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Demir E, Öz S, Aral N, Gürsoy F. A Reliability Generalization Meta-Analysis of the Mother-To-Infant Bonding Scale. Psychol Rep 2024; 127:447-464. [PMID: 35815798 DOI: 10.1177/00332941221114413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Mother-to-Infant Bonding Scale (MIBS) is among the most popular measurement tools to evaluate caregiver-infant attachment. We carried out a meta-analysis study to explore the generalizability of the reliability coefficients for the MIBS in different studies. The literature review yielded a total of 702 studies investigating caregiver-infant attachment. After removing duplicate studies, we also excluded compilations, meta-analyses, qualitative studies, those using different measurement tools, studies published in a language other than English, citations, and those whose full texts could not be accessed. Eventually, we considered a total of 26 studies with 33 Cronbach's alpha coefficients that satisfied the inclusion criteria. We normalized the alpha coefficients using Bonett's transformation, and the analyses were performed using a 95% confidence interval. The findings revealed a Cronbach's alpha (n = 33) coefficient of 0.73 (CI = 0.68-0.77); hence, the present reliability generalization study provides evidence that the reliability scores produced after measurements with the MIBS in previous studies are acceptable across samples. Overall, further studies may reliably utilize the MIBS to evaluate mother-infant attachment.
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Affiliation(s)
- Emin Demir
- Faculty of Health Sciences, Department of Child Development, Tarsus University, Tarsus, Turkey
| | - Sena Öz
- Faculty of Health Sciences, Department of Child Development, Ankara University, Ankara, Turkey
| | - Neriman Aral
- Faculty of Health Sciences, Department of Child Development, Ankara University, Ankara, Turkey
| | - Figen Gürsoy
- Faculty of Health Sciences, Department of Child Development, Ankara University, Ankara, Turkey
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2
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Fenlon EE, Pinciotti CM, Jones AC, Rippey CS, Wild H, Hubert TJJ, Tipsword JM, Badour CL, Adams TG. Assessment of Comorbid Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder. Assessment 2024; 31:126-144. [PMID: 37904505 DOI: 10.1177/10731911231208403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are commonly comorbid and share prominent features (e.g., intrusions, safety behaviors, and avoidance). Excellent self-report and clinician-administered assessments exist for OCD and PTSD individually, but few assess both disorders, and even fewer provide instruction on differential diagnosis or detection of comorbid OCD and PTSD. To address this gap in the literature, the current paper aims to (1) highlight diagnostic and functional similarities and differences between OCD and PTSD to inform differential diagnosis, (2) outline assessment recommendations for individuals with suspected comorbid OCD and PTSD, OCD with a significant trauma history or posttraumatic symptoms, or PTSD with significant obsessive-compulsive symptoms, and (3) explore future directions to evaluate and improve methods for assessing co-occurring OCD and PTSD.
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Affiliation(s)
| | | | - Alyssa C Jones
- Ralph H. Johnson VA Health Care System, Charleston, SC, USA
- Medical University of South Carolina, Charleston, USA
| | | | | | | | | | | | - Thomas G Adams
- University of Kentucky, Lexington, USA
- Yale School of Medicine, New Haven, CT, USA
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3
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Cox RC, Knowles KA, Jessup SC, Adamis AM, Olatunji BO. Psychometric properties of a daily obsessive-compulsive symptom scale for ecological momentary assessment. J Obsessive Compuls Relat Disord 2023; 39:100840. [PMID: 37808900 PMCID: PMC10552676 DOI: 10.1016/j.jocrd.2023.100840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Despite growing interest in ecological momentary assessment (EMA) in psychopathology and clinical observation of day-to-day fluctuations in obsessive-compulsive disorder (OCD) symptoms, there is not a standardized EMA measure of such symptoms that can guide systematic research. In the absence of such a measure, prior EMA research in OCD has utilized heterogeneous approaches to sampling momentary and daily OCD symptoms, which limits the ability to compare results between studies. The present study sought to examine the psychometric properties of a daily OCD symptom (d-OCS) measure that assesses common OCD symptom themes (e.g., contamination, checking, intrusive thoughts) in a sample of adults with OCD (n = 20), psychiatric controls (n = 27), and healthy controls (n = 27). Participants completed the d-OCS 3 times per day for 1 week. The d-OCS distinguished those with OCD from psychiatric controls and healthy controls. The d-OCS demonstrated good internal consistency, adequate test-retest reliability, and good convergent validity. These findings offer initial psychometric support for the use of the d-OCS in EMA research examining day-to-day fluctuations in symptoms of OCD. Additional investigation is needed to examine the discriminant validity of the d-OCS and generalize these findings to more diverse samples.
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Affiliation(s)
| | - Kelly A Knowles
- Vanderbilt University
- Anxiety Disorders Center, Institute of Living/Hartford Hospital
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4
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Lisi DM, Hawley LL, McCabe RE, Rowa K, Cameron DH, Richter MA, Rector NA. Online versus in-person delivery of cognitive behaviour therapy for obsessive compulsive disorder: An examination of effectiveness. Clin Psychol Psychother 2023. [PMID: 37699581 DOI: 10.1002/cpp.2908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/13/2023] [Accepted: 08/28/2023] [Indexed: 09/14/2023]
Abstract
Cognitive behavioural therapy (CBT) including exposure and response prevention is the first-line psychological treatment for obsessive compulsive disorder (OCD). Given changes in the clinical landscape, there are increasing efforts to evaluate its effectiveness in online contexts. Mirroring the traditional in-person delivery, few studies have assessed the role of therapist-guided, manual-based CBT for OCD delivered in real-time via videoconferencing methods. The present study sought to fill this gap by comparing in-person and online delivery of group-based CBT for the treatment of OCD. A convenience sample of participants with moderate to severe OCD (n = 144) were recruited from a naturalistic database from two large OCD specialty assessment and treatment centres. Patients received group-based CBT that was provided in-person (pre-COVID-19 pandemic; March 2018 to March 2020) or online via videoconferencing (during the COVID-19 pandemic; March 2020 to April 2021). In both delivery methods, treatment consisted of 2-h weekly sessions led by trained clinicians. Analyses revealed that, regardless of treatment modality, both in-person and online groups demonstrated significant, reliable, and statistically equivalent improvements in OCD symptoms post-treatment. Videoconferenced, clinician-led CBT may be a promising alternative to in-person delivery for those with moderate to severe OCD symptoms.
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Affiliation(s)
- Diana M Lisi
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Lance L Hawley
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Rowa
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Duncan H Cameron
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Margaret A Richter
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Neil A Rector
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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5
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Patrick AK, Ramsey KA, Essoe JKY, McGuire JF. Clinical Considerations for an Evidence-Based Assessment for Obsessive-Compulsive Disorder. Psychiatr Clin North Am 2023; 46:17-38. [PMID: 36740351 DOI: 10.1016/j.psc.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Obsessive-compulsive disorder (OCD) is an impairing mental health disease, generally beginning in childhood, affecting up to ∼3% of the population. Using evidence-based assessments (EBAs) is the starting point for the accurate diagnosis and treatment of OCD. EBAs consist of structured and semistructured clinician-administered interviews, parent-report and child-report, and self-report for adults. This article details the practical application, psychometric properties, and limitations of available assessments to determine the presence of OCD and evaluate OCD symptom severity. The following reviews measurement of constructs relevant to OCD (ie, insight, family accommodation, impairment) and details considerations for best clinical interview practices.
