Factor structure of the Edinburgh Postnatal Depression Scale in a population-based sample

To demonstrate validity, questionnaires should measure the same construct in different groups and across time. The Edinburgh Postnatal Depression Scale (EPDS) was designed as a unidimensional scale, but factor analyses of the EPDS have been equivocal, and demonstrate other structures: this may be because of sample characteristics and timing of administration. We aimed to examine the factor structure of the EPDS in pregnancy and postpartum at 4 time-points in a large population-based sample. We carried out exploratory and confirmatory factor analysis on the Avon Longitudinal Study of Parents and Children sample (n = 11,195-12,166) randomly split in 2. We used data from 18 and 32 weeks pregnancy gestation; and 8 weeks and 8 months postpartum. A 3-factor solution was optimal at all time-points, showing the clearest factor structure and best model fit: Depression (4 items) accounted for 43.5-47.2% of the variance; anhedonia (2 items) 10.5-11.1%; and anxiety (3 items) 8.3-9.4% of the variance. Internal reliability of subscales was good at all time points (Cronbach's αs: .73-.78). The EPDS appears to measure 3 related factors of depression, anhedonia, and anxiety and has a stable structure in pregnancy and the first postnatal year. (PsycINFO Database Record

Positive Mental Health and Prevalence of Psychological Ill-Being in University Nursing Professors in Catalonia, Spain

The aim of the current study was to examine the prevalence of psychological ill-being among university nursing professors in Spain and determine their grade of positive mental health. A cross-sectional study was conducted from June 2013 to December 2013 with a sample of 263 university nursing professors. Sociodemographic and occupational variables, as well as variables related to daily habits and lifestyle, were collected. Psychological ill-being was measured using the General Health Questionnaire (GHQ-12) and positive mental health was evaluated with the Positive Mental Health Questionnaire (PMHQ). Prevalence of psychological ill-being (GHQ-12 score >2) among the sample was 27% (range = 21.8% to 32.6%), with a higher prevalence in teachers from first and second cycles (Bachelor's degree and Master's degree, respectively) and a lower prevalence in those having very satisfactory social relationships. Significant differences were found in relation to consumption of tranquilizer drugs and Bach flower remedies. PMHQ scores were lower among teachers with a GHQ-12 score >2. Participants presented a good level of positive mental health. Preventive policies should be applied with the aim of reducing psychological ill-being among professors and potentiating positive mental health. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 38-48.].

Life-Space Mobility and Cognitive Decline Among Mexican Americans Aged 75 Years and Older

OBJECTIVES

To examine the association between life-space mobility and cognitive decline over a five-year period among older Mexican Americans.

DESIGN

Longitudinal study.

SETTING

Hispanic Established Population for the Epidemiologic Study of the Elderly survey conducted in the southwestern of United States (Texas, Colorado, Arizona, New Mexico, and California).

PARTICIPANTS

Four hundred thirty-two Mexican Americans aged 75 and older with normal or high cognitive function at baseline.

MEASUREMENTS

Socio-demographic factors, living arrangement, type of household, social support, financial strain, self-reported medical conditions, Mini-Mental State Examination (MMSE), depressive symptoms, activities of daily living (ADLs), and Short Physical Performance Battery. Life-space assessment (LSA) during the past 4 weeks was assessed during in-home interview. Scores ranged from 0 (daily restriction to the bedroom) to 120 (daily trips outside of their own town without assistance) and categorized as 0 to 20, 21 to 40, 41 to 60, 61 to 80, and 81 to 120. Because of the small sample size in the category of 81 to 120, the two highest categories were combined into a single group.

RESULTS

The mean LSA score and MMSE score of participants at baseline was 44.6 (Standard Deviation [SD], 20.7) and 25.7 (SD, 3.2), respectively. Mixed Model analyses showed that participants in the highest life-space category (≥61) experienced slower rates of cognitive decline over time compared to participants in the lowest category (0 to 20) (β = 1.03, Standard Error [SE] = 0.29, P = 0.0004), after adjusting for all covariates.

