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| 17. |
- Fontenelle, LF, et al.
(författare)
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A transdiagnostic perspective of constructs underlying obsessive-compulsive and related disorders: An international Delphi consensus study
- 2020
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Ingår i: The Australian and New Zealand journal of psychiatry. - : SAGE Publications. - 1440-1614 .- 0004-8674. ; 54:7, s. 719-731
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Tidskriftsartikel (refereegranskat)abstract
- The Research Domain Criteria seeks to bridge knowledge from neuroscience with clinical practice by promoting research into valid neurocognitive phenotypes and dimensions, irrespective of symptoms and diagnoses as currently conceptualized. While the Research Domain Criteria offers a vision of future research and practice, its 39 functional constructs need refinement to better target new phenotyping efforts. This study aimed to determine which Research Domain Criteria constructs are most relevant to understanding obsessive-compulsive and related disorders, based on a consensus between experts in the field of obsessive-compulsive and related disorders.Methods:Based on a modified Delphi method, 46 experts were recruited from Australia, Africa, Asia, Europe and the Americas. Over three rounds, experts had the opportunity to review their opinion in light of feedback from the previous round, which included how their response compared to other experts and a summary of comments given.Results:Thirty-four experts completed round one, of whom 28 (82%) completed round two and 24 (71%) completed round three. At the final round, four constructs were endorsed by ⩾75% of experts as ‘primary constructs’ and therefore central to understanding obsessive-compulsive and related disorders. Of these constructs, one came from the Positive Valence System (Habit), two from the Cognitive Control System (Response Selection/Inhibition and Performance Monitoring) and the final construct was an additional item suggested by experts (Compulsivity).Conclusion:This study identified four Research Domain Criteria constructs that, according to experts, cut across different obsessive-compulsive and related disorders. These constructs represent key areas for future investigation, and may have potential implications for clinical practice in terms of diagnostic processes and therapeutic management of obsessive-compulsive and related disorders.
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| 18. |
- Jost, W. H., et al.
(författare)
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King’s Parkinson’s Disease Pain Scale : Interkulturelle Adaption in deutscher Sprache
- 2018
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Ingår i: Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804. ; 89:2, s. 178-183
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain is a frequent symptom of idiopathic Parkinson’s disease and has a substantial impact on quality of life. The King’s Parkinson’s disease pain scale (KPPS) has become internationally established and is an English-language, standardized, reliable and valid scale for evaluation of pain in idiopathic Parkinson’s disease. This article presents a validated version in German. Method: The German translation was adapted interculturally and developed using an internationally recognized procedure in consultation with the authors of the original publication. The primary text was first translated by two bilingual neuroscientists independently of one another. Thereafter, the two versions were collated to generate a consensus version, which was accepted by the translators and preliminarily trialled with 10 patients. Hereafter, the German version was re-translated back into English by two other neurologists, again independently of one another, and a final consensus was agreed on using these versions. This English version was then compared with the original text by all of the translators, a process which entailed as many linguistic modifications to the German version as the translators considered necessary to generate a linguistically acceptable German version that was as similar as possible to the original English version. After this test text had been subsequently approved by the authors, the German text was applied to 50 patients in two hospitals, and reviewed as to its practicability and comprehensibility. Results: This work led to the successful creation of an inter-culturally adapted and linguistically validated German version of the KPPS. Discussion: The German version presented here is a useful scare for recording and quantifying pain in empirical studies, as well as in clinical practice.
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| 19. |
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| 20. |
- Mathey, EK, et al.
(författare)
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Neurofascin as a novel target for autoantibody-mediated axonal injury
- 2007
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Ingår i: The Journal of experimental medicine. - : Rockefeller University Press. - 0022-1007 .- 1540-9538. ; 204:10, s. 2363-2372
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Tidskriftsartikel (refereegranskat)abstract
- Axonal injury is considered the major cause of disability in patients with multiple sclerosis (MS), but the underlying effector mechanisms are poorly understood. Starting with a proteomics-based approach, we identified neurofascin-specific autoantibodies in patients with MS. These autoantibodies recognize the native form of the extracellular domains of both neurofascin 186 (NF186), a neuronal protein concentrated in myelinated fibers at nodes of Ranvier, and NF155, the oligodendrocyte-specific isoform of neurofascin. Our in vitro studies with hippocampal slice cultures indicate that neurofascin antibodies inhibit axonal conduction in a complement-dependent manner. To evaluate whether circulating antineurofascin antibodies mediate a pathogenic effect in vivo, we cotransferred these antibodies with myelin oligodendrocyte glycoprotein–specific encephalitogenic T cells to mimic the inflammatory pathology of MS and breach the blood–brain barrier. In this animal model, antibodies to neurofascin selectively targeted nodes of Ranvier, resulting in deposition of complement, axonal injury, and disease exacerbation. Collectively, these results identify a novel mechanism of immune-mediated axonal injury that can contribute to axonal pathology in MS.
