A multi-center psychometric evaluation of the Severity Indices of Personality Problems 118 (SIPP-118):Do we really need all those facets?

PURPOSE: The Severity Indices of Personality Problems 118 (SIPP-118) is a self-report questionnaire that aims to measure core components of (mal)adaptive personality functioning that can change over time. In this study, we aimed to assess the facet strength of the 16 facets across three large clinical samples.METHODS: Data from Norwegian and Dutch psychiatric patients were analyzed in this international multi-center study (N1 = 2814, N2 = 4751, N3 = 2217). Bi-factor modeling was used to assess to what degree the SIPP items tap into an overall general factor. The incremental value (distinctiveness) of the facets was studied using proportional reduction in mean squared error (PRMSE) based statistics.RESULTS: The estimated model showed adequate fit. The explained common variance (ECV) attributable to the general factor equaled 50% for all three samples. All but two facets (stable self-image and frustration tolerance) showed sufficient levels of distinctiveness. The findings were observed to be comparable across the three samples.CONCLUSION: Our findings showed that the general factor was relatively weak, and the facets had a clear incremental value.</p

Velferdsteknologi i boliger. Muligheter og utfordringer

-Målsettingen med denne rapporten er å belyse og diskutere muligheter og utfordringer med implementering av velferdsteknologi knyttet til boligløsninger og det å klare seg godt i egen bolig. Utvikling og implementering av velferdsteknologi forventes å være et viktig grep for å møte de kommende samfunnsutfordringene med en aldrende befolkning, endret sykdomsbilde og knapphet på helse- og omsorgspersonell. Etter å ha presentert nåværende og fremtidige teknologiske muligheter og utfordringer og drøftet disse i forhold til konkrete delmål med implementering av velferdsteknologi i boliger, avsluttes rapporten med å gi noen anbefalinger knyttet til Husbankens ulike roller som pådriver, kompetanseutvikler og kvalitetssikrer

Velferdsteknologi i boliger. Muligheter og utfordringer

Målsettingen med denne rapporten er å belyse og diskutere muligheter og utfordringer med implementering av velferdsteknologi knyttet til boligløsninger og det å klare seg godt i egen bolig. Utvikling og implementering av velferdsteknologi forventes å være et viktig grep for å møte de kommende samfunnsutfordringene med en aldrende befolkning, endret sykdomsbilde og knapphet på helse- og omsorgspersonell. Etter å ha presentert nåværende og fremtidige teknologiske muligheter og utfordringer og drøftet disse i forhold til konkrete delmål med implementering av velferdsteknologi i boliger, avsluttes rapporten med å gi noen anbefalinger knyttet til Husbankens ulike roller som pådriver, kompetanseutvikler og kvalitetssikrer.Forlagets publiserte versjo

The effects of tryptophan depletion on impulsivity and mood in healthy men and women

Reduced serotonergic neurotransmission contributes to the pathophysiology of mood disorders, and the majority of modern antidepressants block the serotonin reuptake in the brain. It is also known that people with major depressive disorder are frequently found to have impaired impulse control, and that impulsivity is associated with serotonin. In two separate studies with healthy participants using different designs and a technique called acute tryptophan depletion, which decreases serotonin levels in the brain, men adopted an impulsive response style, but did not experience any mood changes. The second and largest study included both men and women, and the findings regarding men were replicated. However, women reported a worsening of their mood, and they adopted a more cautious response style commonly associated with depression. The lowered mood reported by women in response to tryptophan depletion was also influenced by variation in the promoter region of the triallelic serotonin transporter gene (5-HTTLPR). The possibility of a synergic effect between novel situations and reduced neurotransmission of serotonin is also discussed. These findings confirm the notion that serotonergic neurotransmission is involved in a competition between behavioral suppression and active responding. When the serotonergic neurotransmission was reduced, men would on average increase active responding (impulsive response style), while women would increase behavioral suppression (cautious response style). Serotonin could therefore be one of the mechanisms explaining the sex difference in the prevalence and clinical presentation of mood and impulsivity disorders. This might be relevant in understanding why women show a higher prevalence of mood and anxiety disorders compared to men, while men show a higher prevalence of alcoholism, AD/HD and impulse control disorders. The sex of a given participant or patient should therefore be taken into consideration when conducting research, prescribing treatment or diagnosing conditions associated with serotonin

Substance use disorder treatment retention and completion: a prospective study of horse-assisted therapy (HAT) for young adults

Background Keeping substance use disorder patients actively engaged in treatment is a challenge. Horse-assisted therapy (HAT) is increasingly used as a complementary therapy, with claimed motivational and other benefits to physical and psychological health. This naturalistic study aimed to assess HAT’s impact on the duration and completion of treatment for young substance users at Oslo University Hospital. Methods Discharge and other data were derived from the Youth Addiction Treatment Evaluation Project (YATEP) database for patients (n = 108) admitted during an 18-month period. An intention-to-treat design, and univariate and multivariate analyses were used to compare those receiving treatment as usual (n = 43) with those who received treatment as usual plus HAT (n = 65). Results Despite a lack of randomization, the baseline characteristics of the two groups were similar. However, more HAT participants completed treatment (56.9 vs 14 %, p < 0.001), remained in treatment for longer (mean 141 vs 70 days, p < 0.001) and had a significantly higher chance of completing their treatment than those not given the HAT program. Excluding time in treatment, and after controlling for the potentially confounding influence of age, sex, education, number and severity of substances used, psychological distress and number of temporary exits, the adjusted odds ratio for treatment completion was 8.4 in the HAT group compared with those not participating in HAT (95 % CI 2.7–26.4, p < 0.001). Conclusion The study found a statistically significant association between HAT participation and time in treatment, and between HAT participation and completion of treatment. This association does not infer causality. However, it adds supporting evidence for the development of an innovative therapy, and warrants investment in further research in relation to its inclusion in substance use disorder treatment

