Strategies, processes, outcomes, and costs of implementing experience sampling-based monitoring in routine mental health care in four European countries:study protocol for the IMMERSE effectiveness-implementation study

BACKGROUND: Recent years have seen a growing interest in the use of digital tools for delivering person-centred mental health care. Experience Sampling Methodology (ESM), a structured diary technique for capturing moment-to-moment variation in experience and behaviour in service users' daily life, reflects a particularly promising avenue for implementing a person-centred approach. While there is evidence on the effectiveness of ESM-based monitoring, uptake in routine mental health care remains limited. The overarching aim of this hybrid effectiveness-implementation study is to investigate, in detail, reach, effectiveness, adoption, implementation, and maintenance as well as contextual factors, processes, and costs of implementing ESM-based monitoring, reporting, and feedback into routine mental health care in four European countries (i.e., Belgium, Germany, Scotland, Slovakia).METHODS: In this hybrid effectiveness-implementation study, a parallel-group, assessor-blind, multi-centre cluster randomized controlled trial (cRCT) will be conducted, combined with a process and economic evaluation. In the cRCT, 24 clinical units (as the cluster and unit of randomization) at eight sites in four European countries will be randomly allocated using an unbalanced 2:1 ratio to one of two conditions: (a) the experimental condition, in which participants receive a Digital Mobile Mental Health intervention (DMMH) and other implementation strategies in addition to treatment as usual (TAU) or (b) the control condition, in which service users are provided with TAU. Outcome data in service users and clinicians will be collected at four time points: at baseline (t0), 2-month post-baseline (t1), 6-month post-baseline (t2), and 12-month post-baseline (t3). The primary outcome will be patient-reported service engagement assessed with the service attachment questionnaire at 2-month post-baseline. The process and economic evaluation will provide in-depth insights into in-vivo context-mechanism-outcome configurations and economic costs of the DMMH and other implementation strategies in routine care, respectively.DISCUSSION: If this trial provides evidence on reach, effectiveness, adoption, implementation and maintenance of implementing ESM-based monitoring, reporting, and feedback, it will form the basis for establishing its public health impact and has significant potential to bridge the research-to-practice gap and contribute to swifter ecological translation of digital innovations to real-world delivery in routine mental health care.TRIAL REGISTRATION: ISRCTN15109760 (ISRCTN registry, date: 03/08/2022).</p

Skrátená verzia škály reziliencie – psychometrická analýza prostredníctvom IRT

Škála reziliencie (Wagnild, Young, 1993) patrí v súčasnosti medzi najčastejšie používané metódy na skúmanie reziliencie ako osobnostnej črty. Výsledky výskumov poukazujú na veľmi dobré psychometrické charakteristiky škály. Cronbachovo α sa pohybuje od .72 do .94. Výsledky zahraničných aj lokálnych výskumov potvrdzujú dobrú konštruktovú validitu škály. Pôvodná verzia obsahuje 25 položiek. Autori vytvorili aj skrátenú verziu, ktorá pozostáva zo 14 položiek. Cieľom výskumu bolo overiť psychometrické vlastnosti skrátenej verzie škály. Výskumný súbor tvorilo 609 uchádzačov o štúdium na Katedre psychológie na FiF UK, ktorí vyplnili kompletnú 25 položkovú verziu. Pri analýze sme porovnávali psychometrické ukazovatele klasickej teórie testov a taktiež sme pri analýzach aplikovali aj Teóriu odpovede na položku (IRT). Na odhad parametrov položiek sme použili Samejimovej model. Priemerná bodovo-biseriálna korelácia skrátenej verzie škály bola r = .513. Odhad úrovne reziliencie (prostredníctvom IRT) zo skrátenej verzie škály bol takmer identický ako pri použití 25 položkovej verzie (R2 = .932). Obidve verzie škály merajú dostatočne presne na pomerne širokom intervale úrovne reziliencie a prinášajú najviac informácií o ľuďoch s podpriemernou až priemernou úrovňou reziliencie. Pôvodná 25 položková verzia meria trochu presnejšie, čo je spôsobené väčším počtom položiek. Z výsledkov vyplýva, že skrátená verzia Škály reziliencie je vhodný a dostatočne reliabilný nástroj, ktorý je časovo menej náročný ako pôvodná plná verzia Škály reziliencie. Resilience Scale (Wagnild, Young, 1993) is currently one of the most frequently used questionnaire for research about resilience as a personality traits. The research findings have showed very good psychometric characteristics of the scale. Cronbach's α ranging from .72 to .94. The results of foreign and local studies confirmed good construct validity. The original version contains 25 items. The authors have developed a shortened version consisting only of 14 items. The aim of the research was to investigate the psychometric properties of shortened version of the scale.  Sample consisted of 609 applicants for study at the Department of Psychology at the Faculty of Arts UK, who filled the entire 25 item version. In the analysis, we compared the psychometric properties of Classical Test Theory and Item Response Theory (IRT). We used Samejima`s model. The average point-biserial correlation of shortened version scale was r = .513. Estimated level of resilience (through IRT) with a shortened version of the scale was almost identical to estimate from 25 item version (R2 = .932). Both scales measure with sufficient accuracy on relatively wide range level of resilience. Both scales bring the most information about people with below-average to average level of resilience. The original 25 item version measured more accurately, due to a larger number of items. Shortened version of Resilience Scale is truly suitable and sufficiently reliable tool to measure resilience, which is less time consuming than the original full version scale

