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Although psychoeducation is generally recommended for the treatment of adult attention-deficit hyperactivity disorder (ADHD), participation in clinical psychoeducation groups is impeded by waiting times and the constrained number of patients who can simultaneously attend a group. Digital psychoeducation attempts are promising, but the rapidly expanding number of apps lack evidence and are mostly limited to only a few implemented interactive elements.
To determine the potential of digital, self-guided psychoeducation for adult ADHD, a newly developed interactive chatbot was compared with a previously validated, conventional psychoeducation app.
Forty adults with ADHD were randomised, of whom 17 participants in each group completed self-guided psychoeducation based on either a chatbot or conventional psychoeducation app between October 2020 and July 2021. ADHD core symptoms were assessed before and after the 3-week interventions, using both the blinded observer-rated Integrated Diagnosis of ADHD in Adulthood interview and the self-rated ADHD Self-Assessment Scale (ADHS-SB).
Observer- and patient-rated ADHD symptoms were significantly reduced from pre- to post-intervention (observer-rated: mean difference −6.18, 95% CI −8.06 to −4.29; patient-rated: mean difference −2.82, 95% CI −4.98 to −0.67). However, there were no group × intervention interaction effects that would indicate a stronger therapeutic benefit of one of the interventions. Likewise, administered psychoeducational knowledge quizzes did not show differences between the groups. No adverse events were reported.
Self-guided psychoeducation based on a chatbot or a conventional app appears similarly effective and safe for improving ADHD core symptoms. Future research should compare additional control interventions and examine patient-related outcomes and usability preferences in detail.
Mutual wills have attracted little interest among legal scholars. Partly, no doubt, this is because only a few jurisdictions recognise their validity, and in some of these they have fallen out of fashion. This is somewhat surprising since, in the past, mutual wills were in use almost all over Europe, especially in the northern regions, and they were widespread in a number of jurisdictions which consider them unlawful today. Developed by custom in the late Middle Ages, mutual wills were recognised as a valid legal instrument in the ius commune. Until the age of codification, they represented a valuable device for families to protect their estates and dispose of them in a way which was consistent with their long-term objectives. In many cases they provided a mechanism of guaranteeing rights of enjoyment to the survivor while at the same time assigning certain items of property to selected beneficiaries.
But if this is so, why did the process of codification often bring about the demise of this legal instrument? In order to understand the reasons, it is first necessary to consider the characteristics of mutual wills. This task is less easy than one would think, for the definitions given in those countries which recognise mutual wills are not uniform. This can be explained to a certain degree by the existence of a broad spectrum of mutual wills.
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