematic analysis. Three categories emerged: experiences and adaption strategies employed by the person with a stoma, the role of the care provider, and education as a tool in healthcare. Persons with a stoma need time and support from caregivers, family, and friends to adjust to the changes and adapt to having a stoma. This includes the ability to overcome the stigma of appearance and activities involving social interaction. Caregivers and health professionals need to serve as information resources while encouraging care autonomy. The more informed the patient, the smoother the adaption process. The literature also suggests nursing education may affect caregiving. Further research to elucidate the adaption experienced by each person with an ostomy is needed to help the multidisciplinary team plan care appropriately.

Treatment planning: A key milestone to prevent treatment dropout in adolescents with borderline personality disorder.

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Desrosiers, Lyne; Saint-Jean, Micheline; Breton, Jean-Jacques

2015-06-01

The aim of this study was to gain a broader appreciation of processes involved in treatment dropout in adolescents with borderline personality disorder (BPD). A constructivist grounded theory was chosen using a multiple-case research design with three embedded levels of analysis (adolescent, parent, and care setting). Theoretical sampling and the different stages of analysis specific to grounded theory were performed according to the iterative process of constant comparative analysis. Twelve cases were examined (nine dropouts among adolescents with BPD and for the purpose of falsification, one dropout of suicidal adolescent without BPD and two completed treatments among adolescents with BPD). To document the cases, three groups of informants were recruited (adolescents, parents, and therapists involved in the treatment) and 34 interviews were conducted. Psychological characteristics, perception of mental illness and mental health care, and help-seeking context were the specific treatment dropout vulnerabilities identified in adolescents with BPD and in their parents. However, their disengagement became an issue only when care-setting response--including mitigation of accessibility problems, adaptation of services to needs of adolescents with BPD, preparation for treatment, and concern for clinicians' disposition to treat--was ill-suited to these treatment dropout vulnerabilities. Treatment planning proves to be a key milestone to properly engage adolescents with BPD and their parent. Systematic assessment of treatment dropout vulnerabilities before the intervention plan is laid out could foster better-suited responses of the care setting thus decreasing the incidence of treatment discontinuation in adolescents with BPD. Treatment dropout vulnerabilities specific to adolescents with BPD and their parents can be detected before the beginning of treatment. Premature treatment termination may be prevented if the care setting considers these vulnerabilities at treatment

Primary healthcare-based integrated care with opioid agonist treatment: First experience from Ukraine.

Science.gov (United States)

Morozova, Olga; Dvoriak, Sergey; Pykalo, Iryna; Altice, Frederick L

2017-04-01

Ukraine's HIV epidemic is concentrated among people who inject drugs (PWID), however, coverage with opioid agonist therapies (OATs) available mostly at specialty addiction clinics is extremely low. OAT integrated into primary healthcare clinics (PHCs) provides an opportunity for integrating comprehensive healthcare services and scaling up OAT. A pilot study of PHC-based integrated care for drug users conducted in two Ukrainian cities between 2014 and 2016 included three sub-studies: 1) cross-sectional treatment site preference assessment among current OAT patients (N=755); 2) observational cohort of 107 PWID who continued the standard of care versus transition of stabilized and newly enrolled PWID into PHC-based integrated care; and 3) pre/post analysis of attitudes toward PWID and HIV patients by PHC staff (N=26). Among 755 OAT patients, 53.5% preferred receiving OAT at PHCs, which was independently correlated with convenience, trust in physician, and treatment with methadone (vs. buprenorphine). In 107 PWID observed over 6 months, retention in treatment was high: 89% in PWID continuing OAT in specialty addiction treatment settings (standard of care) vs 94% in PWID transitioning to PHCs; and 80% among PWID newly initiating OAT in PHCs. Overall, satisfaction with treatment, subjective self-perception of well-being, and trust in physician significantly increased in patients prescribed OAT in PHCs. Among PHC staff, attitudes towards PWID and HIV patients significantly improved over time. OAT can be successfully integrated into primary care in low and middle-income countries and improves outcomes in both patients and clinicians while potentially scaling-up OAT for PWID. Copyright © 2017 Elsevier B.V. All rights reserved.

Personalized versus standardized dosing strategies for the treatment of childhood amblyopia: study protocol for a randomized controlled trial.

