Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder

Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Simpson, 2013). However, these treatments are not accessible to many sufferers around the world. Currently available guidelines for care are deemed to be essential but insufficient because of highly variable clinician knowledge and competencies specific to OCD. The phase two mandate of the 14 nation International OCD Accreditation Task Force (ATF) created by the Canadian Institute for Obsessive Compulsive Disorders is development of knowledge and competency standards for specialized treatments for OCD through the lifespan deemed by experts to be foundational to transformative change in this field. This paper presents knowledge and competency standards for specialized CBT for adult OCD developed to inform, advance, and offer a model for clinical practice and training for OCD. During upcoming ATF phases three and four criteria and processes for training in specialized treatments for OCD through the lifespan for certification (individuals) and accreditation (sites) will be developed based on the ATF standards

Does the level of expressed emotion (LEE) questionnaire have the same factor structure for adolescents as it has for adults?

Background The level of expressed emotion (LEE) is a four-factor questionnaire that measures expressed emotion (EE) as perceived by the recipient. These factors are: perceived lack of emotional support, perceived intrusiveness, perceived irritation, and perceive criticism. The four factors of the LEE has previously been found to be related to psychological disorders and has good psychometric properties for adults. However, it has not previously been studied in adolescent populations. Methods A total of 311 adolescents participated in this study. Using structural equation modeling, confirmatory factor analyses were conducted to examine if the LEE also had the same four-factor structure for adolescents as it does for adults. Results The confirmatory factor analyses demonstrated that the LEE's four-factor structure also applied to adolescents. The internal consistency of the scales were good and all the inter-correlations between the scales were significant. Additionally, the factors were significantly correlated to adolescent depressive and anxiety symptom score dimensions. Conclusion These findings seem to indicate that the LEE may be a good instrument in the measurement of adolescents perceived EE

Discordant Gene Expression Signatures and Related Phenotypic Differences in Lamin A- and A/C-Related Hutchinson-Gilford Progeria Syndrome (HGPS)

Hutchinson-Gilford progeria syndrome (HGPS) is a genetic disorder displaying features reminiscent of premature senescence caused by germline mutations in the LMNA gene encoding lamin A and C, essential components of the nuclear lamina. By studying a family with homozygous LMNA mutation (K542N), we showed that HGPS can also be caused by mutations affecting both isoforms, lamin A and C. Here, we aimed to elucidate the molecular mechanisms underlying the pathogenesis in both, lamin A- (sporadic) and lamin A and C-related (hereditary) HGPS. For this, we performed detailed molecular studies on primary fibroblasts of hetero- and homozygous LMNA K542N mutation carriers, accompanied with clinical examinations related to the molecular findings. By assessing global gene expression we found substantial overlap in altered transcription profiles (13.7%; 90/657) in sporadic and hereditary HGPS, with 83.3% (75/90) concordant and 16.7% (15/90) discordant transcriptional changes. Among the concordant ones we observed down-regulation of TWIST2, whose inactivation in mice and humans leads to loss of subcutaneous fat and dermal appendages, and loss of expression in dermal fibroblasts and periadnexial cells from a LMNAK542N/K542N patient further confirming its pivotal role in skin development. Among the discordant transcriptional profiles we identified two key mediators of vascular calcification and bone metabolism, ENPP1 and OPG, which offer a molecular explanation for the major phenotypic differences in vascular and bone disease in sporadic and hereditary HGPS. Finally, this study correlates reduced TWIST2 and OPG expression with increased osteocalcin levels, thereby linking altered bone remodeling to energy homeostasis in hereditary HGPS

The IASI NH₃ version 4 product: averaging kernels and improved consistency

Satellite measurements play an increasingly important role in the study of atmospheric ammonia (NH3). Here, we present version 4 of the Artificial Neural Network for IASI (ANNI; IASI: Infrared Atmospheric Sounding Interferometer) retrieval of NH3. The main change is the introduction of total column averaging kernels (AVKs), which can be used to undo the effect of the vertical profile shape assumption of the retrieval. While the main equations can be matched term for term with analogous ones used in UV/Vis retrievals for other minor absorbers, we derive the formalism from the ground up, as its applicability to thermal infrared measurements is non-trivial. A large number of other smaller changes were introduced in ANNI v4, most of which improve the consistency of the measurements across time and across the series of IASI instruments. This includes a more robust way of calculating the hyperspectral range index (HRI), explicitly accounting for long-term changes in CO2 in the HRI calculation and the use of a reprocessed cloud product that was specifically developed for climate applications. The NH3 distributions derived with ANNI v4 are very similar to the ones derived with v3, although values are about 10 %–20 % larger due to the improved setup of the HRI. We exclude further large biases of the same nature by showing the consistency between ANNI v4 derived NH3 columns with columns obtained with an optimal estimation approach. Finally, with v4, we revised the uncertainty budget and now report systematic uncertainty estimates alongside random uncertainties, allowing realistic mean uncertainties to be estimated.</p

Mother-child interactions and childhood OCD: Effects of CBT on mother and child observed behaviors

This waitlist-controlled study investigates the impact of a groupbased cognitive-behavioral therapy with family involvement (CBT-F) on observed mother and child behaviors in children with obsessive-compulsive disorder (OCD). Forty-four children and adolescents with OCD and their mothers were observed during family discussions before and after treatment=waitlist. Participants were rated on behavioral dimensions of criticism, overinvolvement, doubt, avoidance, warmth, confidence, positive problem solving, and rewarding independence. Significant differences between treatment and waitlist condition occurred from pretreatment to posttreatment, with ratings of negative behaviors decreasing and ratings of positive behaviors increasing in the treatment group. Findings suggest that CBT-F has the potential to improve mother and child interactions in families with a child diagnosed with OCD