A Psychometric Evaluation of the DSM-IV Criteria for Antisocial Personality Disorder:Dimensionality, Local Reliability, and Differential Item Functioning Across Gender

This study aims at evaluating the psychometric properties of the antisocial personality disorder (ASPD) criteria in a large sample of patients, most of whom had one or more personality disorders (PD). PD diagnoses were assessed by experienced clinicians using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Axis II PDs. Analyses were performed within an item response theory framework. Results of the analyses indicated that ASPD is a unidimensional construct that can be measured reliably at the upper range of the latent trait scale. Differential item functioning across gender was restricted to two criteria and had little impact on the latent ASPD trait level. Patients fulfilling both the adult ASPD criteria and the conduct disorder criteria had similar latent trait distributions as patients fulfilling only the adult ASPD criteria. Overall, the ASPD items fit the purpose of a diagnostic instrument well, that is, distinguishing patients with moderate from those with high antisocial personality scores

Psychiatric symptoms in COVID-19-positive individuals in the general population: Trajectories of depression, anxiety, and insomnia

The present study investigates differences in the trajectories of anxiety, depression, and sleep problems among infected versus non-infected case-controlled individuals. Patients who tested positive for COVID-19 were selected from a representative sample in Norway (N > 10,000). In total, 126 of these individuals were infected during the project period, and this group was analyzed at T5 (May 2021). Of these positive cases, those who had completed both PHQ-9 and GAD-7 at all three measurement points were selected for longitudinal analysis using multilevel modeling. There was a significant difference at T5 between those who had tested positive for COVID-19 and matched controls. Anxiety and depression were reduced among those who tested positive, but there were no differences in trajectory when compared to matched controls. Limitations include the use of self-report measures and the assessment of symptoms at a time when strict virus mitigation protocols were in place. The present findings indicate that individuals who test positive for COVID-19 exhibit higher levels of depressive symptoms after restrictions are lifted. However, comparison of anxiety and depression symptom trajectories with matched controls reveals that both groups exhibited stable or slightly decreased symptoms.publishedVersio

Matrix-assisted laser desorption ionization hydrogen/deuterium exchange studies to probe peptide conformational changes

AbstractHydrogen/deuterium (H/D) exchange chemistry monitored by matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry is used to study solution phase conformational changes of bradykinin, α-melanocyte stimulating hormone, and melittin as water is added to methanol-d4, acetonitrile, and isopropanol-d8 solutions. The results are interpreted in terms of a preference for the peptides to acquire more compact conformations in organic solvents as compared to the random conformations. Our interpretation is supported by circular dichroism spectra of the peptides in the same solvent systems and by previously published structural data for the peptides. These results demonstrate the utility of MALDI-TOF as a method to monitor the H/D exchange chemistry of peptides and investigations of solution-phase conformations of biomolecules

Two randomised and placebo-controlled studies of an oral prostacyclin analogue (Iloprost) in severe leg ischaemia [The Oral Iloprost in severe Leg Ischaemia Study Group]