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| 21. |
- Odin, Per, et al.
(författare)
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Viewpoint and practical recommendations from a movement disorder specialist panel on objective measurement in the clinical management of Parkinson's disease
- 2018
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Ingår i: Npj Parkinson's Disease. - : Springer Science and Business Media LLC. - 2373-8057. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Motor aspects of Parkinson's disease, such as fluctuations and dyskinesia, can be reliably evaluated using a variety of "wearable" technologies, but practical guidance on objective measurement (OM) and the optimum use of these devices is lacking. Therefore, as a first step, a panel of movement disorder specialists met to provide guidance on how OM could be assessed and incorporated into clinical guidelines. A key aspect of the incorporation of OM into the management of Parkinson's disease (PD) is defining cutoff values that separate "controlled" from "uncontrolled" symptoms that can be modified by therapy and that relate to an outcome that is relevant to the person with PD (such as quality of life). Defining cutoffs by consensus, which can be subsequently tested and refined, is the first step to optimizing OM in the management of PD. OM should be used by all clinicians that treat people with PD but the least experienced may find the most value, but this requires guidance from experts to allow non-experts to apply guidelines. While evidence is gained for devices that produce OM, expert opinion is needed to supplement the evidence base.
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| 22. |
- Selles, R. R., et al.
(författare)
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Avoidance, Insight, Impairment Recognition Concordance, and Cognitive-Behavioral Therapy Outcomes in Pediatric Obsessive-Compulsive Disorder
- 2020
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567. ; 59:5
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Insight and avoidance are commonly discussed factors in obsessive-compulsive disorder (OCD) that have demonstrated associations with increased severity as well as reduced treatment response in adults, but these factors have not been sufficiently examined in pediatric OCD. This study examined the impacts of avoidance, insight, and impairment recognition concordance on cognitive-behavioral therapy (CBT) outcomes as well as impacts of CBT on insight and avoidance in a large sample of youths affected by OCD. Method: Data from 573 OCD-affected youths enrolled in CBT trials were aggregated. Children's Yale-Brown Obsessive-Compulsive Scale items measured treatment response, insight, and avoidance. Standardized differences between child and parent ratings of impairment were used to calculate impairment recognition concordance. Binary logistic regression was used to identify variables associated with treatment response. Results: Greater avoidance, limited child recognition of impairment, older age, and lower baseline severity predicted reduced likelihood of treatment response, but insight did not. Both insight and avoidance improved significantly following CBT. Response rates were lower when posttreatment insight and avoidance were worse. Conclusion: Contrasting with prevailing belief, poor insight does not appear to limit CBT response potential in pediatric OCD. Avoidance and impairment recognition are understudied CBT response predictors and warrant further consideration in pediatric OCD. Clinicians should attend to these factors to optimize outcomes for children affected by this common, debilitating illness.
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| 23. |
- Smárason, Orri, et al.
(författare)
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Exploring latent clusters in pediatric OCD based on symptoms, severity, age, gender, and comorbidity.
- 2024
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Ingår i: European Child and Adolescent Psychiatry. - 1018-8827 .- 1435-165X.
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Tidskriftsartikel (refereegranskat)abstract
- Given diverse symptom expression and high rates of comorbid conditions, the present study explored underlying commonalities among OCD-affected children and adolescents to better conceptualize disorder presentation and associated features. Data from 830 OCD-affected participants presenting to OCD specialty centers was aggregated. Dependent mixture modeling was used to examine latent clusters based on their age- and gender adjusted symptom severity (as measured by the Children’s Yale-Brown Obsessive-Compulsive Scale; CY-BOCS), symptom type (as measured by factor scores calculated from the CY-BOCS symptom checklist), and comorbid diagnoses (as assessed via diagnostic interviews). Fit statistics favored a four-cluster model with groups distinguished primarily by symptom expression and comorbidity type. Fit indices for 3–7 cluster models were only marginally different and characteristics of the clusters remained largely stable between solutions with small clusters of distinct presentations added in more complex models. Rather than identifying a single classification system, the findings support the utility of integrating dimensional, developmental, and transdiagnostic information in the conceptualization of OCD-affected children and adolescents. Identified clusters point to the centrality of contamination concerns to OCD, relationships between broader symptom expression and higher levels of comorbidity, and the potential for complex/neurodevelopmental presentations.