CONCLUSION

Greater life-space mobility at baseline was predictor of slower rates of cognitive decline over 5 years in older Mexican Americans.

Prevalence of Major Depression and Its Associations With Demographic and Clinical Characteristics and Quality of Life in Chinese Patients With HBV-related Liver Diseases

BACKGROUND

There are no data about the frequency of major depression in patients with liver disease related to Hepatitis B virus (HBV) in China. This study examined the prevalence of major depression and its clinical correlates and association with quality of life (QOL) in patients with HBV-related liver diseases.

METHOD

Altogether 634 patients with HBV-related liver diseases met study entry criteria and completed the survey. The diagnosis of major depression was established with the Mini International Neuropsychiatric Interview (MINI). Socio-demographic and clinical characteristics, Global Assessment of Functioning (GAF) and QOL were measured.

RESULTS

The prevalence of major depression was 6.4%. Multivariable logistic regression analyses revealed that insomnia (P=0.01, OR=5.5, 95%CI=1.4-21.6) and global functioning (P<0.001, OR=0.6, 95% CI=0.5-0.7) were independently associated with major depression. Major depression was associated with both poor physical (F _{(1, 634)}=4.0, P=0.04) and mental QOL (F _{(1, 634)}=26.2, P<0.001).

CONCLUSIONS

Given the negative impact of depression on patients' QOL, more attempts should be made to identify and treat it in HBV-related diseases.

Clinical phenotypes of perinatal depression and time of symptom onset: analysis of data from an international consortium

BACKGROUND

The perinatal period is a time of high risk for onset of depressive disorders and is associated with substantial morbidity and mortality, including maternal suicide. Perinatal depression comprises a heterogeneous group of clinical subtypes, and further refinement is needed to improve treatment outcomes. We sought to empirically identify and describe clinically relevant phenotypic subtypes of perinatal depression, and further characterise subtypes by time of symptom onset within pregnancy and three post-partum periods.

METHODS

Data were assembled from a subset of seven of 19 international sites in the Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. In this analysis, the cohort was restricted to women aged 19-40 years with information about onset of depressive symptoms in the perinatal period and complete prospective data for the ten-item Edinburgh postnatal depression scale (EPDS). Principal components and common factor analysis were used to identify symptom dimensions in the EPDS. The National Institute of Mental Health research domain criteria functional constructs of negative valence and arousal were applied to the EPDS dimensions that reflect states of depressed mood, anhedonia, and anxiety. We used k-means clustering to identify subtypes of women sharing symptom patterns. Univariate and bivariate statistics were used to describe the subtypes.

FINDINGS

Data for 663 women were included in these analyses. We found evidence for three underlying dimensions measured by the EPDS: depressed mood, anxiety, and anhedonia. On the basis of these dimensions, we identified five distinct subtypes of perinatal depression: severe anxious depression, moderate anxious depression, anxious anhedonia, pure anhedonia, and resolved depression. These subtypes have clear differences in symptom quality and time of onset. Anxiety and anhedonia emerged as prominent symptom dimensions with post-partum onset and were notably severe.

INTERPRETATION

Our findings show that there might be different types and severity of perinatal depression with varying time of onset throughout pregnancy and post partum. These findings support the need for tailored treatments that improve outcomes for women with perinatal depression.

FUNDING

Janssen Research & Development.

Antipsychotic treatment and the Rorschach Perceptual Thinking Index (PTI) in psychotic disorder patients: Effects of treatment

The Rorschach-based Perceptual Thinking Index (PTI) is used to identify and rate features of psychotic disorders, but effects of antipsychotic treatment on such ratings is not clear. Accordingly, we examined potential effects of antipsychotic drugs on PTI measures in 114 patients with a psychotic or bipolar-I disorder. Use and doses of antipsychotic drugs (as chlorpromazine-equivalent [CPZ-eq] mg/day) were unrelated to PTI total or subscale scores in any diagnostic group. PTI scores were independently and significantly associated with psychotic symptomatic severity (PANSS score) and less with female sex. These findings support the validity and value of the PTI in identifying features of psychosis even in the presence of antipsychotic treatment.

