Disorder-specific patterns of emotion coregulation in couples: Comparing obsessive compulsive disorder and anorexia nervosa

Impaired emotion regulation and maladaptive strategies to manage distress are central to psychopathology, including obsessive-compulsive disorder (OCD) and anorexia nervosa (AN). Emotion regulation can be fostered or thwarted by romantic partners, and the tendency to rely on interpersonally oriented emotion regulation may vary by disorder. This study examined coregulation as a form of interpersonal emotion regulation in OCD and AN. We hypothesized that OCD is associated with exaggerated and AN with diminished coregulation, and that OCD patients have greater overall levels of emotional arousal than AN patients. Greater symptom severity was expected to exacerbate these opposing tendencies. Vocally encoded emotional arousal was measured during couple conversations in 34 AN patients, 18 OCD patients, and their partners. Two indicators of coregulation (covariation and coupling) were analyzed using cross-lagged actor-partner interdependence and coupled linear oscillator models. As hypothesized, OCD was associated with greater overall emotional arousal than AN. Symptom severity was not associated with emotional arousal or coregulation. Covariation differed in the opposite direction of the hypothesis; there was no difference in coupling. AN patients exhibited consistent coregulation, indicating high reactivity to partners' emotional arousal which may contribute to interpersonal avoidance. OCD couples showed limited predictability of patients' arousal over time, while partners were affected by the patients' emotional arousal; thus, symptom accommodation may in part be partners' attempts at managing their own distress along with the patients'. A better understanding of interpersonal emotion regulation in OCD and AN can inform treatment by targeting interaction patterns that may maintain symptoms

On the scaling of entropy viscosity in high order methods

In this work, we outline the entropy viscosity method and discuss how the choice of scaling influences the size of viscosity for a simple shock problem. We present examples to illustrate the performance of the entropy viscosity method under two distinct scalings

The UK HeartSpare study: randomised evaluation of voluntary deep-inspiratory breath-hold in women undergoing breast radiotherapy

Purpose: to determine whether voluntary deep-inspiratory breath-hold (v_DIBH) and deep-inspiratory breath-hold with the active breathing coordinator™ (ABC_DIBH) in patients undergoing left breast radiotherapy are comparable in terms of normal-tissue sparing, positional reproducibility and feasibility of delivery.Methods: following surgery for early breast cancer, patients underwent planning-CT scans in v_DIBH and ABC_DIBH. Patients were randomised to receive one technique for fractions 1–7 and the second technique for fractions 8–15 (40?Gy/15 fractions total). Daily electronic portal imaging (EPI) was performed and matched to digitally-reconstructed radiographs. Cone-beam CT (CBCT) images were acquired for 6/15 fractions and matched to planning-CT data. Population systematic (?) and random errors (?) were estimated. Heart, left-anterior-descending coronary artery, and lung doses were calculated. Patient comfort, radiographer satisfaction and scanning/treatment times were recorded. Within-patient comparisons between the two techniques used the paired t-test or Wilcoxon signed-rank test.Results: twenty-three patients were recruited. All completed treatment with both techniques. EPI-derived ? were ?1.8?mm (v_DIBH) and ?2.0?mm (ABC_DIBH) and ? ?2.5?mm (v_DIBH) and ?2.2?mm (ABC_DIBH) (all p non-significant). CBCT-derived ? were ?3.9?mm (v_DIBH) and ?4.9?mm (ABC_DIBH) and ? ??4.1?mm (v_DIBH) and ??3.8?mm (ABC_DIBH). There was no significant difference between techniques in terms of normal-tissue doses (all p non-significant). Patients and radiographers preferred v_DIBH (p?=?0.007, p?=?0.03, respectively). Scanning/treatment setup times were shorter for v_DIBH (p?=?0.02, p?=?0.04, respectively).Conclusions: v_DIBH and ABC_DIBH are comparable in terms of positional reproducibility and normal tissue sparing. v_DIBH is preferred by patients and radiographers, takes less time to deliver, and is cheaper than ABC_DIB

