The bi-factor structure of the 17-item Hamilton Depression Rating Scale in persistent major depression; dimensional measurement of outcome

Background:The 17-item Hamilton Depression Rating Scale (HDRS17) is used world-wide as an observer-rated measure of depression in randomised controlled trials (RCTs) despite continued uncertainty regarding its factor structure. This study investigated the dimensionality of HDRS17 for patients undergoing treatment in UK mental health settings with moderate to severe persistent major depressive disorder (PMDD).Methods:Exploratory Structural Equational Modelling (ESEM) was performed to examine the HDRS17 factor structure for adult PMDD patients with HDRS17 score ≥16. Participants (n = 187) were drawn from a multicentre RCT conducted in UK community mental health settings evaluating the outcomes of a depression service comprising CBT and psychopharmacology within a collaborative care model, against treatment as usual (TAU). The construct stability across a 12-month follow-up was examined through a measurement equivalence/invariance (ME/I) procedure via ESEM.Results:ESEM showed HDRS17 had a bi-factor structure for PMDD patients (baseline mean (sd) HDRS17 22.6 (5.2); 87% PMDD >1 year) with an overall depression factor and two group factors: vegetative-worry and retardation-agitation, further complicated by negative item loading. This bi-factor structure was stable over 12 months follow up. Analysis of the HDRS6 showed it had a unidimensional structure, with positive item loading also stable over 12 months.Conclusions:In this cohort of moderate-severe PMDD the HDRS17 had a bi-factor structure stable across 12 months with negative item loading on domain specific factors, indicating that it may be more appropriate to multidimensional assessment of settled clinical states, with shorter unidimensional subscales such as the HDRS6 used as measures of change

Biological vulnerability to depression: Linked structural and functional brain network findings

Background: Patients in recovery following episodes of major depressive disorder (MDD) remain highly vulnerable to future recurrence. Although psychological determinants of this risk are well established, little is known about associated biological mechanisms. Recent work has implicated the default mode network (DMN) in this vulnerability but specific hypotheses remain untested within the high risk, recovered state of MDD. Aims: To test the hypothesis that there is excessive DMN functional connectivity during task performance within recovered-state MDD and to test for connected DMN cortical gyrification abnormalities. Method: A multimodal structural and functional magnetic resonance imaging (fMRI) study, including task-based functional connectivity and cortical folding analysis, comparing 20 recoveredstate patients with MDD with 20 matched healthy controls. Results: The MDD group showed significant task-based DMN hyperconnectivity, associated with hypogyrification of key DMN regions (bilateral precuneus). Conclusions: This is the first evidence of connected structural and functional DMN abnormalities in recovered-state MDD, supporting recent hypotheses on biological-level vulnerability

Towards Knowledge in the Cloud

Knowledge in the form of semantic data is becoming more and more ubiquitous, and the need for scalable, dynamic systems to support collaborative work with such distributed, heterogeneous knowledge arises. We extend the “data in the cloud” approach that is emerging today to “knowledge in the cloud”, with support for handling semantic information, organizing and finding it efficiently and providing reasoning and quality support. Both the life sciences and emergency response fields are identified as strong potential beneficiaries of having ”knowledge in the cloud”

Investigating the relationship between student engagement and transition

Failure to establish meaningful and effective transition for undergraduates can lead to academic underachievement. Student engagement represents a key component of student success. This study sought to investigate the impact of a bespoke transition programme featuring a wide range of innovative, student-centred activities on enhancing students' engagement with educationally effective practices through examining student relations with others, learning and the discipline. For the study 104 undergraduates on a Sport Development course at a British university undertook a five-week transition programme. Data were collected via weekly questionnaires and focus groups at the end of weeks 1, 3 and 5. The investigation revealed that transition programmes require a high-intensity, novel and varied timetable supported by a student-centred staff team. Effective transition programmes can enhance students' engagement with educationally effective practices. Future research should investigate the longer-term impact of such programmes

Experiences and psychological wellbeing outcomes associated with bullying in treatment-seeking transgender and gender-diverse youth

This paper is in closed access until 11 June 2020.Purpose: Bullying in the adult transgender population is well documented, but less is known about bullying among transgender and gender-diverse (TGD) youth. Studies have begun to explore experiences of bullying and the associated psychological distress in TGD youth; however, they often fail to distinguish among the separate groups within LGBT samples. This study sought to explore the prevalence, nature, and outcomes of bullying in TGD youth attending a transgender health service in the United Kingdom (UK), taking into account birth-assigned sex and out and social transition status. Methods: Prior to their first appointment at a specialist gender clinic, participants completed a brief sociodemographic questionnaire, a questionnaire assessing experiences and outcomes of bullying, and a clinically-validated measure of anxiety and depression (Hospital Anxiety and Depression Scale). Results: A total of 274 young TGD people aged 16 to 25 years participated in the study. The majority of participants (86.5%) reported having experienced bullying, predominantly in school. Bullying was more prevalent in birth-assigned females and in out individuals, and commonly consisted of homophobic/transphobic (particularly in socially-transitioned individuals) or appearance-related (particularly in out individuals) name-calling. Individuals who reported having experienced bullying showed greater anxiety symptomology and also self-reported effects on anxiety, depression, and self-esteem. Birth-assigned females also reported greater effects on family relationships and social life. Conclusion: These findings indicate very high levels of bullying within the young TGD population attending a transgender health service in the UK, which affects wellbeing significantly. More intervention work and education need to be introduced in schools to reduce the amount of bullying