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Affiliation(s)
- Ainsley K Patrick
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21224, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Center for OCD, Anxiety, and Related Disorders for Children, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA
| | - Kesley A Ramsey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21224, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Center for OCD, Anxiety, and Related Disorders for Children, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA
| | - Joey K-Y Essoe
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21224, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Center for OCD, Anxiety, and Related Disorders for Children, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA
| | - Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 550 North Broadway, Baltimore, MD 21224, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Center for OCD, Anxiety, and Related Disorders for Children, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA.
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Lundström L, Flygare O, Ivanova E, Mataix-Cols D, Enander J, Pascal D, Chen LL, Andersson E, Rück C. Effectiveness of Internet-based cognitive-behavioural therapy for obsessive-compulsive disorder (OCD-NET) and body dysmorphic disorder (BDD-NET) in the Swedish public health system using the RE-AIM implementation framework. Internet Interv 2023; 31:100608. [PMID: 36852382 PMCID: PMC9958485 DOI: 10.1016/j.invent.2023.100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/02/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Objectives Therapist-guided internet-delivered cognitive behaviour therapy (ICBT) is an efficacious treatment for obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD), but it is unclear if the results obtained in controlled trials can be reproduced in clinical settings. We evaluated the implementation of ICBT for OCD (OCD-NET) and BDD (BDD-NET) in the Swedish public health system. Methods Consecutive referrals to an outpatient psychiatric clinic providing ICBT, with a primary diagnosis of OCD or BDD, were included in the study. Four hundred and thirty-four participants started OCD-NET and 163 started BDD-NET. The primary outcome measures were the Yale Brown Obsessive Compulsive Scale (Y-BOCS) and the Y-BOCS for BDD (BDD-YBOCS), respectively. Participants were assessed before treatment, weekly during treatment, and after treatment. The study used the RE-AIM implementation framework, and the elements of reach, effectiveness, adoption, and implementation for the evaluation. Results Intention to treat analysis of the OCD-NET sample (n = 434) showed a significant decrease in OCD symptoms from pre-treatment to post-treatment (mean reduction = -8.77 [95 % CI -9.48 to -8.05] p < .001, d = 1.94 [95 % CI 1.75 to 2.13]). Forty-nine percent (95 % CI 43 % to 56 %) of the participants in OCD-NET were classified as treatment responders and 21 % (95 % CI 16 % to 27 %) were in remission. Participants in BDD-NET (n = 163) also showed a significant decrease in BDD symptoms from pre-post treatment (mean reduction = -11.37 [95 % CI -12.9 to -9.87] p < .001, d = 2.07 [95 % CI 1.74 to 2.40]) and 69 % (95 % CI 58 % to 79 %) of the participants were classified as treatment responders and 48 % (95 % CI 38 % to 58 %) were in full or partial remission. Eighty-seven percent of the participants in OCD-NET and 78 % in BDD-NET were treatment completers and participants in both treatment groups reported a high treatment satisfaction at post treatment (OCD-NET = 87 %, BDD-NET = 79 %). The most reported negative effects attributed to the treatments were transient experiences of unpleasant feelings (52 %) and anxiety (50 %). The implementation also influenced treatment delivery and dramatically decreased the mean number of patients waiting to receive face-to-face treatment at the clinic. Conclusions Our results indicate that OCD-NET and BDD-NET are suitable treatments for implementation in a Swedish public health service.
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Affiliation(s)
- Lina Lundström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, SE-141 86 Stockholm, Sweden,Corresponding author at: Karolinska Institutet, M46, SE-14186 Huddinge, Sweden.
| | - Oskar Flygare
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Ekaterina Ivanova
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, SE-113 30 Stockholm, Sweden,Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Gävlegatan 22, SE-113 30 Stockholm, Sweden
| | - Jesper Enander
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Diana Pascal
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Long-Long Chen
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Erik Andersson
- Department of Clinical Neuroscience, Division of Psychology, Nobels väg 9, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
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7
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Sandoval-Lentisco A, López-Nicolás R, López-López JA, Sánchez-Meca J. Florida Obsessive-Compulsive Inventory and Children's Florida Obsessive Compulsive Inventory: A reliability generalization meta-analysis. J Clin Psychol 2023; 79:28-42. [PMID: 35849418 PMCID: PMC10084361 DOI: 10.1002/jclp.23416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/13/2022] [Accepted: 06/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The Florida Obsessive Compulsive Inventory (FOCI) and its pediatric version, the Children's Florida Obsessive Compulsive Inventory (C-FOCI), are instruments for evaluating obsessive-compulsive symptomatology. METHOD A reliability generalization meta-analysis was conducted to estimate an average reliability of the scores and to identify study characteristics that explained the heterogeneity among scores. Using Kuder-Richardson 20 (KR-20) and Cronbach's α, a total of 23 and 20 independent samples were included in the meta-analysis for the FOCI and C-FOCI. RESULTS We found an average KR-20 of 0.826 for the FOCI's Symptom Checklist and an α of 0.882 FOCI's Symptom Severity. An average KR-20 of 0.740 was found for the C-FOCI's Symptom Checklist, while an average α of 0.794 was found for the C-FOCI's Symptom Severity. Moderator analyses showed that the source of the coefficients (i.e., whether they were reported by the authors of the primary study or estimated by the meta-analysts) was an important variable for the FOCI Symptom Severity, and that the focus of the study (i.e., whether it was psychometric or applied) and the sample size were relevant for the C-FOCI Symptom Checklist. CONCLUSIONS Considering that the FOCI and C-FOCI are scales characterized by their brevity and ease of use, and the reliabilities obtained here, both scales are well suited for screening purposes.
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Affiliation(s)
| | - Rubén López-Nicolás
- Department of Basic Psychology and Methodology, University of Murcia, Murcia, Spain
| | | | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, University of Murcia, Murcia, Spain
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8
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Olofsdotter Lauri K, Aspvall K, Bagøien Hustad I, Malmqvist K, Serlachius E, Mataix‐Cols D, Rück C, Ivanov V, Andersson E. Initial evaluation of a therapist-supported online cognitive therapy self-help for patients with taboo obsessions. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:964-982. [PMID: 35429005 PMCID: PMC9790335 DOI: 10.1111/bjc.12369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/23/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The current study evaluated the feasibility of an internet-delivered cognitive therapy (I-CT) in a self-help format with minimal therapist support for patients with obsessive-compulsive disorder (OCD) with primary taboo obsessions. Specifically, the aims were to investigate (1) whether participants were able to grasp and apply the internet-delivered cognitive framework to their own situation; (2) whether they had clinically meaningful reductions of OCD symptom severity; and (3) whether reduced negative appraisals (hypothesized mechanism of change in CT) preceded reductions in OCD symptom severity. METHOD Nineteen OCD patients with primary taboo obsessions, recruited from an OCD clinic or self-referrals, received the I-CT intervention for 10 weeks. I-CT did not contain any systematic exposure or response prevention. RESULTS Adherence and engagement with the intervention was high. Most participants (n = 13, 68%) understood and successfully applied the cognitive model to their own situation. Within-group analyses showed large reductions in OCD symptom severity at post-treatment (bootstrapped within group d = 1.67 [95% CI; 0.67 to 2.66]) measured with the Yale-Brown Obsessive-Compulsive Scale. The gains were maintained at the 6-month follow-up. Post-hoc analyses revealed that the large reductions in OCD symptom severity were driven by the participants who understood the cognitive model. Reductions in negative appraisals predicted subsequent reductions in OCD symptom severity during treatment. CONCLUSION It is possible to adapt a purely cognitive intervention to a digital guided self-help format and to achieve both cognitive change and meaningful symptom reduction. The results require confirmation in a randomized clinical trial.