Findings from a couple-based open trial for adult anorexia nervosa

Adult anorexia nervosa (AN) often is persistent, significantly erodes quality of life for both the patient and loved ones, and carries high medical and psychiatric comorbidity. Whereas individual psychotherapy for adult AN leads to improvement in some patients, recent findings indicate that the magnitude of improvement is limited: Only a small percentage of individuals fully recover and dropout rates are high. Thus, it is important to build upon current interventions to improve treatment response. We present results from an open trial of a couple-based intervention for adult anorexia nervosa as an adjunct treatment to standard multidisciplinary care. Twenty couples received treatment over approximately 26 weeks, including a couple-based intervention, individual CBT sessions, psychiatry visits for medication management, and nutritional counseling sessions. The results indicate that patients improved at posttest and 3-month follow-up on a variety of AN-related measures, anxiety and depression, and relationship adjustment. Partners also improved on anxiety, depression, and relationship adjustment. In an exploratory analysis, the multicomponent couple treatment intervention was benchmarked to well-conducted randomized controlled trials of individual therapy for AN; the couple intervention seems to compare favorably on AN-related measures and was associated with a lower dropout rate. In spite of methodological limitations, the findings suggest that including partners in the treatment of adult AN holds potential for bolstering treatment outcomes

Mechanical Effects of the Nonuniform Current Distribution on HTS Coils for Accelerators Wound With REBCO Roebel Cable

Future high-energy accelerators will need very high magnetic fields in the range of 20 T. The EuCARD-2 WP10 Future Magnets collaboration is aiming at testing HTS-based Roebel cables in an accelerator magnet. The demonstrator should produce around 17 T, when inserted into the 100-mm aperture of Feather-M2 13-T outsert magnet. HTS Roebel cables are assembled from meander-shaped REBCO-coated conductor tapes. In comparison with fair level of uniformity of current distribution in cables made out of round Nb-Ti or Nb3Sn strands, current distribution within the coils wound from Roebel cables is highly nonhomogeneous. It results in nonuniform electromagnetic force distribution over the cable that could damage the very thin REBCO superconducting layer. This paper focuses on the numerical models to describe the effect of the nonhomogeneous current distribution on stress distribution in the demonstrator magnet designed for the EuCARD-2 project. Preliminary results indicate that the impregnation bonding between the cable glass fiber insulation and layer-to-layer insulation plays a significant role in the pressure distribution at the cable edges. The stress levels are safe for Roebel cables. Assuming fully bonded connection at the interface, the stresses around the edges are reduced by a large factor

Graph Invariants of Vassiliev Type and Application to 4D Quantum Gravity

We consider a special class of Kauffman's graph invariants of rigid vertex isotopy (graph invariants of Vassiliev type). They are given by a functor from a category of colored and oriented graphs embedded into a 3-space to a category of representations of the quasi-triangular ribbon Hopf algebra $U_q(sl(2,\bf C))$. Coefficients in expansions of them with respect to $x$ ($q=e^x$) are known as the Vassiliev invariants of finite type. In the present paper, we construct two types of tangle operators of vertices. One of them corresponds to a Casimir operator insertion at a transverse double point of Wilson loops. This paper proposes a non-perturbative generalization of Kauffman's recent result based on a perturbative analysis of the Chern-Simons quantum field theory. As a result, a quantum group analog of Penrose's spin network is established taking into account of the orientation. We also deal with the 4-dimensional canonical quantum gravity of Ashtekar. It is verified that the graph invariants of Vassiliev type are compatible with constraints of the quantum gravity in the loop space representation of Rovelli and Smolin.Comment: 34 pages, AMS-LaTeX, no figures,The proof of thm.5.1 has been improve

The Association between Symptom Accommodation and Emotional Coregulation in Couples with Binge Eating Disorder