Effect of a Long-Term Intensive Lifestyle Intervention on Cognitive Function: Action for Health in Diabetes Study

OBJECTIVES

To assess whether randomization to 10 years of lifestyle intervention to induce and maintain weight loss improves cognitive function.

DESIGN

Randomized controlled clinical trial.

SETTING

Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Continuation study (U01 DK057136-15).

PARTICIPANTS

Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 (N = 3,751).

INTERVENTION

Intensive lifestyle intervention (ILI) for weight loss through reduced caloric intake and increased physical activity compared with a control condition of diabetes support and education (DSE).

MEASUREMENTS

Certified examiners who were masked to intervention assignment administered a standard battery of cognitive function tests (Modified Mini-Mental State Examination, Rey Auditory Verbal Learning Test, Digit Symbol Coding, Trail-Making Test, Modified Stroop Color-Word Test) to participants 10 to 13 years after enrollment.

RESULTS

Assignment to lifestyle intervention was not associated with significantly different overall (P = .10) or domain-specific (all P > .10) cognitive function than assignment to diabetes support and education. Results were fairly consistent across prespecified groups, but there was some evidence of trends for differential intervention effects showing modest harm in ILI in participants with greater body mass index and in individuals with a history of cardiovascular disease. Cognitive function was not associated with changes in weight or fitness (all P > .05).

CONCLUSION

A long-term behavioral weight loss intervention for overweight and obese adults with diabetes mellitus was not associated with cognitive benefit. Trial Registration clinicaltrials.gov Identifier: NCT00017953.

Psychometric Evaluation of the Saving Inventory-Revised in Older Adults

OBJECTIVES

Hoarding disorder (HD) is a chronic condition characterized by severe impairment in health and functioning for older adults. Researchers and clinicians commonly use the Saving Inventory-Revised (SI-R), a self-report measure validated for the assessment of HD, to establish symptom severity. This study represents the first evaluation of the psychometric properties of the SI-R in a sample of older adults with HD.

METHODS

Participants were 156 older adults with HD and 23 older adults with no psychiatric diagnoses. Demographic and HD symptom severity measures were compared between the two samples. Convergent and discriminant validity was examined in the HD sample. A confirmatory factor analysis was used to test the replicability of the three-factor structure observed in the original sample.

RESULTS

Participants in the HD sample scored significantly higher on the SI-R than did the non-psychiatric sample. The SI-R was significantly correlated with clutter level and symptoms of anxiety and depression. A three-factor model demonstrated poor fit in the HD sample.

CONCLUSIONS

The SI-R can be used to validly assess hoarding severity in geriatric populations.

CLINICAL IMPLICATIONS

Clinicians working with geriatric patients should consider refraining from use of the SI-R subscales as they may be less theoretically distinct in older adults.

Suicide Risk in the Hospitalized Elderly in Turkey and Affecting Factors

OBJECTIVE

This study aimed to investigate the suicide risk among the elderly hospitalized and treated because of physical illnesses, and the factors affecting the risk.

METHODS

The study has a cross-sectional design. It was conducted with 459 elderly people hospitalized and treated in a public hospital between May 25, 2015 and December 4, 2015. Data were collected with the Personal Information Form, Suicide Probability Scale and Hospital Anxiety and Depression Scale. For the analysis, descriptive statistics, the chi-square test, Fisher's exact test and logistic regression analysis were used.

RESULTS

In the study, 24.0% of the elderly were at high risk for suicide. Suicide risk was even higher among the elderly in the 60-74 age group, living alone, drinking alcohol, perceiving his/her religious beliefs as weak, being treated for cancer, having the diagnosis 11 years or over, having a history of admission to a psychiatry clinic, and being at risk for anxiety and depression.

