The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder - study protocol of the randomised, multi-centre controlled SOSTA - net trial

Background: Group-based social skills training (SST) has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD). To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA–FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS) compared to treatment as usual (TAU). It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU. Methods/design: The SOSTA – net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres. Discussion: This study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings. Trial registration: ISRCTN94863788 – SOSTA – net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder

Reducing parental anxiety using a family based intervention for youth mental health : a randomized controlled trial

This paper presents findings on parent anxiety and attachment relationship style from the Deakin Family Options (DFO) pilot study, a randomized controlled pilot study comparing a family-based treatment (BEST Plus), versus a youth only treatment (CBT) versus a group who received both of these treatments (COMBINED). Eligible participants were families with a young person (aged 12 - 25 years) with a high prevalence mental health problem. Youth from participating families scored in the clinical or subclinical range for depression, anxiety and/or substance misuse symptoms on standardized measures during the initial assessment. The collected sample was drawn from regional and urban centers in Victoria, Australia and allocated to treatment condition using a simple randomization procedure (parallel design). It was hypothesized that families receiving the BEST Plus would experience greater reductions in youth and parent mental health symptoms, and improved parent-child relationships, compared with those in the CBT condition. This paper describes and discusses changes in parent anxiety and parent attachment, according to whether the parent participated in a treatment (BEST Plus) or did not (NONBEST Plus). Participants were blind to the study hypotheses. In total 71 parent participants returned pre data and were allocated to a treatment group. In this paper, data from parent participants who completed pre and post measures (n = 48) and pre, post, and 6-month follow-up measures (n = 28) on anxiety and attachment were analyzed by group (BEST Plus versus NONBEST Plus). The results of this study suggest that parent anxiety decreased significantly more following parent involvement in a group treatment, than for parents that did not receive treatment. Unexpectedly, avoidant attachment increased in the no treatment group, but remained relatively stable following the BEST Plus group. There were no significant findings in relation to compulsive traits and anxious attachment. These findings are discussed in light of the study limitations.<br /

Goal-Focused Emotion-Regulation Therapy (GET) for young adult survivors of testicular cancer: a pilot randomized controlled trial of a biobehavioral intervention protocol.

BackgroundTesticular cancer diagnosis and treatment, especially given its threat to sexuality and reproductive health, can be distressing in the formative period of young adulthood and the majority of young survivors experience impairing, distressing, and modifiable adverse outcomes that can persist long after medical treatment. These include psychological distress, impairment in pursuit of life goals, persistent physical side effects, elevated risk of secondary malignancies and chronic illness, and biobehavioral burden (e.g., enhanced inflammation, dysregulated diurnal stress hormones). However, few targeted interventions exist to assist young survivors in renegotiating life goals and regulating cancer-related emotions, and none focus on reducing the burden of morbidity via biobehavioral mechanisms. This paper describes the methodology of a randomized controlled biobehavioral trial designed to investigate the feasibility and preliminary impact of a novel intervention, Goal-focused Emotion-Regulation Therapy (GET), aimed at improving distress symptoms, emotion regulation, goal navigation skills, and stress-sensitive biomarkers in young adult testicular cancer patients.MethodsParticipants will be randomized to receive six sessions of GET or Individual Supportive Therapy (ISP) delivered over 8 weeks. In addition to indicators of intervention feasibility, we will measure primary (depressive and anxiety symptoms) and secondary (emotion regulation and goal navigation skills, career confusion) psychological outcomes prior to (T0), immediately after (T1), and 12 weeks after (T2) intervention. Additionally, identified biomarkers will be measured at baseline and at T2.DiscussionGET may have the potential to improve self-regulation across biobehavioral domains, improve overall cancer adjustment, and address the need for targeted supportive care interventions for young adult cancer survivors.Trial registrationClinicaltrials.gov, NCT04150848. Registered on 28 October 2019

weSPOT: a cloud-based approach for personal and social inquiry

Scientific inquiry is at the core of the curricula of schools and universities across Europe. weSPOT is a new European initiative proposing a cloud-based approach for personal and social inquiry. weSPOT aims at enabling students to create their mashups out of cloud-based tools in order to perform scientific investigations. Students will also be able to share their inquiry accomplishments in social networks and receive feedback from the learning environment and their peers

