HoNOSCA-D as a measure of the severity of diagnosed mental disorders in children and adolescents : psychometric properties of the German translation

The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), in use worldwide, is a 13-item measure assessing the biopsychosocial severity of mental health problems in children and adolescents. This article introduces the authorized German-language version of HoNOSCA, the HoNOSCA-D, and examines and discusses its psychometric properties based on a clinical sample of 1,533 children and adolescents aged 4;0 to 17;11 years. For the HoNOSCA-D total score (severity of mental health problems), internal consistency (Cronbach's alpha) was 0.63. The discriminative power of the items ranged from 0.07 to 0.44; the average interitem correlation was 0.11. Due to this stochastic independence, calculation of a total severity index is acceptable. Using factor analysis, the principal axis factoring and varimax rotation resulted in a four-factor structure, which with a Kaiser-Meyer-Olkin measure of sampling adequacy of 0.684 explained 30.62% of total variance. The convergent correlations with the German-language parent report version of the Strengths and Difficulties Questionnaire were as expected and showed a medium effect size. Gender and age differences in the HoNOSCA-D total score were small. Regarding the 13 items gender and age differences were negligible to medium. The highest severity was found for schizophrenia and psychotic disorders, followed by affective disorders and social behavior disorders. Overall, validity of HoNOSCA-D was clearly supported

Pathways of behavioural and emotional symptoms in kindergarten children: What is the role of pro-social behaviour?

The study investigated the predictive value of pro-social behaviour for developmental pathways of behavioural and emotional problems at kindergarten age. One hundred and sixty children participated in the study at the ages of 5 and 6. Teachers and parents completed the Strengths and Difficulties Questionnaire; children completed the Berkeley Puppet Interview at both assessment points. Single-informant data were aggregated to enhance the reliability and validity of data. Gender and parental educational status were controlled. Symptoms (conduct problems, hyperactivity and emotional symptoms) and pro-social behaviour were moderately stable over time. Compared to girls, boys showed higher levels and increases of conduct problems and hyperactivity and lower levels of pro-social behaviour. Lower parental educational level was associated with higher levels and increases in hyperactivity. Although pro-social behaviour was cross-sectionally associated with behavioural and emotional symptoms, pro-social behaviour did not predict changes in conduct problems or hyperactivity over time. However, children with above average emotional symptoms and above average pro-social behaviour at Age_5 showed the highest level of emotional symptoms at Age_6. The results indicate that low levels of pro-social behaviour are associated with children's externalising behaviour problems, but that for children with high levels of emotional symptoms, higher levels of pro-social behaviour should also be considered as a risk factor. In sum, our results suggest mainly homotypic pathways of internalising and externalising symptoms across kindergarten age, but indicate that the assessment of pro-social behaviour yields additional information regarding the developmental pathways of emotional symptom

Personality traits and psychopathology over the course of six months of outpatient psychotherapy : a prospective observational study

There is a lack of prospective studies that test pre-specified hypotheses on the role of personality traits in outpatient psychotherapy. A total of 47 patients with a broad range of psychopathological syndromes were enrolled in a prospective 6-month observational study conducted in Zurich, Switzerland. We found evidence for remarkably high differential stability in all Big Five personality traits during the first 6 months of psychotherapy. Mean-level stability was very high in agreeableness and conscientiousness, while modest changes were observed in neuroticism, extraversion and openness. Baseline scores in neuroticism and conscientiousness at the beginning of therapy predicted modest change in self-reported severity of psychopathology over 6 months, but no effect was found in association with therapist-rated functional deficits. We conclude that personality trait levels may change slightly over the course of 6 months of psychotherapy and that both neuroticism and conscientiousness may have weak associations with the self-perceived improvement in psychopathology

Improving work ability of mentally burdened emerging adults in vocational integration programs : a study protocol