CONCLUSION

In the study, approximately one out of every four elderly people was at high risk for suicide. Therefore, older people should be assessed for suicide risk and programs targeting to prevent the elderly from committing suicide should be organized.

Patient Expectancy as a Mediator of Placebo Effects in Antidepressant Clinical Trials

OBJECTIVE

Causes of placebo effects in antidepressant trials have been inferred from observational studies and meta-analyses, but their mechanisms have not been directly established. The goal of this study was to examine in a prospective, randomized controlled trial whether patient expectancy mediates placebo effects in antidepressant studies.

METHOD

Adult outpatients with major depressive disorder were randomly assigned to open or placebo-controlled citalopram treatment. Following measurement of pre- and postrandomization expectancy, participants were treated with citalopram or placebo for 8 weeks. Independent samples t tests determined whether patient expectancy differed between the open and placebo-controlled groups, and mixed-effects models assessed group effects on Hamilton Depression Rating Scale (HAM-D) scores over time while controlling for treatment assignment. Finally, mediation analyses tested whether between-group differences in patient expectancy mediated the group effect on HAM-D scores.

RESULTS

Postrandomization expectancy scores were significantly higher in the open group (mean=12.1 [SD=2.1]) compared with the placebo-controlled group (mean=11.0 [SD=2.0]). Mixed-effects modeling revealed a significant week-by-group interaction, indicating that HAM-D scores for citalopram-treated participants declined at a faster rate in the open group compared with the placebo-controlled group. Patient expectations postrandomization partially mediated group effects on week 8 HAM-D.

CONCLUSIONS

Patient expectancy is a significant mediator of placebo effects in antidepressant trials. Expectancy-related interventions should be investigated as a means of controlling placebo responses in antidepressant clinical trials and improving patient outcome in clinical treatment.

Validity of LIDAS (LIfetime Depression Assessment Self-report): a self-report online assessment of lifetime major depressive disorder

BACKGROUND

There is a paucity of valid, brief instruments for the assessment of lifetime major depressive disorder (MDD) that can be used in, for example, large-scale genomics, imaging or biomarker studies on depression. We developed the LIfetime Depression Assessment Self-report (LIDAS), which assesses lifetime MDD diagnosis according to DSM criteria, and is largely based on the widely used Composite International Diagnostic Interview (CIDI). Here, we tested the feasibility and determined the sensitivity and specificity for measuring lifetime MDD with this new questionnaire, with a regular CIDI as reference.

METHOD

Sensitivity and specificity analyses of the online lifetime MDD questionnaire were performed in adults with (n = 177) and without (n = 87) lifetime MDD according to regular index CIDIs, selected from the Netherlands Study of Depression and Anxiety (NESDA) and Netherlands Twin Register (NTR). Feasibility was tested in an additional non-selective, population-based sample of NTR participants (n = 245).

RESULTS

Of the 753 invited persons, 509 (68%) completed the LIDAS, of which 419 (82%) did this online. User-friendliness of the instrument was rated high. Median completion time was 6.2 min. Sensitivity and specificity for lifetime MDD were 85% [95% confidence interval (CI) 80-91%] and 80% (95% CI 72-89%), respectively. This LIDAS instrument gave a lifetime MDD prevalence of 20.8% in the population-based sample.

CONCLUSIONS

Measuring lifetime MDD with an online instrument was feasible. Sensitivity and specificity were adequate. The instrument gave a prevalence of lifetime MDD in line with reported population prevalences. LIDAS is a promising tool for rapid determination of lifetime MDD status in large samples, such as needed for genomics studies.