Science.gov (United States)

Moseley, Merrick J; Wallace, Michael P; Stephens, David A; Fielder, Alistair R; Smith, Laura C; Stewart, Catherine E

2015-04-25

Amblyopia is the commonest visual disorder of childhood in Western societies, affecting, predominantly, spatial visual function. Treatment typically requires a period of refractive correction ('optical treatment') followed by occlusion: covering the nonamblyopic eye with a fabric patch for varying daily durations. Recent studies have provided insight into the optimal amount of patching ('dose'), leading to the adoption of standardized dosing strategies, which, though an advance on previous ad-hoc regimens, take little account of individual patient characteristics. This trial compares the effectiveness of a standardized dosing strategy (that is, a fixed daily occlusion dose based on disease severity) with a personalized dosing strategy (derived from known treatment dose-response functions), in which an initially prescribed occlusion dose is modulated, in a systematic manner, dependent on treatment compliance. A total of 120 children aged between 3 and 8 years of age diagnosed with amblyopia in association with either anisometropia or strabismus, or both, will be randomized to receive either a standardized or a personalized occlusion dose regimen. To avoid confounding by the known benefits of refractive correction, participants will not be randomized until they have completed an optical treatment phase. The primary study objective is to determine whether, at trial endpoint, participants receiving a personalized dosing strategy require fewer hours of occlusion than those in receipt of a standardized dosing strategy. Secondary objectives are to quantify the relationship between observed changes in visual acuity (logMAR, logarithm of the Minimum Angle of Resolution) with age, amblyopia type, and severity of amblyopic visual acuity deficit. This is the first randomized controlled trial of occlusion therapy for amblyopia to compare a treatment arm representative of current best practice with an arm representative of an entirely novel treatment regimen based on statistical

Changing character: A narrative review of personality change in psychotherapies for personality disorder.

Science.gov (United States)

Keefe, John R; DeRubeis, Robert J

2018-01-19

Personality disorder (PD) is a negative prognostic indicator for treatment, and absolute improvements in functioning among these patients are often modest. This may be because personality features that give rise to dysfunction in PD are not targeted optimally during most treatments. Attachment, mentalization, core beliefs, and personality organization/defense use were identified as personality constructs that have been pursued in treatment studies and that are proposed to underlie PD. All constructs correlate with psychiatric symptoms, PD diagnosis, and functioning. Defense mechanisms and core beliefs further distinguish specific PDs, whereas personality organization separates more versus less severe PDs. Evidence from treatment and naturalistic studies indicate that maturation of defense mechanisms temporally precedes improvements in symptoms and functioning. Changes in attachment and mentalization correlate with some outcomes, but mediation of improvement has not been established. In psychodynamic therapy, transference interpretations may promote amelioration of personality dysfunction. With the exception of attachment, the experimental literature is lacking that could explicate the mechanisms by which these personality constructs maintain psychosocial dysfunction. Future research should aim to identify changes in these mechanisms that mediate positive outcomes in PD, as well as the specific therapeutic procedures that best promote positive change in PD.

Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation.

Science.gov (United States)

Ball, Samuel A; Carroll, Kathleen M; Canning-Ball, Monica; Rounsaville, Bruce J

2006-02-01

Previous research has identified risk factors for early attrition from substance abuse treatment, but has not assessed reasons for dropout from the client's perspective. Interview and self-report assessment data were collected from 24 clients who prematurely terminated outpatient treatment to evaluate their subjective reasons for dropping out and the association of these reasons with demographic and clinical variables. Items from scales indicating problems with client motivation or conflicts with program staff were the most commonly endorsed. The severity of participant's symptoms and logistical problems interfering with appointments were less commonly reported as reasons for dropping out. Demographic, substance abuse, and motivational stage indicators were infrequently associated with subjective reasons for dropout. In contrast, indicators of maladaptive personality functioning were strongly associated with many reasons for dropping out, especially concerns about privacy and boundary issues within the program. Results from this preliminary evaluation will guide the development of an instrument and intervention focused on dropout risk factors and treatment reengagement.

