Predicting self-rated health in Diabetes and chronic heart Failure - a Multiple Mediation Model

Purpose: Self-rated health (SRH) is a powerful predictor of health-related outcomes such as morbidity and mortality. Aim of the current study was to examine the role of comorbidity, well-being, functional health, and physical limitations as possible predictors of SRH in diabetes and chronic heart failure (CHF). Methods: Three large samples with persons suffering from diabetes (n = 974), CHF (n = 955), or both diseases combined (n = 934) were analyzed longitudinally over the course of 4 months. To test the mediating effect of comorbidity, well-being, functional health, and physical limitations in association with former and future SRH multiple mediator models were applied. Results: Across all groups emotional well-being was a consistent and powerful determinant of SRH. The effects of functional health and physical limitations on SRH were also significant but varied between diagnostic groups. The number of comorbid diseases did not predict SRH. Conclusion: Emotional well-being and physical health appraisal were strong predictors of SRH. Thus, SRH may be improved by influencing well-being and physical health appraisal via targeted interventions

Parenting Skills for Mothers with Borderline Personality Disorder – a newly developed group training program

Background: Dysfunctional relationships and emotion dysregulation are hallmark features of borderline personality disorder (BPD). Women with BPD are, therefore, particularly challenged when raising a child. A group training program was developed for mothers with BPD to enhance their parenting skills and help them raise their children. The program is based on cognitive-behavioral principles and skills derived from Dialectical Behavior Therapy (DBT). Methods: N = 15 mothers with BPD who had young children (aged 0–6 years) participated in a 12-week training program. To estimate the participants’ impairment, parental stress and psychological distress were assessed before the training. After the training, participants and trainers were asked to provide feedback regarding the evaluation of and the changes due to the training. Results: Participants’ self-reported stress related to parenting, as well as psychological distress and depressive symptoms, was high. Participants’ acceptance of the program was very good. Especially role plays were rated as useful. Trainers evaluated the program as helpful and reported visible changes in participants’ behavior and attitudes towards parenting. Conclusions: The results on the acceptance of the training program are promising

Autobiographical memories of interpersonal trust in borderline personality disorder

Background Establishing and maintaining interpersonal trust is often difficult for patients with Borderline Personality Disorder (BPD). How we trust is influenced by prior trust experiences. Methods For the investigation of trust experiences, autobiographical memories of n = 36 patients with BPD and n = 99 non-clinical controls were examined. Trust objects and interaction partners, emotional valence, perceived relevance and memory specificity were analyzed. Results Content analyses revealed that patients with BPD recalled mostly situations in which their trust was failed by family members or romantic partners. In addition, patients with BPD considered memories with trust and mistrust more relevant for their current lives than the control group. Our results correspond with findings that BPD patients have difficulties trusting close others as well as with theoretical assumptions about deficits in mentalizing and epistemic trust in patients with BPD. Conclusion In conclusion, our findings should encourage clinical practitioners to address trust deficits towards close others, as well as omniscient negative memory retrieval and interpretation biases which might influence current trust behavior

Job Demands, Job Resources, and Well-being in Police Officers - a Resource-Oriented Approach

This study examined the association between job characteristics, namely job demands and job resources, and mental health outcomes in terms of emotional exhaustion and well-being among police officers. Eight hundred forty-three German police officers participated in a cross-sectional online survey. Structural equation modeling was used to examine the validity of the dual process model of the Job Demands-Resources (JD-R) framework in the context of police work. Job demands (verbal assaults by citizens, workload, and administrative stressors) predicted emotional exhaustion whereas job resources (team support, shared values, and perceived fairness) predicted well-being. Moreover, job resources were directly and negatively associated with emotional exhaustion. The findings confirm the capacity of job resources to simultaneously promote well-being and reduce emotional exhaustion. Work place interventions should thus not merely decrease job demands. To improve and protect police officers’ well-being, it is advisable to promote job resources. A supportive and fair organizational climate based on shared values is required to foster mental health in the context of police work

Functional and self-rated health mediate the association between physical indicators of diabetes and depressive symptoms

Background Depression is common among persons with diabetes and associated with adverse health outcomes. To date, little is known about the causal mechanisms that lead to depression in diabetes. The aim of the present study was to examine to which extent functional and self-rated health mediate the association between physical health and depressive symptoms in diabetes. Methods Data of n = 3222 individuals with type 2 diabetes were analyzed cross- sectionally and longitudinally at three measurement occasions using path analysis. Indicators of physical health were glycemic control, number of comorbid somatic diseases, BMI, and insulin dependence. Furthermore, functional health, self-rated health and depressive symptoms were assessed. Results The effects of physical health on depressive symptoms were largely mediated by functional health and self-rated health. There was only a weak indirect effect of physical health on depressive symptoms. In contrast, self- rated health was a strong direct predictor of depressive symptoms. Self-rated health in turn depended strongly on patients’ functional health. Conclusions The way individuals perceive their health appears to have a stronger effect on their depressive symptoms than objective physical indicators of diabetes. Therefore practitioners should be trained to pay more attention to their patients’ subjective health perceptions

Does a Pre-Treatment Diagnostic Interview Affect the Outcome of Internet-Based Self-Help for Social Anxiety Disorder? A Randomized Controlled Trial

