Emotional competence mediates the relationship between communication problems and reactive externalizing problems in children with and without developmental language disorder: A longitudinal study

Language problems are a risk factor for externalizing problems, but the developmental path remains unclear. Emotional competence may mediate the relationship, especially when externalizing problems are reactive in nature, such as in Oppositional Deviant Disorder (ODD) and reactive aggression. We examined the development of reactive and proactive externalizing problems in children with (n = 98) and without (n = 156) Developmental Language Disorder (DLD; age: 8–16 years) over 18 months. Relationships with communicative risk factors (structural, pragmatic and emotion communication) and the mediating role of emotional competence (emotion recognition and anger dysregulation) were examined. Multi-level analyses showed that increasing emotion recognition and decreasing anger dysregulation were longitudinally related to decreasing ODD symptoms in both groups, whereas anger dysregulation was related to more reactive aggression in children with DLD alone. Pragmatic and emotion communication problems were related to more reactive externalizing problems, but these relationships were mediated by emotional competence, suggesting that problems in emotional competence explain the communication problems of children with DLD. Therefore, in addition to interventions for communication skills, there is a need to address the emotional competence of children with DLD, as this decreases the risk for reactive externalizing problems

Systems training for emotional predictability and problem solving in older adults with personality disorders:A pilot study

Background: Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a cognitive behavioural therapy-based group treatment programme for patients with borderline personality disorder (BPD). STEPPS has demonstrated its effectiveness for (younger) adults. However, there are no studies into the effects of STEPPS for older adults. Aim: The aim was to explore the outcome of STEPPS in older adults with personality disorders. Method: In this naturalistic pre- vs post-treatment study, older patients with a personality disorder, reporting emotion regulation difficulties, were included. The primary outcome was BPD symptoms. Secondary outcomes included psychological distress and maladaptive personality functioning. Results: Twenty-four patients, with a mean age of 63.9 years (SD=4.6), completed the 19-week programme. Nine patients (23.1%) did not complete the treatment. There were no significant differences in age, gender or global severity between completers and patients dropping out. There was a significant pre- vs post-treatment decrease of BPD symptoms, with a large effect size (Cohen’s d=1.577). Self-control improved significantly and demonstrated a large effect size (r=.576). Furthermore, identity integration improved significantly, with a medium effect size (Cohen’s d=.509). No significant differences were reported for most domains of psychological distress and maladaptive interpersonal personality functioning. Conclusions: The findings in this pilot study suggest STEPPS is a feasible treatment programme for older adults with personality disorders and emotion regulation difficulties. Adaptations to the program, for a better fit for older adults, however, might be needed

Systems training for emotional predictability and problem solving for borderline personality disorder:A systematic review

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD). The program was intended to be highly accessible, both for patients and therapists. During STEPPS, patients are taught emotion regulation and behavior management skills. This systematic review synthesizes the current empirical status of STEPPS, focusing on research designs, quality of studies, target groups, protocols, and outcome. We selected 20 studies, with three randomized controlled trials. Patients with BPD, subthreshold BPD, and patients with BPD and comorbid antisocial personality disorder were investigated. One study was conducted in adolescents. There were no studies in older adults. Results demonstrated STEPPS to be associated with reduced BPD symptoms, improved quality of life, decreased depressive symptoms, and decreased negative affectivity. Mixed results were found for impulsivity and suicidal behaviors. STEPPS has both been studied as an add-on therapy to patients' ongoing treatment, and, with the addition of individual STEPPS sessions, as a stand-alone treatment. High attrition rates were found in patients attending STEPPS, complicating the generalizability of the results. Although the evidence for STEPPS is promising, further research is needed before firm conclusions can be drawn. Recommendations for future research are discussed

The spliceosome as target for anticancer treatment

The spliceosome is a ribonucleoprotein complex involved in RNA splicing, that is, the removal of non-coding introns from precursor messenger RNA. (Alternative) Splicing events may play an essential role in tumourigenesis. The recent discovery that the spliceosome is a target for novel compounds with anticancer activity opens up new therapeutic avenues