Cancer Survivorship Care: Person Centered Care in a Multidisciplinary Shared Care Model

Directory of Open Access Journals (Sweden)

Jacqueline Loonen

2018-01-01

Full Text Available Survivors of childhood and adult-onset cancer are at lifelong risk for the development of late effects of treatment that can lead to serious morbidity and premature mortality. Regular long-term follow-up aiming for prevention, early detection and intervention of late effects can preserve or improve health. The heterogeneous and often serious character of late effects emphasizes the need for specialized cancer survivorship care clinics. Multidisciplinary cancer survivorship care requires a coordinated and well integrated health care environment for risk based screening and intervention. In addition survivors engagement and adherence to the recommendations are also important elements. We developed an innovative model for integrated care for cancer survivors, the “Personalized Cancer Survivorship Care Model”, that is being used in our clinic. This model comprises 1. Personalized follow-up care according to the principles of Person Centered Care, aiming to empower survivors and to support self management, and 2. Organization according to a multidisciplinary and risk based approach. The concept of person centered care is based on three components: initiating, integrating and safeguarding the partnership with the patient. This model has been developed as a universal model of care that will work for all cancer survivors in different health care systems. It could be used for studies to improve self efficacy and the cost-effectiveness of cancer survivorship care.

Person-Oriented Conception of Happiness and Some Personality Theories

Directory of Open Access Journals (Sweden)

Leonid Z. Levit

2014-01-01

Full Text Available Person-oriented conception of happiness (POCH worked out by the author of the article is based on the ideas of systemic approach. The model also serves as valuable personality theory integrating essential elements of the conceptions of Z. Freud, C. Jung, A. Maslow, C. Rogers, and some other scientists. We show how to solve some problems of modern psychology within POCH, and outline perspectives of further investigations. For the first time in world psychology, such concepts as “Egoism” and “Personal Uniqueness” are represented as multilevel systems. Their productive interaction at the higher levels helps a person achieve full-fledged, happy life.

The successful pharmacological treatment of adolescents and young adults with borderline personality disorder: a preliminary open trial of flupenthixol.

Science.gov (United States)

Kutcher, S; Papatheodorou, G; Reiter, S; Gardner, D

1995-01-01

Borderline personality disorder is a significantly disabling disturbance often arising in adolescents or young adults. In the absence of demonstrated effective treatments in this population, this open prospective study evaluated the effect of low dose (3 mg per day) flupenthixol in 13 rigorously diagnosed adolescents with borderline personality disorder. Therapeutic outcome over eight weeks of treatment assessed across measures of impulsivity, depression/dysphoria, general psychopathology and global functioning showed significant improvement in all spheres. These findings suggest that low dose flupenthixol may have a role to play in the short-term treatment of this population. PMID:7703220

Archetype-Based Modeling of Persona for Comprehensive Personality Computing from Personal Big Data

Science.gov (United States)

Ma, Jianhua

2018-01-01

A model describing the wide variety of human behaviours called personality, is becoming increasingly popular among researchers due to the widespread availability of personal big data generated from the use of prevalent digital devices, e.g., smartphones and wearables. Such an approach can be used to model an individual and even digitally clone a person, e.g., a Cyber-I (cyber individual). This work is aimed at establishing a unique and comprehensive description for an individual to mesh with various personalized services and applications. An extensive research literature on or related to psychological modelling exists, i.e., into automatic personality computing. However, the integrity and accuracy of the results from current automatic personality computing is insufficient for the elaborate modeling in Cyber-I due to an insufficient number of data sources. To reach a comprehensive psychological description of a person, it is critical to bring in heterogeneous data sources that could provide plenty of personal data, i.e., the physiological data, and the Internet data. In addition, instead of calculating personality traits from personal data directly, an approach to a personality model derived from the theories of Carl Gustav Jung is used to measure a human subject’s persona. Therefore, this research is focused on designing an archetype-based modeling of persona covering an individual’s facets in different situations to approach a comprehensive personality model. Using personal big data to measure a specific persona in a certain scenario, our research is designed to ensure the accuracy and integrity of the generated personality model. PMID:29495343

Archetype-Based Modeling of Persona for Comprehensive Personality Computing from Personal Big Data

Directory of Open Access Journals (Sweden)

Ao Guo

2018-02-01

Full Text Available A model describing the wide variety of human behaviours called personality, is becoming increasingly popular among researchers due to the widespread availability of personal big data generated from the use of prevalent digital devices, e.g., smartphones and wearables. Such an approach can be used to model an individual and even digitally clone a person, e.g., a Cyber-I (cyber individual. This work is aimed at establishing a unique and comprehensive description for an individual to mesh with various personalized services and applications. An extensive research literature on or related to psychological modelling exists, i.e., into automatic personality computing. However, the integrity and accuracy of the results from current automatic personality computing is insufficient for the elaborate modeling in Cyber-I due to an insufficient number of data sources. To reach a comprehensive psychological description of a person, it is critical to bring in heterogeneous data sources that could provide plenty of personal data, i.e., the physiological data, and the Internet data. In addition, instead of calculating personality traits from personal data directly, an approach to a personality model derived from the theories of Carl Gustav Jung is used to measure a human subject’s persona. Therefore, this research is focused on designing an archetype-based modeling of persona covering an individual’s facets in different situations to approach a comprehensive personality model. Using personal big data to measure a specific persona in a certain scenario, our research is designed to ensure the accuracy and integrity of the generated personality model.