Intense negative emotions and maladaptive behavioral strategies to reduce emotional distress occur not only in patients with various forms of psychopathology but also in their committed partners. One common strategy to reduce distress is for partners to accommodate to the symptoms of the disorder, which reduces distress short term but maintains symptoms long term. Accommodation is believed to be motivated by the partner reacting behaviorally to the patient's emotions, but the emotions of the partner in this context have yet to be examined. This pilot study examined how partner accommodation related to specific patterns of emotional coregulation between patients with binge eating disorder (BED) and their partners, before and after a couple-based intervention for BED. Vocally encoded emotional arousal was measured during couples’ (n = 11) conversations about BED. As predicted, partners’ emotional reactivity to patients’ emotional arousal was associated with high accommodation before treatment. Thus, partners may use accommodation as a strategy to reduce both the patients’ and their own distress. After treatment, partners’ arousal was no longer associated with the patients’ emotional arousal; instead, partners showed greater emotional stability over time, specifically when accommodation was low. Additionally, patients were less emotionally aroused after treatment. Therefore, treatment may have decreased overall emotionality of patients and altered the association between accommodation and partners’ emotional reactivity. If replicated, this understanding of the emotional context associated with accommodation in BED can inform couple-based treatment by targeting specific emotional precipitants of behaviors that maintain symptoms

A pilot open trial of UNITE-BED: A couple-based intervention for binge-eating disorder

Objective: To evaluate the feasibility, acceptability, and preliminary efficacy of a couple-based intervention for binge-eating disorder (BED), called UNiting couples In the Treatment of Eating disorders-BED edition (UNITE-BED). Method: In an open pilot trial, 11 couples in which one or both adult partners had a diagnosis of DSM-5 threshold or sub-threshold BED participated in 22 weekly sessions of UNITE-BED. Patients also received individual treatment, outside of the context of the trial. Couples completed measures on treatment satisfaction, eating disorder symptom severity, depression, anxiety, emotion regulation, and relational functioning at post-treatment and 3-month follow-up. Statistical analyses were conducted to identify change over the course of treatment. Results: UNITE was feasible and acceptable to the majority of couples (9% dropout; high satisfaction ratings). Objective binge abstinence was 81.8% and subjective binge abstinence was 45.5% by post-treatment. Patient binge-eating symptomatology reduced over the course of treatment with results maintained at follow up. Patients' depression symptoms decreased and patients' emotion regulation improved at both time points. Discussion: Including partners in treatment for BED may be beneficial. Results support further evaluation of the efficacy of couple-based interventions for BED in larger randomized-controlled trials

Thinking about growth : a cognitive mapping approach to understanding small business development

School of Managemen

The Hidradenitis Suppurativa Quality of Life (HiSQOL) score: development and validation of a measure for clinical trials

Background Hidradenitis suppurativa (HS) is a chronic, inflammatory condition that can have a large negative impact on health‐related quality of life (HRQOL). A reliable and validated measure of HS‐specific HRQOL in clinical studies is needed. Objective To develop and validate the Hidradenitis Suppurtiva Quality Of Life (HiSQOL©) scale, for clinical trial measurement of HS‐specific HRQOL. Methods Stage 1: Qualitative concept elicitation (CE) interviews were conducted with HS patients in Denmark (DK) (n = 21) and the United States (US) (n=21). Stage 2: Cognitive debriefing (CD) interviews were performed with US HS patients (n = 30) and Danish HS patients (n=30). Stage 3: Observational study of 222 HS patients in the US was conducted for item reduction, measure validation and assessment of psychometric properties. Stage 4: Observational study of 215 HS patients in Denmark was conducted to confirm the psychometric structure derived in stage 3. In both studies ‐ the Dermatology Life Quality Index, Hospital Anxiety and Depression Scale, and numerical rating scale for pain ‐ were also included. Results In CE, 99 items were generated and reduced to 41 after removing duplicates. In CD, 2 items were added and 1 items removed. A 42‐item instrument was psychometrically assessed. Based on psychometric analyses and patient input, the instrument was reduced to 17 items that had strong psychometric properties in both US and DK samples