The Psychosis Continuum: Testing a Bifactor Model of Psychosis in a General Population Sample

Although the factor structure of psychosis continues to be debated by taxonomists, recent studies have supported a bifactor model consisting of a general psychosis factor and 5 uncorrelated symptom-specific factors. While this model has received support in clinical samples, it has not been tested at the general population level. Analysis was conducted on Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N = 34 653). Twenty-two psychotic symptoms were used as observed indicators of psychosis. These items were chosen based on their conceptual similarity to the items used in a similar study based on clinical samples. Confirmatory factor analysis and confirmatory bifactor modeling were used to test a variety of competing models. The best fitting model consisted of a general psychosis factor that was uncorrelated with 5 specific factors: positive, negative, disorganization, mania, and depression. These findings suggest that the bifactor model can be extended to general population samples, supporting the continuity between clinical and subclinical psychotic experiences. Theoretical and practical implications are discussed.

Comparison of American Indian and Non-Native BASC-2 Self-Report-Adolescent Scores

BASC-2 SRP-A scores of 162 American Indian (AI) youth were compared with those of an ethnically diverse sample (N = 200) to explore group equivalence. A MANOVA indicated group differences among the five composites. AIs outscored non-Natives in Inattention/Hyperactivity. We examined AIs' ADHD scores in relation to their acculturation strategies, measured using the Bicultural Ethnic Identity Scale. Culturally marginalized AIs (low White and low Indian acculturation) reported stronger ADHD symptoms than bicultural, assimilated, or separated youth. The potential impact of culture on clinical measures is discussed.

Efficacy and safety of tau-aggregation inhibitor therapy in patients with mild or moderate Alzheimer's disease: a randomised, controlled, double-blind, parallel-arm, phase 3 trial

BACKGROUND

Leuco-methylthioninium bis(hydromethanesulfonate; LMTM), a stable reduced form of the methylthioninium moiety, acts as a selective inhibitor of tau protein aggregation both in vitro and in transgenic mouse models. Methylthioninium chloride has previously shown potential efficacy as monotherapy in patients with Alzheimer's disease. We aimed to determine whether LMTM was safe and effective in modifying disease progression in patients with mild to moderate Alzheimer's disease.

METHODS

We did a 15-month, randomised, controlled double-blind, parallel-group trial at 115 academic centres and private research clinics in 16 countries in Europe, North America, Asia, and Russia with patients younger than 90 years with mild to moderate Alzheimer's disease. Patients concomitantly using other medicines for Alzheimer's disease were permitted to be included because we considered it infeasible not to allow their inclusion; however, patients using medicines carrying warnings of methaemoglobinaemia were excluded because the oxidised form of methylthioninium in high doses has been shown to induce this condition. We randomly assigned participants (3:3:4) to 75 mg LMTM twice a day, 125 mg LMTM twice a day, or control (4 mg LMTM twice a day to maintain blinding with respect to urine or faecal discolouration) administered as oral tablets. We did the randomisation with an interactive web response system using 600 blocks of length ten, and stratified patients by severity of disease, global region, whether they were concomitantly using Alzheimer's disease-labelled medications, and site PET capability. Participants, their study partners (generally carers), and all assessors were masked to treatment assignment throughout the study. The coprimary outcomes were progression on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and the Alzheimer's Disease Co-operative Study-Activities of Daily Living Inventory (ADCS-ADL) scales from baseline assessed at week 65 in the modified intention-to-treat population. This trial is registered with Clinicaltrials.gov (NCT01689246) and the European Union Clinical Trials Registry (2012-002866-11).

FINDINGS

Between Jan 29, 2013, and June 26, 2014, we recruited and randomly assigned 891 participants to treatment (357 to control, 268 to 75 mg LMTM twice a day, and 266 to 125 mg LMTM twice a day). The prespecified primary analyses did not show any treatment benefit at either of the doses tested for the coprimary outcomes (change in ADAS-Cog score compared with control [n=354, 6·32, 95% CI 5·31-7·34]: 75 mg LMTM twice a day [n=257] -0·02, -1·60 to 1·56, p=0·9834, 125 mg LMTM twice a day [n=250] -0·43, -2·06 to 1·20, p=0·9323; change in ADCS-ADL score compared with control [-8·22, 95% CI -9·63 to -6·82]: 75 mg LMTM twice a day -0·93, -3·12 to 1·26, p=0·8659; 125 mg LMTM twice a day -0·34, -2·61 to 1·93, p=0·9479). Gastrointestinal and urinary effects were the most common adverse events with both high doses of LMTM, and the most common causes for discontinuation. Non-clinically significant dose-dependent reductions in haemoglobin concentrations were the most common laboratory abnormality. Amyloid-related imaging abnormalities were noted in less than 1% (8/885) of participants.