Neuropsy

Standardization of a group of neuropsychological tests in Slovak language tested in adult Slovakian population (18+). The purpose of the project is to stimulate and accelerate the development of neuropsychological diagnostics in Slovakia, to deal with improving diagnostic procedures and tools to detect deficits in cognition mostly by inventing complex neuropsychological battery which is sensitive to early and differential diagnostics of various neurological and psychiatric diseases with cognitive impairment symptomatology

Metóda vývinovej diagnostiky: Skríning psychomotorického vývinu S-PMV. Informácie o projekte

Prinášame informáciu o tvorbe novej metódy vývinovej diagnostiky (S-PMV) určenej pre pediatrov, ale aj odborníkov, ktorí pracujú v oblasti včasnej diagnostiky detí do 3 rokov. Ide o pôvodnú slovenskú metódu, ktorá vzniká na základe potreby aktualizovať a štandardizovať postupy vyšetrení na odhaľovanie rizika oneskoreného vývinu a vývinových porúch. Metóda pozostáva zo súboru dotazníkov určených na vyplnenie rodičmi, ktorých položky prešli viacstupňovým výberom a boli konfrontované s anamnézou a s posúdením dieťaťa pediatrom. S-PMV bol overovaný na vzorke 2710 detí, ktorú sme získali v spolupráci so 45 pediatrami v rámci celého Slovenska. The contribution provides information about creating a new method of developmental diagnostics (S-PMV) designed for pediatricians, as well as professionals working in the field of early diagnostics of children under 3 years. This is the original Slovak method which arises from the need to update and standardize procedures for examinations to detect the risk of delayed development and developmental disorders. The method consists of a set of questionnaires designed to be filled by parents, whose items have gone through a multi-stage selection and were confronted with a history and with assessment of a child by pediatrician. S-PMV was tested on a sample of 2,710 children, which we acquired in cooperation with 45 pediatricians within Slovakia

Heterogeneity of social cognitive performance in autism and schizophrenia

Autistic adults and those with schizophrenia (SCZ) demonstrate similar levels of reduced social cognitive performance at the group level, but it is unclear whether these patterns are relatively consistent or highly variable within and between the two conditions. Seventy-two adults with SCZ (52 male, Mage = 28.2 years) and 94 with diagnoses on the autism spectrum (83 male, Mage = 24.2 years) without intellectual disability completed a comprehensive social cognitive battery. Latent profile analysis identified four homogeneous subgroups that were compared on their diagnosis, independent living skills, neurocognition, and symptomatology. Two groups showed normative performance across most social cognitive tasks but were differentiated by one having significantly higher hostility and blaming biases. Autistic participants were more likely to demonstrate fully normative performance (46.8%) than participants with SCZ, whereas normative performance in SCZ was more likely to co-occur with increased hostility and blaming biases (36.1%). Approximately 43% of participants in the full sample were classified into the remaining two groups showing low or very low performance. These participants tended to perform worse on neurocognitive tests and have lower IQ and fewer independent living skills. The prevalence of low performance on social cognitive tasks was comparable across clinical groups. However, nearly half of autistic participants demonstrated normative social cognitive performance, challenging assumptions that reduced social cognitive performance is inherent to the condition. Subgrouping also revealed a meaningful distinction between the clinical groups: participants with SCZ were more likely to demonstrate hostility biases than autistic participants, even when social cognitive performance was otherwise in the typical range. Lay Summary Social cognition refers to the perception and interpretation of social information. Previous research has shown that both autistic people and those with schizophrenia demonstrate reduced performance on traditional social cognitive tasks, which we replicate here at the group level. However, we also found that almost half of autistic participants performed in the normal range. Over a third of participants with schizophrenia did as well, but for them this performance was accompanied by a hostility bias not commonly found in the autistic sample. Taken together, findings challenge assumptions that difficulties in social cognition are a uniform characteristic of these clinical conditions in those without intellectual disability

Social cognition, neurocognition, symptomatology, functional competences and outcomes in people with schizophrenia – A network analysis perspective

