37 research outputs found
Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population
Purpose: The Demoralization scale (DS-I) is a validated and frequently used instrument
to assess existential distress in patients with cancer and other severe medical illness.
The purpose of this study was to provide normative values derived from a representative
German general population sample and to analyze the correlational structure of the DS-I.
Methods: A representative sample of the adult German general population completed
the DS-I (24 Items), the Emotion Thermometers (ET) measuring distress, anxiety,
depression, anger, need for help, and the Functional Assessment of Chronic Illness
Therapy Fatigue Scale (FACIT-fatigue).
Results: The sample consists of N = 2,407 adults (mean age = 49.8; range = 18â94
years), 55.7% women). The percentages of participants above the DS-I cutoff (30) was
13.5%. The mean scores of the DS-I dimensions were as follows: (1) loss of meaning
and purpose: M = 2.78 SD = 4.49; (2) disheartenment: M = 3.19 SD = 4.03; (3)
dysphoria M = 4.51 SD = 3.20; (4) sense of failure: M = 6.24 SD = 3.40; and for
the DS-I total score: M = 16.72 SD = 12.74. Women reported significantly higher levels
of demoralization than men, with effect sizes between d = 0.09 (Loss of Meaning) and
d = 0.21 (Dysphoria). Age was not associated with demoralization in our sample. DS-I
reliability was excellent (a = 0.94) and DS-I subscales were interrelated (r between 0.31
and 0.87) and significantly correlated with ET, especially depression, anxiety, and need
for help and fatigue (r between 0.14 and 0.69).
Conclusions: In order to use the DS-I as a screening tool in clinical practice and research
the normative values are essential for comparing the symptom burden of groups of
patients within the health care system to the general population. Age and sex differences
between groups of patients can be accounted for using the presented normative scores
of the DS-I
Aberrant Current Source-Density and Lagged Phase Synchronization of Neural Oscillations as Markers for Emerging Psychosis
Background: Converging evidence indicates that neural oscillations coordinate activity across brain areas, a process which is seemingly perturbed in schizophrenia. In particular, beta (13-30 Hz) and gamma (30-50 Hz) oscillations were repeatedly found to be disturbed in schizophrenia and linked to clinical symptoms. However, it remains unknown whether abnormalities in current source density (CSD) and lagged phase synchronization of oscillations across distributed regions of the brain already occur in patients with an at-risk mental state (ARMS) for psychosis. Methods: To further elucidate this issue, we assessed resting-state EEG data of 63 ARMS patients and 29 healthy controls (HC). Twenty-three ARMS patients later made a transition to psychosis (ARMS-T) and 40 did not (ARMS-NT). CSD and lagged phase synchronization of neural oscillations across brain areas were assessed using eLORETA and their relationships to neurocognitive deficits and clinical symptoms were analyzed using linear mixed-effects models. Results: ARMS-T patients showed higher gamma activity in the medial prefrontal cortex compared to HC, which was associated with abstract reasoning abilities in ARMS-T. Furthermore, in ARMS-T patients lagged phase synchronization of beta oscillations decreased more over Euclidian distance compared to ARMS-NT and HC. Finally, this steep spatial decrease of phase synchronicity was most pronounced in ARMS-T patients with high positive and negative symptoms scores. Conclusions: These results indicate that patients who will later make the transition to psychosis are characterized by impairments in localized and synchronized neural oscillations providing new insights into the pathophysiological mechanisms of schizophrenic psychoses and may be used to improve the prediction of psychosi
Testing the Treatment Integrity of the Managing Cancer and Living Meaningfully Psychotherapeutic Intervention for Patients With Advanced Cancer
Introduction: The Managing Cancer and Living Meaningfully (CALM) therapy for
patients with advanced cancer was tested against a supportive psycho-oncological
counseling intervention (SPI) in a randomized controlled trial (RCT). We investigated
whether CALM was delivered as intended (therapistsâ adherence); whether CALM
therapists with less experience in psycho-oncological care show higher adherence
scores; and whether potential overlapping treatment elements between CALM and SPI
can be identified (treatment differentiation).
