The effect of contextual risk factors on the effectiveness of brief personality‐targeted interventions for adolescent alcohol use and misuse : a cluster‐randomized trial

Background A range of school‐based prevention programs has been developed and used to prevent, delay, or reduce alcohol use among adolescents. Most of these programs have been evaluated at the community‐level impact. However, the effect of contextual risk factors has rarely been considered in the evaluation of these programs. The aim of this study was to investigate the potential moderating effects of 2 important contextual risk factors (i.e., socioeconomic status [SES] and peer victimization) on the effectiveness of the school‐based personality‐targeted interventions (Preventure program) in reducing adolescent alcohol use over a 2‐year period using a cluster‐randomized trial. Methods High‐risk adolescents were identified using personality scores on the Substance Use Risk Profile Scale and randomized to intervention and control groups. Two 90‐minute cognitive behavioral therapy‐based group sessions targeted 1 of 4 personality risk profiles: Anxiety Sensitivity, Hopelessness, Impulsivity, or Sensation Seeking. Multilevel linear modeling of alcohol use, binge drinking, and drinking‐related harm was conducted to assess the moderating effect of baseline peer victimization and SES. Results Results indicated that the Preventure program was equally beneficial to all adolescents, regardless of SES and victimization history, in terms of their alcohol outcomes and related harm. Receiving the intervention was additionally beneficial for adolescents reporting peer victimization regarding their alcohol‐related harm compared to nonvictimized youth (β = −0.29, SE = 0.11, p = 0.014). Conclusions Findings suggest that the content of personality‐targeted interventions is beneficial for all high‐risk youth regardless of their SES or experience of peer victimization. The current study suggests that using targeted approaches, such as targeting underlying personality risk factors, may be the most appropriate substance use prevention strategy for high‐risk youth, as it is beneficial for all high‐risk youth regardless of their contextual risk factors

Independent contribution of polygenic risk for schizophrenia and cannabis use in predicting psychotic-like experiences in young adulthood: testing gene × environment moderation and mediation

Background It has not yet been determined if the commonly reported cannabis-psychosis association is limited to individuals with pre-existing genetic risk for psychotic disorders. Methods We examined whether the relationship between polygenic risk score for schizophrenia (PRS-Sz) and psychotic-like experiences (PLEs), as measured by the Community Assessment of Psychic Experiences-42 (CAPE-42) questionnaire, is mediated or moderated by lifetime cannabis use at 16 years of age in 1740 of the individuals of the European IMAGEN cohort. Secondary analysis examined the relationships between lifetime cannabis use, PRS-Sz and the various sub-scales of the CAPE-42. Sensitivity analyses including covariates, including a PRS for cannabis use, were conducted and results were replicated using data from 1223 individuals in the Dutch Utrecht cannabis cohort. Results PRS-Sz significantly predicted cannabis use (p = 0.027) and PLE (p = 0.004) in the IMAGEN cohort. In the full model, considering PRS-Sz and covariates, cannabis use was also significantly associated with PLE in IMAGEN (p = 0.007). Results remained consistent in the Utrecht cohort and through sensitivity analyses. Nevertheless, there was no evidence of a mediation or moderation effects. Conclusions These results suggest that cannabis use remains a risk factor for PLEs, over and above genetic vulnerability for schizophrenia. This research does not support the notion that the cannabis-psychosis link is limited to individuals who are genetically predisposed to psychosis and suggests a need for research focusing on cannabis-related processes in psychosis that cannot be explained by genetic vulnerability

Using RothC Model to Simulate Soil Organic Carbon Stocks under Different Climate Change Scenarios for the Rangelands of the Arid Regions of Southern Iran

Soil organic carbon (SOC) is strongly influenced by climate change, and it is believed that increased temperatures might enhance the release of CO2 with higher emission into the atmosphere. Appropriate models may be used to predict the changes of SOC stock under projected future scenarios of climate change. In this investigation, the RothC model was run for a period of 36 years under climate scenarios namely: P (no climate change) as well as CCH1 and CCH2 (climate change scenarios) in the arid rangelands of Ghir–O-Karzin's BandBast in southern Iran. Model results have shown that after 11 years (2014–25), SOC stock decreased by 3.05% under the CCH1 scenario (with a projected annual precipitation decrease by 6.69% and mean annual temperature increase by 9.96%) and by 0.23% under the P scenario. In CCH2, with further decreases in rainfall (10.93%) and increase in temperature (12.53%) compared to CCH1, the model predicted that the SOC stock during the 25 years (2025–50) was reduced by 2.36% and 3.53% under the CCH1 and CCH2 scenario respectively. According to model predictions, with future climatic conditions (higher temperatures and lower rainfall) the decomposition rate may increase resulting in higher losses of soil organic carbon from the soil matrix. The result from this investigation may also be used for developing management techniques to be practiced in the other arid rangelands of Iran with similar conditions