Archetype-Based Modeling of Persona for Comprehensive Personality Computing from Personal Big Data.

Science.gov (United States)

Guo, Ao; Ma, Jianhua

2018-02-25

A model describing the wide variety of human behaviours called personality, is becoming increasingly popular among researchers due to the widespread availability of personal big data generated from the use of prevalent digital devices, e.g., smartphones and wearables. Such an approach can be used to model an individual and even digitally clone a person, e.g., a Cyber-I (cyber individual). This work is aimed at establishing a unique and comprehensive description for an individual to mesh with various personalized services and applications. An extensive research literature on or related to psychological modelling exists, i.e., into automatic personality computing. However, the integrity and accuracy of the results from current automatic personality computing is insufficient for the elaborate modeling in Cyber-I due to an insufficient number of data sources. To reach a comprehensive psychological description of a person, it is critical to bring in heterogeneous data sources that could provide plenty of personal data, i.e., the physiological data, and the Internet data. In addition, instead of calculating personality traits from personal data directly, an approach to a personality model derived from the theories of Carl Gustav Jung is used to measure a human subject's persona. Therefore, this research is focused on designing an archetype-based modeling of persona covering an individual's facets in different situations to approach a comprehensive personality model. Using personal big data to measure a specific persona in a certain scenario, our research is designed to ensure the accuracy and integrity of the generated personality model.

[Migrant workers. The critical aspects of integration].

Science.gov (United States)

Berra, Alessandro

2011-01-01

The integration of migrant poplulations with the indigeneous population is regulated by the Italian Decree, D.Lgs 9/7/2003 n. 215 in enforcement of the directive 2000/43/EC implementing the principle of equal treatment between persons irrespective of racial or ethnic origin. The Italian decree, D.Lgs 215/2003, at present in force, according to regulation stipulated as to the equal treatment of diverse cohabiting populations, explicitly forbids any form of discrimination whatsoever, be it direct or indirect. A first description of today's migrant panorama is offered by the Caritas Migrantes and the CNEL (Italian National Council of the Economy of Labour). The most critical aspects on the integration of migrants are described and discussed in the text.

Borderline personality disorder in adolescence: the case for medium stay inpatient treatment.

Science.gov (United States)

Williams, Laurel; Sharp, Carla

2013-03-01

The diagnosis of personality disorders in adolescents has been a topic of debate in recent years. This manuscript reviews the case of an adolescent girl admitted for a medium length combined inpatient and partial hospitalization program. This program has developed protocols to assess for Axis I and II pathology as well as various psychological processes. Comprehensive outcome measures were administered to the patient at discharge and follow-up. Diagnosis of a personality disorder in adolescence appears to be associated with psychological processes usually identified in adults. Against the background of an emerging debate about the need to reform a culture of ultra-short inpatient care, this case study provides some support for more thorough assessment, diagnosis, and treatment of adolescents who appear to have comorbid Axis I and II disorders.

Helping Gay and Lesbian Students Integrate Sexual and Religious Identities

Science.gov (United States)

Bayne, Hannah Barnhill

2016-01-01

This article explores the impact of sexual and religious identity on college student development, examining developmental models and discussing how counselors can assist gay and lesbian students with integrating these 2 personal identities. Treatment approaches are presented, and the article concludes with an examination of ethical and…

Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

Directory of Open Access Journals (Sweden)

Qarin Lood

2014-03-01

Full Text Available Normal 0 false false false SV JA X-NONE Objective: For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals’ experiences of facilitators and barriers for their possibilities to support healthy ageing in the context of migration. Methods: Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level. Results: Five different conditions were found to influence supporting healthy ageing in the context of migration: sense of belonging through significant others; emotional bonds to a place called home; expectations on health and support during the ageing process; mutual understanding as a means for communication; and heterogeneity as a point of departure. The one comprehensive theme, complexity, describes how those aspects are interrelated in a complex and unpredictable way. Conclusions: The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice.

Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

Directory of Open Access Journals (Sweden)

Qarin Lood

2014-03-01

Full Text Available Normal 0 false false false SV JA X-NONE Objective: For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals’ experiences of facilitators and barriers for their possibilities to support healthy ageing in the context of migration.Methods: Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level.Results: Five different conditions were found to influence supporting healthy ageing in the context of migration: sense of belonging through significant others; emotional bonds to a place called home; expectations on health and support during the ageing process; mutual understanding as a means for communication; and heterogeneity as a point of departure. The one comprehensive theme, complexity, describes how those aspects are interrelated in a complex and unpredictable way.Conclusions: The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice.

Substance abuse treatment and psychiatric comorbidity: do benefits spill over? analysis of data from a prospective trial among cocaine-dependent homeless persons

Directory of Open Access Journals (Sweden)

Kertesz Stefan G

2006-09-01

Full Text Available Abstract Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998 were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression and anxiety-related disorders (e.g. post-traumatic stress disorder. Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32% and anxiety-related disorders (-20% (p = 0.12. Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.

Intersect between self-esteem and emotion regulation in narcissistic personality disorder - implications for alliance building and treatment.

Science.gov (United States)

Ronningstam, Elsa

2017-01-01

Building an alliance with patients with pathological narcissism or narcissistic personality disorder, NPD, can be challenging and include avoidance, negative reactivity and disruptions. A main contributing factor can be the complex interaction between emotion and self-esteem regulation, which affects patients' ability to engage in a therapeutic alliance and treatment. Recent studies, especially in neuroscience have identified functional characteristic and compromises in self-esteem and emotion regulation related to NPD. Self-enhancement, hyper reactivity and need for control, which patients within the range of disordered narcissism often present, can have different roots and underpinnings that require thorough exploration in the process of building the therapeutic alliance and promote change in treatment. Clinical examples with treatment implications and strategies will be discussed to highlight both internal fluctuations and external features and shifts in narcissistic personality functioning.

Did you get any help? A post-hoc secondary analysis of a randomized controlled trial of psychoeducation for patients with antisocial personality disorder in outpatient substance abuse treatment programs.

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Thylstrup, Birgitte; Schrøder, Sidsel; Fridell, Mats; Hesse, Morten

2017-01-09

People in treatment for substance use disorder commonly have comorbid personality disorders, including antisocial personality disorder. Little is known about treatments that specifically address comorbid antisocial personality disorder. Self-rated help received for antisocial personality disorder was assessed during follow-ups at 3, 9 and 15 months post-randomization of a randomized trial of psychoeducation for people with comorbid substance use and antisocial personality disorder (n = 175). Randomization to psychoeducation was associated with increased perceived help for antisocial personality disorder. Perceived help for antisocial personality disorder was in turn associated with more days abstinent and higher treatment satisfaction at the 3-month follow-up, and reduced risk of dropping out of treatment after the 3-month follow-up, and perceived help mediated the effects of random assignment on days abstinent at 3-month. Brief psychoeducation for antisocial personality disorder increased patients' self-rated help for antisocial personality disorder in substance abuse treatment, and reporting having received help for antisocial personality disorder was in turn associated with better short-term outcomes, e.g., days abstinent, dropout from treatment and treatment satisfaction. ISRCTN registry, ISRCTN67266318 , retrospectively registered 17/7/2012.

[Effects of inpatient treatment on eating disorder symptoms, health-related quality of life and personal resources in anorexia and bulimia nervosa].

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Tagay, Sefik; Düllmann, Sonja; Schlegl, Sandra; Nater-Mewes, Ricarda; Repic, Nevena; Hampke, Christian; Brähler, Elmar; Gerlach, Gabriele; Senf, Wolfgang

2011-07-01

The aim of the present prospective-naturalistic study was the evaluation of psychosomatic inpatient treatment for anorexia nervosa (AN) and bulimia nervosa (BN). 128 patients with eating disorders (n=59 AN and n=69 BN) were investigated on admission and discharge using the following standardized questionnaires: eating disorder symptoms (EDI), general psychopathology (BSI), quality of life (SF-12), and personal resources (SOC-13, SWE). Moderate to large effect sizes were achieved for the eating disorder symptoms; in addition, general psychopathology was substantially reduced at the end of treatment, and quality of life as well as personal resources were enhanced. Personal resources were found to be the strongest predictors for therapy outcome. Based on our data, important insights and recommendations may be gained for the inpatient treatment of eating disorders, especially with regard to the potential influence of personal resources. © Georg Thieme Verlag KG Stuttgart · New York.

