SAS Macros for Calculation of Population Attributable Fraction in a Cohort Study Design

The population attributable fraction (PAF) is a useful measure for quantifying the impact of exposure to certain risk factors on a particular outcome at the population level. Recently, new model-based methods for the estimation of PAF and its confidence interval for different types of outcomes in a cohort study design have been proposed. In this paper, we introduce SAS macros implementing these methods and illustrate their application with a data example on the impact of different risk factors on type 2 diabetes incidence.

Distortion and Western music chord processing : an ERP study of musicians and nonmusicians

GUITAR DISTORTION USED IN ROCK MUSIC MODIFIES a chord so that new frequencies appear in its harmonic structure. A distorted dyad (power chord) has a special role in heavy metal music due to its harmonics that create a major third interval, making it similar to amajor chord. We investigated how distortion affects cortical auditory processing of chords in musicians and nonmusicians. Electric guitar chords with or without distortion and with or without the interval of the major third (i.e., triads or dyads) were presented in an oddball design where one of them served as a repeating standard stimulus and others served as occasional deviants. This enabled the recording of event-related potentials (ERPs) of the electroencephalogram (EEG) related to deviance processing (the mismatch negativity MMN and the attention-related P3a component) in an ignore condition. MMN and P3a responses were elicited in most paradigms. Distorted chords in a non-distorted context only elicited early P3a responses. However, the power chord did not demonstrate a special role in the level of the ERPs. Earlier and larger MMN and P3a responses were elicited when distortion was modified compared to when only harmony (triad vs. dyad) was modified between standards and deviants. The MMN responses were largest when distortion and harmony deviated simultaneously. Musicians demonstrated larger P3a responses than nonmusicians. The results suggest mostly independent cortical auditory processing of distortion and harmony in Western individuals, and facilitated chord change processing in musicians compared to nonmusicians. While distortion has been used in heavy rock music for decades, this study is among the first ones to shed light on its cortical basis.Peer reviewe

Associations of early childhood adversities with mental disorders, psychological functioning, and suitability for psychotherapy in adulthood

Childhood adversities frequently precede adulthood depression and anxiety. Yet, how they impact needed treatment duration, type or focus in these common disorders, is unclear. For developing more individualized and precise interventions, we investigated whether specific early adversities associate with patients' distinct psychiatric problems, psychological vulnerabilities, and suitability for psychotherapy. A total of 221 depressed and anxious adult outpatients (excluding psychotic, severe personality, bipolar, and substance abuse disorders) referred from community, student, occupational, and private healthcare services filled the Childhood Family Atmosphere Questionnaire (CFAQ). They also filled self-reports on interpersonal behavior and problems, perceived competence, dispositional optimism, sense of coherence, defenses, and psychiatric history. Clinicians assessed the patients' symptomatology, personality, object relations, cognitive performance, and psychotherapy suitability. Regression analyses were conducted. Childhood adversities predicted both worse current psychological functioning (e.g., interpersonal problems), and better clinician-rated capacities for benefiting from psychotherapy (e.g. self-reflection, capacity for interaction). Parental problems had the most numerous negative associations to psychological functioning. Best capacities for psychotherapy were predicted by recollected family unhappiness. Associations with psychiatric criteria were, however, largely non-significant. In conclusion, for psychosocial treatment planning, patients' early adversities may indicate both vulnerability and resources. As childhood adversities are frequent among treatment-seekers, further studies examining how early adversities predict psychotherapy outcome are needed.Peer reviewe

Effectiveness of psychoanalysis and long-term psychodynamic psychotherapy on personality and social functioning 10 years after start of treatment

The evidence on potentially greater benefits of psychoanalysis (PA) vs. long-term psychodynamic psychotherapy (LPP) is scarce. This study compared the effectiveness of PA and LPP on personality and social functioning during a 10-year follow-up from the beginning of the treatments. The eligible patients, 41 self-selected for PA and 128 assigned to LPP, were 20–45 years of age and had anxiety or mood disorder. Outcomes were analyzed using ten standard measures of personality and social functioning, carried out 5-9 times during the follow-up. Different change patterns by time in PA and LPP emerged, suggesting less benefit of PA during the first years of follow-up and more benefit in most outcomes thereafter. Greater post-treatment improvement in PA than in LPP was seen up to 1-2 years after PA had ended in more mature defense style (DSQ), level of personality organization (LPO), more positive self-concept (SASB), more improved social adjustment (SAS-SR) and sense of coherence (SOC). However, at the 10-year follow-up the differences were non-significant. In conclusion, PA may give some additional benefits when long-term aims are linked to personality and social functioning. The relatively small differences and higher costs in comparison to LPP may restrict the feasibility of PA.Peer reviewe

Concordance and discordance in how patients and therapists experience the psychotherapy process in the treatment of depression

Despite the extensive literature on the outcome and process of psychotherapy in the treatment of depression, little is known about how the underlying factors of depression and the therapy process are experienced by the patients and therapists. In particular, the recognition of themes that are discordantly experienced by patients and therapists may have practical significance for how the therapy process should be conducted. We have previously developed a process description questionnaire to explore the views of patients with major depression and their therapists during the psychodynamic therapy process. In this study, we used factor analysis on the data collected with the process description questionnaire to explore the perceptions of the patients and therapists at different stages of the therapy process. We derived 15 clusters of variables from the questionnaire, on which we conducted primary and secondary factor analysis. The formation of the factors was found to be largely consistent between the patients and therapists regarding the alliance and affectively neutral aspects of the treatment process, whereas the variables of the patients vs. therapists concerning symptoms of depression and their underlying factors dispersed to a greater extent into separate factors. Dispersion was found especially in the experience of processing affectively laden themes and the developmental background factors underlying depression. Our findings refer to a defective insight of the patients into the developmental, interactional and affective factors underlying their symptoms. These factors should be especially targeted in psychotherapy of depression