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Affiliation(s)
- Klara Olofsdotter Lauri
- Department of Clinical Neuroscience, Division of PsychologyKarolinska InstitutetStockholmSweden,Stockholm Health Care Services, Region StockholmStockholmSweden
| | - Kristina Aspvall
- Department of Clinical Neuroscience, Division of PsychologyKarolinska InstitutetStockholmSweden,Stockholm Health Care Services, Region StockholmStockholmSweden
| | | | - Karin Malmqvist
- Stockholm Health Care Services, Region StockholmStockholmSweden
| | - Eva Serlachius
- Department of Clinical Neuroscience, Division of PsychologyKarolinska InstitutetStockholmSweden,Stockholm Health Care Services, Region StockholmStockholmSweden
| | - David Mataix‐Cols
- Department of Clinical Neuroscience, Division of PsychologyKarolinska InstitutetStockholmSweden,Stockholm Health Care Services, Region StockholmStockholmSweden
| | - Christian Rück
- Stockholm Health Care Services, Region StockholmStockholmSweden
| | - Volen Ivanov
- Department of Clinical Neuroscience, Division of PsychologyKarolinska InstitutetStockholmSweden,Stockholm Health Care Services, Region StockholmStockholmSweden
| | - Erik Andersson
- Department of Clinical Neuroscience, Division of PsychologyKarolinska InstitutetStockholmSweden
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Moreira-de-Oliveira ME, de Menezes GB, Laurito LD, Loureiro CP, dos Santos-Ribeiro S, Fontenelle LF. A longitudinal evaluation of free will related cognitions in obsessive-compulsive disorder. BMC Psychiatry 2022; 22:463. [PMID: 35831831 PMCID: PMC9277897 DOI: 10.1186/s12888-022-04108-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 07/05/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Individuals with obsessive-compulsive disorder (OCD) often feel compelled to perform (compulsive) behaviors, thus raising questions regarding their free will beliefs and experiences. In the present study, we investigated if free will related cognitions (free will beliefs or experiences) differed between OCD patients and healthy subjects and whether these cognitions predicted symptom changes after a one-year follow up. METHODS Sixty OCD outpatients were assessed for their beliefs in and experiences of free will at baseline and after one year of treatment. A subsample of 18 OCD patients had their beliefs compared to 18 age and gender matched healthy controls. A regression analysis was performed to investigate whether free will cognitions at baseline were able to predict long-term OCD severity scores. RESULTS Patients with OCD and healthy controls do not seem to differ in terms of their beliefs in free will (U = 156.0; p = 0.864). Nonetheless, we found significant negative correlation between (i) duration of illness and strength of belief in determinism (ρ = -0.317; p = 0.016), (ii) age and perception of having alternative possibilities (ρ = -0.275; p = 0.038), and (iii) symptoms' severity and perception of having alternative possibilities (ρ = -0.415; p = 0.001). On the other hand, the experience of being an owner of ones' actions was positive correlated with the severity of symptoms (ρ = 0.538; p < 0.001) and were able to predict the severity of OCD symptoms at the follow up assessment. CONCLUSIONS Older individuals or those with a greater severity of symptoms seem to have a perception of decreased free will. In addition, patients with a longer duration of illness tend to have a lower strength of belief in determinism. Finally, the experience of being the owner of the compulsions, along with the baseline severity of symptoms, can be a predictor of a worse outcome in the OCD sample.
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Affiliation(s)
- Maria E. Moreira-de-Oliveira
- grid.472984.4D’Or Institute for Research and Education, Rua Diniz Cordeiro, 30, Rio de Janeiro, Botafogo 22281-100 Brazil ,grid.8536.80000 0001 2294 473XObsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gabriela B. de Menezes
- grid.472984.4D’Or Institute for Research and Education, Rua Diniz Cordeiro, 30, Rio de Janeiro, Botafogo 22281-100 Brazil ,grid.8536.80000 0001 2294 473XObsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luana D. Laurito
- grid.8536.80000 0001 2294 473XObsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carla P. Loureiro
- grid.8536.80000 0001 2294 473XObsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Samara dos Santos-Ribeiro
- grid.8536.80000 0001 2294 473XObsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo F. Fontenelle
- grid.472984.4D’Or Institute for Research and Education, Rua Diniz Cordeiro, 30, Rio de Janeiro, Botafogo 22281-100 Brazil ,grid.8536.80000 0001 2294 473XObsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil ,grid.1002.30000 0004 1936 7857Department of Psychiatry, Monash University, Clayton, VIC Australia
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10
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Messina G, Vetrano IG, Bonomo G, Broggi G. Role of deep brain stimulation in management of psychiatric disorders. PROGRESS IN BRAIN RESEARCH 2022; 270:61-96. [PMID: 35396031 DOI: 10.1016/bs.pbr.2022.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Nowadays, most of patients affected by psychiatric disorders are successfully treated with conservative therapies. Still, a variable percentage of them demonstrate resistance to conventional treatments, and alternative methods can then be considered. During the last 20 years, there is a progressive interest in use of deep brain stimulation (DBS) in mental illnesses. It has become clear nowadays, that this modality may be effectively applied under specific indications in some patients with major depressive disorder, obsessive-compulsive disorder, anorexia nervosa and other eating disorders, Tourette syndrome, schizophrenia, substance use disorder, and even pathologically aggressive behavior. Despite the fact that the efficacy of neuromodulation with DBS, as well as of various lesional interventions, in cases of mental illnesses is still not fully established, there are several premises for wider applications of such "unclassical" psychiatric treatments in the future. Novel technologies of DBS, developments in non-invasive lesioning using stereotactic radiosurgery and transcranial magnetic resonance-guided focused ultrasound, and advances of neurophysiological and neuroimaging modalities may bolster further clinical applications of psychiatric neurosurgery, improve its results, and allow for individually selected treatment strategies tailored to specific needs of the patient.