Background: Emerging adults who do not successfully transition from compulsory education to the upper secondary level have a greater risk of developing mental illness than their working peers. Early intervention is important in these cases; the course of an illness can be positively influenced if treated early and without delay, and consequently, the illness will not affect the professional and personal development of the emerging adults any further. Postponing treatment of a mental illness increases the risk of chronification of the disease. Up to now, vocational integration programs have been mostly educationally oriented. To recognize and treat mental illness in a timely way, we developed an intervention that includes psychotherapy support in a vocational integration program for emerging adults who have not successfully transitioned from compulsory education to the upper secondary level. Aim: The aim of this study is to investigate the effectiveness of the described intervention, which will be delivered to all emerging adults aged 16-29 entering the vocational integration program. Another objective is to determine if it is worthwhile and feasible to proceed with testing the intervention in a full-scale clinical trial. Conducting research with this population can be very difficult, which makes it especially important to test the feasibility of a clinical trial. Methods: A single group clinical trial will be conducted to examine the effectiveness of the intervention described above. Emerging adults aged 16-29 entering a vocational integration program will be recruited. Participants will provide informed consent and complete pre-intervention measures; they then take part in the intervention group in addition to the regular vocational integration program. The primary outcomes for this study are an increase in work ability, mental health literacy, and mental health. Demographic information, vocational biography, and satisfaction with the intervention will also be collected. Questionnaire data will be collected at pre-intervention, post-intervention, and 6-month follow-up. Ethics and dissemination: The study was approved by the Ethics Committee of the Canton of Zurich (2017-00936) and registered in https://clinicaltrials.gov (NCT03328286) before recruitment started. The results will be reported in future scientific publications and international conference presentations

Aging - Workforce : das Potenzial erkennen und mobilisieren

Die Schweizer Wirtschaft sieht sich mit den Herausforderungen des demografischen Wandels und politischen Unsicherheiten bezüglich des Zugangs zu ausländischen Fachpersonen konfrontiert. Gleichzeitig hat sie durchaus Potenzial, die Aging Workforce stärker und besser in den  Erwerbsprozess zu integrieren.  Die vorliegende metrobasel-Studie ist im Rahmen des von der Kommission für Technologie und Innovation (KTI) geförderten Forschungsprojekts „Das Potenzial der Ageing Workforce mobilisieren: Ein interdisziplinärer Ansatz zur Freisetzung der Eigeninitiative der älteren Mitarbeitenden und zum besseren „Match“ zwischen Arbeitnehmern und Arbeitgebern“ entstanden. Sie präsentiert Teilergebnisse aus der ersten Projektphase (Analyseteil), die für ein breiteres Publikum von Interesse sind. Der Bericht stützt sich auf Ergebnisse, die bei Novartis Schweiz und der SBB und damit einerseits in einem international tätigen und andererseits in einem binnenmarktorientierten, staatsnahen Konzern gewonnen wurden. Eine quantitative Umfrage wurde in beiden Firmen online durchgeführt und ergab einen Datensatz von insgesamt 2‘837 Mitarbeitenden. Zusätzlich wurden 14 einstündige, transkribierte Interviews qualitativ ausgewertet, die bei der SBB durchgeführt werden konnten. In beiden Verfahren wurden sowohl Mitarbeitende ohne Führungsfunktion als auch Mitarbeitende mit Führungsfunktion befragt. Bei den Auswertungen wurden folgende drei Schwerpunkte gesetzt: •   Mitarbeiterseitige Voraussetzungen für die Erwerbstätigkeit in späteren Berufsjahren •   Bedeutung der Eigeninitiative der Mitarbeitenden für eine längere Erwerbsätigkeit •   Bedeutung der Mitarbeitenden-Vorgesetzten-Beziehung für eine längere Erwerbstätigkeit Im Themenbereich der arbeitnehmer- bzw. mitarbeiterseitigen Voraussetzungen für die Erwerbstätigkeit in späteren Berufsjahren zeigt sich ein grosses Potenzial an gesunden, kompetenten und leistungsfähigen älteren  Mitarbeitenden in beiden Unternehmen, das weiter erschlossen werden kann. Im zweiten Themenbereich wurde der Einfluss der Eigeninitiative der Mitarbeitenden im Hinblick auf eine längere Erwerbstätigkeit untersucht. Die Auswertungen zeigen, dass Mitarbeitende, die aktiv Einfluss auf die Arbeitsinhalte und -umgebung nehmen, insgesamt länger im Erwerbsprozess bleiben.Der dritte Themenbereich fokussiert auf das Arbeitsumfeld. Die Auswertungen der Daten weisen darauf hin, dass die Mitarbeitenden-Vorgesetzten-Beziehung als treibende Kraft für eine längere Erwerbsarbeit betrachtet werden kann. Zentral ist die Förderung der Mitarbeitenden seitens der Vorgesetzten. Dabei scheint weniger der Zugang zu vorhandenen, formellen Weiterbildungsangeboten relevant, als vielmehr die individuelle Personalentwicklung.