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| 24. |
- Smárason, Orri, et al.
(författare)
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Long-term functional impairment in pediatric OCD after and during treatment: An analysis of distinct trajectories.
- 2023
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Ingår i: Psychiatry research. - 1872-7123. ; 324
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Tidskriftsartikel (refereegranskat)abstract
- The present study aimed to: (a) identify latent class trajectories of OCD-related functional impairment, before, during and over three years after stepped-care treatment in children and adolescents with OCD; (b) describe these classes according to pretreatment characteristics; (c) identify predictors of trajectory class membership and (d) examine the relationship of functional impairment trajectory classes with OCD symptom severity trajectory classes. The sample consisted of 266 children and adolescents (aged 7-17 years) with OCD, participating in the Nordic long-term OCD treatment study. Latent class growth analysis was conducted using Child Obsessive-Compulsive Impact Scale-Revised (COIS-R) data from children and parents on seven assessment points over a three-year period. A 3-class solution was identified. The largest class (70.7%) initiated treatment with lower functional impairment and obtained moderate reduction which was maintained over time. The second class (24.4%) initiated with higher functional impairment which rapidly diminished over time. The third and smallest class (4.9%), initiated with moderate functional impairment which remained stable over time. The classes differed on measures of OCD severity and comorbid symptoms. Most participants improved with treatment and maintained low levels of impairment. However, a subgroup distinguished by higher levels of ADHD symptoms, remained at pretreatment levels of impairment throughout.
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| 25. |
- Weidle, B., et al.
(författare)
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Specialty knowledge and competency standards for pharmacotherapy for pediatric obsessive-compulsive disorder
- 2021
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Ingår i: Psychiatry Research. - : Elsevier BV. - 0165-1781 .- 1872-7123. ; 299
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Tidskriftsartikel (refereegranskat)abstract
- Evidence based treatments for pediatric Obsessive-Compulsive Disorder (OCD) are delivered with varying levels of expertise. This paper is part of the phase two series by the International OCD Accreditation Task Force (ATF) to advance a standardized high level of care globally. This paper presents specific knowledge and competencies recommended for specialized practice for pediatric psychopharmacologists working with OCD, developed by an international group of clinicians with extensive expertise in assessment and treatment of OCD. Tabulated knowledge and competency standards are operationalized as clinician abilities with specification of evidence for each standard. The distinction between current practice guidelines and ATF standards is discussed. Drug treatment has a solid evidence base. However, it should not be applied isolated, but informed by broad competence in general child and adolescent psychiatry and pediatrics. Other treatment relevant areas such as specialty CBT, family functioning, developmental issues, and neurobiology require consideration. Drug treatment includes several phases with varying degrees of evidence: Starting up medication, titration to maximum tolerated dose, maintenance, termination, and relapse prevention. In complex cases, pharmacotherapy with weak evidence may be needed to target symptoms and/or co-morbidity. The ATF knowledge and competency standards presented will be reviewed and updated commensurate with research.
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| 26. |
- Cervin, Matti, et al.
