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Projected changes to post-traumatic stress disorder (PTSD) diagnostic criteria in the upcoming International Classification of Diseases (ICD)-11 may affect the prevalence and severity of identified cases. This study examined differences in rates, severity, and overlap of diagnoses using ICD-10 and ICD-11 PTSD diagnostic criteria during consecutive assessments of recent survivors of traumatic events.
The study sample comprised 3863 survivors of traumatic events, evaluated in 11 longitudinal studies of PTSD. ICD-10 and ICD-11 diagnostic rules were applied to the Clinician-Administered PTSD Scale (CAPS) to derive ICD-10 and ICD-11 diagnoses at different time intervals between trauma occurrence and 15 months.
The ICD-11 criteria identified fewer cases than the ICD-10 across assessment intervals (range −47.09% to −57.14%). Over 97% of ICD-11 PTSD cases met concurrent ICD-10 PTSD criteria. PTSD symptom severity of individuals identified by the ICD-11 criteria (CAPS total scores) was 31.38–36.49% higher than those identified by ICD-10 criteria alone. The latter, however, had CAPS scores indicative of moderate PTSD. ICD-11 was associated with similar or higher rates of comorbid mood and anxiety disorders. Individuals identified by either ICD-10 or ICD-11 shortly after traumatic events had similar longitudinal course.
This study indicates that significantly fewer individuals would be diagnosed with PTSD using the proposed ICD-11 criteria. Though ICD-11 criteria identify more severe cases, those meeting ICD-10 but not ICD-11 criteria remain in the moderate range of PTSD symptoms. Use of ICD-11 criteria will have critical implications for case identification in clinical practice, national reporting, and research.
Empirical data on the use of services due to mental health problems in older adults in Europe is lacking. The objective of this study is to identify factors associated with service utilization in the elderly.
As part of the MentDis_ICF65+ study, N = 3,142 people aged 65–84 living in the community in six European and associated countries were interviewed. Based on Andersen's behavioral model predisposing, enabling, and need factors were analyzed with logistic regression analyses.
Overall, 7% of elderly and 11% of those with a mental disorder had used a service due to mental health problems in the last 12 months. Factors significantly associated with underuse were male sex, lower education, living in the London catchment area, higher functional impairment and more comorbid mental disorders. The most frequently reported barrier to service use was personal beliefs, e.g. “I can deal with my problem on my own” (90%).
Underutilization of mental health services among older people in the European community is common and interventions are needed to achieve an adequate use of services.
be a finite almost simple group. It is well known that
can be generated by three elements, and in previous work we showed that 6 generators suffice for all maximal subgroups of
. In this paper, we consider subgroups at the next level of the subgroup lattice—the so-called second maximal subgroups. We prove that with the possible exception of some families of rank 1 groups of Lie type, the number of generators of every second maximal subgroup of
is bounded by an absolute constant. We also show that such a bound holds without any exceptions if and only if there are only finitely many primes
for which there is a prime power
is prime. The latter statement is a formidable open problem in Number Theory. Applications to random generation and polynomial growth are also given.
Except for dementia and depression, little is known about common mental disorders in elderly people.
To estimate current, 12-month and lifetime prevalence rates of mental disorders in different European and associated countries using a standardised diagnostic interview adapted to measure the cognitive needs of elderly people.
The MentDis_ICF65+ study is based on an age-stratified, random sample of 3142 older men and women (65–84 years) living in selected catchment community areas of participating countries.
One in two individuals had experienced a mental disorder in their lifetime, one in three within the past year and nearly one in four currently had a mental disorder. The most prevalent disorders were anxiety disorders, followed by affective and substance-related disorders.
Compared with previous studies we found substantially higher prevalence rates for most mental disorders. These findings underscore the need for improving diagnostic assessments adapted to the cognitive capacity of elderly people. There is a need to raise awareness of psychosocial problems in elderly people and to deliver high-quality mental health services to these individuals.
Two independent lines of inquiry suggest that growing up under conditions of contextual adversity (e.g., poverty and household chaos) accelerates aging and undermines long-term health. Whereas work addressing the developmental origins of health and disease highlights accelerated-aging effects of contextual adversity on telomere erosion, that informed by an evolutionary analysis of reproductive strategies highlights such effects with regard to pubertal development (in females). That both shorter telomeres early in life and earlier age of menarche are associated with poor health later in life raises the prospect, consistent with evolutionary life-history theory, that these two bodies of theory and research are tapping into the same evolutionary–developmental process whereby longer term health costs are traded off for increased probability of reproducing before dying via a process of accelerated aging. Here we make the case for such a claim, while highlighting biological processes responsible for these effects, as well as unknowns in the epigenetic equation that might instantiate these contextually regulated developmental processes.