INTERPRETATION

The primary analysis for this study was negative, and the results do not suggest benefit of LMTM as an add-on treatment for patients with mild to moderate Alzheimer's disease. Findings from a recently completed 18-month trial of patients with mild Alzheimer's disease will be reported soon.

FUNDING

TauRx Therapeutics.

Paranormal Belief, Schizotypy, and Body Mass Index

There are indications that subjects with schizotypal personality have a lower Body Mass Index. Also schizotypal personality is linked to a higher incidence of paranormal belief. In this study we examined whether low Body Mass Index is also linked to paranormal belief. In a pilot study 48 students of psychology (85.4% women) between the ages of 20 and 27 years were administered a questionnaire assessing weight, height, and paranormal belief. Analysis suggested an association between belief in paranormal phenomena and low Body Mass Index. In a follow-up study with 300 subjects and equal sex distribution, the relationship was examined under control of schizotypy. The results for Body Mass Index could not be confirmed; however, paranormal belief was heavily associated with the cognitive-perceptual component of schizotypy.

Preliminary Report of a Validation Study of Instrumental Activities of Daily Living in a Greek Sample

To validate the Instrumental Activities of Daily Living in Greek, 44 men ( M age = 70.5 yr., SD = 7.2) and 58 women ( M age = 68.4, SD = 9.2), outpatients of memory clinics, were studied. Sex differences in the item responses were evaluated. Reliability assessed as Cronbach alpha was .84, while validity was assessed by correlation of .77 with the Mini-Mental State Examination. 21 men and 20 women had moderate to severe dementia, with Mini-Mental State Examination scores < 20. The results show that this Greek language version can be effectively used in Greece.

Optimal Cutoff Scores for Alzheimer's Disease Using the Chinese Version of Mini-Mental State Examination Among Chinese Population Living in Rural Areas

To explore the optimal cutoff score for initial detection of Alzheimer's Disease (AD) through the Chinese version of Mini-Mental State Examination (CMMSE) in rural areas in China, we conducted a cross-sectional study within the Linxian General Population Nutritional Follow-up study. 16,488 eligible cohort members participated in the survey and 881 completed the CMMSE. Among 881 participants, the median age (Interquartile range) was 69.00 (10.00), 634 (71.92%) were female, 657 (74.57%) were illiterate, 35 (3.97%) had 6 years of education or higher, and 295 (33.48%) were diagnosed with AD. By reducing the CMMSE criteria for illiterate to 16 points, primary school to 19 points, and middle school or higher to 23 points, the efficiency of Chinese version of Mini-Mental State Examination can be significantly improved for initial detection of AD in rural areas in China, especially in those nutrition deficient areas.

The sensitivity and specificity of a diagnostic test of sequence-space synesthesia

People with sequence-space synesthesia (SSS) report stable visuo-spatial forms corresponding to numbers, days, and months (amongst others). This type of synesthesia has intrigued scientists for over 130 years but the lack of an agreed upon tool for assessing it has held back research on this phenomenon. The present study builds on previous tests by measuring the consistency of spatial locations that is known to discriminate controls from synesthetes. We document, for the first time, the sensitivity and specificity of such a test and suggest a diagnostic cut-off point for discriminating between the groups based on the area bounded by different placement attempts with the same item.

Effects of Relaxation Exercises and Music Therapy on the Psychological Symptoms and Depression Levels of Patients with Schizophrenia

PURPOSE

This study aims to identify the effects of relaxation exercises and music therapy on the psychological symptoms and depression levels of patients with chronic schizophrenia.