(författare)
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Cognitive Beliefs Across the Symptom Dimensions of Pediatric Obsessive-Compulsive Disorder: Type of Symptom Matters
- 2022
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Ingår i: Behavior Therapy. - : Elsevier BV. - 0005-7894. ; 53:2, s. 240-254
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Tidskriftsartikel (refereegranskat)abstract
- The cognitive model of obsessive-compulsive disorder (OCD) posits that dysfunctional cognitive beliefs are crucial to the onset and maintenance of OCD; however, the relationship between these cognitive beliefs and the heterogeneity of OCD symptoms in children and adolescents remains unknown. We examined how the major belief domains of the cognitive model (inflated responsibility/threat estimation, perfectionism/intolerance of uncertainty, importance/control of thoughts) and dysfunctional metacognitions were related to OCD symptoms across the following dimensions: doubting/checking, obsessing, hoarding, washing, ordering, and neutralization. Self-report ratings from 137 treatment-seeking youth with OCD were analyzed. When cognitive beliefs and symptom dimensions were analyzed in tandem, inflated responsibility/threat estimation and dysfunctional metacognitions were uniquely related to doubting/checking, obsessing, and hoarding and perfectionism/intolerance of uncertainty to ordering. Cognitive beliefs explained a large proportion of variation in doubting/checking (61%) and obsessing (46%), but much less so in ordering (15%), hoarding (14%), neutralization (8%), and washing (3%). Similar relations between cognitive beliefs and symptom dimensions were present in children and adolescents. Cognitive beliefs appear to be relevant for pediatric OCD related to harm, responsibility, and checking, but they do not map clearly onto contamination and symmetry-related symptoms. Implications for OCD etiology and treatment are discussed.
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| 27. |
- Cervin, Matti, et al.
(författare)
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Measuring misophonia in youth: A psychometric evaluation of child and parent measures
- 2023
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Ingår i: Journal of Affective Disorders. - 0165-0327. ; 338, s. 180-186
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMisophonia is characterized by intense emotional reactions to specific sounds or visual stimuli and typically onsets during childhood. An obstacle for research and clinical practice is that no comprehensively evaluated measures for pediatric misophonia exist.MethodsIn a sample of 102 youth meeting the proposed diagnostic criteria of misophonia, we evaluated the child and parent-proxy versions of the self-reported Misophonia Assessment Questionnaire (MAQ; assessing broad aspects of misophonia) and the child version of the Amsterdam Misophonia Scale (A-MISO-S; assessing misophonia severity). Confirmatory and exploratory factor analysis were used to examine factor structures of the measures. Further, child-parent agreement on the MAQ and associations between MAQ/A-MISO-S and impairment, quality of life, and misophonia-related school interference were examined to evaluate aspects of convergent validity.ResultsFor both youth- and parent-ratings, four MAQ factors emerged: pessimism, distress, interference, and non-recognition. A-MISO-S showed a unidimensional structure, but the item ‘effort to resist’ did not load significantly onto the unidimensional factor. Good child-parent agreement on the MAQ scales were found and both MAQ and A-MISO-S were moderately to strongly associated with misophonia-related impairment and school interference, and inversely associated with quality of life.LimitationsMAQ and A-MISO-S assess sensitivity to auditory but not visual stimuli, the sample size was modest, and repeated assessments were not conducted.ConclusionsThe combination of MAQ and A-MISO-S shows promise as a multidimensional assessment approach for pediatric misophonia. Future evaluations should include known-groups validity, screening performance, and sensitivity to change in symptom severity.
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| 28. |
- Cervin, Matti, et al.
(författare)
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Posttraumatic Symptoms in 3–7 Year Old Trauma‑Exposed Children: Links to Impairment, Other Mental Health Symptoms, Caregiver PTSD, and Caregiver Stress
- 2020
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Ingår i: Child Psychiatry and Human Development. - : Springer Science and Business Media LLC. - 0009-398X .- 1573-3327.
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have examined how PTSD symptoms in young children are associated with other mental health symptoms and mood and functioning in caregivers. This is an important gap in the literature as such knowledge may be important for assessment and treatment. This study used network analysis to identify how the major symptom domains of PTSD in young trauma-exposed children were related to impairment, internalizing and externalizing symptoms, caregiver PTSD, and caregiver stress. Caregivers of 75 trauma-exposed 3–7 year old children reported on their child’s symptoms and impairment and their own PTSD symptoms and caregiver stress. A strong association between the child PTSD domains of intrusions and avoidance emerged, which is in line with theoretical notions of how PTSD onsets and is maintained in adolescents and adults. Externalizing child symptoms were strongly linked to PTSD-related impairment and caregiver stress, highlighting the need to carefully assess and address such symptoms when working with young trauma-exposed children. Internalizing symptoms were uniquely associated with all three of the major childhood PTSD symptom domains with further implications for assessment and treatment.
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| 29. |
- Cervin, Matti, et al.