Modular Architecture for Integrated Model-Based Decision Support.

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Gaebel, Jan; Schreiber, Erik; Oeser, Alexander; Oeltze-Jafra, Steffen

2018-01-01

Model-based decision support systems promise to be a valuable addition to oncological treatments and the implementation of personalized therapies. For the integration and sharing of decision models, the involved systems must be able to communicate with each other. In this paper, we propose a modularized architecture of dedicated systems for the integration of probabilistic decision models into existing hospital environments. These systems interconnect via web services and provide model sharing and processing capabilities for clinical information systems. Along the lines of IHE integration profiles from other disciplines and the meaningful reuse of routinely recorded patient data, our approach aims for the seamless integration of decision models into hospital infrastructure and the physicians' daily work.

Approaching multidimensional forms of knowledge through Personal Meaning Mapping in science integrating teaching outside the classroom

DEFF Research Database (Denmark)

Hartmeyer, Rikke; Bolling, Mads; Bentsen, Peter

2017-01-01

knowledge dimensions is important, especially in science teaching outside the classroom, where “hands-on” approaches and experiments are often part of teaching and require procedural knowledge, among other things. Therefore, this study investigates PMM as a method for exploring specific knowledge dimensions......Current research points to Personal Meaning Mapping (PMM) as a method useful in investigating students’ prior and current science knowledge. However, studies investigating PMM as a method for exploring specific knowledge dimensions are lacking. Ensuring that students are able to access specific...... in formal science education integrating teaching outside the classroom. We applied a case study design involving two schools and four sixth-grade classes. Data were collected from six students in each class who constructed personal meaning maps and were interviewed immediately after natural science...

Integrated thermal treatment system study: Phase 1 results. Volume 1

International Nuclear Information System (INIS)

Feizollahi, F.; Quapp, W.J.; Hempill, H.G.; Groffie, F.J.

1994-07-01

An integrated systems engineering approach is used for uniform comparison of widely varying thermal treatment technologies proposed for management of contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. Ten different systems encompassing several incineration design options are studied. All subsystems, including facilities, equipment, and methods needed for integration of each of the ten systems are identified. Typical subsystems needed for complete treatment of MLLW are incoming waste receiving and preparation (characterization, sorting, sizing, and separation), thermal treatment, air pollution control, primary and secondary stabilization, metal decontamination, metal melting, mercury recovery, lead recovery, and special waste and aqueous waste treatment. The evaluation is performed by developing a preconceptual design package and planning life-cycle cost (PLCC) estimates for each system. As part of the preconceptual design process, functional and operational requirements, flow sheets and mass balances, and conceptual equipment layouts are developed for each system. The PLCC components estimated are technology development, production facility construction, pre-operation, operation and maintenance, and decontamination and decommissioning. Preconceptual design data and other technology information gathered during the study are examined and areas requiring further development, testing, and evaluation are identified and recommended. Using a qualitative method, each of the ten systems are ranked

Predictors of early dropout in treatment for gambling disorder: The role of personality disorders and clinical syndromes.

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Maniaci, G; La Cascia, C; Picone, F; Lipari, A; Cannizzaro, C; La Barbera, D

2017-11-01

Several treatment options for gambling disorder (GD) have been tested in recent years; however dropout levels still remain high. This study aims to evaluate whether the presence of psychiatric comorbidities predicts treatment outcome according to Millon's evolutionary theory, following a six-month therapy for GD. The role of severity, duration of the disorder, typology of gambling (mainly online or offline) and pharmacological treatment were also analysed. The recruitment included 194 pathological gamblers (PGs) to be compared with 78 healthy controls (HCs). Psychological assessment included the South Oaks Gambling Screen and the Millon Clinical Multiaxial Inventory-III. The "treatment failure" group (n = 70) comprised PGs who prematurely dropped out of the treatment whereas the "abstinent group" (n = 124) included PGs who completed the treatment regardless of whether the outcome was successful or not. As expected, the presence of psychiatric comorbidities was highlighted as a significant predictor in dropping out of the therapy. Specifically negativistic personality disorder, antisocial personality disorder, drug dependence and PTSD were associated with early dropout. These variables were predictive of treatment outcome independently from the typology of gambling, severity, duration of the disorder and pharmacological treatment. Implications for psychological and psychiatric care are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Influence of Men’s Personality and Social Support on Treatment Decision-Making for Localized Prostate Cancer