Methods: Two trained and blinded raters assessed on 19 items four subscales of
the Treatment Integrity Scale covering treatment domains of CALM (SC: Symptom
Management and Communication with Health Care Providers; CSR: Changes in Self
and Relationship with Others; SMP: Spiritual Well-being and Sense of Meaning and
Purpose; FHM: Preparing for the Future, Sustaining Hope and Facing Mortality).
A random sample of 150 audio recordings (75 CALM, 75 SPI) were rated on a threepoint
Likert scale with 1 = âadherent to some extent,â 2 = âadherent to a sufficient
extent,â 3 = âvery adherent.â
Results: All 19 treatment elements were applied, but in various frequencies. CALM
therapists most frequently explored symptoms and/or relationship to health care
providers (SC_1: n_applied = 62; 83%) and allowed expression of sadness and anxiety
about the progression of disease (FHM_2: n_applied = 62; 83%). The exploration of CALM
treatment element SC_1 was most frequently implemented in a satisfactory or excellent
manner (n_sufficient or very adherent = 34; 45%), whereas the treatment element SMP_4:
Therapist promotes acknowledgment that some life goals may no longer be achievable
(n_sufficient or very adherent = 0; 0%) was not implemented in a satisfactory manner.
In terms of treatment differentiation, no treatment elements could be identified which
were applied significantly more often by CALM therapists than by SPI therapists.
Conclusion: Results verify the application of CALM treatment domains. However,
CALM therapistsâ adherence scores indicated manual deviations. Furthermore, raters
were not able to significantly distinguish CALM from SPI, implying that overlapping
treatment elements were delivered to patients
Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer
Objective: To test the psychometric properties, internal consistency, dimensional
structure, and convergent validity of the German version of the Demoralization Scale-
II (DS-II), and to examine the association between demoralization, sociodemographic,
disease- and treatment-related variables in patients with cancer.
Methods: We recruited adult patients with cancer at a Psychosocial Counseling Center
and at oncological wards. Participants completed the 16-item DS-II, Patient Health
Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Screener-2 (GAD-2), Distress
Thermometer (DT), and Body Image Scale (BIS). We analyzed internal consistency
of the DS-II using Cronbachâs Alpha (a). We tested the dimensional structure of the
DS-II with Confirmatory Factor Analyses (CFA). Convergent validity was expressed
through correlation coefficients with established measures of psychological distress.
The associations between demoralization, sociodemographic, disease- and treatmentrelated
variables were examined with ANOVAs.
Results: Out of 942 eligible patients, 620 participated. The average DS-II total score
was M = 5.78, SD = 6.34, the Meaning and Purpose subscale M = 2.20, SD = 3.20,
and the Distress and Coping Ability subscale M = 3.58, SD = 3.45. Internal consistency
ranged from high to excellent with a = 0.93 for the DS-II total scale, a = 0.90 for
the Meaning and Purpose subscale, and a = 0.87 for the Distress and Coping Ability
subscale. The one-factor and the two-factor model yielded similar model fits, with
CFI and TLI ranging between 0.910 and 0.933, SRMR < 0.05. The DS-II correlated
significantly with depression (PHQ-9: r = 0.69), anxiety (GAD-2: r = 0.72), mental distress
(DT: r = 0.36), and body image disturbance (BIS: r = 0.58). High levels of demoralization
were reported by patients aged between 18 and 49 years (M = 7.77, SD = 6.26), patients
who were divorced/separated (M = 7.64, SD = 7.29), lung cancer patients (M = 9.29,
SD = 8.20), and those receiving no radiotherapy (M = 7.46, SD = 6.60).
Conclusion: The DS-II has very good psychometric properties and can be
recommended as a reliable tool for assessing demoralization in patients with cancer.