(författare)
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Symptom-specific effects of cognitive-behavioral therapy, sertraline, and their combination in a large randomized controlled trial of pediatric anxiety disorders
- 2020
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Ingår i: Journal of Child Psychology and Psychiatry. - : Wiley. - 0021-9630 .- 1469-7610. ; 61:4, s. 492-502
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pediatric anxiety disorders are highly prevalent and associated with significant functional disabilities and lifelong morbidity. Cognitive-behavioral therapy (CBT), sertraline, and their combination are effective treatments, but little is known about how these treatments exert their effects.Methods: Using network intervention analysis (NIA), we analyzed data from the largest randomized controlled treatment trial of pediatric anxiety disorders (Child/Adolescent Anxiety Multimodal Study, NCT00052078, clinicaltrials.gov/ct2/show/NCT00052078) and outlined the causal symptom domain-specific effects of CBT, sertraline, and their combination over the course of the 12-week treatment while taking into account both specificity and overlap between symptom dimensions. Results: All active treatments produced positive effects with the most pronounced and consistent effects emerging in relation to psychological distress, family interference, and avoidance. Psychological distress was consistently the most and physical symptoms the least influential symptom domain in the disorder network.Conclusions: All active treatments showed beneficial effects when compared to placebo and NIA identified that these effects were exerted similarly across treatments and primarily through a reduction of psychological distress, family interference, and avoidance. CBT and sertraline may have differential mechanisms of action in relation to psychological distress. Given the lack of causal effects on interference outside family and physical symptoms, interventions tailored to target these domains may aid in the building of more effective treatments. Psychological distress and avoidance should remain key treatment focuses because of their central roles in the disorder network. The findings inform and promote developing more effective interventions. Keywords: CBT/cognitive behavior therapy; anxiety/anxiety disorders; pharmacotherapy; clinical trials; child/adolescent.
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| 30. |
- Cervin, Matti, et al.
(författare)
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The p Factor Consistently Predicts Long-Term Psychiatric and Functional Outcomes in Anxiety-Disordered Youth
- 2021
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567. ; 60:7, s. 902-912
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivePediatric anxiety disorders can have a chronic course and are considered gateway disorders to adult psychopathology, but no consistent predictors of long-term outcome have been identified. A single latent symptom dimension that reflects features shared by all mental health disorders, the p factor, is thought to reflect mechanisms that cut across mental disorders. Whether p predicts outcome in youth with psychiatric disorders has not been examined. We tested whether the p factor predicted long-term psychiatric and functional outcomes in a large naturalistically followed-up cohort of anxiety-disordered youth.MethodYouth enrolled in a randomized controlled treatment trial of pediatric anxiety during childhood/adolescence were followed-up on average six years posttreatment and then annually for four years. Structural equation modeling was used to estimate p at baseline. p and previously established predictors were modeled as predictors of long-term outcome.ResultsHigher levels of p at baseline were related to more mental health disorders, poorer functioning, and greater impairment across all measures at all follow-up time points. p predicted outcome above and beyond previously identified predictors, including diagnostic comorbidity at baseline. Post hoc analyses showed that p predicted long-term anxiety outcomes, but not acute treatment outcome, suggesting that p may be uniquely associated with long-term outcome.ConclusionYouth with anxiety disorders who present with a liability towards broad mental health problems may be at a higher risk for poor long-term outcome across mental health and functional domains. Efforts to assess and address this broad liability may enhance long-term outcome.
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| 31. |
- Gomes-da-Silva, LC, et al.
(författare)
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Recruitment of LC3 to damaged Golgi apparatus
- 2019
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Ingår i: Cell death and differentiation. - : Springer Science and Business Media LLC. - 1476-5403 .- 1350-9047. ; 26:8, s. 1467-1484
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Tidskriftsartikel (refereegranskat)
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| 32. |
- Hunsche, Michelle, et al.