Adapting group schema therapy for older adults with personality disorders:Lessons learnt

A first empirical study into group schema therapy in older adults with mood disorders and personality disorder (PD) features has shown that brief group schema therapy has potential to decrease psychological distress and to change early maladaptive schemas (EMS). Effect sizes however were smaller than those found in similar studies in younger adults. Therefore, we set out to adapt the treatment protocol for older adults in order to enhance its feasibility and outcome in this age group. We examined this adapted protocol in 29 older adults (mean age 66 years) with PDs from four Dutch mental health institutes. The primary outcome was symptomatic distress, measured by the Brief Symptom Inventory. Secondary outcomes were measured by the Young Schema Questionnaire, the Schema Mode Inventory, and the short version of the Severity Indices of Personality Problems. Contrary to our expectations, the adapted treatment protocol yielded only a small effect size in our primary outcome, and no significant improvement in EMS, modes and personality functioning. Patients pointed out that they were more aware of their dysfunctional patterns, but maybe they had not been able yet to work on behavioural change due to this schema therapy treatment being too brief. We recommend more intensive treatment for older patients with PDs, as they might benefit from more schema therapy sessions, similar to the treatment dosage in younger PD patients. They might also benefit from a combination of group therapy and individual treatment sessions

Emotional competence mediates the relationship between communication problems and reactive externalizing problems in children with and without developmental language disorder: a longitudinal study

Language problems are a risk factor for externalizing problems, but the developmental path remains unclear. Emotional competence may mediate the relationship, especially when externalizing problems are reactive in nature, such as in Oppositional Deviant Disorder (ODD) and reactive aggression. We examined the development of reactive and proactive externalizing problems in children with (n= 98) and without (n= 156) Developmental Language Disorder (DLD; age: 8-16 years) over 18 months. Relationships with communicative risk factors (structural, pragmatic and emotion communication) and the mediating role of emotional competence (emotion recognition and anger dysregulation) were examined. Multi-level analyses showed that increasing emotion recognition and decreasing anger dysregulation were longitudinally related to decreasing ODD symptoms in both groups, whereas anger dysregulation was related to more reactive aggression in children with DLD alone. Pragmatic and emotion communication problems were related to more reactive externalizing problems, but these relationships were mediated by emotional competence, suggesting that problems in emotional competence explain the communication problems of children with DLD. Therefore, in addition to interventions for communication skills, there is a need to address the emotional competence of children with DLD, as this decreases the risk for reactive externalizing problems.Pathways through Adolescenc

Возможностим развития конкуренции на рынках теплоснабжения Донбасса

Проаналізовано стан ситем теплопостачання Донбасу, виявлено зниження виробництва та відпуску теплової енергії, що викликано появою конкурента — автономного опалення. Обгрунтовано причини протиріччя законодавства, що регулює діяльність у сфері комунального теплопостачання — природної монополії, в результаті чого порушені конституційні, цивільні, споживчі права людей. Розглянуто практику регулювання ринків теплопостачання в країнах з розвиненою ринковою економікою, і можливості застосування їх досвіду в Україні. Визначено роль держави, як найважливішого регулятора, який здійснює контроль за ринком теплопостачання, і є влавником стратегічно важливих підприємств сектора. Ключові слова: централізоване теплопостачання, природна монополія, автономне опалення, конкуренція, приватний капітал, державне регулювання.Проанализировано состояние ситем теплоснабжения Донбасса, выявлено снижение производства и отпуска тепловой энергии, что вызвано появлением конкурента — автономного отопления. Обоснованы причины протеворечивости законодательства регулирующего деятельность в сфере коммунального теплоснабжения — естественной монополии, в результате чего нарушены конституционные, гражданские, потребительские права людей. Рассмотрена практика регулирования рынков теплоснабжения в странах с развитой рыночной экономикой, и возможности применения их опыта в Украине. Определена роль государства, как важнейшего регулятора, осуществляющего контроль за рынком теплоснабжения, и собственика стратегически важных предприятий сектора. Ключевые слова: централизованное теплоснабжение, естественная монополия, автономное отопление, конкуренция, частный капитал, государственное регулирование.The state of Donbass Heating System Works, showed a reduction in production and supply of heat energy that is caused by the emergence of competitors — independent heating. Substantiated reasons imperfect legislation governing activities in the field of district heating — natural monopoly, resulting in a violation of the constitutional, civil, consumer rights of people. The practical management of district heating markets in countries with developed market economies, and the possibility of applying their experience in Ukraine. Defined the place of government as an important regulator, controlling the heating market, and the owners of strategically important enterprises in the sector. Key words: district heating, natural monopoly, independent heating, competition, private capital, government regulation