Background: Numerous studies suggest that Internet-based self-help treatments are effective in treating anxiety disorders. Trials evaluating such interventions differ in their screening procedures and in the amount of clinician contact in the diagnostic assessment phase. The present study evaluates the impact of a pre-treatment diagnostic interview on the outcome of an Internet-based treatment for Social Anxiety Disorder (SAD). Method: One hundred and nine participants seeking treatment for SAD were randomized to either an interview-group (IG, N = 53) or to a non-interview group (NIG, N = 56). All participants took part in the same 10-week cognitive-behavioural unguided self-help programme. Before receiving access to the programme, participants of the IG underwent a structured diagnostic interview. Participants of the NIG started directly with the programme. Results: Participants in both groups showed significant and substantial improvement on social anxiety measures from pre- to post-assessment (d IG = 1.30-1.63; d NIG = 1.00-1.28) and from pre- to 4-month follow-up assessment (d IG = 1.38-1.87; d NIG = 1.10-1.21). Significant between-groups effects in favour of the IG were found on secondary outcome measures of depression and general distress (d = 0.18-0.42). Conclusions: These findings suggest that Internet-based self-help is effective in treating SAD, whether or not a diagnostic interview is involved. However, the pre-treatment interview seems to facilitate change on secondary outcomes such as depression and general distres

Processing of increased frequency of social interaction in social anxiety disorder and borderline personality disorder

We investigated how patients with social anxiety disorder (SAD) and patients with borderline personality disorder (BPD) process an increase in the frequency of social interaction. We used an EEG-compatible version of the online ball-tossing game Cyberball to induce an increase in the frequency of social interaction. In the first condition, each player received the ball equally often (inclusion: 33% ball reception). In the following condition, the frequency of the ball reception was increased (overinclusion: 45% ball reception). The main outcome variable was the event-related potential P2, an indicator for social reward processing. Moreover, positive emotions were assessed. Twenty-eight patients with SAD, 29 patients with BPD and 28 healthy controls (HCs) participated. As expected, HCs and patients with BPD, but not patients with SAD, showed an increase in the P2 amplitude from the inclusion to the overinclusion condition. Contrary to our expectations, positive emotions did not change from the inclusion to the overinclusion condition. EEG results provide preliminary evidence that patients with BPD and HCs, but not patients with SAD, process an increase in the frequency of social interaction as rewarding

Optimisation of different concrete mix designs for 3D Printing by utilising 6DOF industrial robot

Additive Manufacturing (AM) technologies are becoming increasingly viable for commercial and research implementation into various applications. AM refers to the process of forming structures layer upon layer and finds application in prototyping and manufacturing for building construction. It has recently begun to be considered as a viable and attractive alternative in certain circumstances in the construction industry. This paper focuses on the utilisation of different concrete mixtures paired with extrusion techniques facilitated by a six Degree of Freedom (DOF) industrial robot. Using methods of Damp Least Squares (DLS) in conjunction with Resolved Motion Rate Control (RMRC), it is possible to plan stable transitions between several waypoints representing the various print cross-sections. Calculated paths are projected via 'spline' interpolation into the manipulator controlled by custom software. This article demonstrates the properties of different concrete mixture designs, showing their performance when used as a filament in 3D Printing and representing a comparison of the results that were found. In this study, the prepared materials consist of ordinary Portland cement, fine sand between (425-450) micron, coarse aggregate ranges (3) mm and chemical admixtures which have been used to accelerate setting times and reduce water content. Numerous tests were performed to check the buildability, flowability, extrudability and moldability of the concrete mixtures. The horizontal test was used to determine the flowability and consistency, while the vertical and squeeze-flow tests were used to determine the buildability of the layers. The extrudability and moldability of the concrete mixtures were controlled by the robot and associated extruder speeds

Suicidal ideation, self-injury, aggressive behavior and substance use during intensive trauma-focused treatment with exposure-based components in adolescent and young adult PTSD patients

Background Multiple traumata such as child sexual and/or physical abuse often result in complex psychopathologies and a range of associated dysfunctional behaviors. Although evidence-based interventions exist, some therapists are concerned that trauma-focused psychotherapy with exposure-based elements may lead to the deterioration of associated dysfunctional behaviors in adolescents and young adults. Therefore, we examined the course of suicidal ideation, self-injury, aggressive behavior and substance use in a group of abuse-related posttraumatic stress disorder (PTSD) patients during phase-based, trauma-focused PTSD treatment. Methods Daily assessments from a randomized controlled trial (RCT) of Developmentally adapted Cognitive Processing Therapy (D-CPT) were analyzed to test for differences in the stated dysfunctional behaviors between the four treatment phases. We conducted multilevel modeling and repeated measure ANOVAs. Results We did not find any significant differences between the treatment phases concerning the stated dysfunctional behaviors, either at the level of urge or at the level of actual actions. On the contrary, in some primary outcomes (self-injury, aggressive behavior), as well as secondary outcomes (distress caused by trauma, joy), we observed significant improvements. Discussion Overall, during D-CPT, adolescents and young adults showed no deterioration in dysfunctional behaviors, while even showing improvements in some, suggesting that trauma-focused treatment preceded by skills building was not deleterious to this population. Hence, the dissemination of effective interventions such as D-CPT should be fostered, whilst the concerns of the therapists regarding exposure-based components need to be addressed during appropriate training. Nevertheless, further studies with momentary assessment, extended measurement methods, a control group and larger sample sizes are needed to confirm our preliminary findings