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Affiliation(s)
- Giuseppe Messina
- Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - Ignazio G Vetrano
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giulio Bonomo
- Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giovanni Broggi
- Functional Neurosurgery Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Department of Neurosurgery, M Cecilia Hospital-GVM, Ravenna, Italy
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11
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Yoon S, Yang Y, Ro E, Ahn WY, Kim J, Shin SH, Chey J, Choi KH. Reliability, and Convergent and Discriminant Validity of Gaming Disorder Scales: A Meta-Analysis. Front Psychol 2021; 12:764209. [PMID: 34950088 PMCID: PMC8689178 DOI: 10.3389/fpsyg.2021.764209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/10/2021] [Indexed: 12/29/2022] Open
Abstract
Background: An association between gaming disorder (GD) and the symptoms of common mental disorders is unraveled yet. In this preregistered study, we quantitatively synthesized reliability, convergent and discriminant validity of GD scales to examine association between GD and other constructs. Methods: Five representative GD instruments (GAS-7, AICA, IGDT-10, Lemmens IGD-9, and IGDS9-SF) were chosen based on recommendations by the previous systematic review study to conduct correlation meta-analyses and reliability generalization. A systematic literature search was conducted through Pubmed, Proquest, Embase, and Google Scholar to identify studies that reported information on either reliability or correlation with related variables. 2,124 studies were full-text assessed as of October 2020, and 184 were quantitatively synthesized. Conventional Hedges two-level meta-analytic method was utilized. Results: The result of reliability generalization reported a mean coefficient alpha of 0.86 (95% CI = 0.85-0.87) and a mean test-retest estimate of 0.86 (95% CI = 0.81-0.89). Estimated effect sizes of correlation between GD and the variables were as follows: 0.33 with depression (k = 45; number of effect sizes), 0.29 with anxiety (k = 37), 0.30 with aggression (k = 19), -0.22 with quality of life (k = 18), 0.29 with loneliness (k = 18), 0.56 with internet addiction (k = 20), and 0.40 with game playtime (k = 53), respectively. The result of moderator analyses, funnel and forest plots, and publication bias analyses were also presented. Discussion and Conclusion: All five GD instruments have good internal consistency and test-retest reliability. Relatively few studies reported the test-retest reliability. The result of correlation meta-analysis revealed that GD scores were only moderately associated with game playtime. Common psychological problems such as depression and anxiety were found to have a slightly smaller association with GD than the gaming behavior. GD scores were strongly correlated with internet addiction. Further studies should adopt a rigorous methodological procedure to unravel the bidirectional relationship between GD and other psychopathologies. Limitations: The current study did not include gray literature. The representativeness of the five tools included in the current study could be questioned. High heterogeneity is another limitation of the study. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42020219781].
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Affiliation(s)
- Seowon Yoon
- School of Psychology, Korea University, Seoul, South Korea
| | - Yeji Yang
- School of Psychology, Korea University, Seoul, South Korea
| | - Eunbin Ro
- School of Psychology, Korea University, Seoul, South Korea
| | - Woo-Young Ahn
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Jueun Kim
- Department of Psychology, Chungnam National University, Daejeon, South Korea
| | - Suk-Ho Shin
- Dr. Shin’s Neuropsychiatric Clinic, Seoul, South Korea
| | - Jeanyung Chey
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Kee-Hong Choi
- School of Psychology, Korea University, Seoul, South Korea
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12
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Núñez-Núñez RM, Rubio-Aparicio M, Marín-Martínez F, Sánchez-Meca J, López-Pina JA, López-López JA. A Reliability Generalization Meta-analysis of the Padua Inventory-Revised (PI-R). Int J Clin Health Psychol 2021; 22:100277. [PMID: 34703467 PMCID: PMC8517387 DOI: 10.1016/j.ijchp.2021.100277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/13/2021] [Indexed: 12/14/2022] Open
Abstract
Background/Objective: The Padua Inventory-Revised (PI-R) is a widely applied instrument to measure obsessive-compulsive symptoms in clinical and nonclinical samples. We conducted a reliability generalization meta-analysis on the PI-R. Method: An exhaustive literature search yielded 118 empirical studies that had applied the PI-R, from which 30 studies (33 samples) reported an original reliability estimate. Results: Assuming a random-effects model, the average internal consistency reliability (Cronbach's alpha) was .92 (95% CI [.91, .93]) for the total scores, and ranged from .74 to .89 for the subscales. Assuming mixed-effects models, moderator analyses showed a positive statistically significant association between the standard deviation of the total scores and the reliability coefficients (p = .002; R2 = .38). Conclusions: In terms of reliability, the PI-R scale was found to be adequate for both research and clinical purposes, although exhibiting large heterogeneity across studies. Future empirical studies using the PI-R should be required to provide at least one reliability estimate based on their own data.
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Affiliation(s)
- Rosa María Núñez-Núñez
- Department of Behavioural and Health Sciences, Miguel Hernández University, Elche, Spain
| | - María Rubio-Aparicio
- Department of Health Psychology, University of Alicante, Spain
- Corresponding author: Department of Health Psychology, Faculty of Health Science, University of Alicante, Carretera San Vicente del Raspeig, s/n, 03690 San Vicente del Raspeig (Alicante), Spain
| | | | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, University of Murcia, Spain
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13
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Sen S. A Reliability Generalization Meta-Analysis of Runco Ideational Behavior Scale. CREATIVITY RESEARCH JOURNAL 2021. [DOI: 10.1080/10400419.2021.1960719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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14
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Palazón-Bru A, Tomás Rodríguez MI, Mares-García E, Hernández-Sánchez S, Carbonell-Torregrosa MÁ, Gil-Guillén VF. The Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P): A Reliability Generalization Meta-analysis. Clin J Sport Med 2021; 31:455-464. [PMID: 32044845 DOI: 10.1097/jsm.0000000000000810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/26/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The Victorian Institute of Sport Assessment-Patella (VISA-P) is a questionnaire to assess the severity of patellar tendinopathies. Its use requires good reliability indicators: internal consistency, test-retest and parallel forms. Several studies have been published examining this question, but to date the reliability of this questionnaire (meta-analysis) has not been generalized. The aim of this study was to perform a meta-analysis to generalize the reliability of the VISA-P. DATA SOURCES MEDLINE, EMBASE, and Scopus. STUDY SELECTION Studies included were those examining the reliability coefficients of the VISA-P: Cronbach alpha, intraclass correlation coefficient (ICC), and parallel-forms (correlation coefficients compared with other scales). DATA EXTRACTION All coefficients were extracted and the mean reliability was obtained using fixed- or random-effects models. Sensitivity (leave-one-out analysis) was analyzed. Quality assessment was performed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. DATA SYNTHESIS Of 364 scientific articles, 12 fulfilled meta-analysis criteria. The summary statistic was 0.86 [95% confidence interval (CI): 0.78-0.92] for Cronbach alpha and 0.94 (95% CI: 0.89-0.97) for the ICC. Parallel forms depended on the comparative test used, ranging from -0.83 to 0.68. The sensitivity analysis found an influential study for the parallel-forms reliability in the Blazina score. We were unable to analyze the asymmetry of funnel plots and meta-regression models because of the number of studies. CONCLUSIONS The reliability of VISA-P for assessing the severity of patellar tendinopathies requires greater evaluation with more scientific evidence before it can be implemented in clinical practice.