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Elyse Reamer

2017-01-01

Full Text Available Background. Optimal treatment for localized prostate cancer (LPC is controversial. We assessed the effects of personality, specialists seen, and involvement of spouse, family, or friends on treatment decision/decision-making qualities. Methods. We surveyed a population-based sample of men ≤ 75 years with newly diagnosed LPC about treatment choice, reasons for the choice, decision-making difficulty, satisfaction, and regret. Results. Of 160 men (71 black, 89 white, with a mean age of 61 (±7.3 years, 59% chose surgery, 31% chose radiation, and 10% chose active surveillance (AS/watchful waiting (WW. Adjusting for age, race, comorbidity, tumor risk level, and treatment status, men who consulted friends during decision-making were more likely to choose curative treatment (radiation or surgery than WW/AS (OR = 11.1, p<0.01; 8.7, p<0.01. Men who saw a radiation oncologist in addition to a urologist were more likely to choose radiation than surgery (OR = 6.0, p=0.04. Men who consulted family or friends (OR = 2.6, p<0.01; 3.7, p<0.01 experienced greater decision-making difficulty. No personality traits (pessimism, optimism, or faith were associated with treatment choice/decision-making quality measures. Conclusions. In addition to specialist seen, consulting friends increased men’s likelihood of choosing curative treatment. Consulting family or friends increased decision-making difficulty.

Prevalence and treatment of narcissistic personality disorder in the community: a systematic review.

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Dhawan, Nikhil; Kunik, Mark E; Oldham, John; Coverdale, John

2010-01-01

Few studies have examined the prevalence and treatment of narcissistic personality disorder (NPD). We systematically reviewed studies of NPD that used suitable diagnostic methods in adult nonclinical samples and evaluated their strengths and weaknesses. Searches were conducted of MEDLINE (using both MeSH category and free-word search terms), PsycINFO, and PsycLIT for articles in English from January 1980 to August 2008 using the terms Narcissis* and prevalence, of unpublished work identified via contacts with experts in the field, of books on personality disorders, and of reference lists from relevant articles and books. We evaluated articles using a 6-point epidemiologic quality tool that we developed. To determine the most efficacious treatments for NPD without other comorbidities, we performed searches using Narcissis*, pharmacology, clinical pharmacology, therapeutics, and psychotherapy for reports of controlled trials from January 1980 to August 2008. We identified 7 prevalence studies that had used a structured or semistructured interview, 5 of which scored 5/6 using the epidemiologic quality tool. Mean prevalence was 1.06%, and the range was 0% to 6.2%. We found no studies of treatment meeting our inclusion criteria. There was an overall finding of a low prevalence of NPD in adult nonclinical samples. Changes in the classification system might promote further empirical investigations. Published by Elsevier Inc.

Review of the integrated thermal and nonthermal treatment system studies

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-10-01

This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

Review of the integrated thermal and nonthermal treatment system studies

International Nuclear Information System (INIS)

1996-01-01

This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering

Developing an Integrative Treatment Program for Cancer-Related Fatigue Using Stakeholder Engagement - A Qualitative Study.

Science.gov (United States)

Canella, Claudia; Mikolasek, Michael; Rostock, Matthias; Beyer, Jörg; Guckenberger, Matthias; Jenewein, Josef; Linka, Esther; Six, Claudia; Stoll, Sarah; Stupp, Roger; Witt, Claudia M

2017-11-01

Although cancer-related fatigue (CRF) has gained increased attention in the past decade, it remains difficult to treat. An integrative approach combining conventional and complementary medicine interventions seems highly promising. Treatment programs are more likely to be effective if the needs and interests of the people involved are well represented. This can be achieved through stakeholder engagement. The aim of the study was to develop an integrative CRF treatment program using stakeholder engagement and to compare it to an expert version. In a qualitative study, a total of 22 stakeholders (4 oncologists, 1 radiation-oncologist, 1 psycho-oncologist, 5 nurses/nurse experts, 9 patients, 1 patient family member, 1 representative of a local Swiss Cancer League) were interviewed either face-to-face or in a focus group setting. For data analysis, qualitative content analysis was used. With stakeholder engagement, the integrative CRF treatment program was adapted to usual care using a prioritizing approach and allowing more patient choice. Unlike the expert version, in which all intervention options were on the same level, the stakeholder engagement process resulted in a program with 3 different levels. The first level includes mandatory nonpharmacological interventions, the second includes nonpharmacological choice-based interventions, and the third includes pharmacological interventions for severe CRF. The resulting stakeholder based integrative CRF treatment program was implemented as clinical practice guideline at our clinic (Institute for Complementary and Integrative Medicine, University Hospital Zurich). Through the stakeholder engagement approach, we integrated the needs and preferences of people who are directly affected by CRF. This resulted in an integrative CRF treatment program with graded recommendations for interventions and therefore potentially greater sustainability in a usual care setting.

