The dopamine D2 receptor mediates approach-avoidance tendencies in smokers

Dopamine D2 receptors (DRD2) have been strongly implicated in reward processing of natural stimuli and drugs. By using the Approach-Avoidance Task (AAT), we recently demonstrated that smokers show an increased approach bias toward smoking-related cues but not toward naturally-rewarding stimuli. Here we examined the contribution of the DRD2 Taq1B polymorphism to smokers’ and non-smokers’ responsivity toward smoking versus naturally-rewarding stimuli in the AAT. Smokers carrying the minor B1 allele of the DRD2 Taq1B polymorphism showed reduced approach behavior for food-related pictures compared to non-smokers with the same allele. In the group of smokers, a higher approach-bias toward smoking-related compared to food-related pictures was found in carriers of the B1 allele. This pattern was not evident in smokers homozygous for the B2 allele. Additionally, smokers with the B1 allele reported fewer attempts to quit smoking relative to smokers homozygous for the B2 allele. This is the first study demonstrating that behavioral shifts in response to smoking relative to natural rewards in smokers are mediated by the DRD2 Taq1B polymorphism. Our results indicate a reduced natural-reward brain reactivity in smokers with a genetically determined decrease in dopaminergic activity (i.e., reduction of DRD2 availability). It remains to be determined whether this pattern might be related to a different outcome after psychological cessation interventions, i.e. AAT modification paradigms, in smokers

Depression measures in clinical trials

A systematic review of the measures used in clinical trials for depression based on data from clinicaltrials.org. To reproduce the results in the article "Not sad enough for a depression trial? A systematic review of depression measures and cut points in clinical trial registrations" the R files have to be run in order

Depressive Symptom Inventory Suicidality Subscale : Optimal Cut Points for Clinical and Non-Clinical Samples

Suicide is a major cause of death in adulthood and specifically in patients suffering from mental illnesses. The Depressive Symptom Inventory Suicidality Subscale (DSI-SS) is widely used to detect and prevent suicidal ideation. The aim of the present study was to determine optimal cut points for the DSI-SS in different populations. We analysed the data of one population-based sample (n = 532), one outpatient sample (n = 180) and one inpatient sample (n = 244). Internal consistency, convergent validity and optimal cut points according to receiver operating characteristics were calculated. In all samples, we found excellent item-total correlations and internal consistencies for the DSI-SS. Zero-order correlations between the DSI-SS and theoretically related constructs showed positive correlation coefficients, ranging from 0.50 to 0.67. The DSI-SS differentiated well between patients with and without suicide attempts in the population-based sample, but less so in the inpatient sample and only marginally in the outpatient sample. A bootstrapping analysis showed some variability in the cut points that emerged as optimal, but there was no overlap between the different samples. The specific cut points that we identified may be used to improve the diagnostic utility of the DSI-SS and the chance to detect suicidal ideation

Liebowitz Social Anxiety Scale (LSAS) : Optimal cut points for remission and response in a German sample

The Liebowitz Social Anxiety Scale (LSAS) is the most frequently used instrument to assess social anxiety disorder (SAD) in clinical research and practice. Both a self‐reported (LSAS‐SR) and a clinician‐administered (LSAS‐CA) version are available. The aim of the present study was to define optimal cut‐off (OC) scores for remission and response to treatment for the LSAS in a German sample. Data of N = 311 patients with SAD were used who had completed psychotherapeutic treatment within a multicentre randomized controlled trial. Diagnosis of SAD and reduction in symptom severity according to the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, served as gold standard. OCs yielding the best balance between sensitivity and specificity were determined using receiver operating characteristics. The variability of the resulting OCs was estimated by nonparametric bootstrapping. Using diagnosis of SAD (present vs. absent) as a criterion, results for remission indicated cut‐off values of 35 for the LSAS‐SR and 30 for the LSAS‐CA, with acceptable sensitivity (LSAS‐SR: .83, LSAS‐CA: .88) and specificity (LSAS‐SR: .82, LSAS‐CA: .87). For detection of response to treatment, assessed by a 1‐point reduction in the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, rating, a reduction of 28% for the LSAS‐SR and 29% for the LSAS‐CA yielded the best balance between sensitivity (LSAS‐SR: .75, LSAS‐CA: .83) and specificity (LSAS‐SR: .76, LSAS‐CA: .80). To our knowledge, we are the first to define cut points for the LSAS in a German sample. Overall, the cut points for remission and response corroborate previously reported cut points, now building on a broader data basis