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Affiliation(s)
- Antonio Palazón-Bru
- Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Alicante, Spain; and
| | - María Isabel Tomás Rodríguez
- Department of Pathology and Surgery, Center for Translational Research in Physiotherapy, Miguel Hernández University, San Juan de Alicante, Alicante, Spain
| | - Emma Mares-García
- Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Alicante, Spain; and
| | - Sergio Hernández-Sánchez
- Department of Pathology and Surgery, Center for Translational Research in Physiotherapy, Miguel Hernández University, San Juan de Alicante, Alicante, Spain
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15
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Huston JC, Thom RP, Ravichandran CT, Mullett JE, Moran C, Waxler JL, Pober BR, McDougle CJ. Repetitive Thoughts and Repetitive Behaviors in Williams Syndrome. J Autism Dev Disord 2021; 52:852-862. [PMID: 33837487 DOI: 10.1007/s10803-021-04979-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
The purpose of the study was to characterize repetitive phenomena in Williams syndrome (WS). The parents of 60 subjects with WS completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) or Children's Y-BOCS, the Yale Global Tic Severity Scale, the Stereotyped Behavior Scale, and the Spence Children's Anxiety Scale-Parent Version. Nineteen males and 41 females participated in the study. Six subjects (10%) had obsessions only, six (10%) had compulsions only, and eleven (18%) had at least one obsession and at least one compulsion. None of the subjects had tics. Fifty subjects (83.3%) endorsed at least one stereotypy. Increased anxiety was associated with increased severity of obsessions, but not severity of compulsions or stereotypies.
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Affiliation(s)
- John C Huston
- Department of Internal Medicine, Yale Medical School, 333 Cedar St, New Haven, CT, 06510, USA.,Lurie Center for Autism, 1 Maguire Road, Lexington, MA, 02421, USA
| | - Robyn P Thom
- Lurie Center for Autism, 1 Maguire Road, Lexington, MA, 02421, USA.,Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.,Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Caitlin T Ravichandran
- Lurie Center for Autism, 1 Maguire Road, Lexington, MA, 02421, USA.,Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.,Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.,McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA
| | - Jennifer E Mullett
- Lurie Center for Autism, 1 Maguire Road, Lexington, MA, 02421, USA.,Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Carly Moran
- Lurie Center for Autism, 1 Maguire Road, Lexington, MA, 02421, USA
| | - Jessica L Waxler
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Barbara R Pober
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Christopher J McDougle
- Lurie Center for Autism, 1 Maguire Road, Lexington, MA, 02421, USA. .,Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA. .,Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
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16
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Hudiburgh SE, Reese HE, Carver CS, Çek D, Timpano KR. A multi-method examination of the link between obsessive-compulsive symptomatology and emotion-related impulsivity. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 60:293-311. [PMID: 33836094 DOI: 10.1111/bjc.12290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/06/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Obsessive-compulsive disorder (OCD) is a condition marked by recurrent and distressing thoughts, images, and urges accompanied by repetitive physical or mental rituals. An emerging line of work suggests that emotion may be an important consideration when looking at the role of impulsivity across the spectrum of psychopathology, including OCD. The current study examined the relationship between obsessive-compulsive symptomatology (OCS) and impulsive cognitive and behavioural reactions to emotion using a multi-study, multi-method approach. DESIGN Data were collected cross-sectionally online (Study 1) or via an in-person laboratory visit (Study 2). METHODS In Study 1, self-report measures of impulsivity and OCS were administered to a large, non-selected community sample (N = 386). Study 2 extended these findings with a young adult sample (N = 107) with clinically elevated OCS using self-report measures, clinical interview, and two behavioural symptom provocation tasks. RESULTS Emotion-related impulsivity, but not non-emotion-related impulsivity, was associated with greater severity of OCS across symptom domains and across all modes of assessment. Impulsive cognitive responses to emotion were associated with greater obsession severity, while impulsive behavioural reactions to emotion were associated with greater compulsions. Emotion-related impulsivity also acted synergistically with a belief in the importance and control of thoughts, such that this established risk factor for OCD was associated with greater OCS severity only when behavioural reactivity to emotion was also present. CONCLUSIONS Results highlight the importance of considering emotional context when studying impulsivity in OCD, and point to the potentially differential relationship between OCS and behavioural versus cognitive impulsive reactions to emotion. PRACTITIONER POINTS Emotion-related impulsivity (ERI) reflects a tendency to act impulsively in the context of strong emotions. ERI was associated with greater OCS across symptom domains and type of symptom assessment (self-report, interview, or symptom provocation). ERI also interacted with an established OCS risk factor, a belief in the importance and control of thoughts, to predict symptom severity, suggesting that it may be important to evaluate and address ERI alongside unhelpful beliefs in patients with OCS. Given the present study's cross-sectional nature, we cannot draw conclusions about the directionality of the ERI - OCS relationship, and while our study included individuals with clinically elevated OCS, results should be replicated in a fully clinical sample.
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Affiliation(s)
| | | | | | - Demet Çek
- University of Miami, Coral Gables, Florida, USA
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17
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Naesström M, Hariz M, Strömsten L, Bodlund O, Blomstedt P. Deep Brain Stimulation in the Bed Nucleus of Stria Terminalis in Obsessive-Compulsive Disorder-1-Year Follow-up. World Neurosurg 2021; 149:e794-e802. [PMID: 33540102 DOI: 10.1016/j.wneu.2021.01.097] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) is under investigation as a treatment for therapy-refractory obsessive-compulsive disorder (OCD). As a crucial part of the anxiety circuit, the bed nucleus of stria terminalis (BNST) has been proposed as a target for DBS in OCD. Here, we investigate clinical outcomes and safety of DBS in the BNST in a series of 11 participants with severe therapy-refractory OCD. METHODS Eleven consecutive participants diagnosed with refractory OCD were treated with BNST DBS and completed follow-up. The primary outcome was a change in scores of the Yale Brown Obsessive Compulsive Scale (YBOCS) at 1 year after surgery. Secondary outcomes included changes in scores of the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Global Assessment of Functioning. RESULTS At baseline, the mean ± SD YBOCS score was 33 ± 3.0, MADRS score was 29 ± 4.5, and GAF score was 49 ± 5.4. One year after DBS, mean ± SD YBOCS score was 20 ± 4.8 (38% improvement (range 10%-60%) P < 0.01), MADRS score was 21 ± 5.8 (27% improvement, range 4%-74%, P < 0.01), and Global Assessment of Functioning score was 55 ± 6.5 (12% improvement, range 4%-29%, P < 0.05). Of the 11 participants, 6 were considered responders (decrease in YBOCS ≥35%) and 4 partial responders (decrease in YBOCS 25%-34%). Surgical adverse events included 1 case of skin infection leading to reimplantation. The most common transient stimulation-related side effects were anxiety and insomnia. CONCLUSIONS BNST DBS is a promising therapy in severe therapy-refractory OCD. Our results are in line with previous publications regarding effect and safety profile. Nevertheless, DBS for OCD remains an investigational therapy and should therefore be performed in multidisciplinary clinical studies.
