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Patient's outgroup socialization may be a problem in the psychotherapeutic group functioning. Disadvantages – and even benefits – of this common issue in psychotherapy have been described (Vinogradov S., Yalom I.). However, the impact of new social networks – that facilitate other ways of immediate and easy communication – on this phenomenon is still unknown.
Aims and objectives
To explore the risks of spontaneous “self-help groups” supported by new technologies for the psychotherapeutic group functioning.
Course description of a psychotherapeutic group, composed by patients with eating disorders (bulimia nervosa and binge eating disorder) in the context of a specialized hospital day.
A patient – who has recently had a breakup – asked help to the group through a non-reported whatsapp chat. Gradually, patients used this new channel to express distress and daily interpersonal difficulties, showing less implication in the supervised group sessions. The patient presented a symptomatic relapse with self-harm injuries and severe eating symptoms. Finally, she left the therapy and, in the next weeks, other patients also left the group, due to different reasons, in a “drag phenomenon”. The analysis showed that the formation of this outgroup socialization changed the relationships between members and new roles were taken.
It is necessary to early address the formation of outgroup socialization in the pre-group interview, emphasizing its high risk for the future group functioning. Therapists should consider that out-group communication is common and easy due to new technologies, so the use of specific questionnaires about this issue may prevent or detect pathological events.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To discuss the potential usefulness of a public health approach for ‘mental health and psychosocial support’ (MHPSS) interventions in humanitarian settings.
Building on public mental health terminology in accordance with recent literature on this topic and considering existing international consensus guidelines on MHPSS interventions in humanitarian settings, this paper reflects on the relevance of the language of promotion and prevention for supporting the rationale, design and evaluation of interventions, with a particular focus on populations affected by disasters and conflicts in low- and middle-income countries.
A public mental health approach and associated terminology can form a useful framework in the design and evaluation of MHPSS interventions, and may contribute to reducing a divisive split between ‘mental health’ and ‘psychosocial’ practice in the humanitarian field. Many of the most commonly implemented MHPSS interventions in humanitarian settings can be described in terms of promotion and prevention terminology.
The use of a common terminology across health, protection, education, nutrition and other relevant sectors providing humanitarian interventions has the potential to allow for integration of MHPSS activities in one overall framework, with diverse humanitarian practitioners working to achieve a common goal.
Dimensional models of co-morbidity have the potential to improve the conceptualization of mental disorders in research and clinical work, yet little is known about how relatively uncommon disorders may fit with more common disorders. The present study estimated the meta-structure of psychopathology in the US general population focusing on the placement of five under-studied disorders sharing features of thought disorder: paranoid, schizoid, avoidant and schizotypal personality disorders, and manic episodes as well as bipolar disorder.
Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a face-to-face interview of 34 653 non-institutionalized adults in the US general population. The meta-structure of 16 DSM-IV Axis I and Axis II psychiatric disorders, as assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version (AUDADIS-IV), was examined using exploratory and confirmatory factor analysis.
We document an empirically derived thought disorder factor that is a subdomain of the internalizing dimension, characterized by schizoid, paranoid, schizotypal and avoidant personality disorders as well as manic episodes. Manic episodes exhibit notable associations with both the distress subdomain of the internalizing dimension as well as the thought disorder subdomain. The structure was replicated for bipolar disorder (I or II) in place of manic episodes.
As our understanding of psychopathological meta-structure expands, incorporation of disorders characterized by detachment and psychoticism grows increasingly important. Disorders characterized by detachment and psychoticism may be well conceptualized, organized and measured as a subdimension of the internalizing spectrum of disorders. Manic episodes and bipolar disorder exhibit substantial co-morbidity across both distress and thought disorder domains of the internalizing dimension. Clinically, these results underscore the potential utility of conceptualizing patient treatment needs using an approach targeting psychopathological systems underlying meta-structural classification rubrics.
In paediatric practice, mean reference energy requirements for groups are often used to predict individual infant energy requirements. References from the FAO/WHO/United Nations University are based on infants not fed according to the current infant feeding recommendations. The objective of the present study was to measure total energy expenditure (TEE) and determine energy requirements using criterion methods, and validate the use of TEE prediction equation and mean energy requirement references for predicting individual TEE and energy requirements, respectively, in infants who were exclusively breast-fed (EBF) to 6 months of age. EBF infants were included from Greater Glasgow for measurements at 3·5 (n 36) and 6 (n 33) months of age. TEE was measured using doubly labelled water and energy requirements were determined using the factorial approach. TEE and energy requirements were also predicted using equations based on body weight. Relationships between criterion methods and predictions were assessed using correlations. Paired t tests and Bland–Altman plots were used to assess agreement. At the population level, predicted and measured TEE were similar. The energy requirement reference significantly underestimated energy requirements by 7·2 % at 3·5 months at the population level, but there was no bias at 6 months. Errors at individual levels were large and energy requirements were underestimated to a larger extent for infants with higher energy requirements. This indicates that references presently used in clinical practice to estimate energy requirements may not fully account for the different growth pattern of EBF infants. More studies in infants EBF to 6 months of age are needed to understand how growth of EBF infants influences energy requirements.