MATERIALS AND METHODS

This semi-experimental study was conducted using pre- and post-tests with a control group. The study population consists of patients with schizophrenia who regularly attended community mental health centers in the Malatya and Elazığ provinces of Turkey between May 2015 and September 2015. The study's sample consists of 70 patients with schizophrenia (n=35 in the control group; n=35 in the experimental group) who were selected randomly based on power analysis. The "Patient Information Form," the "Brief Psychiatric Rating Scale (BPRS)" and the "Calgary Depression Scale for Schizophrenia (CDSS)" were used for data collection. Patients in the experimental group participated in relaxation exercises and music therapy 5 times a week for 4 weeks. The experimental group of 35 persons was divided into three groups of approximately 10-12 individuals in order to enable all participants to attend the program. No intervention was applied to the patients in the control group. The data were evaluated using percentage distribution, arithmetic means, standard deviations, Chi-square and independent samples t-tests.

RESULTS

The study found that patients in the experimental group showed a decrease in total mean scores on the BPRS and CDSS; the difference between the post-test scores of the experimental group and the post-test scores of the control group was statistically significant (p<0.05). The practice of relaxation exercises and music therapy was proven to be effective in reducing schizophrenic patients' psychological symptoms and levels of depression.

CONCLUSION

Relaxation exercises and music therapy can be used as a complementary therapy in the medical treatment of patients with chronic schizophrenia.

Ego Functions in Relation to Stressful Life Events and Indices of Psychopathology in Paranoid Schizophrenia

This study explored the role of 12 ego functions in relation to Stressful Life Events and three indices of psychopathology, namely, Psychoticism, Anxiety, and Depression among 60 Bengali adult patients suffering from Paranoid Schizophrenia. Adapted versions of Bellak's Ego Function Assessment–M, Eysenck's Personality Questionnaire, Beck Depression Inventory, and the State-Trait Anxiety Inventory were administered to them. Stepwise multiple regression analyses indicated that Object Relation was associated with all three indices. Scores on Reality Testing correlated with those on Psychoticism, Stressful Life Events and scores on Thought Process with Anxiety, and Stressful Life Events, Sense of Reality, and scores on Defensive Functions with Depression. Hierarchical multiple regression analyses indicated that Object Relation also moderated between stressful life events and anxiety.

Sixteen-Item Anxiety Sensitivity Index

The present investigation examined the factor structure, internal consistency, and construct validity of the 16-item Anxiety Sensitivity Index (ASI; Reiss Peterson, Gursky, & McNally 1986) in a young adult sample (n = 420) from the Netherlands. Confirmatory factor analysis was used to comparatively evaluate two-factor, three-factor, and four-factor models of the anxiety sensitivity construct. Support was found for a hierarchical structure of anxiety sensitivity, with one global higher-order factor and four lower-order factors. Internal consistency for the global and lower-order factors of the 16-item ASI was adequate. Convergent and discriminant associations between the 16-item ASI and general mood and panic-specific variables were consistent with anxiety sensitivity theory. In addition, incremental validity of the anxiety sensitivity construct was established, relative to negative affectivity, for unexpected panic attacks and agoraphobic avoidance.

Axis I Screens and Suicide Risk in Jails

Mental health professionals conducting screenings in jail settings face formidable challenges in identifying inmates at risk for major depression and suicide. Psychologists often rely on correctional staff to provide initial appraisals of those inmates requiring further evaluation. In a sample of 100 jail detainees, the effectiveness of two specialized screens (the Referral Decision Scale and Mental Disability/Suicide Intake Screen or MDSIS) and one general screen (Personality Assessment Screener or PAS) was evaluated. For suicidal ideation, the MDSIS composite score evidenced promise (sensitivity = 1.00; specificity = 0.71). In ruling out major depression, the PAS Negative Affect subscale was useful for the inmate participants.