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Affiliation(s)
- Matilda Naesström
- Department of Clinical Sciences/Psychiatry, Umeå University, Sweden.
| | - Marwan Hariz
- Unit of Deep Brain Stimulation, Department Clinical Sciences/Neuroscience, Umeå University, Sweden; Unit of Functional Neurosurgery, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Lotta Strömsten
- Department of Clinical Sciences/Psychiatry, Umeå University, Sweden
| | - Owe Bodlund
- Department of Clinical Sciences/Psychiatry, Umeå University, Sweden
| | - Patric Blomstedt
- Unit of Deep Brain Stimulation, Department Clinical Sciences/Neuroscience, Umeå University, Sweden
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18
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Sullivan CRP, Olsen S, Widge AS. Deep brain stimulation for psychiatric disorders: From focal brain targets to cognitive networks. Neuroimage 2021; 225:117515. [PMID: 33137473 PMCID: PMC7802517 DOI: 10.1016/j.neuroimage.2020.117515] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/19/2020] [Accepted: 10/24/2020] [Indexed: 01/16/2023] Open
Abstract
Deep brain stimulation (DBS) is a promising intervention for treatment-resistant psychiatric disorders, particularly major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). Up to 90% of patients who have not recovered with therapy or medication have reported benefit from DBS in open-label studies. Response rates in randomized controlled trials (RCTs), however, have been much lower. This has been argued to arise from surgical variability between sites, and recent psychiatric DBS research has focused on refining targeting through personalized imaging. Much less attention has been given to the fact that psychiatric disorders arise from dysfunction in distributed brain networks, and that DBS likely acts by altering communication within those networks. This is in part because psychiatric DBS research relies on subjective rating scales that make it difficult to identify network biomarkers. Here, we overview recent DBS RCT results in OCD and MDD, as well as the follow-on imaging studies. We present evidence for a new approach to studying DBS' mechanisms of action, focused on measuring objective cognitive/emotional deficits that underpin these and many other mental disorders. Further, we suggest that a focus on cognition could lead to reliable network biomarkers at an electrophysiologic level, especially those related to inter-regional synchrony of the local field potential (LFP). Developing the network neuroscience of DBS has the potential to finally unlock the potential of this highly specific therapy.
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Affiliation(s)
- Christi R P Sullivan
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
| | - Sarah Olsen
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
| | - Alik S Widge
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
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19
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Alternatives to Pharmacological and Psychotherapeutic Treatments in Psychiatric Disorders. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint2010001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Nowadays, most of the patients affected by psychiatric disorders are successfully treated with psychotherapy and pharmacotherapy. Nevertheless, according to the disease, a variable percentage of patients results resistant to such modalities, and alternative methods can then be considered. The purpose of this review is to summarize the techniques and results of invasive modalities for several treatment-resistant psychiatric diseases. A literature search was performed to provide an up-to-date review of advantages, disadvantages, efficacy, and complications of Deep-Brain Stimulation, Magnetic Resonance-guided Focused-Ultrasound, radiofrequency, and radiotherapy lesioning for depression, obsessive-compulsive disorder, schizophrenia, addiction, anorexia nervosa, and Tourette’s syndrome. The literature search did not strictly follow the criteria for a systematic review: due to the large differences in methodologies and patients’ cohort, we tried to identify the highest quality of available evidence for each technique. We present the data as a comprehensive, narrative review about the role, indication, safety, and results of the contemporary instrumental techniques that opened new therapeutic fields for selected patients unresponsive to psychotherapy and pharmacotherapy.
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20
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Zaccari V, Gragnani A, Pellegrini V, Caiazzo T, D'Arienzo MC, Magno A, Femia G, Mancini F. An Observational Study of OCD Patients Treated With Cognitive Behavioral Therapy During the COVID-19 Pandemic. Front Psychiatry 2021; 12:755744. [PMID: 34744841 PMCID: PMC8569247 DOI: 10.3389/fpsyt.2021.755744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/23/2021] [Indexed: 12/30/2022] Open
Abstract
Background and Objectives: While the consequences of the COVID-19 pandemic for general mental health and the increase in anxiety and depression are clear, less is known about the potential effect of the pandemic on OCD. The purpose of this study is to collect new data to monitor the symptomatic status of patients with OCD during the period of emergency due to COVID-19 and to make a comparison between two psychodiagnostic evaluations. Methods: Eleven OCD patients and their psychotherapists were recruited. All patients had a specific psychodiagnostic assessment for OCD (SCL-90; OCI-R; Y-BOCS self-report) performed between December 2019 and January 2020 (t0), and undertook cognitive behavioral therapy (CBT) and exposure and prevention of response protocol (ERP) before the lockdown. The psychodiagnostic assessment carried out at t0 was re-administered (t1) to all patients, together with a set of qualitative questions collected through an online survey. The respective therapists were asked to document the status of the therapy and the monitoring of symptoms through use of a semi-structured interview (Y-BOCS) and a qualitative interview. Non-parametric analyses were conducted. Results: Patients reported a significant decrease in OCD symptoms. Data analysis showed a decrease in the scores across t0 and at t1 on the Y-BOCS (SR) total self-report, and on OCD symptoms' severity assessed by means of the OCI-r and SCL-90 r OC subscale, for 11 participants. Relating to the measures detected by psychotherapists, marginally significant improvements and lower scores were found in the Y-BOCS (I). An improvement in symptoms was noticed by 90.9% of the clinical sample; this was confirmed by 45.4% of the therapists, who claimed moderate progress in their patients. Conclusions: The data collected through standardized measurements at two different times, albeit relative to a small sample, assume relevance from a clinical point of view. In the literature, some studies document the worsening of OCD. However, in many studies, the type of treatment, the detection time, and the intervention period are not well-specified. These results confirm the effectiveness of CBT/ERP as an elective treatment for OCD through a specific intervention procedure.
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Affiliation(s)
- Vittoria Zaccari
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy.,Department of Human Sciences, Marconi University, Rome, Italy
| | - Andrea Gragnani
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy
| | - Valerio Pellegrini
- Department of Social and Developmental Psychology Sapienza, University of Rome, Rome, Italy
| | - Tecla Caiazzo
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy
| | | | - Antonella Magno
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy
| | - Giuseppe Femia
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy
| | - Francesco Mancini
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy.,Department of Human Sciences, Marconi University, Rome, Italy
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21
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Hilbert K, Jacobi T, Kunas SL, Elsner B, Reuter B, Lueken U, Kathmann N. Identifying CBT non-response among OCD outpatients: A machine-learning approach. Psychother Res 2020; 31:52-62. [DOI: 10.1080/10503307.2020.1839140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Kevin Hilbert
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tanja Jacobi
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stefanie L. Kunas
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Björn Elsner
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Benedikt Reuter
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ulrike Lueken
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Norbert Kathmann
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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22
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Obsessive-Compulsive Disorder in Older Adults: A Comprehensive Literature Review. J Psychiatr Pract 2020; 26:175-184. [PMID: 32421289 DOI: 10.1097/pra.0000000000000463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We reviewed English-language articles concerning obsessive-compulsive disorder (OCD) in older adults. PubMed was searched using key words that included obsessive-compulsive disorder, geriatric, elderly, aging, and older. Of the 644 articles identified, we included 78 that were relevant to the topic. Articles that were excluded as irrelevant included studies that were not focused on OCD in older adults, animal studies, and older case reports if we identified similar more recent case reports. The literature contains very little information about the epidemiology, diagnosis, psychopathology, and treatment of OCD in older adults. Even though the diagnostic criteria for OCD are the same for older and younger adults, different manifestations and progression in older patients have been reported. While the domains and severity of symptoms of OCD do not change with age, pathologic doubt may worsen. The Yale-Brown Obsessive Compulsive Scale is used for diagnosing and evaluating illness severity, and the Obsessive-Compulsive Inventory-Revised is another valuable tool for use in older adults. Psychotherapy, specifically exposure and response prevention, is the first-line treatment for OCD because of minimal adverse effects and reported benefit. Although the US Food and Drug Administration has not approved any medications specifically for OCD in older adults, pharmacotherapy is a consideration if psychotherapy is not successful. Selective serotonin reuptake inhibitors have the fewest side effects, while the cardiovascular and anticholinergic side effects of tricyclic antidepressants are especially worrisome in older adults. OCD in older adults has received little attention, and further studies are needed.
