The effectiveness of adapted schema therapy for cluster C personality disorders in older adults – integrating positive schemas

Introduction: Schema therapy (ST) is an efficacious psychotherapy for personality disorders (PDs) in adults. The first empirical support for the effectiveness of ST in older adults with cluster C PDs was provided recently. ST partly focusses on the positive, but there is an increasing awareness of imbalance in the ST community because of the emphasis on negative schemas versus attention to positive schemas. Positive schemas may be important vehicles of therapeutic change in psychotherapy with older people, as it may help strengthen the healthy adult mode, and it might also help change a negative life review. Suggestions were made to increase the efficacy and feasibility of ST in older adults, including adjusting the case conceptualisation, modifying the experiential techniques, making use of the patient's wisdom and reactivating positive schemas. The aim of the current study is to investigate the feasibility and effectiveness of adapted individual ST for older adults. Methods/design: A multiple baseline design is used with positive and negative core beliefs as primary outcome measures. Ten older adults (age > 60 years) with cluster C PDs are treated with schema therapy, with weekly sessions during one year. This treatment phase is preceded by a baseline phase varying randomly from 4 to 8 weeks. After treatment, there is a 6-month follow-up phase with monthly booster sessions. Symptomatic distress, schema modes, early maladaptive schemas (EMS) and early adaptive schemas (EAS) are secondary outcome measures. PD will be diagnosed before baseline and after treatment phase. EAS are assessed with the Dutch version of the Young Positive Schema Questionnaire (YPSQ). Discussion: To the best of our knowledge, this is the first empirical study in which positive schemas are integrated in ST treatment to examine the efficacy of an adapted form of ST for older adults. This is in line with wider developments supporting the integration of positive schema's into ST. It offers the possibility to improve the effectiveness of ST in older adults. Trial registration: The Netherlands National Trial Register NL8346, registered 1 February 2020

Internal Friction uder Low-Amplitude torsional and High-Amplitude Uniaxial Load in Silicon Nitride.

High temperatures stimulate thermally activated deformation mechanisms. For single crystal ceramics the consequences are limited up to temperatures of about 1400*C. However, for polycrystalline ceramic materials it has been observed that at temperatures typically in excess of 1000*C, the deformation behaviour becomes increasingly time-dependent. This phenomeno is known to be affected by grain boundary processes. In ceramics produced with liquid phase forming sintering additives the latter will remain at least partially in the grain boundaries after processing. Ceramics containing such amorphous intergranular phases (IGPs) are even more prone to changes of the mechanical behaviour at high temperatures, since at temperatures exceeding the glass transition temperature of the IGPs their viscosity drops.JRC.(IAM)-Institute For Advanced Material

Fatigue resistant silicon nitride ceramics due to anelastic deformation and energy dissipation

To investigate the link between internal friction and fatigue resistance of sintered silicon nitride at elevated temperatures, impulse excitation, torsion pendulum and uniaxial tension-compression tests were performed. At low stress-amplitudes, an internal friction peak is observed and associated with the glass transition of amorphous intergranular phases (IGPs). This peak constitutes a reliable means of energy dissipation for otherwise brittle ceramics. The high amplitude uniaxial tests have revealed a new and much larger internal friction effect than previously could be expected from low amplitude test results. Rheological analysis indicates that the underlying deformation is truly anelastic. Within the investigated stress-amplitude range (30-150 MPa), the damping is shown to increase Linearly with stress-amplitude. As a consequence, energy dissipation in a cyclically loaded component will increase locally at stress concentrations such as crack tips. This results in an increased crack propagation resistance, and explains earlier observations of a positive fatigue effect in sintered silicon nitride at high temperature. (C) 2000 Elsevier Science S.A. All rights reserved.status: publishe

The effectiveness of adapted schema therapy for cluster C personality disorders in older adults: Integrating positive schemas

