43 research outputs found

    Genomic investigations of unexplained acute hepatitis in children

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    Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children

    Psychotherapeutic and pharmacological treatment for problematic digital technology use: Formulating principles and practice guides from the scientific and professional literature

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    This chapter focuses on the psychological treatment of problem Internet and digital technology use (PRIU), such as excessive gaming, and also briefly overviews pharmacological approaches. Forms of Internet and digital technology use that provide alternative vehicles for more specific problem or addictive behavior, such as excessive gambling or shopping, and which often seem to present with differing features, are not covered here [editors’ comment: but rather addressed in other chapters of this book]. Although treatment research is still in an early stage of development, an accumulating body of literature involving a diverse range of presentations and populations and a variety of treatment strategies has often yielded positive and robust effect sizes. Hence, a relatively compelling justification can be provided for therapeutic intervention, especially when using treatments of demonstrated effectiveness with similar clients, when PRIU seems to be associated with significant malfunction or worsening of co-occurring conditions, and when trends suggest that problems are not remitting or are worsening. Beyond these broad conclusions, research on PRIU in general and treatment studies, although often considerably less complete than preferable, provide varying levels of guidance for tailoring or designing intervention in lines with client presentation. Hence, the chapter also covers various specific topics and possible guides for therapeutic planning and implementation

    Refining Video Game Use Questionnaires for Research and Clinical Application: Detection of Problematic Response Sets

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    Even when relatively infrequent, deviant response sets, such as defensive and careless responding, can have remarkably robust effects on individual and group data and thereby distort clinical evaluations and research outcomes. Given such potential adverse impacts and the widespread use of self-report measures when appraising addictions and addictive behavior, the detection of deviant response sets is an important clinical and research objective. Using a video game questionnaire as an exemplar, we examined the capacity of individuals to manipulate questionnaire scores and the effectiveness of various items to detect defensive, careless, and random responding. Individuals who obtained elevated questionnaire results when instructed to respond honesty often reduced their scores to unremarkable levels under fake good instructions. Most types of items for detecting defensive responding were ineffective with a possible exception, although items for detecting random and careless responding seemed promising. Potential guides for item development and use are provided. © 2012 Springer Science+Business Media, LLC

    The Impact of Careless and Random Responding on Juvenile Forensic Assessment: Susceptibility of Commonly Used Measures and Implications for Research and Practice

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    Forensic assessment experts and practice guidelines strongly endorse appraisal of response styles that can distort psychological assessment results and lead to serious interpretive errors, including careless and random responding (C/RR). Little attention has been directed to the implications of C/RR for juvenile forensic mental health assessment. To address this gap in the literature, we reviewed frequently used measures in juvenile forensic assessment. We found that many such measures do not include built-in checks for detecting C/RR. We then conducted simulation studies examining two frequently used measures, one without a built-in check for C/RR and one with such a scale: the Youth Self-Report (YSR) and the Millon Adolescent Clinical Inventory (MACI), respectively. Results indicated that random responding substantially influenced scores on the YSR, raising most scales well above normative levels, yet often producing protocols that seemed genuine. On the MACI, random responding was undetected 25% of the time and another 50% of the time appears to yield computer-based reports that do not explicitly reject the test results as invalid. Taken together, these simulations suggest that randomly generated assessment protocols may often be mistaken for genuine results. Implications for both practitioners and applied researchers involved in juvenile forensic assessment are discussed

    Careless and Random Responding on Clinical and Research Measures in the Addictions: A Concerning Problem and Investigation of their Detection

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    Even when relatively infrequent, careless and random responding (C/RR) can have robust effects on individual and group data and thereby distort clinical evaluations and research outcomes. Given such potential adverse impacts and the broad use of self-report measures when appraising addictions and addictive behavior, the detection of C/RR can reduce error substantially. Based on earlier research using a video game questionnaire as an exemplar, we cross-validated promising items for detecting C/RR and developed an expanded set of items, in this case using an Internet questionnaire to examine efficacy and generalization. Research participants were instructed to complete the questionnaire in standard fashion (i.e., cooperatively) or to adopt either a careless or random response set. Careless and random responders often obtained elevated mean questionnaire scores. Most items for detecting careless or random responding demonstrated significant differences across groups, and combinations of items showed high levels of accuracy, particularly in detecting random responders. Results suggest that a relatively small number of items, which might only add a minute or two to questionnaire completion time, can detect the great majority of random responders and most careless responders. Guidelines are provided for the development and application of items. © 2012 Springer Science+Business Media New York
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