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23
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Obsessive-Compulsive Disorder: Lesions. Stereotact Funct Neurosurg 2020. [DOI: 10.1007/978-3-030-34906-6_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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24
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Palazón-Bru A, Tomás-Rodríguez MI, Mares-García E, Gil-Guillén VF. A Reliability Generalization Meta-Analysis of the Victorian Institute of Sport Assessment Scale for Achilles Tendinopathy (VISA-A). Foot Ankle Int 2019; 40:430-438. [PMID: 30569746 DOI: 10.1177/1071100718816953] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND: A reliability generalization study of a questionnaire is necessary to provide higher-level evidence for its reliability. This has not been performed for the Victorian Institute of Sport Assessment-Achilles tendinopathy (VISA-A) questionnaire. The VISA-A has been a commonly used questionnaire to evaluate the symptoms of Achilles tendon disorders and their impact on physical activity, one of the most common disorders among athletes and sports persons (9%-40%). Furthermore, this questionnaire has been translated to several languages and due to its simplicity is one of the most widely used questionnaires for patients with this type of disorder. Therefore, we performed a reliability generalization study of the VISA-A using MEDLINE (through PubMed) and Scopus as data sources. METHODS: We selected studies that analyzed the reliability of the VISA-A by evaluating Cronbach's alpha, the intraclass correlation coefficient (ICC), and the Spearman correlation coefficients to compare VISA-A with similar scales. The data were analyzed using fixed- and random-effects models. We assessed sensitivity through the leave-one-out method. Quality analysis was performed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. RESULTS: Of a total of 263 studies (eliminating duplicates), 7 fulfilled inclusion criteria. The mean reliability was (1) Cronbach's alpha, 0.75 (95% CI, 0.70-0.79); (2) ICC, 0.91 (95% CI, 0.82-0.96); (3) correlation coefficient with the Curwin and Stanish grading system, -0.82 (95% CI, -0.93 to -0.56); and (4) correlation coefficient with the Percy and Conochie classification, 0.91 (95% CI, 0.87-0.93). We were unable to perform the funnel plot analysis and estimate meta-regression models. The Spearman correlation coefficients for both comparative scales showed influential studies (sensitivity analysis). CONCLUSION: Internal consistency and reproducibility were found to be good, but the parallel-forms reliability could not be supported. Therefore, more scientific evidence is needed to generalize the reliability of the VISA-A. LEVEL OF EVIDENCE: Level I, meta-analysis of literature.
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Affiliation(s)
- Antonio Palazón-Bru
- 1 Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Alicante, Spain
| | - María Isabel Tomás-Rodríguez
- 2 Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Miguel Hernández University, San Juan de Alicante, Alicante, Spain
| | - Emma Mares-García
- 1 Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Alicante, Spain
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Maternal unwanted and intrusive thoughts of infant-related harm, obsessive-compulsive disorder and depression in the perinatal period: study protocol. BMC Psychiatry 2019; 19:94. [PMID: 30898103 PMCID: PMC6429780 DOI: 10.1186/s12888-019-2067-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/21/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Unwanted, intrusive thoughts of harm-related to the infant are reported by the vast majority of new mothers, with half of all new mothers reporting unwanted, intrusive thoughts of harming their infant on purpose. Thoughts of intentional harm, in particular, are distressing to women, their partners and the people who care for them. While maternal, unwanted and intrusive thoughts of infant-related harm are known to be associated with obsessive compulsive disorder (OCD) and depression, preliminary evidence suggests that they are not associated with an increased risk of harm to infants. Perinatal care providers and policy makers, as well as new mothers and their partners require evidence-based information in order to respond appropriately to these types of thoughts. The purpose of this research is to address important gaps regarding the (a) prevalence and characteristics of intrusive, unwanted thoughts of baby-related harm, (b) their association (or lack thereof) with child abuse, and (c) the prevalence and course of obsessive-compulsive disorder and depression in the perinatal period. METHODS Participant were 763 English-speaking women and recruited during pregnancy. In this province-wide study in British Columbia, participants were recruited proportionally from hospitals, city centers and rural communities between January 23, 2014 and September 09, 2016. Participants were administered online questionnaires and diagnostic interviews over the phone at 33-weeks gestation, 7-weeks postpartum and 4-months postpartum. The study assessed intrusive and unwanted thoughts of harm related to the infant, obsessive-compulsive disorder (OCD) and major depressive episode (MDE) disorders and symptomatology, sleep, medical outcomes, parenting attitudes, and infant abuse. DISCUSSION There is a scarcity of literature concerning maternal unwanted, intrusive, postpartum thoughts of infant-related harm and their relationship to child harming behaviors, OCD and depression. This longitudinal cohort study was designed to build on the existing research base to ensure that policy developers, child protection workers and health-care providers have the guidance they need to respond appropriately to the disclosure of infant-related harm thoughts. Thus, its main goals will be to investigate whether intrusive postpartum thoughts of infant-related harm are a risk factor for child abuse or the development of OCD.
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Congruence and discrepancy between self-rated and clinician-rated symptom severity on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) before and after a low-intensity intervention. Psychiatry Res 2019; 273:595-602. [PMID: 30716599 DOI: 10.1016/j.psychres.2019.01.092] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 11/21/2022]
Abstract
The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most common measure of Obsessive-Compulsive symptom severity. The Y-BOCS interview is considered gold standard, but its self-rating format is increasingly used in clinical trials. Few studies investigated congruency and potential changes over treatment. This question is highly relevant, as a systematic bias might obscure results of clinical trials. We examined the relationship of self- and clinician-rated Y-BOCS scores in participants with obsessive-compulsive disorder in pre (N = 128), post, (4 weeks, n = 104) and follow-up (6 months, n = 98) assessments of a randomized-controlled clinical trial. We administered Y-BOCS interview via telephone paralleling online administration of the self-report form. Analyses showed medium-to-strong correlations of Y-BOCS interview and self-rating scores at pre-assessment. Patients rated symptoms lower than clinicians. Larger discrepancies were associated with hoarding and age. Congruency was inferior for obsessions relative to compulsions, largely owing to the "resistance against obsessions" item. Agreement strongly increased at post and follow-up. Though overall congruency between the two Y-BOCS forms was satisfactory, results suggest a "correction over time" effect. Such bias may distort the precise interpretation of treatment effects. Therefore, we made several suggestions to improve the reliability of change scores assessed with the Y-BOCS self-rating.
