The effect of twice-weekly versus once-weekly sessions of either imagery rescripting or eye movement desensitization and reprocessing for adults with PTSD from childhood trauma (IREM-Freq): a study protocol for an international randomized clinical trial

Background Trauma-focused treatments for posttraumatic stress disorder (PTSD) are commonly delivered either once or twice a week. Initial evidence suggests that session frequency affects treatment response, but very few trials have investigated the effect of session frequency. The present study’s aim is to compare treatment outcomes of twice-weekly versus once-weekly sessions of two treatments for PTSD related to childhood trauma, imagery rescripting (ImRs) and eye movement desensitization and reprocessing (EMDR). We hypothesize that both treatments will be more effective when delivered twice than once a week. How session frequency impacts treatment response, whether treatment type moderates the frequency effect, and which treatment type and frequency works best for whom will also be investigated. Methods The IREM-Freq trial is an international multicenter randomized clinical trial conducted in mental healthcare centers across Australia, Germany, and the Netherlands. We aim to recruit 220 participants, who will be randomized to one of four conditions: (1) EMDR once a week, (2) EMDR twice a week, (3) ImRs once a week, or (4) ImRs twice a week. Treatment consists of 12 sessions. Data are collected at baseline until one-year follow-up. The primary outcome measure is clinician-rated PTSD symptom severity. Secondary outcome measures include self-reported PTSD symptom severity, complex PTSD symptoms, trauma-related cognitions and emotions, depressive symptoms, dissociation, quality of life, and functioning. Process measures include memory, learning, therapeutic alliance, motivation, reluctance, and avoidance. Additional investigations will focus on predictors of treatment outcome and PTSD severity, change mechanisms of EMDR and ImRs, the role of emotions, cognitions, and memory, the optimization of treatment selection, learned helplessness, perspectives of patients and therapists, the network structure of PTSD symptoms, and sudden treatment gains. Discussion This study will extend our knowledge on trauma-focused treatments for PTSD related to childhood trauma and, more specifically, the importance of session frequency. More insight into the optimal session frequency could lead to improved treatment outcomes and less dropout, and in turn, to a reduction of healthcare costs. Moreover, the additional investigations will broaden our understanding of how the treatments work and variables that affect treatment outcome. Trial registration Netherlands Trial Register NL6965, registered 25/04/2018

The Importance of Context in Understanding Homelessness and Mental Illness: Lessons Learned From a Research Demonstration Project

Research reports on the housing outcomes for persons who are homeless and mentally ill have focused on client characteristics, program type, and services as independent variables, with mixed results. From social work practice, evaluation theory, and public policy perspectives, context is an important variable. Yet, it has received scant research attention in studies of the outcomes of persons who are mentally ill and homeless. This article summarizes research results from a demonstration project providing outreach or linkage services to this target population, illustrating the significant impact of context variables (site and recruitment source) on client characteristics, implementation, qualitative and quantitative service assessments, and housing outcomes. The discussion suggests how these contextual factors may operate, and it goes on to make recommendations to improve social work research and practice concerning the important dimensions of context that should be assessed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69136/2/10.1177_104973159800800203.pd

MOLECULAR MODELS FOR EXPLOSIVES

Plusieurs propriétés moléculaires ont été calculées pour quelques explosifs. Des calculs de densité cristalline obtenus par des méthodes complètement empiriques pour des nitrates et des perchlorates sont présentés. Les chaleurs de formation, les géométries et les énergies de dissociation (EDB) ont été obtenues pour plusieurs explosifs en utilisant la méthode semi empirique d'orbitale moléculaire AM1. Finalement les calculs ab initio montrent que la participation de la résonance des groupes Nitro sur les benzènes est négligeable.Molecular properties of various kinds have been obtained for explosives. Crystal density calculations, performed by entirely empirical methods, for nitrates and perchlorates are presented. Heats of formation, geometries, and bond dissociation (BDE's) energies were obtained for several explosives, using the semi-empirical AM1 molecular orbital method. Finally, results from ab initio calculations show that resonance participation by nitro groups on benzenes is negligible