The Impact of Residential Treatment on Emotionally Disturbed Boys

Within the past four decades, social work has witnessed the development of increasingly specialized servicecs to children, among these a sort of “total impact therapy” generally defined as residential treatment. In conjunction with the basic social work values of the bio-psycho-social nature of human maladjustment, residential centres have attempted to help the child effect a happier adjustment to his life situation by meeting some ungratified basic need. Institutions for dependent children complimented those for custodial care of even isolation; contemporary residential treatment centres are designed to meet a broader range of needs of the child than those of forty years ago through a variety of approaches, often referred to as milieu therapy. Consideration of the common needs of children is basic to questions concerning the place of institutional treatment and the particular type of child for which this social work service is the most appropriate one. The residential treatment centre addresses the whole gamut of a child’s needs from physical care to rehabilitation. Exposure to, and participation in, a group life experience simulating as closely as possible the family or community life experience is the element differentiating residential care from other treatment modes. By involvement in the realities of his daily situation and the working through or resolution of these, the child is helped to cope with his own growth and development—physical, emotional, and social. Problems and questions examined in this paper revolve around the residential treatment centre defined vaguely by the Child Welfare League of America as “A building....maintained and operated by a chartered agency, organization or institution, whose main purpose is to provide shelter and care to a group of unrelated children and youths up to eighteen years of age.” More specifically, the concern for research, the proposal and plans for implementation are focused on Mount St. Joseph, an autonomous, non-profit institution providing care for boys with moderate to severe emotional disturbances

Affect Recognition in Autism: a single case study on integrating a humanoid robot in a standard therapy.

Autism Spectrum Disorder (ASD) is a multifaceted developmental disorder that comprises a mixture of social impairments, with deficits in many areas including the theory of mind, imitation, and communication. Moreover, people with autism have difficulty in recognising and understanding emotional expressions. We are currently working on integrating a humanoid robot within the standard clinical treatment offered to children with ASD to support the therapists. In this article, using the A-B-A' single case design, we propose a robot-assisted affect recognition training and to present the results on the child’s progress during the five months of clinical experimentation. In the investigation, we tested the generalization of learning and the long-term maintenance of new skills via the NEPSY-II affection recognition sub-test. The results of this single case study suggest the feasibility and effectiveness of using a humanoid robot to assist with emotion recognition training in children with ASD

Risikofaktoren und Prävention aggressiven Verhaltens von Kindern und Jugendlichen

Contrary to often very simplified explanatory approaches published in the media, the ongoing research takes into account a multi-causal framework and different developmental processes with respect to the causes of aggressive behavior. Meanwhile, a bio-psycho-social model has been established which broadly describes the conditions correlating with the development of aggressive behavior. In addition to the developmental risk and the protective factors listed in this model, situative factors such as provocation, special incentives, ownership of weapons and other provoking factors are also decisive. In accordance with the broad range of developmental and triggering factors, numerous interventions and most of all preventive programs are suggested to reduce aggressive behavior. One of the most intensively evaluated and internationally known prevention programs is “Faustlos” (“without fists”). This article outlines evaluation outcomes, content and structure of the Faustlos-curriculum. The text also summarizes the risk and protective factors for aggressive behavior in children and adolescents. (DIPF/Orig.)Im Gegensatz zu den teilweise sehr vereinfachenden Erklärungsansätzen in den Medien, ist bezüglich der Ursachen für aggressives Verhalten von einem multikausalen Bedingungsgefüge und unterschiedlichen Entwicklungsverläufen aggressiven Verhaltens auszugehen. Für eine umfassende Beschreibung der Bedingungen, die mit der Entstehung aggressiven Verhaltens korrelieren, hat sich inzwischen ein bio-psycho-soziales Modell etabliert. Neben den hier aufgeführten ursächlichen Risiko- und Schutzfaktoren sind für das Auftreten aggressiver Verhaltensweisen auch situative Faktoren wie Provokationen, spezielle Anreize, Waffenbesitz und andere auslösende Momente entscheidend. Entsprechend der breiten Palette ursächlicher und auslösender Faktoren werden zur Eindämmung aggressiven Verhalten vielfältige Interventions- und v.a. Präventionsmaßnahmen vorgeschlagen. Eines der am intensivsten evaluierten und international sehr verbreiteten Präventionsprogramme ist „Faustlos“. Im vorliegenden Artikel werden Evaluationsergebnisse, Inhalte und Struktur des Faustlos-Programms beschrieben, und es werden die Risiko- und Schutzfaktoren aggressiven Verhaltens von Kindern und Jugendlichen zusammenfassend dargestellt. (DIPF/Orig.