(författare)
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Social functioning and the presentation of anxiety in children on the autism spectrum: A multimethod, multiinformant analysis
- 2022
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Ingår i: Journal of Abnormal Psychology. - : American Psychological Association (APA). - 0021-843X. ; 131:2, s. 198-208
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Tidskriftsartikel (refereegranskat)abstract
- Co-occurring anxiety in children on the autism spectrum is associated with greater social challenges, including poorer social skills and relationships, which may influence the severity and presentation of anxiety symptoms, particularly social anxiety. The current study used Bayesian network analytics (Williams & Mulder, 2020) and a multimethod approach to examine (a) how different facets of social functioning relate to one another and to anxiety severity and comorbidity, (b) which facet(s) are most influential and thus may represent optimal targets for intervention, and (c) how social functioning relates to the presentation of social fears in a large treatment-seeking sample of autistic children with anxiety disorders (n = 191, 7–13 years). Results indicated strong associations among measures of social ability (i.e., theory of mind [ToM], social motivation, friendship attainment) and among measures of social integration (i.e., bullying, interpersonal and peer difficulties), with only bullying demonstrating a significant association with anxiety. ToM was the most interconnected variable in the network, and social motivation demonstrated the strongest individual connections with other variables, particularly with other facets of social ability. Socially anxious children with impaired ToM were less likely to express fears of negative evaluation, resulting in a distinct diagnostic presentation of social fears. Findings suggest that social motivation and ToM may represent important targets for intervention for autistic children with co-occurring anxiety. Further, social–cognitive difficulties associated with autism, like ToM, may play a role in distinct manifestations of anxiety in these youth.
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| 33. |
- Klingelhoefer, L., et al.
(författare)
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Dystonia Non-Motor Symptoms Questionnaire (DNMSQuest) zur Erhebung nichtmotorischer Symptome bei Dystonie : Interkulturelle Adaptation in deutscher Sprache
- 2020
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Ingår i: Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804. ; 91, s. 337-342
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Tidskriftsartikel (refereegranskat)abstract
- Background: Non-motor symptoms (NMS) in patients with dystonia have a relevant impact on health-related quality of life; however, a comprehensive easy to use NMS assessment tool for clinical bedside use is currently not available. Objective: The validated German version of the dystonia non-motor symptoms questionnaire (DNMSQuest) for assessing NMS in craniocervical dystonia is presented. Methods: The DNMSQuest in the German language was developed based on internationally recognized standards for intercultural adaptation of self-completed patient questionnaires. Translation of the original English questionnaire into the German language as well as back translation to English was carried out independently by four bilingual specialists in neurological movement disorders. In each case a consensus version accepted by each translator was created by another neurologist. The back translated English version was compared with the original English questionnaire for relevant linguistic and content discrepancies by a neurologist who was significantly involved in the development of the original questionnaire. The final German version was used in 130 patients with cervical dystonia and 48 healthy controls in an international, multicenter validation study. Results: An interculturally adapted validated version of the DNMSQuest in the German and English languages was developed for rapid bedside assessment and evaluation of NMS in cervical dystonia. Conclusion: The DNMSQuest successfully bridges the current gap of a validated disease-specific, patient self-administered, short, comprehensive questionnaire for NMS assessment in routine clinical practice in craniocervical dystonia. It is envisaged that this tool will be useful for the clinical practice and trials.
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| 34. |
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| 35. |
- Mauritsen, Thorsten, et al.
(författare)
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Developments in the MPI-M Earth System Model version 1.2 (MPI-ESM1.2) and Its Response to Increasing CO2
- 2019
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Ingår i: Journal of Advances in Modeling Earth Systems. - 1942-2466. ; 11:4, s. 998-1038
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Tidskriftsartikel (refereegranskat)abstract
- A new release of the Max Planck Institute for Meteorology Earth System Model version 1.2 (MPI-ESM1.2) is presented. The development focused on correcting errors in and improving the physical processes representation, as well as improving the computational performance, versatility, and overall user friendliness. In addition to new radiation and aerosol parameterizations of the atmosphere, several relatively large, but partly compensating, coding errors in the model's cloud, convection, and turbulence parameterizations were corrected. The representation of land processes was refined by introducing a multilayer soil hydrology scheme, extending the land biogeochemistry to include the nitrogen cycle, replacing the soil and litter decomposition model and improving the representation of wildfires. The ocean biogeochemistry now represents cyanobacteria prognostically in order to capture the response of nitrogen fixation to changing climate conditions and further includes improved detritus settling and numerous other refinements. As something new, in addition to limiting drift and minimizing certain biases, the instrumental record warming was explicitly taken into account during the tuning process. To this end, a very high climate sensitivity of around 7 K caused by low-level clouds in the tropics as found in an intermediate model version was addressed, as it was not deemed possible to match observed warming otherwise. As a result, the model has a climate sensitivity to a doubling of CO2 over preindustrial conditions of 2.77 K, maintaining the previously identified highly nonlinear global mean response to increasing CO2 forcing, which nonetheless can be represented by a simple two-layer model.
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| 36. |
- Pinciotti, Caitlin M., et al.