Optimal Cut Points for Remission and Response for the German Version of the Social Phobia Anxiety Inventory (SPAI)

Objective: The German version of the Social Phobia and Anxiety Inventory (SPAI-G) is avalidated measure for the detection of social anxiety disorder (SAD). The aim of the presentstudy was to develop optimal cut points (OC) for remission and response to treatment for theSPAI-G. Methods: We used Receiver Operating Characteristic methods and bootstrapping to analysethe data of 359 patients after psychotherapeutic treatment. OCs where defined as the cut pointswith the highest sensitivity and specificity after bootstrapping. Results: For remission, an OC of 2.79 was found, and for response, a change in score frompre- to posttreatment by 11% yielded best results. Conclusions: The OC we identified for remission may be used to improve the diagnostic utilityof the SPAI-G. However, the cut point for response achieved only borderline-acceptable levelsof sensitivity and specificity, calling into doubt their utility in clinical and research setting.Fragestellung: Die deutsche Version des Social Phobia and Anxiety Inventory (SPAI-G) ist einvalidiertes Maß bei der Erkennung von Sozialer Phobie. Das Ziel der vorliegenden Studie wardie Entwicklung optimaler Cut-Points (OC) für Remission und Response to treatment für dasSPAI-G. Methode: Wir verwendeten Receiver Operating Characterstic Methoden und Bootstrapping,um die Daten von 359 Patienten nach Beendigung einer psychotherapeutischen Behandlungzu untersuchen. Ergebnisse: Als optimaler Cut-Point wurde der Cut-Point mit der höchsten Sensitivität undSpezifität definiert. Für Remission erreichte ein optimaler Cut-Point von 2.79 und für Re-sponse eine Prä-Post-Veränderung von 11 % die besten Ergebnisse. Diskussion: Der von uns identifizierte optimale Cut-Point für Remission kann zur Verbesse-rung des diagnostischen Nutzens der SPAI-G genutzt werden. Der Cut-Point für Responseerreichte allerdings nur grenzwertige Sensitivität und Spezifität, weshalb sein Nutzen für kli-nische und wissenschaftliche Zwecke zweifelhaft ist

Difficulties in screening for peripheral neuropathies in children with diabetes

Aims: To assess the diagnostic utility of a novel abbreviated monofilament test in comparison with the tuning fork test to detect diabetic peripheral neuropathy in children. Methods: A total of 88 children with Type 1 diabetes mellitus were screened for diabetic peripheral neuropathy using the monofilament test and the tuning fork. Nerve conduction studies were performed according to the ‘gold standard’ for neuropathy. We assessed the diagnostic utility and inter-rater agreement of the two screening methods. Results: A total of 43 (49%) children (aged 6–18 years) had at least one abnormal nerve conduction study result. Diagnostic utility and inter-rater agreement were very low for both screening methods. The monofilament test yielded a sensitivity of 18% and a specificity of 80%. The tuning fork yielded a sensitivity of 0% and a specificity of 98%. Conclusion: The present study found that an abbreviated monofilament test has low diagnostic utility for the detection of early diabetic peripheral neuropathy because of its low reliability. The problem of reliability needs to be more thoroughly addressed in order to improve the screening procedures in diabetes management in childhood and adolescence

Mobilität von morgen

Die Studie wurde von Studierenden des Kurses »Die Zukunft der Mobilität« am Institut für angewandte Forschung Urbane Zukunft der Fachhochschule Potsdam entwickelt und durchgeführt. Über einen Fragebogen wurden realistische Mobilitätsszenarien auf Basis von Expert_innenmeinungen erfasst und ausgewertet. Im Gegensatz zu ähnlich gelagerten Studien erfolgte eine Beschränkung auf Berlin und Brandenburg. Lokale Probleme, Entwicklungen und Lösungsmöglichkeiten standen somit im Zentrum der Untersuchung. Über die Auswahl der Teilnehmer_innen konnten praxisnahe und inhaltlich konkrete Antworten auf wichtige Zukunftsfragen unserer Region gewonnen werden