Patients with Borderline Personality Disorder Not Participating in an RCT: Are They Different?

Background: Despite the notion that randomized controlled trials are regarded as the gold standard in psychotherapy research, questions about their generalizability have been raised. This paper focuses on the differences between participants and eligible nonparticipants of a randomized controlled trial for patients with borderline personality disorder (BPD). Sampling and Methods: One hundred forty-two patients were screened, and 122 were found eligible for study participation. Out of these, 64 patients (52.5%) gave informed consent and were included in the study. Results: The 58 eligible nonparticipants showed a lower level of functioning (global assessment of functioning score), had a history of more outpatient treatment attempts and were living alone more often. Regarding acute symptoms and severity of BPD as indexed by suicide attempts, inpatient treatments, substance abuse and history of trauma, no differences between the groups could be detected. Moreover, participants showed significantly more eating disorders, whereas nonparticipants presented more affective and anxiety disorders. Conclusions: The results indicate that lower psychosocial functioning and comorbid affective and anxiety disorders decrease BPD patients' willingness to participate in an RCT. Copyright (C) 2010 S. Karger AG, Base

On the Subgroup Distance Problem

We investigate the computational complexity of finding an element of a permutation group H subset S_n with a minimal distance to a given pi in S_n , for different metrics on S_n . We assume that H is given by a set of generators, such that the problem cannot be solved in polynomial time by exhaustive enumeration. For the case of the Cayley Distance, this problem has been shown to be NP-hard, even if H is abelian of exponent two Pinch, 2006. We present a much simpler proof for this result, which also works for the Hamming Distance, the l\_p distance, Lee's Distance, Kendall's tau, and Ulam's Distance. Moreover, we give an NP-hardness proof for the l\_oo distance using a different reduction idea. Finally, we settle the complexity of the corresponding fixed-parameter and maximization problems

Роль компетентностного подхода при управлении профессиональными рисками

В статье рассмотрены соответствия между опасностью, вредом здоровью, профессиональным риском и компетентностью работников, которые могут послужить основой для системы выявления и управления профессиональными рисками, обусловленными человеческим фактором.In this article compliances between danger, harm to health, occupational risk and competence of employees are considered. They can serve as a basis for the system for the detection and management of occupational risks caused by human factors

Oxytocin and vasopressin levels are decreased in the plasma of male schizophrenia patients

Objective Impaired social functioning and autistic symptoms are characteristics of schizophrenia. The social hormones oxytocin (OT) and arginine-vasopressin (AVP) both modulate social interaction and therefore may be involved in the pathogenesis of schizophrenia. We investigated whether men with schizophrenia show altered OT and AVP levels compared with healthy controls (HC) and whether autism symptoms are associated with OT levels. Methods Forty-one men with non-acute schizophrenia and 45 matched HC were enroled. Schizophrenia was assessed with the Positive and Negative Syndrome Scale (PANSS). Blood samples were collected on 2 days, and plasma OT and AVP levels were measured by ELISA immunoassay. Results The schizophrenia patients had significantly lower plasma OT levels than the HC; a similar trend was found for AVP. Plasma OT levels were associated with severe life events, fewer important attached persons, and a higher score on the PANSS negative scale; the most dominant PANSS items were ‘preoccupation’, ‘emotional withdrawal’, and ‘passive/apathetic social withdrawal’. Conclusion These findings support an association between the social hormones OT and AVP and schizophrenia. We suggest that OT metabolism may be altered in schizophrenia, but other possible causes for decreased plasma OT levels in schizophrenia patients include decreased OT synthesis, mRNA expression, and translation. Especially the ‘autistic’ symptoms of schizophrenia seem to be closely linked to an altered metabolism of OT, the ‘attachment’ hormone

Lower oxytocin plasma levels in borderline patients with unresolved attachment trauma

Interpersonal problems and affective dysregulation are core characteristics of borderline personality disorder (BPD). BPD patients predominantly show unresolved attachment representations. The oxytocin (OT) system is associated with human social attachment and affiliative behavior, and OT dysregulation may be related to distinct attachment characteristics. Here, we investigated whether attachment representations are related to peripheral OT levels in BPD patients. Twenty-one female BPD patients and 20 age-, gender-, and education- matched healthy controls (HCs) were assessed with clinical scales and measures of interpersonal and attachment-related characteristics, including the Adult Attachment Projective Picture System (AAP). Plasma OT concentrations were measured prior to and during social exclusion in a virtual ball tossing game (Cyberball). The majority of BPD patients (63.2%) but no HCs showed unresolved (disorganized) attachment representations. In this subgroup of patients, baseline OT plasma levels were significantly lower than in BPD patients with organized attachment representations. This pilot study extends previous findings of altered OT regulation in BPD as a putative key mechanism underlying interpersonal dysregulation. Our results provide first evidence that altered OT plasma levels are related to disorganized attachment representations in BPD patients

Individualized and Clinically Derived Stimuli Activate Limbic Structures in Depression: An fMRI Study

In the search for neurobiological correlates of depression, a major finding is hyperactivity in limbic-paralimbic regions. However, results so far have been inconsistent, and the stimuli used are often unspecific to depression. This study explored hemodynamic responses of the brain in patients with depression while processing individualized and clinically derived stimuli.Eighteen unmedicated patients with recurrent major depressive disorder and 17 never-depressed control subjects took part in standardized clinical interviews from which individualized formulations of core interpersonal dysfunction were derived. In the patient group such formulations reflected core themes relating to the onset and maintenance of depression. In controls, formulations reflected a major source of distress. This material was thereafter presented to subjects during functional magnetic resonance imaging (fMRI) assessment.Increased hemodynamic responses in the anterior cingulate cortex, medial frontal gyrus, fusiform gyrus and occipital lobe were observed in both patients and controls when viewing individualized stimuli. Relative to control subjects, patients with depression showed increased hemodynamic responses in limbic-paralimbic and subcortical regions (e.g. amygdala and basal ganglia) but no signal decrease in prefrontal regions.This study provides the first evidence that individualized stimuli derived from standardized clinical interviewing can lead to hemodynamic responses in regions associated with self-referential and emotional processing in both groups and limbic-paralimbic and subcortical structures in individuals with depression. Although the regions with increased responses in patients have been previously reported, this study enhances the ecological value of fMRI findings by applying stimuli that are of personal relevance to each individual's depression

Die Wiener October-Revolution

Boberach: Die Darstellung der Ereignisse vom 6. bis 31. Oktober [1848] soll die Forderung unterstützen, den Kampf um die Republik fortzusetzen. - Welsch (Projektbearbeiter): Die Verfasser waren Redakteure des am 26. Oktober 1848 eingestellten 'Politischen Studenten-Couriers' in Wiendargest. und beleuchtet von Adolf Buchheim und Oskar FalkeIn Fraktu