The impact of underreporting and overreporting on the validity of the Personality Inventory for DSM-5 (PID-5): A simulation analog design investigation

The Personality Inventory for DSM-5 (PID-5) is a 220-item self-report instrument that assesses the alternative model of personality psychopathology in Section III (Emerging Measures and Models) of DSM-5. Despite its relatively recent introduction, the PID-5 has generated an impressive accumulation of studies examining its psychometric properties, and the instrument is also already widely and frequently used in research studies. Although the PID-5 is psychometrically sound overall, reviews of this instrument express concern that this scale does not possess validity scales to detect invalidating levels of response bias, such as underreporting and overreporting. McGee Ng et al. (2016), using a "known-groups" (partial) criterion design, demonstrated that both underreporting and overreporting grossly affect mean scores on PID-5 scales. In the current investigation, we replicate these findings using an analog simulation design. An important extension to this replication study was the finding that the construct validity of the PID-5 was also significantly compromised by response bias, with statistically significant attenuation noted in validity coefficients of the PID-5 domain scales with scales from other instruments measuring congruent constructs. This attenuation was found for underreporting and overreporting bias. We believe there is a need to develop validity scales to screen for data-distorting response bias in research contexts and in clinical assessments where response bias is likely or otherwise suspected. (PsycINFO Database Record

The use of a brief mental health screener to enhance the ability of police officers to identify persons with serious mental disorders

Police agencies in Canada and elsewhere have received much criticism over how they respond to persons with serious mental disorders. The adequacy of training provided to police officers on mental health issues and in particular on recognizing indicators of serious mental disorders has been a major concern. This paper describes the process that led to the development of a new brief mental health screener (interRAI Brief Mental Health Screener, BMHS) designed to assist police officers to better identify persons with serious mental disorders. The interRAI BMHS was developed in collaboration with interRAI, an international, not-for-profit consortium of researchers. The government of Ontario had previously partnered with interRAI to develop and implement the Resident Assessment Instrument for Mental Health (RAI-MH), the assessment system mandated for use on all persons admitted into inpatient psychiatric care in the province. Core items on the interRAI BMHS were obtained through analysis (N=41,019) of RAI-MH data together with input from representatives from health care, police services, and patient groups. Two police services in southwestern Ontario completed forms (N=235) on persons thought to have a mental disorder. Patient records were later accessed to determine patient disposition. The use of summary and inferential statistics revealed that the variables significantly associated with being taken to hospital by police included performing a self-injurious act in the past 30days, and others being concerned over the person's risk for self-injury. Variables significantly associated with being admitted included abnormal thought process, delusions, and hallucinations. The results of the study indicate that the 14-variable algorithm used to construct the interRAI BMHS is a good predictor of who was most likely to be taken to hospital by police officers and who was most likely to be admitted. The instrument is an effective means of capturing and standardizing police officer observations enabling them to provide more and better quality information to emergency department (ED) staff. Teaching police officers to use the form constitutes enhanced training on major indicators of serious mental disorders. Further, given that items on the interRAI BMHS are written in the language of the health system, language acts as common currency between police officers and ED staff laying the foundation for a more collaborative approach between the systems.

Validation of the delirium observation screening scale in a hospitalized older population

Delirium is challenging to diagnose in older populations. It is often reversible, and when detected, treatment can improve patient outcomes. Delirium detection currently relies on trained staff to conduct neurocognitive interviews. The Delirium Observation Screening Scale (DOS) is a screen designed to allow faster, easier identification of delirium. In this validation study, conducted at an academic tertiary care center, we attempted to determine the accuracy of the DOS as a delirium screening tool in hospitalized patients over 64 years old. We compared DOS results to a validated delirium diagnostic tool, the Delirium Rating Scale-Revised-98. We also assess the user-friendliness of the DOS by nurses via electronic survey. In 101 assessments of 54 patients, the DOS had sensitivity of 90% and specificity of 91% for delirium. The DOS is an accurate and easy way to screen for delirium in older inpatients. Journal of Hospital Medicine 2016;11:494-497. © 2016 Society of Hospital Medicine.