The results support the implementation of a screening for demoralization in specific risk
groups due to significantly increased demoralization scores
Sex differences in cognitive functioning in at-risk mental state for psychosis, first episode psychosis and healthy control subjects
BACKGROUND: Several sex differences in schizophrenia have been reported including differences in cognitive functioning. Studies with schizophrenia patients and healthy controls (HC) indicate that the sex advantage for women in verbal domains is also present in schizophrenia patients. However, findings have been inconsistent. No study focused on sex-related cognitive performance differences in at-risk mental state for psychosis (ARMS) individuals yet. Thus, the aim of the present study was to investigate sex differences in cognitive functioning in ARMS, first episode psychosis (FEP) and HC subjects. We expected a better verbal learning and memory performance of women in all groups. METHODS: The neuropsychological data analysed in this study were collected within the prospective Fruherkennung von Psychosen (FePsy) study. In total, 118 ARMS, 88 FEP individuals and 86 HC completed a cognitive test battery covering the domains of executive functions, attention, working memory, verbal learning and memory, IQ and speed of processing. RESULTS: Women performed better in verbal learning and memory regardless of diagnostic group. By contrast, men as compared to women showed a shorter reaction time during the working memory task across all groups. CONCLUSION: The results provide evidence that women generally perform better in verbal learning and memory, independent of diagnostic group (ARMS, FEP, HC). The finding of a shorter reaction time for men in the working memory task could indicate that men have a superior working memory performance since they responded faster during the target trials, while maintaining a comparable overall working memory performance level
Early detection of psychosis: helpful or stigmatizing experience? A qualitative study
Aim: Despite the large scientific debate concerning potential stigmatizing effects of identifying an individual as being in an atârisk mental state (ARMS) for psychosis, studies investigating this topic from the subjective perspective of patients are rare. This study assesses whether ARMS individuals experience stigmatization and to what extent being informed about the ARMS is experienced as helpful or harmful. Methods Eleven ARMS individuals, currently participating in the followâup assessments of the prospective Basel FrĂźherkennung von Psychosen (FePsy; English: Early Detection of Psychosis) study, were interviewed in detail using a semistructured qualitative interview developed for this purpose. Data were analysed using Interpretative Phenomenological Analysis. Results Most individuals experiencing first symptoms reported sensing that there was 'something wrong with them' and felt in need of help. They were relieved that a specific term was assigned to their symptoms. The support received from the early detection centre was generally experienced as helpful. Many patients reported stigmatization and discrimination that appeared to be the result of altered behaviour and social withdrawal due to the prepsychotic symptoms they experienced prior to contact with the early detection clinic. Conclusions The results suggest that early detection services help individuals cope with symptoms and potential stigmatization rather than enhancing or causing the latter. More emphasis should be put on the subjective experiences of those concerned when debating the advantages and disadvantages of early detection with regard to stigma. There was no evidence for increased perceived stigma and discrimination as a result of receiving information about the ARMS
The 2MASS Redshift Survey - Description and Data Release
We present the results of the 2MASS Redshift Survey (2MRS), a ten-year
project to map the full three-dimensional distribution of galaxies in the
nearby Universe. The 2 Micron All-Sky Survey (2MASS) was completed in 2003 and
its final data products, including an extended source catalog (XSC), are
available on-line. The 2MASS XSC contains nearly a million galaxies with Ks <=
13.5 mag and is essentially complete and mostly unaffected by interstellar
extinction and stellar confusion down to a galactic latitude of |b|=5 deg for
bright galaxies. Near-infrared wavelengths are sensitive to the old stellar
populations that dominate galaxy masses, making 2MASS an excellent starting
point to study the distribution of matter in the nearby Universe.
We selected a sample of 44,599 2MASS galaxies with Ks =5
deg (>= 8 deg towards the Galactic bulge) as the input catalog for our survey.
We obtained spectroscopic observations for 11,000 galaxies and used
previously-obtained velocities for the remainder of the sample to generate a
redshift catalog that is 97.6% complete to well-defined limits and covers 91%
of the sky. This provides an unprecedented census of galaxy (baryonic mass)
concentrations within 300 Mpc.
