The effectiveness of adapted schema therapy for cluster C personality disorders in older adults – integrating positive schemas

Introduction: Schema therapy (ST) is an efficacious psychotherapy for personality disorders (PDs) in adults. The first empirical support for the effectiveness of ST in older adults with cluster C PDs was provided recently. ST partly focusses on the positive, but there is an increasing awareness of imbalance in the ST community because of the emphasis on negative schemas versus attention to positive schemas. Positive schemas may be important vehicles of therapeutic change in psychotherapy with older people, as it may help strengthen the healthy adult mode, and it might also help change a negative life review. Suggestions were made to increase the efficacy and feasibility of ST in older adults, including adjusting the case conceptualisation, modifying the experiential techniques, making use of the patient's wisdom and reactivating positive schemas. The aim of the current study is to investigate the feasibility and effectiveness of adapted individual ST for older adults. Methods/design: A multiple baseline design is used with positive and negative core beliefs as primary outcome measures. Ten older adults (age > 60 years) with cluster C PDs are treated with schema therapy, with weekly sessions during one year. This treatment phase is preceded by a baseline phase varying randomly from 4 to 8 weeks. After treatment, there is a 6-month follow-up phase with monthly booster sessions. Symptomatic distress, schema modes, early maladaptive schemas (EMS) and early adaptive schemas (EAS) are secondary outcome measures. PD will be diagnosed before baseline and after treatment phase. EAS are assessed with the Dutch version of the Young Positive Schema Questionnaire (YPSQ). Discussion: To the best of our knowledge, this is the first empirical study in which positive schemas are integrated in ST treatment to examine the efficacy of an adapted form of ST for older adults. This is in line with wider developments supporting the integration of positive schema's into ST. It offers the possibility to improve the effectiveness of ST in older adults. Trial registration: The Netherlands National Trial Register NL8346, registered 1 February 2020

Search for the best indicators for the presence of a VPS13B gene mutation and confirmation of diagnostic criteria in a series of 34 patients genotyped for suspected Cohen syndrome

BACKGROUND: Cohen syndrome is a rare autosomal recessive inherited disorder that results from mutations of the VPS13B gene. Clinical features consist of a combination of mental retardation, facial dysmorphism, postnatal microcephaly, truncal obesity, slender extremities, joint hyperextensibility, myopia, progressive chorioretinal dystrophy, and intermittent neutropenia.PATIENTS AND METHODS: The aim of the study was to determine which of the above clinical features were the best indicators for the presence of VPS13B gene mutations in a series of 34 patients with suspected Cohen syndrome referred for molecular analysis of VPS13B. RESULTS: 14 VPS13B gene mutations were identified in 12 patients, and no mutation was found in 22 patients. The presence of chorioretinal dystrophy (92% vs 32%, p=0.0023), intermittent neutropenia (92% vs 5%, p<0.001), and postnatal microcephaly (100% vs 48%, p=0.0045) was significantly higher in the group of patients with a VPS13B gene mutation compared to the group of patients without a mutation. All patients with VPS13B mutations had chorioretinal dystrophy and/or intermittent neutropenia. The Kolehmainen diagnostic criteria provided 100% sensibility and 77% specificity when applied to this series. CONCLUSION: From this study and a review of more than 160 genotyped cases from the literature, it is concluded that, given the large size of the gene, VPS13B screening is not indicated in the absence of chorioretinal dystrophy or neutropenia in patients aged over 5 years. The follow-up of young patients could be a satisfactory alternative unless there are some reproductive issues

Microstructure and mechanical properties of cubic zirconia (8YSZ)/SiC nanocomposites

The mechanical properties of cubic zirconia (8YSZ)/SiC 'nanocomposites' were studied. These properties were found to be strongly dependent on the microstructure and processing conditions. For nanocomposites with SiC particles mostly inside the zirconia grains the bending strength, toughness and hardness were similar to that of monolithic 8YSZ. For nanocomposites with SiC particles located mainly on the grain boundaries, an improvement of the strength and an increase of the toughness were observed. The increase in strength is strongest at room temperature and decreases with rising temperature; the strengths of all materials are identical at ~750°C. The higher strength cannot be completely accounted for by the observed increase in toughness, implying a reduced critical flaw size in the stronger material. (C) 2000 Elsevier Science Ltd. All rights reserved