Two separate studies are described using the same prostacyclin analogue in a similar group of patients. Objectives: to assess the tolerability and efficacy of two dose regimens of oral Iloprost compared with placebo in the treatment of patients with ischaemic ulcers, gangrene or rest pain due to severe arterial disease over a period of 4 weeks (Study A) and one year (Study B). Design: multicentre, placebo controlled, double-blind, randomized prospective studies. Subjects & Methods: 178 (study A) and 624 (study B) patients with trophic skin lesions (ulcers or gangrene) or ischaemic rest pain due to severe arterial disease. To confirm severe arterial disease patients were required to have a systolic ankle Doppler pressure of 70 mmHg or less or a toe systolic Doppler pressure of 50 mmHg or less in one leg.In both studies patients were randomly allocated to three treatment groups: placebo, low dose Iloprost (50\u2013100 g twice a day) or high dose (150\u2013200 g twice a day) In Study A the main outcome measures were tolerability of different doses of Iloprost and death, major amputation, healing of trophic lesions and relief of rest pain at the end of the follow up, which was 5 months after the end of the treatment. In Study B the primary end point was time to major amputation and stroke or death up to 12 months. Secondary pre-defined end points included the combined end point of patients alive without amputation, no trophic skin changes, no rest pain and not on regular analgesics. Results: the proportion of patients who completed the 4-week treatment period in Study A at the intended dose was 58%, 43%, 45% respectively in the placebo, low dose and high dose Iloprost groups. In an intention to treat analysis the proportion of patients who survived without major amputation, ulcers or gangrene and had no rest pain was 11% in the placebo group, 19% in the low dose iloprost group and 28% in the high dose Iloprost group. The pooled Iloprost groups showed a statistically significantly better result than the placebo group (p=0.04), as did the high dose Iloprost group compared to the placebo (p=0.014). In Study B there was no treatment benefit in terms of a primary end point of amputation and death. However the secondary combined end point of patients who survived without a major amputation, ulcers or gangrene and had no rest pain, nor a need for regular analgesia was favourable for Iloprost, with 18% of patients in the placebo group reaching this optimal secondary end point, compared to 23% in the low dose Iloprost group and 26% in the higher dose Iloprost group (p<0.05). Conclusions: oral Iloprost administered for a year showed no clear benefit in patients with advanced severe leg ischaemia (PAOD III and IV). The results obtained with 4 weeks\u2019 treatment in Study A and in previous trials of intravenous Iloprost could not be reproduce

Step-down versus outpatient psychotherapeutic treatment for personality disorders: 6-year follow-up of the Ullevål personality project

Background Although psychotherapy is considered the treatment of choice for patients with personality disorders (PDs), there is no consensus about the optimal level of care for this group of patients. This study reports the results from the 6-year follow-up of the Ullevål Personality Project (UPP), a randomized clinical trial comparing outpatient individual psychotherapy with a long-term step-down treatment program that included a short-term day hospital treatment followed by combined group and individual psychotherapy. Methods The UPP included 113 patients with PDs. Outcome was evaluated after 8 months, 18 months, 3 years and 6 years and was based on a wide range of clinical measures, such as psychosocial functioning, interpersonal problems, symptom severity, and axis I and II diagnoses. Results At the 6-year follow-up, there were no statistically significant differences in outcome between the treatment groups. Effect sizes ranged from medium to large for all outcome variables in both treatment arms. However, patients in the outpatient group had a marked decline in psychosocial functioning during the period between the 3- and 6-year follow-ups; while psychosocial functioning continued to improve in the step-down group during the same period. This difference between groups was statistically significant. Conclusions The findings suggest that both hospital-based long-term step-down treatment and long-term outpatient individual psychotherapy may improve symptoms and psychosocial functioning in poorly functioning PD patients. Social and interpersonal functioning continued to improve in the step-down group during the post-treatment phase, indicating that longer-term changes were stimulated during treatment. Trial registration NCT00378248

Mechanisms of Parental Stress During and After the COVID-19 Lockdown: A two-wave longitudinal study