Psychometric Properties of the Severity Indices of Personality Problems (SIPP) in Two Samples: A Norwegian Community Sample and Clinical Samples of Patients With and Without Personality Disorders

This study investigated psychometric properties of a dimensional measure of maladaptive core pathology for personality disorders, the Severity Indices of Personality Problems (SIPP). The study analyzed data from 941 respondents in a community sample, 949 psychiatric patients with Personality Disorders (PD), and 413 psychiatric patients without PD in Norway. The facets of SIPP had acceptable internal consistency, but the construct validity of some facets had potentials for improvement. The original SIPP domains (the factor structures of the facets) were not supported, and factor analysis gave different results across the three current study samples. All facets of SIPP have good discriminative properties with respect to differentiating between a nonclinical sample, a clinical sample without PD, and a clinical PD sample. Further research and improvements in SIPP are suggested

Predictors of Dropout From Inpatient Substance Use Treatment: A Prospective Cohort Study

Introduction: Dropout from inpatient treatment for substance use disorder (SUD) is an ongoing challenge. The aim of this study was to identify demographic, substance use, and psychological factors that predict dropout from postdetoxification inpatient SUD treatment. Materials and methods: A total of 454 patients from 5 inpatient SUD centers in Central Norway were consecutively included in this naturalistic, prospective cohort study. Results: A total of 132 patients (28%) did not complete the planned treatment stay (dropped out). Cox regression analysis showed that higher levels of intrinsic motivation for changing personal substance use reduced the dropout risk (adjusted hazard ratio [adjHR]: 0.62, 95% confidence interval [CI]: 0.48-0.79). Higher levels of mental distress were associated with an increased risk for dropout (adjHR: 1.48, 95% CI: 1.11-1.97). Conclusions: The role of mental health and motivation in reducing dropout risk from inpatient SUD treatment should be targeted in future prospective intervention studies

Velferdsteknologi i boliger. Muligheter og utfordringer

Målsettingen med denne rapporten er å belyse og diskutere muligheter og utfordringer med implementering av velferdsteknologi knyttet til boligløsninger og det å klare seg godt i egen bolig. Utvikling og implementering av velferdsteknologi forventes å være et viktig grep for å møte de kommende samfunnsutfordringene med en aldrende befolkning, endret sykdomsbilde og knapphet på helse- og omsorgspersonell. Etter å ha presentert nåværende og fremtidige teknologiske muligheter og utfordringer og drøftet disse i forhold til konkrete delmål med implementering av velferdsteknologi i boliger, avsluttes rapporten med å gi noen anbefalinger knyttet til Husbankens ulike roller som pådriver, kompetanseutvikler og kvalitetssikrer

One-year abstinence improves ADHD symptoms among patients with polysubstance use disorder

Introduction Attention-deficit/hyperactivity disorder (ADHD) is a common comorbid disorder in patients suffering from substance use disorder (SUD). Individuals with co-occurring SUD and ADHD are more likely than SUD patients without ADHD to have developed SUD at a younger age, be polysubstance users, and need inpatient treatment more often. The present study investigates whether individuals with polysubstance use disorder who remain abstinent for a year after entering treatment have a more substantial reduction in ADHD symptoms than those who relapsed and controls. Material and methods: Subjects were SUD patients (N = 115) and healthy controls (N = 34). ADHD symptoms were assessed using the adult ADHD Self-Report Scale (ASRS). Substance use was assessed by self-reports on the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT). Participants were defined as having relapsed if they had an AUDIT score &ge; 8 or a DUDIT score &ge; 2 for women and &ge; 6 for men. Results: Patients who remained abstinent for one year reported a substantial reduction of ADHD symptoms compared to patients who relapsed and controls. Conclusions: Abstinence alleviates ADHD symptoms among patients with polysubstance use disorder. We suggest that confirmation of an ADHD diagnosis should follow a period of abstinence to avoid identification of false-positive cases

Interactive effects of sex and 5-HTTLPR on mood and impulsivity during tryptophan depletion in healthy people.

BACKGROUND: Serotonin (5-HT) plays a central role in mood regulation and impulsivity. We studied whether healthy men and women react differently on mood and impulsivity measures during acute tryptophan depletion (ATD). We also studied the relative contribution of a functional length triallelic polymorphism in the promoter region of the serotonin transporter, designated 5-HTTLPR, to the behavioral responses to ATD. METHODS: Thirty-nine men and 44 women participated in a randomized, double-blind, parallel group ATD study. Behavioral measures of impulsivity and mood were obtained. RESULTS: During ATD, women reported mood reduction and showed a cautious response style, which is commonly associated with depression. Men showed an impulsive response style and did not report mood reduction. The 5-HTTLPR influenced the mood response to ATD in women. CONCLUSIONS: Healthy men became more impulsive, whereas healthy women showed mood reduction in response to ATD. This suggests that 5-HT could be one mechanism contributing to the sex differences in the prevalence of mood and impulsivity disorders. The influence of 5-HTTLPR on mood responses in women further substantiates the relevance of this variant in the pathophysiology of at least a subgroup of patients with major depressive disorder