Impact of personality functioning and pathological traits on mental wellbeing of older patients with personality disorders

BACKGROUND: Although personality disorders are common and consequential, they are largely ignored in geriatric mental healthcare. We examined the relative contributions of different aspects of personality disorders and comorbid mental disorders to the impairment of mental wellbeing in older adults. METHODS: Baseline data were used of 138 patients who participated in a randomized controlled trial on schema therapy for geriatric mental health outpatients with a full or subthreshold cluster B or C personality disorder. Personality was assessed according to both the categorical and dimensional model of DSM-5. Aspects of mental wellbeing assessed were; psychological distress, positive mental health, subjective health, and life satisfaction. The current study uses baseline data of the RCT to examine the associations between different aspects of personality pathology and mental wellbeing by multivariate regression analysis, controlling for age, sex, level of education, and number of chronic somatic illnesses. RESULTS: The vast majority of patients (79.0%) had one or more mental disorders in addition to personality disorder. Personality pathology was responsible for the core of the mental health burden experienced by patients, and negated the influence of co-occurring mental disorders when entered subsequently in multivariate analysis. Personality dimensions proved to be highly predictive of mental wellbeing, and this contrasted with absence of influence of personality disorder diagnosis. Although the personality functioning dimensions – and in particular Identity integration (large effect size with partial eta-squared = 0.36) – were the primary predictors of mental wellbeing, personality trait dimensions added significant predictive value to that (Disinhibition 0.25 and Negative affect 0.24). CONCLUSIONS: Personality disorders seriously affect the mental wellbeing of patients, and this overshadows the impact of comorbid mental disorders. In particular personality functioning and pathological traits of the Alternative Model of Personality Disorders (AMPD) of DSM-5 contribute to this impact on mental wellbeing. Alertness for and treatment of personality disorders in geriatric mental healthcare seems warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-022-03857-8

Strengths and Weaknesses for Climate Change: Adaptation in Water Governance: A Comparison Across Six European Regions

This chapter comparatively analyses the policy and governance contexts of six European regions that are affected by different hydrological impacts of climate change. The results demonstrate that a major governance strength across regions lies in the organization of management capacities to deal with existing water-related risks. For example, the Dutch context focuses on water safety, Cyprus has a clear policy framework to deal with water scarcity and in the Norwegian city of Bergen, wastewater is well managed. As a consequence of this focus on present-day risks, climate adaptation governance also focuses on historical risks. New or exacerbated risks posed by climate change remain largely untreated, and responsibilities for dealing with climate-related risks remain unspecified, as also becomes clear in the German and Spanish cases. A high degree of governmental fragmentation is identified as another point of weakness. Identified most clearly in the Portuguese case but recognizable in all regional contexts, different subdomains of water management are dealt with under separate policies and are governed by different responsible agencies. Consequently, information about current performance of the water system is scattered and coordinative efforts, which are key to developing adaptation strategies, are hampered