Background: In the unpredictable times of the ongoing global coronavirus disease (COVID-19), parents worldwide are affected by stressors and strains that follow in the wake of the government-initiated distancing protocols. Objective: In a two‐wave longitudinal survey, we examined levels of parental perceived stress and symptoms of anxiety and depression among a sample of parents at two time points; in the midst of the strictest government-initiated physical distancing protocols following the onset of the COVID-19 pandemic (T1, N = 2868) and three months after the protocols discontinued (T2, n = 1489). Further, we investigated the levels of parental stress, anxiety, and depression relative to perceived relationship quality and anger aimed at child(ren) at the two time points, including subgroups based on age, sex, cultural background, civil status, education level, number of children in household, employment status, and pre-existing psychiatric diagnosis. Methods and findings: Parents were asked to fill out a set of validated questionnaires on the two measurement occasions. As expected, the findings indicate that the high levels of parental stress significantly decreased from T1 to T2, indicating that the cumulative stressors that parent’s experiences during distancing protocols declined as a function of the phaseout of the protocols. The decrease of perceived parental stress at the two time points, was accompanied by a significant decrease in symptoms of both depression and anxiety among the participating parents. Symptoms meeting the clinical cut-off for depression (23.0%) and generalized anxiety disorder (23.3%) were reported among participating parents at T1, compared to 16.8% and 13.8% respectively at T2. Reduction in depression and angry at child(ren) from T1 to T2 were further associated with a reduction in perceived parental stress. In addition, relationship quality and angry at child(ren) at T1 predicted change in parental stress. Conclusions: The findings underline some of the negative psychological impact of physical distancing protocols on parent’s health and well-being. Parents who are facing physical distancing and remaining at home with their children may be particularly vulnerable to parental stress, anxiety and depression. Uncovering the nature of how these constructs are associated to parents and families facing social crisis, such as the ongoing pandemic, can contribute to design relevant interventions to reduce parental stress and strengthen parental coping and resilience. Keywords: COVID-19 lockdown, parental stress, anxiety, depression, social distancing

Feelings of Worthlessness Links Depressive Symptoms and Parental Stress: A Network Analysis During the COVID-19 Pandemic

The prevalent co-occurrence between parental stress and depression has been previously established prior to and during the COVID-19 pandemic outbreak. However, no studies to date have identified the connections through which these symptom domains interact with each other to emerge into a complex and detrimental mental health state, along with the plausible mechanistic variables that may play key roles in maintaining parental stress and depression. The aim of this research is to uncover these interactions in a period where parents experience heighted demands and stress as a consequence of the strict social distancing protocols. Network analysis is utilized to examine parental stress and depressive symptoms during the COVID-19 pandemic in a large cross-sectional study (N = 2868) of parents. Two graphical Gaussian graphical network models were estimated, one in which only parental stress and depression symptoms were included, and another in which several mechanistic variables were added. Expected influence and bridge expected influence revealed that feeling worthless was the most influential node in the symptoms network and bridged the two psychological states. Among the mechanistic variables, worry and rumination was specifically relevant in the depressive cluster of symptoms, and self-criticism was connected to both constructs. The study display that the co-occurrence of parental stress and depression have specific pathways, were manifested through feelings of worthlessness, and have specific patterns of connection to important mechanisms of psychopathology. The results are of utility when aiming to avoid the constellation of co-occurring parental stress and depressive symptoms during the pandemic

Daily Dynamics of Parental Mental Health: Investigating Depressive Symptoms and Negative Parental Experiences

Background: Investigating psychopathological processes and how these are connected to psychiatric symptoms is important to understand how disorder states emerge and are maintained over time. Focusing on within-person relationships between variables further allows investigation of how these relations on average unfold within individuals. Methods: This preregistered intensive longitudinal study investigates connections between depressive symptoms, psychopathological processes, and negative parental experiences. Daily observations from 1036 parents were retrieved from two 40-day periods during the COVID-19 pandemic. The data was modelled using multilevel dynamic network analysis, unveiling across-day associations and contemporaneous interactions within the same time window. Results: On an across-day basis, helplessness was strongly interwoven with and predictive of the cognitive-affective features of depression and the other psychopathological processes. Being overwhelmed by the parental role (parenting stress) and emotionally drained as a parent (parental burnout) reciprocally reinforced each other from one day to the next, indicating how these components can manifest as a vicious loop over time. Finally, depressive symptomatology and negative parental experiences displayed within-day connections, with emotion regulation difficulties being connected to all parental components. Conclusions: The findings suggest that vicious cycles between helplessness and worthlessness predict the prolonged experience of depressed states in parents and that elevations in parenting stress and parental burnout reinforce each other over time