Trauma characteristics, post-traumatic symptoms, psychiatric disorders and suicidal behaviours: Results from the 2007 Australian National Survey of Mental Health and Wellbeing

Objective: The current study examined whether trauma characteristics such as the type and number of traumatic events were associated with three suicidal behaviours (i.e. ideation, plan and attempt) after adjusting for sociodemographic factors, post-traumatic symptoms and history of psychiatric disorders. Method: Data came from the 2007 Australian National Survey of Mental Health and Wellbeing (N = 8841). Respondents were asked about exposure to 28 traumatic events that occurred during their lifetime. Suicidal behaviours were measured using three statements about whether the person ever seriously thought about or planned or attempted suicide. Results: Sexual violence and exposure to multiple traumatic events were particularly associated with suicidal behaviours. The presence of the emotional numbing symptom cluster and co-occurrence of three psychiatric disorders (major depressive disorder, alcohol use disorder and substance use disorder) also increased the odds of suicidal behaviours. Analysis of age of onset revealed that the mean age of traumatic exposure was earlier than the age at which suicidal behaviours emerged. Conclusions: The current study is the first to demonstrate that sexual violence and exposure to multiple traumatic events are associated with suicidal behaviours in a representative sample of Australian adults. The results underline the potential benefits of thorough assessment of trauma history, post-traumatic symptoms and history of psychiatric disorders and their additive contribution in suicide risk among trauma victims. These findings can be used by clinicians and researchers for early intervention programmes

Necessity of Observing Patient’s Rights: A Survey on the Attitudes of Patients, Nurses and Physicians

Studying the situation of observance of patients' rights and interaction of those individuals who provide and/or receive health services are regarded as the most significant and salient parameters of qualitative evaluation of health services.The main aim of this study is to compare the attitudes of patients as recipients of healthcare services with those of physicians and nurses as representatives of healthcare providers regarding the necessity of observance of various aspects of patients' rights in three hospitals selected as representing the three models of providing medical service (teaching, private and public).This was a cross-sectional descriptive analytical study and the data were gathered using a questionnaire. Researchers helped the patients to fill in the questionnaire through interviewing and the physicians and nurses filled in their own questionnaires.The field consisted of three hospitals (a teaching general hospital, a private hospital and a public general one) all located in Tehran. The questionnaires included a set of general questions regarding demographic information and 21 questions about the necessity of observance of patients' rights. They were filled in by the interviewer for 143 patients and, after being sent to other groups, 143 nurses (response rate = 61.3%) and 82 physicians (response rate = 27.5%) filled them in. The criterion for necessity of each right was measured according to the Likert Scale [from 0 (not necessary) to 10 (absolutely necessary]. The data were analyzed using SPSS 11.5 software. Given the abnormal distribution of the data, non-parametrical tests were used.The results of this study showed that all of the study groups agreed wih the necessity of almost all aspects of patients' rights and the highest level of disagreement between groups was related to patients' right of access to information and right of choosing provision provider and deciding on treatment plan. However, these disagreements were not significant altogether.According to the results, it seems that healthcare providers, especially physicians, should be better familiarized with patients' right of access to information and right of choosing and deciding. Based on the disagreement between the attitudes of the patients and physicians in this study, it seems that the patients had a higher level of expectations concerning their rights compared to physicians

Screen time, impulsivity, neuropsychological functions and their relationship to growth in adolescent attention-deficit/hyperactivity disorder symptoms

Abstract Previous longitudinal studies found significant associations between screen time and increase in attention-deficit/hyperactivity disorder (ADHD) symptoms, but the mechanisms mediating this association remain understudied. Thus, we used data from a 5-year population-based longitudinal cohort of nearly 4000 Canadian high school students, modeled using multivariate multilevel mediation, to investigate the association of screen time (i.e., social media, television, video games, computer use) with ADHD symptoms via different potential behavioral and neuropsychological mediators (i.e. impulsivity, response inhibition, working memory). We studied direct and indirect between-person, concurrent within-person, and lagged-within-person effects of screens on ADHD symptoms. Results showed that increases in screen time in a given year were associated with an exacerbation of ADHD symptoms within that same year (within-person association), over and above potential common vulnerability (between-person association). Impulsivity proved to be the most robust mediator in the association of screen time with ADHD symptoms at both between and within-person levels. Only social media use displayed a significant lagged-within-person association with ADHD symptoms mediated by impulsivity, indicating an enduring influence on behavior, which was further shown to be mediated by chained changes in response inhibition on a Go/No-Go task. These findings provide clinical implications of screen time and should be an important focus in the management and prevention of ADHD symptoms among adolescents

