A clinical case study of the use of ecological momentary assessment in obsessive compulsive disorder

Accurate assessment of obsessions and compulsions is a crucial step in treatment planning for Obsessive-Compulsive Disorder (OCD). In this clinical case study, we sought to determine if the use of Ecological Momentary Assessment (EMA) could provide additional symptom information beyond that captured during standard assessment of OCD. We studied three adults diagnosed with OCD and compared the number and types of obsessions and compulsions captured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) compared to EMA. Following completion of the Y-BOCS interview, participants then recorded their OCD symptoms into a digital voice recorder across a 12-h period in reply to randomly sent mobile phone SMS prompts. The EMA approach yielded a lower number of symptoms of obsessions and compulsions than the Y-BOCS but produced additional types of obsessions and compulsions not previously identified by the Y-BOCS. We conclude that the EMA-OCD procedure may represent a worthy addition to the suite of assessment tools used when working with clients who have OCD. Further research with larger samples is required to strengthen this conclusion

The proqol-21: A revised version of the professional quality of life (ProQOL) scale based on Rasch analysis

The Professional Quality of Life scale is a measure intended to provide practitioners and researchers with an indication of a caring professional’s compassion satisfaction, burnout, and secondary traumatic stress. While this measure has been used extensively in nursing research, owing to the relevancy of patient-care associated satisfaction and fatigue within this profession, information regarding the construct validity of this measure is less well represented in the literature. We examined the construct validity of the Professional Quality of Life scale using a Rasch analysis procedure on each of its three scales, as a means of substantiating their measurement adequacy. Responses on the Professional Quality of Life scale from 1615 registered nurses (age x̅ = 46.48 years, SD = 11.78) were analysed. While support for the measurement adequacy (invariance, person/item fit, and unidimensionality) of the compassion satisfaction scale was found, the burnout and secondary traumatic stress scales did not demonstrate adequate measurement properties. We instead present an alternative measurement model of these subscales, involving items from each, to form a robust measure of compassion fatigue, and provide recoding, scoring, and normed scores for both measures. Our findings indicate that use of the Professional Quality of Life scale’s burnout and secondary traumatic stress scales may require caution, while our revised compassion satisfaction and fatigue scales provide robust measurement options for practitioners and researchers

What happens when you tell someone you self-injure? The effects of disclosing NSSI to adults and peers

Background: Non-suicidal self-injury (NSSI) is associated with significant adverse consequences, including increased risk of suicide, and is a growing public health concern. Consequently, facilitating help-seeking in youth who self-injure is an important goal. Although young people who disclose their NSSI typically confide in peers and family, it is unclear how this disclosure and related variables (e.g. support from family and friends, coping behaviours, reasons for living) affect help-seeking over time. The aim of this study was to advance understanding of the impact of disclosure of NSSI by young people and to investigate these effects over time. Methods: A sample of 2637 adolescents completed self-report questionnaires at three time points, one year apart. Results: Of the sample, 526 reported a history of NSSI and 308 of those who self-injured had disclosed their behaviour to someone else, most commonly friends and parents. Conclusions: Overall, we observed that disclosure of NSSI to parents facilitates informal help-seeking, improves coping and reduces suicidality, but that disclosure to peers might reduce perceived social support and encourage NSSI in others. We discuss these findings in light of their clinical and research implications

Comparing In-Person to Videoconference-Based Cognitive Behavioral Therapy for Mood and Anxiety Disorders: Randomized Controlled Trial

