Common Versus Unique Variance Across Measures of Worry and Rumination: Predictive Utility and Mediational Models for Anxiety and Depression

Repetitive negative thinking (RNT) has been identified as a transdiagnostic construct. However, diagnosis- specific questionnaires have traditionally been used to measure RNT across emotional disorders, and thus the degree to which they assess shared versus unique aspects of RNT is unclear. Furthermore, the degree to which shared versus unique variance across these measures contributes to the prediction of anxiety and depression symptoms is yet to be fully understood. This study had three aims. First, confirmatory factor analysis was used to test the degree to which two common, diagnosis-specific questionnaires assess common versus unique variance in RNT. One questionnaire measured worry whereas the other measured two aspects of rumination (brooding, reflection). Second, the contribution of the shared and unique variance in predicting symptoms of anxiety and depression was determined. Third, the role of shared and unique variance in mediating the relationships between the vulnerability factor of negative affectivity and symptoms of anxiety and depression was assessed

Percutaneous drainage versus emergency cholecystectomy for the treatment of acute cholecystitis in critically ill patients: does it matter?

Background The aim if this study was to compare percutaneous drainage (PD) of the gallbladder to emergency cholecystectomy (EC) in a well-defined patient group with sepsis related to acute calculous/acalculous cholecystitis (ACC/AAC).Methods Between 2001 and 2007, all consecutive patients of our ICU treated by either PD or EC were retrospectively analyzed. Cases were collected from a prospective database. Percutaneous drainage was performed by a transhepatic route and EC by open or laparoscopic approach. Patients' general condition and organ dysfunction were assessed by two validated scoring systems (SAPS II and SOFA, respectively). Morbidity, mortality, and long-term outcome were systematically reviewed and analyzed in both groups.Results Forty-two patients [median age = 65.5 years (range = 32-94)] were included; 45% underwent EC (ten laparoscopic, nine open) and 55% PD (n = 23). Both patient groups had similar preoperative characteristics. Percutaneous drainage and EC were successful in 91 and 100% of patients, respectively. Organ dysfunctions were similarly improved by the third postoperative/postdrainage days. Despite undergoing PD, two patients required EC due to gangrenous cholecystitis. The conversion rate after laparoscopy was 20%. Overall morbidity was 8.7% after PD and 47% after EC (P = 0.011). Major morbidity was 0% after PD and 21% after EC (P = 0.034). The mortality rate was not different (13% after PD and 16% after EC, P = 1.0) and the deaths were all related to the patients' preexisting disease. Hospital and ICU stays were not different. Recurrent symptoms (17%) occurred only after ACC in the PD group.Conclusions In high-risk patients, PD and EC are both efficient in the resolution of acute cholecystitis sepsis. However, EC is associated with a higher procedure-related morbidity and the laparoscopic approach is not always possible. Percutaneous drainage represents a valuable intervention, but secondary cholecystectomy is mandatory in cases of acute calculous cholecystitis

The relation between co-rumination, maternal depressive symptoms and child psychopathology

Item does not contain fulltextLittle is known about which processes explain the well-established link between maternal and child symptomatology. Interpersonal coping processes may be worth exploring, as depressed mothers have characteristic coping styles that may influence interactions with their children. We examined two interpersonal coping processes as potential factors explaining how depressive symptomatology in mothers impacts child psychopathology: parent-child co-rumination (dwelling on negative affect, over-analyzing problems) and impaired problem-solving. We analyzed 198 aggressive children (most of whom also had elevated internalizing symptoms) who engaged in structured discussions with their mothers. Coders rated the extent to which dyads problem-solved and co-ruminated during discussions, and mothers filled out questionnaires assessing maternal and child symptoms. Path analysis tested whether higher levels of co-rumination and poor problem-solving statistically mediated the relation between depressive symptoms in mothers and child internalizing and externalizing behaviour. Maternal depressive symptomatology was correlated with greater child symptoms, higher rates of co-rumination and poorer problem-solving. Statistical mediation was non-significant. Results support the established link between maternal depression and child psychopathology, and suggest that dysphoric mothers and their children engage in maladaptive coping interactions.11 p