(författare)
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Co-occurring PTSD in intensive OCD treatment : Impact on treatment trajectory vs. response
- 2024
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Ingår i: Journal of Affective Disorders. - 0165-0327. ; 353, s. 109-116
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Tidskriftsartikel (refereegranskat)abstract
- Background: Obsessive-compulsive disorder (OCD) and co-occurring posttraumatic stress disorder (PTSD) is associated with more severe and chronic OCD. However, findings regarding treatment effectiveness of cognitive behavioral treatment (CBT) with exposure and response prevention (ERP) with this comorbidity are mixed. Research aimed at understanding the precise barriers to OCD treatment effectiveness for individuals with co-occurring PTSD may help elucidate unique treatment needs. Methods: The current study used linear regression and latent growth curve analysis comparing treatment response and trajectory from patients with OCD (n = 3083, 94.2 %) and OCD + PTSD (n = 191, 5.2 %) who received CBT with ERP in two major intensive OCD treatment programs. Results: Although patients with OCD + PTSD evidenced similar trajectories of overall severity change, patients at one site required nearly 11 additional treatment days to achieve comparable reduction in OCD severity. Further, at the dimensional level, those with OCD + PTSD had poorer treatment response for unacceptable thoughts and symmetry symptoms. The moderate effect for unacceptable thoughts, indicating the widest gap in treatment response, suggests these symptoms may be particularly relevant to PTSD. Limitations: Findings are limited by a naturalistic treatment sample with variation in treatment provision. Conclusions: Findings emphasize caution in using a one-size-fits-all approach for patients with co-occurring OCD + PTSD within intensive OCD treatment programs, as broadly defined outcomes (e.g., reduction in overall severity) may not translate to reduction in the nuanced symptom dimensions likely to intersect with trauma. Unacceptable thoughts and symmetry symptoms, when co-occurring with PTSD, may require a trauma-focused treatment approach within intensive OCD treatment.
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| 37. |
- Pontarp, Mikael, et al.
(författare)
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The Latitudinal Diversity Gradient : Novel Understanding through Mechanistic Eco-evolutionary
- 2019
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Ingår i: Trends in Ecology & Evolution. - : Elsevier. - 0169-5347 .- 1872-8383. ; 34:3, s. 211-223
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Forskningsöversikt (refereegranskat)abstract
- The latitudinal diversity gradient (LDG) is one of the most widely studied patterns in ecology, yet no consensus has been reached about its underlying causes. We argue that the reasons for this are the verbal nature of existing hypotheses, the failure to mechanistically link interacting ecological and evolutionary processes to the LDG, and the fact that empirical patterns are often consistent with multiple explanations. To address this issue, we synthesize current LDG hypotheses, uncovering their eco-evolutionary mechanisms, hidden assumptions, and commonalities. Furthermore, we propose mechanistic eco-evolutionary modeling and an inferential approach that makes use of geographic, phylogenetic, and trait-based patterns to assess the relative importance of different processes for generating the LDG.
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| 38. |
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| 39. |
- Spencer, Samuel, et al.
(författare)
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Things that make you go Hmm: Myths and misconceptions within cognitive-behavioral treatment of obsessive-compulsive disorder
- 2023
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier BV. - 2211-3649. ; 37
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Tidskriftsartikel (refereegranskat)abstract
- The past four decades have yielded a robust body of evidence supporting the efficacy and effectiveness of cognitive-behavioral therapy (CBT) as a gold-standard treatment for obsessive-compulsive disorder (OCD) across the lifespan. Exposure and response prevention (E/RP) has been identified as a key component of this approach. Despite robust research support for CBT with E/RP, several myths and misconceptions continue to proliferate in both research and practice settings. Such myths and misconceptions are concerning, as they lack empirical basis, may hinder widespread dissemination and implementation of CBT for OCD, and run contrary to the practice of evidence-based psychological medicine. Focusing on the importance of promoting evidence-based practice and generative clinical science, the present review article synthesizes relevant research within the field of treatments for OCD to address the following myths/misconceptions: (a) uncertainty exists concerning the evidence base supporting CBT for OCD, (b) E/RP attrition and dropout rates are unacceptably high due to excessive risk and perceived patient intolerability, and (c) alternative treatments for OCD need to be expeditiously developed due to major limitations of E/RP. Recommendations for future research and clinical dissemination and implementation to further advance a generative clinical science of OCD treatment are discussed.