Earlier versions of our survey have been used in a number of publications
that have studied the bulk motion of the Local Group, mapped the density and
peculiar velocity fields out to 50 Mpc, detected galaxy groups, and estimated
the values of several cosmological parameters.
Additionally, we present morphological types for a nearly-complete sub-sample
of 20,860 galaxies with Ks = 10 deg.Comment: Accepted for publication in The Astrophysical Journal Supplement
Series. The 2MRS catalogs and a version of the paper with higher-resolution
figures can be found at http://tdc-www.harvard.edu/2mrs
Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population
Purpose: The Demoralization scale (DS-I) is a validated and frequently used instrument
to assess existential distress in patients with cancer and other severe medical illness.
The purpose of this study was to provide normative values derived from a representative
German general population sample and to analyze the correlational structure of the DS-I.
Methods: A representative sample of the adult German general population completed
the DS-I (24 Items), the Emotion Thermometers (ET) measuring distress, anxiety,
depression, anger, need for help, and the Functional Assessment of Chronic Illness
Therapy Fatigue Scale (FACIT-fatigue).
Results: The sample consists of N = 2,407 adults (mean age = 49.8; range = 18â94
years), 55.7% women). The percentages of participants above the DS-I cutoff (30) was
13.5%. The mean scores of the DS-I dimensions were as follows: (1) loss of meaning
and purpose: M = 2.78 SD = 4.49; (2) disheartenment: M = 3.19 SD = 4.03; (3)
dysphoria M = 4.51 SD = 3.20; (4) sense of failure: M = 6.24 SD = 3.40; and for
the DS-I total score: M = 16.72 SD = 12.74. Women reported significantly higher levels
of demoralization than men, with effect sizes between d = 0.09 (Loss of Meaning) and
d = 0.21 (Dysphoria). Age was not associated with demoralization in our sample. DS-I
reliability was excellent (a = 0.94) and DS-I subscales were interrelated (r between 0.31
and 0.87) and significantly correlated with ET, especially depression, anxiety, and need
for help and fatigue (r between 0.14 and 0.69).
Conclusions: In order to use the DS-I as a screening tool in clinical practice and research
the normative values are essential for comparing the symptom burden of groups of
patients within the health care system to the general population. Age and sex differences
between groups of patients can be accounted for using the presented normative scores
of the DS-I
Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population
Purpose: The Demoralization scale (DS-I) is a validated and frequently used instrument
to assess existential distress in patients with cancer and other severe medical illness.
The purpose of this study was to provide normative values derived from a representative
German general population sample and to analyze the correlational structure of the DS-I.
Methods: A representative sample of the adult German general population completed
the DS-I (24 Items), the Emotion Thermometers (ET) measuring distress, anxiety,
depression, anger, need for help, and the Functional Assessment of Chronic Illness
Therapy Fatigue Scale (FACIT-fatigue).
Results: The sample consists of N = 2,407 adults (mean age = 49.8; range = 18â94
years), 55.7% women). The percentages of participants above the DS-I cutoff (30) was
13.5%. The mean scores of the DS-I dimensions were as follows: (1) loss of meaning
and purpose: M = 2.78 SD = 4.49; (2) disheartenment: M = 3.19 SD = 4.03; (3)
dysphoria M = 4.51 SD = 3.20; (4) sense of failure: M = 6.24 SD = 3.40; and for
the DS-I total score: M = 16.72 SD = 12.74. Women reported significantly higher levels
of demoralization than men, with effect sizes between d = 0.09 (Loss of Meaning) and
d = 0.21 (Dysphoria). Age was not associated with demoralization in our sample. DS-I
reliability was excellent (a = 0.94) and DS-I subscales were interrelated (r between 0.31
and 0.87) and significantly correlated with ET, especially depression, anxiety, and need
for help and fatigue (r between 0.14 and 0.69).
Conclusions: In order to use the DS-I as a screening tool in clinical practice and research
the normative values are essential for comparing the symptom burden of groups of
patients within the health care system to the general population. Age and sex differences
between groups of patients can be accounted for using the presented normative scores
of the DS-I