Arthroscopy or ultrasound in undergraduate anatomy education: a randomized cross-over controlled trial

Background: The exponential growth of image-based diagnostic and minimally invasive interventions requires a detailed three-dimensional anatomical knowledge and increases the demand towards the undergraduate anatomical curriculum. This randomized controlled trial investigates whether musculoskeletal ultrasound (MSUS) or arthroscopic methods can increase the anatomical knowledge uptake. Methods: Second-year medical students were randomly allocated to three groups. In addition to the compulsory dissection course, the ultrasound group (MSUS) was taught by eight, didactically and professionally trained, experienced student-teachers and the arthroscopy group (ASK) was taught by eight experienced physicians. The control group (CON) acquired the anatomical knowledge only via the dissection course. Exposure (MSUS and ASK) took place in two separate lessons (75 minutes each, shoulder and knee joint) and introduced standard scan planes using a 10-MHz ultrasound system as well as arthroscopy tutorials at a simulator combined with video tutorials. The theoretical anatomic learning outcomes were tested using a multiple-choice questionnaire (MCQ), and after cross-over an objective structured clinical examination (OSCE). Differences in student's perceptions were evaluated using Likert scale-based items. Results: The ASK-group (n = 70, age 23.4 (20--36) yrs.) performed moderately better in the anatomical MC exam in comparison to the MSUS-group (n = 84, age 24.2 (20--53) yrs.) and the CON-group (n = 88, 22.8 (20--33) yrs.; p = 0.019). After an additional arthroscopy teaching 1 % of students failed the MC exam, in contrast to 10 % in the MSUS- or CON-group, respectively. The benefit of the ASK module was limited to the shoulder area (p < 0.001). The final examination (OSCE) showed no significant differences between any of the groups with good overall performances. In the evaluation, the students certified the arthroscopic tutorial a greater advantage concerning anatomical skills with higher spatial imagination in comparison to the ultrasound tutorial (p = 0.002; p < 0.001). Conclusions: The additional implementation of arthroscopy tutorials to the dissection course during the undergraduate anatomy training is profitable and attractive to students with respect to complex joint anatomy. Simultaneous teaching of basic-skills in musculoskeletal ultrasound should be performed by medical experts, but seems to be inferior to the arthroscopic 2D-3D-transformation, and is regarded by students as more difficult to learn. Although arthroscopy and ultrasound teaching do not have a major effect on learning joint anatomy, they have the potency to raise the interest in surgery

Efficacy and cost-effectiveness of an experimental short-term inpatient Dialectical Behavior Therapy (DBT) program: Study protocol for a randomized controlled trial

__Abstract__ Background: Borderline Personality Disorder (BPD) is a serious psychiatric condition associated with substantial mortality, burden and public health costs. DBT is the treatment model with the largest number of published research articles showing effectiveness. However, some patients are not sufficiently engaged in outpatient treatment while presenting severe parasuicidal behavior, making hospitalization necessary. The Center for Personality Disorders Jelgersma developed an intensive 12-week inpatient DBT program that (i) rapidly reduces core borderline symptoms like suicidal behavior, (ii) minimizes the negative effects of an inpatient setting, and (iii) enhances compliance with outpatient treatment. We evaluate the (cost-) effectiveness of this experimental program.Methods/design: Seventy patients, aged 18 to 45 years with a primary diagnosis of BPD, showing a chronic pattern of parasuicidal gestures and/or reporting high degrees of severity of other borderline symptoms, are randomly allocated to the control and intervention groups. Subjects in the control group receive standard outpatient DBT, provided in one of three regular mental health settings in GGZ Rivierduinen. Subjects in the intervention group receive 12 weeks of intensified inpatient DBT plus six months of standard DBT, provided in the Center for Personality Disorders Jelgersma. The primary outcome is the number of suicide attempts/self-harming acts. Secondary outcomes are severity of other borderline complaints, quality of life, general psychopathological symptoms and health care utilization and productivity costs. Data are gathered using a prospective, two (group: intervention and control) by five (time of measurement) repeated measures factorial design.Participants will complete three-monthly outcome assessments in the course of therapy: at baseline, and 12, 24, 36 and 52 weeks after the start of the treatment. The period of recruitment started in March 2012 and the study will end in December 2014.Discussion: Highly suicidal outpatient patients can pose a dilemma for mental health care professionals. Although hospitalization seems inevitable under some circumstances, it has proven to be harmful in its own right. This paper outlines the background and methods of a randomized trial evaluating the possible surplus value of a short-term inpatient DBT program

Parenting interventions for ADHD: a systematic literature review and meta-analysis

Objective. To evaluate the evidence base relating to the effectiveness of parent-administered behavioral interventions for ADHD