Studies have criticized the low level of agreement between the various methods of personality disorder (PD) assessment. This is an important issue for research and clinical purposes.
Seven hundred and forty-two participants in the Hopkins Epidemiology of Personality Disorders Study (HEPS) were assessed on two occasions using the Personality Disorder Schedule (PDS) and the International Personality Disorder Examination (IPDE). The concordance between the two diagnostic methods for all DSM-IV PDs was assessed using standard methods and also two item response analytic approaches designed to take account of measurement error: a latent trait-based approach and a generalized estimating equations (GEE)-based approach, with post-hoc adjustment.
Raw criteria counts, using the intraclass correlation coefficient (ICC), κ and odds ratio (OR), showed poor concordance. The more refined statistical methods showed a moderate to moderately high level of concordance between the methods for most PDs studied. Overall, the PDS produced lower prevalences of traits but higher precision of measurement than the IPDE. Specific criteria within each PD showed varying endorsement thresholds and precision for ascertaining the disorder.
Concordance in the raw measurement of the individual PD criteria between the two clinical methods is lacking. However, based on two statistical methods that adjust for differential endorsement thresholds and measurement error in the assessments, we deduce that the PD constructs themselves can be measured with a moderate degree of confidence regardless of the clinical approach used. This may suggest that the individual criteria for each PD are, in and of themselves, less specific for diagnosis, but as a group the criteria for each PD usefully identify specific PD constructs.
High-resolution laser-Doppler anemometer measurements were acquired in a two-dimensional turbulent boundary layer over a $4^\circ$ ramp. The goals were to provide a detailed data set for an adverse pressure gradient boundary layer far from separation and to examine near-wall behaviour of the Reynolds stresses as compared to flat-plate boundary layers. The flow develops over a flat plate, reaching a momentum thickness Reynolds number of 3350 at an upstream reference location. The boundary layer is then subjected to a varying pressure gradient along the length of the ramp and partially redevelops on a downstream flat plate. Mean velocity measurements show a log law region in all velocity profiles, but the outer layer does not collapse in deficit coordinates indicating that the boundary layer is not in equilibrium. Measurements of non-dimensional stress ratios and quadrant analysis of the two-component data indicate relatively small changes to the turbulence structure. However, the streamwise normal stress has an extended outer layer plateau, and the shear stress and wall-normal stress have outer layer peaks. Near the wall, the streamwise normal stress and shear stress collapse with flat-plate data using standard scaling, but the wall normal stress is substantially larger than flat-plate cases.
Measurements in the turbulent momentum and thermal boundary layers on a rotating
disk with a uniform heat flux surface are described for Reynolds numbers up to 106.
Measurements include mean velocities and temperatures, all six Reynolds stresses,
turbulent temperature fluctuations, and three turbulent heat fluxes. The mean velocity
profiles have no wake region, but the mean temperature profiles do. The turbulent
temperature fluctuations have a large peak in the outer layer, and there is a third
turbulent heat flux in the cross-flow direction. Correlation coefficients and structure
parameters are not constant across the boundary layer as they are in two-dimensional
boundary layers (2DBLs), and their values are lower. The turbulent Prandtl number
agrees with 2DBL values in the lower part of the outer region but is reduced from the
2DBL values higher in the boundary layer. In the outer region of the boundary layer,
the transport processes differ significantly from what is observed in two-dimensional
turbulent boundary layers: ejections dominate the transport of momentum while both
ejections and sweeps contribute to the transport of the passive scalar.
We study the stability of linear filters associated with certain types of linear difference equations with variable coefficients. We show that stability is determined by the locations of the poles of a rational transfer function relative to the spectrum of an associated weighted shift operator. The known theory for filters associated with constant-coefficient difference equations is a special case.
The evolution of the turbulent boundary layer over a bump defined by three tangential circular arcs and swept at 45° was examined. The flat-plate boundary layer approaching the swept bump had a momentum thickness Reynolds number of approximately 3800. The ratios of upstream boundary-layer thickness to bump height and convex radius of curvature were 1.5 and 0.06, respectively. The boundary layer was influenced by alternating signs of streamwise pressure gradient, wall curvature, and mean crossflow, which resulted in a complex boundary-layer flow that grew rapidly on the downstream side of the bump. The mean flow profiles deviated significantly from typical logarithmic layer behaviour, but the flow remained attached. The evolution of the Reynolds stress components was explained by the growth of two internal layers triggered by discontinuities in wall curvature near the leading and trailing edges of the bump. The shear stress vector was found to lag the velocity gradient vector, despite the spanwise flow changing direction above the bump. The measurements were compared to the previous results from a two-dimensional bump with the same profile shape and Reynolds number. Contrary to previous studies, the addition of mean crossflow to this complex flow field did not reduce the vertical mixing relative to the turbulent kinetic energy.