Background Extensive difficulties in reaching functional milestones characterize schizophrenia and related psychotic disorders. These impairments are in part explained by lower social cognitive abilities, cognitive impairment, and current psychopathology. The present study aims to model dynamic associations among social cognition, neurocognition, psychopathology, social skills, functional capacity, and functional outcomes in schizophrenia using network analysis in order to identify those factors that are most central to functioning. Methods The sample consisted of 408 patients with schizophrenia spectrum disorders who were drawn from the SCOPE project. Participants completed a complex battery of state-of-the-art measures of social cognition, neurocognition, and functional outcomes. Gaussian Graphical Modeling was used for estimation of the network structure. Accuracy of the network was evaluated using the Bootstrap method. Results Data supported the importance of functional capacity and social skills, which are prerequisites to real - world outcomes. These variables were among the most central in the network. Social cognition was related to functional capacity, social skills, and real - world functioning. Negative symptoms were connected to functional capacity, social skills, and real - world functioning. Conclusions Predictors of functional outcomes are complexly associated with each other. Functional capacity, social - skills, working memory, negative symptoms, mentalizing, and emotion recognition were central nodes that support their importance as potential targets of personalized intervention

Social cognitive impairments in individuals with schizophrenia vary in severity

Social cognitive deficits are a hallmark feature of schizophrenia and have been confirmed by several meta-analyses; however, the uniformity of these impairments across individuals remains unknown. The present study evaluated the heterogeneity of social cognitive impairment. A secondary aim was to identify a subset of measures to quickly identify those individuals who are most in need of remediation. Two independent samples of people with schizophrenia (n = 176; n = 178) and their respective healthy control groups (n = 104; n = 154) were selected from two phases of the Social Cognition Psychometric Evaluation (SCOPE) project, which assessed multiple domains of social cognition. Latent profile analysis was utilized to identify sub-clusters of performance within each patient sample. Receiver operator curve and discriminant analysis were implemented to identify tasks suitable as screening tools. Three clusters were identified in each sample that differed primarily in severity of impairment. The first showed no social cognitive impairment (∼25% of patients). The second consisted of patients with mild impairment (∼40% of each sample), and the third showed severe SC impairment (∼32%). Patients in the severe cluster were older, less educated, more neurocognitively impaired, and lower functioning. Using the Bell Lysaker Emotion Recognition Task (BLERT) for screening provided sensitivity of 80.15% and specificity 89.13%. Combining BLERT with the Reading the Mind in the Eyes task yielded sensitivity of 91.60% and specificity 75.00% for identifying impaired individuals. These results illustrate the existence of distinct degrees of social cognitive impairment in schizophrenia and indicate that remediation efforts may not be necessary for all individuals

Paranoia and interpersonal functioning across the continuum from healthy to pathological: Network analysis

Objective Previous research has suggested that paranoia is associated with impaired social functioning in patients with schizophrenia and healthy individuals with high levels of paranoid ideation. This study analysed the relationship between paranoia and interpersonal functioning across the paranoia continuum using network analysis. Method Levels of paranoid ideation and interpersonal functioning were measured in a non‐clinical sample (N = 853) and in patients with schizophrenia spectrum disorders (N = 226). Network analyses were used to examine the nature of paranoia's relation to interpersonal functioning in both populations. Results Although the most central characteristic of paranoia in both samples was the feeling of being talked about behind one's back, across samples, individual characteristics were differentially related to various aspects of interpersonal functioning. Among clinical individuals, difficulties in interpersonal functioning were related to perceived previous experiences of being treated poorly by others, whereas among the non‐clinical sample, interpersonal functioning was related to negative beliefs about others. Conclusions The current results support previous findings linking paranoid ideation to interpersonal functioning in both clinical and non‐clinical samples. Patterns of these relationships differed slightly across groups. Results in general support a continuum model of paranoia

Psychometric properties of the Observable Social Cognition Rating Scale (OSCARS) : Self-report and informant-rated social cognitive abilities in schizophrenia

Individuals with schizophrenia spectrum disorders (SSD) consistently show deficits in social cognition (SC) which is associated with real world outcomes. Psychosocial treatments have demonstrated reliable improvements in SC abilities, highlighting the need for accurate identification of SC deficits for efficient and individualized treatment planning. To this end, the Observable Social Cognition Rating Scale (OSCARS) is an 8-item scale with both self and informant versions. This study investigated psychometric properties of the OSCARS as both a self and informant-reported scale in a large sample of SSD (n = 382) and individuals without a psychiatric diagnosis (n = 289). A two-factor structure (Social Cognitive Bias and Social Cognitive Ability) of the OSCARS demonstrated acceptable model fit with good internal consistency for both self- and informant-report. The OSCARS had adequate convergent, external, and predictive validity. Area Under the Curve (AUC) values suggest the OSCARS has some value in identifying individuals with impaired SC and social competence, although stronger AUC values were demonstrated when identifying individuals with impaired real-world functioning. Overall, psychometric properties indicate the OSCARS may be a useful first-step tool for clinicians to detect functioning deficits in SSD and efficiently identify individuals in need of additional assessment or psychosocial interventions