Introduction Schema therapy (ST) is an efficacious psychotherapy for personality disorders (PDs) in adults. The first empirical support for the effectiveness of ST in older adults with cluster C PDs was provided recently. ST partly focusses on the positive, but there is an increasing awareness of imbalance in the ST community because of the emphasis on negative schemas versus attention to positive schemas. Positive schemas may be important vehicles of therapeutic change in psychotherapy with older people, as it may help strengthen the healthy adult mode, and it might also help change a negative life review. Suggestions were made to increase the efficacy and feasibility of ST in older adults, including adjusting the case conceptualisation, modifying the experiential techniques, making use of the patient's wisdom and reactivating positive schemas. The aim of the current study is to investigate the feasibility and effectiveness of adapted individual ST for older adults. Methods/design A multiple baseline design is used with positive and negative core beliefs as primary outcome measures. Ten older adults (age > 60 years) with cluster C PDs are treated with schema therapy, with weekly sessions during one year. This treatment phase is preceded by a baseline phase varying randomly from 4 to 8 weeks. After treatment, there is a 6-month follow-up phase with monthly booster sessions. Symptomatic distress, schema modes, early maladaptive schemas (EMS) and early adaptive schemas (EAS) are secondary outcome measures. PD will be diagnosed before baseline and after treatment phase. EAS are assessed with the Dutch version of the Young Positive Schema Questionnaire (YPSQ). Discussion To the best of our knowledge, this is the first empirical study in which positive schemas are integrated in ST treatment to examine the efficacy of an adapted form of ST for older adults. This is in line with wider developments supporting the integration of positive schema's into ST. It offers the possibility to improve the effectiveness of ST in older adults

Viscous energy dissipation at high temperatures in silicon nitride

Viscous energy dissipation in a liquid phase sintered silicon nitride, and the resulting internal friction, were investigated at temperatures up to 1300 degrees C with uniaxial tension-compression, torsion pendulum, and impulse excitation tests. The amount of internal friction, which is lower after heat treatment of the silicon nitride, reaches a steady-state value only after long-term tests at high temperature. A low and a high (> 50 MPa) stress amplitude regime are distinguished, revealing the existence of different anelastic deformation mechanisms. The evolution of the microstructure is investigated by X-ray diffraction, analysis of scanning electron microscopy images, and high resolution and analytical transmission electron microscopy in order to relate specific internal friction features to the silicon nitride microstructure. (C) 1998 Acta Metallurgica Inc. Published by Elsevier Science Ltd. Ali rights reserved.status: publishe

Internal friction under low-amplitude torsional and high-amplitude uniaxial load in silicon nitride

status: publishe

Fatigue Resistant Silicon Nitride Ceramics Due to Anelastic Deformation and Energy Dissipation.

Abstract not availableJRC.(IAM)-Institute For Advanced Material

Viscous Energy Dissipation at High Temperatures in Silicon Nitride.

Viscous energy dissipation in a liquid phase sintered silicon nitride was investigated at temperatures up to 1300*C. The internal friction, caused by the viscous energy dissipation, was measured with uniaxial tension-compression, torsion pendulum, and impulse excitation tests. The amount of internal friction before and after heat treatment is compared. The dependence of internal friction on temperature, frequency and stress amplitude is studied, distinguishing a low and a high (>50 MPa) stress amplitude regime. the time-dependence of the internal friction at high temperature is monitored. In addition, the evolution of the microstructure is investigated by x-ray diffraction, analysis of scanning electron microscopy images, and high resolution and analytical transmission electron microscopy in order to relate specific internal friction features to the silicon nitride microstructure.JRC.(IAM)-Institute For Advanced Material

Clinical, molecular, and genotype–phenotype correlation studies from 25 cases of oral–facial–digital syndrome type 1: a French and Belgian collaborative study

Oral–facial–digital syndrome type 1 (OFD1) is characterised by an X linked dominant mode of inheritance with lethality in males. Clinical features include facial dysmorphism with oral, tooth, and distal abnormalities, polycystic kidney disease, and central nervous system malformations. Large interfamilial and intrafamilial clinical variability has been widely reported, and 18 distinct mutations have been previously reported within OFD1. A French and Belgian collaborative study collected 25 cases from 16 families. OFD1 was analysed using direct sequencing and phenotype–genotype correlation was performed using χ2 test. X inactivation studies were performed on blood lymphocytes. In 11 families, 11 novel mutations, including nine frameshift, one nonsense, and one missense mutation were identified, which spanned nine different exons. A combination of our results with previously reported cases showed that the majority of mutations (65.5%) was located in exons 3, 8, 9, 13, and 16. There was phenotype–genotype correlation between (a) polycystic kidney disease and splice mutations; (b) mental retardation and mutations located in exons 3, 8, 9, 13, and 16; and (c) tooth abnormalities and mutations located in coiled coil domains. Comparing the phenotype of the families with a pathogenic mutation to families with absence of OFD1 mutation, polycystic kidneys and short stature were significantly more frequent in the group with no OFD1 mutation, whereas lingual hamartomas were significantly more frequent in the group with OFD1 mutation. Finally, an X inactivation study showed non‐random X inactivation in a third of the samples. Differential X inactivation between mothers and daughters in two families with high intrafamilial variability was of particular interest. Slight phenotype–genotype correlations were established, and X inactivation study showed that skewed X inactivation could be partially involved in the pathogenesis of intrafamilial clinical variability