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Miller BK, Nicols KM, Clark S, Daniels A, Grant W. Meta-analysis of coefficient alpha for scores on the Narcissistic Personality Inventory. PLoS One 2018; 13:e0208331. [PMID: 30513127 PMCID: PMC6279043 DOI: 10.1371/journal.pone.0208331] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 11/15/2018] [Indexed: 12/30/2022] Open
Abstract
The Narcissistic Personality Inventory (NPI) has greatly facilitated the scientific study of trait narcissism. However, there is great variability in the reported reliability of scores on the NPI. This study meta-analyzes coefficient alpha for scores on the NPI and its sub-scales (e.g. entitlement) with transformed alphas weighted by the inverse of the variance of alpha. Three coders evaluated 1213 individual studies for possible inclusion and determined that 1122 independent samples were suitable for coding on 12 different characteristics of the sample, scale, and study. A fourth author cross-coded 15 percent of these samples resulting in 85 percent overall agreement. In the independent samples, comprised of 195,038 self-reports, the expected population coefficient alpha for the NPI was .82. The population value for alpha on the various sub-scales ranged from .48 for narcissistic self-sufficiency to .76 for narcissistic leadership/authority. Because significant heterogeneity existed in coded study alphas for the overall NPI, moderator tests and an explanatory model were also conducted and reported. It was found that longer scales, the use of a Likert response scale as opposed to the original forced choice response format, higher mean scores and larger standard deviations on the scale, as well as the use of samples with a larger percentage of female respondents were all positively related to the expected population alpha for scores on the overall NPI. These results will likely aid researchers who are concerned with the reliability of scores on the NPI in their research on non-clinical subjects.
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Affiliation(s)
- Brian K. Miller
- Department of Management, Texas State University, San Marcos, Texas, United States of America
- * E-mail:
| | - Kay M. Nicols
- Department of Management, Texas State University, San Marcos, Texas, United States of America
| | - Silvia Clark
- Department of Management, University of South Carolina, Columbia, South Carolina, United States of America
| | - Alison Daniels
- Department of Management, Texas State University, San Marcos, Texas, United States of America
| | - Whitney Grant
- Department of Management, Texas State University, San Marcos, Texas, United States of America
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Rubio-Aparicio M, Núñez-Núñez RM, Sánchez-Meca J, López-Pina JA, Marín-Martínez F, López-López JA. The Padua Inventory-Washington State University Revision of Obsessions and Compulsions: A Reliability Generalization Meta-Analysis. J Pers Assess 2018; 102:113-123. [PMID: 30089225 DOI: 10.1080/00223891.2018.1483378] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The Padua Inventory-Washington State University Revision (PI-WSUR) is a frequently used test to assess obsessive-compulsive symptoms in screening and clinical contexts. A reliability generalization meta-analysis was carried out to estimate the average reliability of the PI-WSUR scores and its subscales and to search for characteristics of the studies that can explain the heterogeneity among reliability coefficients. A total of 124 independent samples reported some coefficient alpha or test-retest correlation with the data at hand for the PI-WSUR scores. The average internal consistency reliability of the PI-WSUR total scores was .929 (95% CI [.922, .936]), and for the subscales, the means ranged from .792 to .900. The test-retest reliability for PI-WSUR total scores was .767 (95% CI [.700, .820]), with the subscales ranging from .540 to .790. Moderator analyses revealed a positive relationship between the standard deviation of PI-WSUR total scores and alpha coefficients, as well as higher reliability estimates for the original version of the test and for studies from North America. The reliability induction rate for the PI-WSUR was 53.7%. Regarding reliability, the PI-WSUR ranks among the best scales for assessing obsessive-compulsive symptoms. Internal consistency reliability was excellent for the PI-WSUR total score and good for the subscales.
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Affiliation(s)
- María Rubio-Aparicio
- Department of Basic Psychology and Methodology, Faculty of Psychology, Espinardo Campus, University of Murcia, Murcia, Spain
| | - Rosa M Núñez-Núñez
- Department of Health Psychology, Faculty of Social and Legal Sciences, Miguel Hernández University, Elche, Spain
| | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, Faculty of Psychology, Espinardo Campus, University of Murcia, Murcia, Spain
| | - José Antonio López-Pina
- Department of Basic Psychology and Methodology, Faculty of Psychology, Espinardo Campus, University of Murcia, Murcia, Spain
| | - Fulgencio Marín-Martínez
- Department of Basic Psychology and Methodology, Faculty of Psychology, Espinardo Campus, University of Murcia, Murcia, Spain
| | - José Antonio López-López
- School of Social and Community Medicine, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
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Variability of Coefficient Alpha: An Empirical Investigation of the Scales of Psychological Wellbeing. REVIEW OF GENERAL PSYCHOLOGY 2017. [DOI: 10.1037/gpr0000112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Using reliability generalization analysis, the purpose of this study was to characterize the average score reliability, the variability of the score reliability estimates, and explore possible characteristics (e.g., sample size) that influence the reliability of scores across studies using the Scales of Psychological Wellbeing (PWB; Ryff, 1989 , 2014 ). Published studies were included in this investigation if they appeared in a peer-reviewed journal, used 1 or more PWB subscales, estimated coefficient alpha value(s) for the PWB subscale(s), and were written in English. Of the 924 articles generated by the search strategy, a total of 264 were included in the final sample for meta-analysis. The average value reported for coefficient alpha referencing the composite PWB Scale was 0.858, with mean coefficient alphas ranging from 0.722 for the autonomy subscale to 0.801 for the self-acceptance subscale. The 95% prediction intervals ranged from [.653, .996] for the composite PWB. The lower bound of the prediction intervals for specific subscales were >.350. Moderator analyses revealed significant differences in score reliability estimates across select sample and test characteristics. Most notably, R2 values linked with test length ranged from 40% to 71%. Concerns were identified with the use of the 3-item per PWB subscale which reinforces claims advanced by Ryff (2014) . Suggestions for researchers using the PWB are advanced which span measurement considerations and standards of reporting. Psychological researchers who calculate score reliability estimates within their own work should recognize the implications of alpha coefficient values on validity, null hypothesis significant testing, and effect sizes.
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PANDAS: A systematic review of treatment options. Int J Pediatr Otorhinolaryngol 2016; 89:149-53. [PMID: 27619047 DOI: 10.1016/j.ijporl.2016.08.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/09/2016] [Accepted: 08/10/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) is a rare but important condition for pediatric otolaryngologists to recognize. Several treatment options exist including tonsillectomy, antibiotic treatment/prophylaxis, intravenous immunoglobulin (IVIG), and psychiatric medications/therapy. METHODS A systematic review of the PubMed, EMBASE, and Scopus databases was performed searching for articles that focused exclusively on the aforementioned treatment modalities in the PANDAS population. Review articles, single patient case reports, and studies examining the natural history or diagnostic strategies were excluded. RESULTS Five articles regarding tonsillectomy treatments with level of evidence (LOE) 4 were found but no clear benefit could be determined. Three articles were selected involving the use of antibiotic therapy. One prospective study and one double-blind randomized control trial (DB RCT) supported the use of antibiotics but a separate DB RCT showed no benefit. Two selected articles described the use of IVIG: one unblinded RCT and one retrospective study. One prospective study on cognitive-behavioral therapy (CBT) showed benefit in PANDAS. CONCLUSION There is a paucity of high-level studies regarding this rare disorder and no hard treatment recommendations can be made. Tonsillectomy should only be performed in those who are surgical candidates based on current published guidelines. Antibiotics are an option but provide uncertain benefit. CBT remains a low-risk option. Studies support the use of IVIG, however more investigation is needed prior to widespread adoption of this treatment given its potential risks.
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