Les déterminants psychosociaux de participation à l'ETP en amont d'une chirurgie bariatrique

Introduction : L'éducation thérapeutique du patient (ETP) a prouvé son efficacité dans la prise en charge de plusieurs pathologies. Peu d'études évaluent les freins ou les déterminants de la participation à une ETP. Comprendre les raisons de cette participation permettrait de mieux adapter les programmes aux besoins des patients. Cette étude vise l'identification d'un profil psychosocial des patients acceptant l'ETP en amont d'une chirurgie bariatrique, l'hypothèse étant que des déterminants psychosociaux influencent la participation. Méthode : La méthode mixte intègre l'approche quantitative mesurant la qualité de vie liée à la santé (MOS SF-36, Ware, 1994), l'anxiété–dépression (HADS, Zigmond & Snaith, 1983) et de personnalité (TCI-226, Cloninger, Przybeck, Svrakic, & Wetzel, 1994) à la perspective qualitative focalisant sur l'expérience du sujet. Des entretiens semi-directifs ont permis de recueillir le contexte de la demande de chirurgie, les évènements associés à la prise de poids, la perception de l'obésité, les habitudes alimentaires, les attentes concernant la chirurgie et les raisons données à participer au programme. Résultats : Les régressions logistiques multiples et les analyses textuelles mettent en avant le rôle des tendances comportementales et des perceptions des patients dans l'acceptabilité du programme. Un profil de patients « adhérents » à l'ETP se distingue par des schémas cognitifs d'instabilité émotionnelle (recherche de soutien social, besoin de liens affectifs et dépendance à la récompense), une internalisation de la maladie et des évènements de vie associés ainsi que des stratégies de coping actives. Ils recherchent de l'information supplémentaire, ont besoin d'échanges avec des professionnels et leurs pairs pour prendre des décisions pour leur santé. Discussion : L'adhésion à un programme d'ETP dépend de multiples facteurs intrinsèques à l'individu. Il convient d'adapter les programmes aux besoins des patients

Network approach to the symptom-level association between alcohol use disorder and posttraumatic stress disorder

Purpose The high prevalence of alcohol use disorder among individuals with a history of trauma and posttraumatic stress disorder is well documented. The current study applied network analysis to map the structure of symptom associations between these disorders. Methods Data come from a community sample of 449 Australian adults with a history of trauma and alcohol consumption during the last 12 months. Data analysis consisted of the construction of the comorbidity network of PTSD/AUD symptoms, identification of the bridging symptoms, computation of the centrality measures, and evaluation of the robustness of the results. Results Results highlighted two main symptom clusters, corresponding to two disorders, and that only nine edges connected the two clusters. Bridging symptoms connecting the two clusters were: alcohol use in dangerous situations, physical or mental health problems as a result of alcohol use, loss of interest or reduced social activities, and reckless/self-destructive behaviour. Conclusions Identification of both central symptoms, because of their key role in the constellation and strong associations with majority of symptoms, and bridge symptoms, because of their mediating role between two disorders, has some implications in terms of self-medication and risk-taking/self-regulation theories of comorbidity and provides a number of clinical implications, which warrants further exploration within clinical samples.This project was funded by the Endeavour research fellowship granted by department of education and training—Australian Government

Rapid antidepressant effects of repeated doses of ketamine compared with electroconvulsive therapy in hospitalized patients with major depressive disorder.

Accumulating evidence suggests that N-methyl-d-aspartate receptor (NMDAR) antagonists (e.g. ketamine) may exert rapid antidepressant effects in MDD patients. In the present study, we evaluated the rapid antidepressant effects of ketamine compared with the electroconvulsive therapy (ECT) in hospitalized patients with MDD. In this blind, randomized study, 18 patients with DSM-IV MDD were divided into two groups which received either three intravenous infusions of ketamine hydrochloride (0.5 mg/kg over 45 min) or ECT on 3 test days (every 48 h). The primary outcome measure was the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS), which was used to rate overall depressive symptoms at baseline, 24 h after each treatment, 72 h and one week after the last (third) ketamine or ECT. Within 24 h, depressive symptoms significantly improved in subjects receiving the first dose of ketamine compared with ECT group. Compared to baseline level, this improvement remained significant throughout the study. Depressive symptoms after the second dose ketamine was also lower than the second ECT. This study showed that ketamine is as effective as ECT in improving depressive symptoms in MDD patients and have more rapid antidepressant effects compared with the ECT