We study the distribution of products of conjugacy classes in finite simple groups, obtaining effective two-step mixing results, which give rise to an approximation to a conjecture of Thompson.
Our results, combined with work of Gowers and Viola, also lead to the solution of recent conjectures they posed on interleaved products and related complexity lower bounds, extending their work on the groups SL(2, q) to all (non-abelian) finite simple groups.
In particular it follows that, if G is a finite simple group, and A, B ⊆ Gt for t ⩾ 2 are subsets of fixed positive densities, then, as a = (a1, . . ., at) ∈ A and b = (b1, . . ., bt) ∈ B are chosen uniformly, the interleaved product a • b:=a1b1 . . . atbt is almost uniform on G (with quantitative estimates) with respect to the ℓ∞-norm.
It also follows that the communication complexity of an old decision problem related to interleaved products of a, b ∈ Gt is at least Ω(t log |G|) when G is a finite simple group of Lie type of bounded rank, and at least Ω(t log log |G|) when G is any finite simple group. Both these bounds are best possible.
With the establishment of the State of Israel and the enactment of sec. 11 of the Law and Administration Ordinance, 1948, Israeli law absorbed the Mandatory law which had applied prior to independence. Israeli contract law of forty years ago was comprised of two main components: Ottoman law and English law.
The component of Ottoman law consisted primarily of the Mejelle and of the substantive provisions of the Ottoman Code of Civil Procedure. Some of the books of the Mejelle regulated important contractual transactions, such as sale and lease. The Ottoman Code of Civil Procedure included provisions concerning compensation for damage, but the most important and significant provision was sec. 64, which established, in our law, the principle of freedom of contract. By virtue of this section, validity was conferred upon all contracts made in Israel, except those contrary to statutory law, to morality or to public order, and the power of the parties to a contract to contract out of the provisions of the Mejelle was accorded recognition.
The Contracts (General Part) Law, 1973, is the fundamental statute in Israeli contract law, and will in the future serve as the basis for the codification of Israel civil law. The Law was enacted following a decade of meticulous preparatory work by a committee headed by Professor Tedeschi. Prof. Tedeschi was the leading intellectual force in this committee; his influence is apparent in the approaches, principles and concepts of the Law, as well as in its particular provisions. Prof. Tedeschi also devoted a part of his prolific writings to the realm of contracts law. This article, dealing with only two sections of the wide-ranging Contracts (General Part) Law, is dedicated with admiration to the father of Israeli modern contract law.
The law's treatment of abortion has undergone a fundamental transformation in the present century which has been marked by a clear trend towards decriminalization of the matter vis-à-vis the abortionist and the woman. The increasing secularization of society, the advance of libertarian thinking in western democracies and the movement towards social equality for women has increasingly led to the view that the abortion decision is one which properly belongs to the private realm of the individual woman. This view has been reinforced by utilitarian arguments founded on acknowledgement of the fact that the criminal prohibition has always been evaded by a resort to illegal procedures with all the danger to the woman's health that this entails.
Despite religious and moral objections based on the interest in protecting fetal life, the law has responded to pressures for the legitimization of abortion in varying degrees. In some countries abortion has been totally decriminalized and indeed made available on demand; in others decriminalization has been only partial and abortion allowed only upon a showing of cause defined by statute (abortion on cause) or only at certain stages of pregnancy.
On the whole, the law has remained silent as to the status of the father in the abortion decision; in any event he was not subject to any criminal sanction.
The legal debate concerning political agreements has lately won renewed interest in Israel, following some disturbing incidents that took place just prior to the establishment of the present government. These events, which were referred to by Justice Elon as “a weakness of political culture” and even “political eclipse”, have forced the High Court of Justice to deal with a number of petitions concerning political agreements over the past year. The Legislature also has had to give this matter considerable attention; the Basic Law: The Knesset, Amendment no. 12, allows for amending and even preventing disruptive phenomena such as political defection which tend to occur alongside political agreements.
Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs.
General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. Survival analysis was carried out to examine associations of sociodemographic characteristics and prior traumatic events with subsequent exposure.
Over 70% of respondents reported a traumatic event; 30.5% were exposed to four or more. Five types – witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury – accounted for over half of all exposures. Exposure varied by country, sociodemographics and history of prior traumatic events. Being married was the most consistent protective factor. Exposure to interpersonal violence had the strongest associations with subsequent traumatic events.
Given the near ubiquity of exposure, limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence. Identifying mechanisms that account for the associations of prior interpersonal violence with subsequent trauma is critical to develop interventions to prevent revictimization.