Ergebnisqualität ambulanter Psychotherapie : Ergebnisse aus der Grundversorgung in der Schweiz

Die Ergebnisqualität von ambulanten Psychotherapien aus der Grundversorgung in der Schweiz wurde überprüft. Die untersuchte Stichprobe umfasste 300 Patienten, welche mehrheitlich mit einem tiefenpsychologischen oder humanistischen Therapieverfahren behandelt wurden. Die häufigsten Hauptdiagnosen waren affektive Störungen und Angststörungen; zwei Drittel der Patienten hatten eine oder mehrere komorbide Störungen. Fehlende Outcome-Werte wurden mit der multiplen Imputation behandelt. Die Analyse der Prä-post-Veränderungen zeigte grosse signifikante Effektstärken bei den globalen Massen der psychosozialen Beeinträchtigung und der Symptombelastung. Die Ergebnisse der vorliegenden Stichprobe wurden mit denen aus Effectiveness-Studien verglichen, in welchen das Outcome von kognitiv-behavioralen Behandlungsansätzen evaluiert wurde. Der Vergleich zeigte, dass die Effektivität von humanistischen und tiefenpsychologischen Therapien vergleichbar mit der von evidenzbasierten kognitiv-verhaltenstherapeutischen Verfahren ist. This study investigated the outcome quality of outpatient psychotherapies in Switzerland’s primary health care. The sample analyzed encompassed 300 patients, the majority of whom had been treated with humanistic-experiential psychotherapy or psychodynamic psychotherapy. The most frequent axis I diagnoses were mood disorders or anxiety disorders; two-thirds of the patients had one or more comorbid disorders. Missing outcome values were handled by multiple imputation. The analysis of the pre-post differences revealed large significant effect sizes in the global measures “psychosocial functioning” and “symptom distress”. The results from this sample were compared with the results of published studies that tested the effectiveness of evidence-based cognitive-behavioral psychotherapies. The comparison revealed that the effectiveness of humanistic-experiential and psychodynamic treatment approaches was similar to the effectiveness of cognitive-behavioral approaches. Valutazione della qualità dei risultati delle psicoterapie ambulatoriali prestate nell'ambito dell'assistenza di base. Il campione esaminato comprendeva 300 pazienti, la maggioranza dei quali è stata trattata con metodi terapeutici della psicologia del profondo o umanistici. Le diagnosi principali più frequenti riguardavano disturbi affettivi e d'ansia; due terzi dei pazienti presentavano uno o più disturbi concomitanti. I valori di outcome assenti sono stati trattati con l'imputazione multipla. L'analisi dei cambiamenti pre-post ha mostrato grandi e significative dimensioni dell'effetto per l'ampiezza globale della limitazione psicosociale e del peso dei sintomi. I risultati del presente campione sono stati confrontati con quelli degli studi di effectiveness che valutavano l'outcome degli approcci di trattamento cognitivo-comportamentali. Il confronto ha mostrato che l'efficacia delle terapie umanistiche e della psicologia del profondo è paragonabile a quella delle procedure della terapia cognitiva e comportamentale basate su prove di efficacia