Background: Cognitive-behavioral therapy (CBT) has demonstrated efficacy and effectiveness for treating mood and anxiety disorders. Dissemination of CBT via videoconference may help improve access to treatment. Objective: The present study aimed to compare the effectiveness of CBT administered via videoconference to in-person therapy for a mixed diagnostic cohort. Methods: A total of 26 primarily Caucasian clients (mean age 30 years, SD 11) who had a primary Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV-TR) diagnosis of a mood or anxiety disorder were randomly assigned to receive 12 sessions of CBT either in-person or via videoconference. Treatment involved individualized CBT formulations specific to the presenting diagnosis; all sessions were provided by the same therapist. Participants were recruited through a university clinic. Symptoms of depression, anxiety, stress, and quality of life were assessed using questionnaires before, after, and 6 weeks following treatment. Secondary outcomes at posttreatment included working alliance and client satisfaction.Results: Retention was similar across treatment conditions; there was one more client in the videoconferencing condition at posttreatment and at follow-up. Statistical analysis using multilevel mixed effects linear regression indicated a significant reduction in client symptoms across time for symptoms of depression (P<.001, d=1.41), anxiety (P<.001, d=1.14), stress (P<.001, d=1.81),and quality of life (P<.001, d=1.17). There were no significant differences between treatment conditions regarding symptoms of depression (P=.165, d=0.37), anxiety (P=.41, d=0.22), stress (P=.15, d=0.38), or quality of life (P=.62, d=0.13). There were no significant differences in client rating of the working alliance (P=.53, one-tailed, d=–0.26), therapist ratings of the working alliance (P=.60, one-tailed, d=0.23), or client ratings of satisfaction (P=.77, one-tailed, d=–0.12). Fisher’s Exact P was not significant regarding differences in reliable change from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P=.41, P=.26), anxiety (P=.60, P=.99), or quality of life (P=.65, P=.99) but was significant for symptoms of stress in favor of the videoconferencing condition (P=.03, P=.035). Difference between conditions regarding clinically significant change was also not observed from pre- to posttreatment or from pretreatment to follow-up for symptoms of depression (P=.67, P=.30), anxiety (P=.99, P=.99), stress (P=.19, P=.13), or quality of life (P=.99, P=.62). Conclusions: The findings of this controlled trial indicate that CBT was effective in significantly reducing symptoms of depression, anxiety, and stress and increasing quality of life in both in-person and videoconferencing conditions, with no significant differences being observed between the two

Superoxide radicals can act synergistically with hypochlorite to induce damage to proteins

AbstractActivated phagocytes generate both superoxide radicals via a respiratory burst, and HOCl via the concurrent release of the haem enzyme myeloperoxidase. Amine and amide functions on proteins and carbohydrates are major targets for HOCl, generating chloramines (RNHCl) and chloramides (RC(O)NClR′), which can accumulate to high concentrations (>100 μM). Here we show that superoxide radicals catalyse the decomposition of chloramines and chloramides to reactive nitrogen-centred radicals, and increase the extent of protein fragmentation compared to that observed with either superoxide radicals or HOCl, alone. This synergistic action may be of significance at sites of inflammation, where both superoxide radicals and chloramines/chloramides are formed simultaneously

Understanding individual resilience in the workplace: the international collaboration of workforce resilience model

When not managed effectively, high levels of workplace stress can lead to several negative personal and performance outcomes. Some professional groups work in highly stressful settings and are therefore particularly at risk of conditions such as anxiety, depression, secondary traumatic stress, and burnout. However, some individuals are less affected by workplace stress and the associated negative outcomes. Such individuals have been described as “resilient.” A number of studies have found relationships between levels of individual resilience and specific negative outcomes such as burnout and compassion fatigue. However, because psychological resilience is a multi-dimensional construct it is necessary to more clearly delineate it from other related and overlapping constructs. The creation of a testable theoretical model of individual workforce resilience, which includes both stable traits (e.g., neuroticism) as well as more malleable intrapersonal factors (e.g., coping style), enables information to be derived that can eventually inform interventions aimed at enhancing individual resilience in the workplace. The purpose of this paper is to introduce a new theoretical model of individual workforce resilience that includes several intrapersonal constructs known to be central in the appraisal of and response to stressors and that also overlap with the construct of psychological resilience. We propose a model in which psychological resilience is hypothesized to mediate the relationship between neuroticism, mindfulness, self-efficacy, coping, and psychological adjustment

Common pathways to NSSI and suicide ideation: The roles of rumination and self-compassion

OBJECTIVES: We investigated whether rumination and self-compassion moderate and/or mediate the relationships between negative affect and both non-suicidal self-injury (NSSI) and suicide ideation. METHODS: Undergraduate university students (n?=?415) completed well-validated measures of negative affect, rumination, self-compassion, NSSI, and suicide ideation. RESULTS: Neither rumination nor self-compassion moderated associations between negative affect and NSSI and suicide ideation. However, both rumination and self-compassion mediated associations between negative affect and life-time history of NSSI and suicide ideation. Self-compassion additionally mediated the association between negative affect and both 12 month NSSI and suicide ideation. CONCLUSION: The salience of self-compassion, particularly in predicting recent NSSI and suicide ideation, offers promise for early intervention initiatives focusing on less judgmental or self-critical means of self-relation