Microstructure and mechanical properties of cubic zirconia (8YSZ)/SiC nanocomposites

The mechanical properties of cubic zirconia (8YSZ)/SiC 'nanocomposites' were studied. These properties were found to be strongly dependent on the microstructure and processing conditions. For nanocomposites with SiC particles mostly inside the zirconia grains the bending strength, toughness and hardness were similar to that of monolithic 8YSZ. For nanocomposites with SiC particles located mainly on the grain boundaries, an improvement of the strength and an increase of the toughness were observed. The increase in strength is strongest at room temperature and decreases with rising temperature; the strengths of all materials are identical at ~750°C. The higher strength cannot be completely accounted for by the observed increase in toughness, implying a reduced critical flaw size in the stronger material. (C) 2000 Elsevier Science Ltd. All rights reserved

Mechanical Spectroscopy of a YSiAlON Glass

A YSiAlON glass has been studied by mechanical spectroscopy, through the glass transition. The α-relaxation peak observed in the YSiAlON glass can be interpreted well by a formalism of hierarchically correlated molecular mobility through the glass transition. In particular this formalism accounts for the observation of unusually high apparent activation energy. The viscoelastic properties of the glass are compared to the mechanical behavior of a silicon nitride ceramic

Effect of foodstuffs on the absorption of zinc sulfate

Single doses of zinc sulfate were given to healthy young volunteers, either in the fasting state or with various types of meals. Dairy products (milk and cheese) and brown bread decreased zinc absorption, as indicated by a significant drop in peak serum zinc levels. Zinc absorption was decreased when zinc was given in the fasting state with the same amounts of purified phosphate or phytate as those found in foods above. Experiments in vitro have shown that zinc is precipitated by phosphate and phytate at pH values close to that of the intestinal lumen. Coffee also seems to inhibit zinc absorption

Internal Friction uder Low-Amplitude torsional and High-Amplitude Uniaxial Load in Silicon Nitride.

High temperatures stimulate thermally activated deformation mechanisms. For single crystal ceramics the consequences are limited up to temperatures of about 1400*C. However, for polycrystalline ceramic materials it has been observed that at temperatures typically in excess of 1000*C, the deformation behaviour becomes increasingly time-dependent. This phenomeno is known to be affected by grain boundary processes. In ceramics produced with liquid phase forming sintering additives the latter will remain at least partially in the grain boundaries after processing. Ceramics containing such amorphous intergranular phases (IGPs) are even more prone to changes of the mechanical behaviour at high temperatures, since at temperatures exceeding the glass transition temperature of the IGPs their viscosity drops.JRC.(IAM)-Institute For Advanced Material

Fatigue resistant silicon nitride ceramics due to anelastic deformation and energy dissipation

To investigate the link between internal friction and fatigue resistance of sintered silicon nitride at elevated temperatures, impulse excitation, torsion pendulum and uniaxial tension-compression tests were performed. At low stress-amplitudes, an internal friction peak is observed and associated with the glass transition of amorphous intergranular phases (IGPs). This peak constitutes a reliable means of energy dissipation for otherwise brittle ceramics. The high amplitude uniaxial tests have revealed a new and much larger internal friction effect than previously could be expected from low amplitude test results. Rheological analysis indicates that the underlying deformation is truly anelastic. Within the investigated stress-amplitude range (30-150 MPa), the damping is shown to increase Linearly with stress-amplitude. As a consequence, energy dissipation in a cyclically loaded component will increase locally at stress concentrations such as crack tips. This results in an increased crack propagation resistance, and explains earlier observations of a positive fatigue effect in sintered silicon nitride at high temperature. (C) 2000 Elsevier Science S.A. All rights reserved.status: publishe