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| 40. |
- Storch, A., et al.
(författare)
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Non-motor Symptoms Questionnaire and Scale for Parkinson's disease
- 2010
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Ingår i: Nervenarzt. - : Springer Science and Business Media LLC. - 0028-2804. ; 81:8, s. 980-985
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Tidskriftsartikel (refereegranskat)abstract
- Idiopathic Parkinson's disease (PD) is a multisytem degenerative disorder. In addition to motor symptoms such as akinesia, rigidity and tremor, various non-motor symptoms occur, which are still insufficiently diagnosed. Moreover, the frequently used scales and scores do not adequately detect these non-motor symptoms. The Non-motor Symptoms Questionnaire (NMSQuest) is an established self-completed patient questionnaire with 30 qualitative questions covering all important non-motor symptoms of PD. The Non-motor Symptoms Scale (NMSScale) is a grade rating scale for estimating the frequency and severity of non-motor symptoms in PD. Since there are only original English versions of both questionnaires available, self-translated versions were frequently used or the questionnaires were not used at all in native German patients. We used international guidelines for cross-cultural adaptation of questionnaires to provide standard versions of both non-motor symptoms questionnaires in the German language.
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| 41. |
- Storch, Eric A, et al.
(författare)
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Family Accommodation in Children and Adolescents with Misophonia
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Ingår i: Behavior Therapy. - 1878-1888.
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Tidskriftsartikel (refereegranskat)abstract
- Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared to parents of children with anxiety disorders, parents of children with misophonia more frequently reported child distress and anger when they did not accommodate. Family accommodation was a moderate to strong predictor of misophonia severity even when accounting for co-occurring internalizing and externalizing symptoms and sociodemographic factors. This first study of family accommodation in pediatric misophonia suggests accommodation may be an important clinical feature oand a potential candidate to target in interventions.
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| 42. |
- Storch, Eric A., et al.
(författare)
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Little Doubt That CBT Works for Pediatric OCD
- 2020
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567. ; 59:7, s. 785-787
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Tidskriftsartikel (refereegranskat)abstract
- We write with great concern in response to the recent systematic review and meta-analysis of cognitive-behavioral therapy (CBT) in pediatric obsessive-compulsive disorder (OCD) by Uhre et al.1 Although the authors’ results consistently support the clinical efficacy of CBT for pediatric OCD, we expect that, much like ourselves, readers will be confused by the discordant and inappropriate conclusions that they put forward. These conclusions stem from the authors’ application and interpretation of their particular qualitative methods, which could lead important stakeholders (eg, parents, patients, clinicians, and payers) to wrongly discount clear evidence for what is known to be the best evidence-based therapy for pediatric OCD.
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| 46. |
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| 47. |
- Strophauer, Emily, et al.
(författare)
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The clinical presentation of major depressive disorder in youth with co-occurring obsessive-compulsive disorder
- 2024
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Ingår i: Journal of Affective Disorders. - 0165-0327. ; 349, s. 349-357
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMajor depressive disorder (MDD) is common in youth and among the most frequent comorbid disorders in pediatric obsessive-compulsive disorder (OCD), but it is unclear whether the presence of OCD affects the symptom presentation of MDD in youth.MethodsA sample of youth with OCD and MDD (n = 124) and a sample of youth with MDD but no OCD (n = 673) completed the Patient Health Questionnaire for Adolescents (PHQ-A). The overall and symptom-level presentation of MDD were examined using group comparisons and network analysis.ResultsYouth with MDD and OCD, compared to those with MDD and no OCD, had more severe MDD (Cohen's d = 0.39) and more reported moderate to severe depression (75 % vs 61 %). When accounting for demographic variables and the overall severity of MDD, those with comorbid OCD reported lower levels of anhedonia and more severe difficulties with psychomotor retardation/agitation. No significant differences in the interconnections among symptoms emerged.LimitationsData were cross-sectional and self-reported, gold standard diagnostic tools were not used to assess OCD, and the sample size for the group with MDD and OCD was relatively small yielding low statistical power for network analysis.ConclusionsYouth with MDD and OCD have more severe MDD than those with MDD and no OCD and they experience more psychomotor issues and less anhedonia, which may relate to the behavioral activation characteristic of OCD.KeywordsOCDChildrenAdolescentsDepressionMajor depressive disorderComorbidity
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