Influences of the Big Five personality traits on the treatment response and longitudinal course of depression in patients with acute coronary syndrome: A randomised controlled trial.

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Kim, Seon-Young; Stewart, Robert; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Hong, Young Joon; Ahn, Youngkeun; Jeong, Myung Ho; Yoon, Jin-Sang; Kim, Jae-Min

2016-10-01

Influences of the Big Five personality traits on the treatment response and longitudinal course of depression in patients with acute coronary syndrome: A randomised controlled trial. This naturalistic observational study initially recruited 1152 ACS patients; 685 patients completed personality assessments at baseline, of whom 630 were followed-up one year later. Of the 294 patients with depression, 207 participated in a 24-week double blind trial of escitalopram or placebo. The remaining 87 patients who received medical treatment only and the 391 who had not depression were also followed in a one year naturalistic observational study. The Big five personality traits were assessed using the Big Five Inventory. The influences of personality on the Hamilton Depression Rating Scale score changes were analysed using a mixed-model repeated-measures analysis of covariance. A Cluster analysis identified two personality types: resilient and vulnerable. The vulnerable personality type was characterized by lower extraversion, agreeableness, and conscientiousness - but higher neuroticism - than the resilient type. This personality type was independently associated with a poorer outcome of depression in ACS patients during the 24-week treatment period and the one year longitudinal follow-up period compared to the resilient personality type, irrespective of treatment allocation. Recruitment from a single institution may limit generalisability. Personality traits were investigated 12-weeks after ACS; thus, the responses may have been influenced by the prior receipt of escitalopram. Personality types influences the treatment outcome and longitudinal course of depression in ACS patients independent of antidepressant treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

[Personality disorders, violence and criminal behaviour].

Science.gov (United States)

Palmstierna, Tom

2016-12-06

Personality disorders, violence and criminal behaviour The importance of personality disorders for violent and criminal behaviour is illustrated by their high prevalence in prison populations. Especially antisocial personality disorder and antisocial personality traits are linked to violence. During diagnostic assessment of personality disorders, violence risk screening is recommended. Cognitive behaviour treatment focused on violent behaviour has some effect in criminal populations, but the antisocial personality traits are resistant to treatment. Evidence for pharmacological treatment of repetitive aggressive behaviour is weak. But, bensodiazepines seem to increase the risk of violent behaviour among patients with personality disorders. Antisocial personality traits diminish over time. This spontaneous decrease can be delayed by comorbidity such as other personality disorder, substance use disorder, psychosis and attention deficit disorders. Therefore it is recommended to actively treat these comorbid conditions.

The comparition of Personality Patterns, irrational beliefs and impulsivity in males with with drug abuse disorder under Treatment

Directory of Open Access Journals (Sweden)

samere asadi

2015-03-01

Full Text Available Objective: the aim of this research was to determine the difference between personality Patterns, irrational beliefs and impulsivity in men with drug abuse disorder under Treatment. Method: in this casual- comparative research, 80 men ( 40 males with drug abuse under Treatment and 40 of normal males that were selected with available sampling .Groups were matched in terms of demoghraphy characteristics ( age, sexuality, education level and marital status and were valued with means of Eysenk Perceived Stress Inventory, Jonze Irrational Beliefs Scale and Baret Impulsivity Inventory. Results: The result of variance analysis showed that addicts compared to normal people, get more scores on extraversion, neuroticism and psychosis. Addicts group had Higher men scores in irrational beliefs compare of other group. There was significant difference between groups in impulsivity and impulsivity in addicts persons is the most. Conclussion: The traits of Personality, irrational beliefs and Unrealistic and high level impulsivity are factors that propel individuals toward more drug abuse and finally addict and aiming this factors in individuals with abuse disorder under Treatment can lead to prevent of Substance Abuse Relapse.

The Relationship between Obsessive Compulsive Personality and Obsessive Compulsive Disorder Treatment Outcomes: Predictive Utility and Clinically Significant Change.

Science.gov (United States)