The turbulent flow development was examined for a two-dimensional boundary layer over a bump. The upstream boundary layer had a momentum-thickness. Reynolds number of approximately 4030. The ratios of upstream boundary layer thickness to bump height and convex radius of curvature were 1.5 and 0.06, respectively. The bump was defined by three tangential circular arcs, which subjected the flow to alternating signs of pressure gradient and surface curvature. The boundary layer grew rapidly on the downstream side of the bump but did not separate. The mean velocity profiles deviated significantly from the law of the wall above the bump. The change from concave to convex surface curvature near the leading edge triggered an internal boundary layer, as shown by knee points in the turbulent stress profiles. The internal layer grew rapidly away from the wall on the downstream side of the bump owing to the adverse pressure gradient. The effect of convex surface curvature was considered small since the flow behaviour was generally explained by the effects due to streamwise pressure gradient. A second internal layer was triggered by the change from convex to concave curvature near the trailing edge. The boundary layer recovered rapidly in the downstream section and approached typical flat-plate boundary layer behaviour at the last measurement location.
Associations between affective disorders, anxiety disorders, and substance use disorders were examined in epidemiological studies conducted in Germany, Switzerland, Puerto Rico, and the mainland US. There was a remarkable degree of similarity across studies in the magnitude and type of specific disorders associated with the affective disorders. Comorbidity with affective disorders was greater for the anxiety disorders than for substance misuse. Panic disorder was the subtype of anxiety that was most highly comorbid with depression. Social phobia was the specific phobic type with the strongest association with the affective disorders. The magnitude of associations between substance misuse and affective disorders generally was quite low and less consistent across sites. No major differences were found in the patterns of comorbidity by gender or age group, affective subtype or prevalence period. The onset of anxiety disorders generally preceded that of depression, whereas alcohol misuse was equally likely to pre- or post-date the onset of affective disorders. Finally, comorbidity was associated with an elevation in treatment ratesacross all sites, confirming Berkson's paradox on an international level.
The interactions between small dense particles and fluid turbulence have been investigated in a downflow fully developed channel in air. Particle velocities of, and fluid velocities in the presence of, 50 μm glass, 90 μm glass and 70 μm copper spherical beads were measured by laser Doppler anemometry, at particle mass loadings up to 80%. These particles were smaller than the Kolmogorov lengthscale of the flow and could respond to some but not all of the scales of turbulent motion. Streamwise mean particle velocity profiles were flatter than the mean fluid velocity profile, which was unmodified by particle loading. Particle velocity fluctuation intensities were larger than the unladen-fluid turbulence intensity in the streamwise direction but were smaller in the transverse direction. Fluid turbulence was attenuated by the addition of particles; the degree of attenuation increased with particle Stokes number, particle mass loading and distance from the wall. Turbulence was more strongly attenuated in the transverse than in the streamwise direction, because the turbulence energy is at higher frequencies in the transverse direction. Streamwise turbulence attenuation displayed a range of preferred frequencies where attenuation was strongest.
We report on the further development of an ion source for producing intense, continuous beams of large positive and negative cluster ions comprised of high temperature materials. This device, the Smoke-Ion Source, is the result of combining inert gas condensation methods with techniques for injecting electrons directly into expanding jets. We demonstrate the capability of this ion source to generate strong beams of cluster ions comprised of materials including metals, semiconductors, and metal oxide ceramics.
Weed competition in soybeans [Glycine max (L.) Merr. ‘Clark 63′] with planted stands of velvetleaf (Abutilon theophrasti Medic.), prickly sida (Sida spinosa L.), and Venice mallow (Hibiscus trionum L.) is reported. Weeds were planted 0, 10, 20, 30, and 40 days after soybeans and competed until soybeans matured. Soybean seed yields were reduced 720, 250, and 230 kg/ha by velvetleaf, Venice mallow, and prickly sida, respectively. Weeds that emerged with soybeans reduced yields 1,010 kg/ha. Weeds planted 10 days later reduced yields 480 kg/ha, but weeds planted 20 to 40 days after soybeans did not significantly reduced yield. Soybean yields were reduced regardless of weed placement in or between soybean rows. Weed competition reduced numbers of soybean pods per plant more than other soybean-yield components.
Competition studies were conducted with soybeans Glycine max. (L.) Merr. ‘Clark 63’ and Venice mallow (Hibiscus trionum L.). One Venice mallow per 7.5 cm of soybean row reduced soybean seed yield 632 kg/ha after 85 days competition. Thirty to 40-cm weed bands in and between soybean rows reduced yields 270 to 651 kg/ha with 35 to 40 days of competition. A natural stand of 215 Venice mallow plants per square meter reduced soybean yield 454 kg/ha after 30 days of competition, and competition up to 110 days reduced yield as much as 1490 kg/ha. Weed competition affected the number of pods per soybean plant more than any other seed-yield component, and soybean height was reduced. Soybean yields were reduced more when soil moisture was abundant early in the growing season and limited in late summer than when moisture was limited early in the growing season and above average until soybeans matured.
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