Effect of micro and bulk solvation on the mechanism of nucleophilic substitution at sulfur in disulfides

Computational studies of the solution-phase mechanism of nucleophilic substitution at sulfur in disulfides with explicit water representation indicate that the pathway is dependent on the substituent on the sulfur under attack. B3LYP/6-1+G* optimizations for prototype thiolate-disulffide exchange reactions were performed including one to four explicit water molecules, followed by single-point free energy calculations with B3LYP/6-31+G* and the polarized continuum model (PCM). The solution-phase mechanism is the addition-elimination mechanism when the sulfur under attack bears a hydrogen, while the SN2 mechanism is predicted when the sulfur substituent is a methyl group

Unusual bond paths in organolithium compounds

We have applied the topological method to a number of organolithium compounds. The wavefunctions were determined with GAUSSIAN-82 using 3-21G basis set and fully optimized geometries. Gradient paths were obtained using the RHODER package and critical points were located using EXTREME. These results indicate the unusual nature of organolithium compounds. The strange bond paths arise mainly from the ionic nature of the C-Li interaction. We suggest that the term ''bond path'' may best be suited for covalent bonds. 4 figs., 1 tab

Theoretical study of nucleophilic substitution at sulfur in sulfinyl derivatives

A series of gas-phase nucleophilic substitution reactions at sulfur of methanesulfinyl derivatives by small anions (chloride, cyanide, hydroxide, methoxide, amide, and phosphide, identical to the leaving group in each case) were examined by Hartree-Fock, MP2, and DFT computations. In most cases, substitution was found to follow an addition-elimination mechanism, resulting in a triple-well potential energy surface with small barriers of activation on either side of the central, tetracoordinate-sulfur minimum. The geometries of the central minima, as in the analogous methanesulfenyl cases, are unsymmetrical trigonal bipyramidal, with the nucleophiles and leaving groups occupying apical positions and the sulfur lone pair an equatorial position. The apparent exception, cyanide, may undergo an SN2 displacement

Density functional theory gas- and solution-phase study of nucleophilic substitution at di- and trisulfides

Density functional calculations indicate that nucleophilic substitution in the thiolate-disulfide and thiolate-trisulfide exchange reactions proceeds by an addition-elimination pathway. Solution calculations were performed using B3LYP/6-31 + G* and the polarized continuum method. These solution-phase calculations indicate that for the reactions where the sulfur under attack bears a hydrogen atom, the substitution proceeds via an addition-elimination mechanism; however, when a methyl group is attached to the sulfur under attack, the SN2 mechanism is predicted

Potential energy surface of SOCl3 -

Sulfur trichloride monoxide anion (SOCl3-) is stable in the gas phase. The G2 estimate of the energy for its dissociation to thionyl chloride and chloride anion is 102.8 kJ mol-1. The potential energy surface for the reaction SOCl2 + Cl- → SOCl3- has just a single well corresponding to the product. Collision-induced dissociation observed using a flowing afterglow-tandem mass spectrometer indicates a D0(SOCl2−Cl-) bond energy of 85.4 ± 7.6 kJ mol-1, which is very similar to the previously determined bond energy D0(SCl2−Cl-) = 85 kJ mol-1

The quest for a triplet ground-state alkene: Highly twisted CC double bonds.

Density functional theory and extrapolated CCSD(T) computations of several "anti-Bredt" alkenes were carried to explore possible 1,2-diyl "alkene" candidates with a triplet ground state. Ten candidates containing twisted double bonds at the bridgehead positions of bicyclic structures (1-6) or adamantene (7-10) derivatives were studied. Based on a combination of ring strain, rigid scaffolding, and steric crowding, four species were identified to have surprisingly low singlet-triplet energy gaps (lower than 4 kcal/mol). A tert-butyl substituted bicyclic structure (4) was identified to have a near-zero singlet-triplet energy gap, but no triplet ground-state alkene was found. Ring strain energy (RSE) calculations, pi-orbital axis vector (POAV) analyses, and multiple linear regression models were performed to elucidate the geometric and energetic effects of double bond twisting in 1-10. Based on our computational exploration, it appears unlikely that there is a ground-state triplet olefin