To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Social cognitive impairments are intrinsically related to symptoms of neuropsychiatric disorders and to inadequate social interaction. Consequently, daily functioning and quality of life is strongly impeded. Several social cognitive training programs have been developed, but for patients with mild intellectual disabilities and/or genetic syndromes, however, treatment options are rarely available.
Development of a high quality, evidence-based intervention for the enhancement of social cognition in patients with combined genetic and neuropsychiatric disorders.
The aim of the current investigation is to identify and review relevant intervention studies, and to pinpoint effective elements of treatment.
An extensive literature search was performed (PubMed, PsycINFO and WebOfKnowledge databases) and articles were selected and scrutinized according to the PRISMA guidelines.
Out of 341 relevant records, 58 full-text articles were finally assessed of which only 26 met the inclusion criteria. Social cognitive interventions were predominantly developed for people with psychotic disorders (n=21), and incidentally for autism spectrum disorders, anxiety and mood disorders. Studies provided evidence for effectiveness of the concerning intervention, in terms of improvement in either (social) cognitive functioning, or on behavioural outcome measures. Regarding broad-based and multiple interventions, most studies did not provide information on the differential effectiveness of the treatment components.
Social cognitive treatment in neuropsychiatric patients with intellectual disability may profit from the inclusion of low level behavioural training programs targeted at basic perspective taking. Future evaluation studies should specify and test the constituents of a training program more explicitly and should include long term follow-up.
The Wechsler Adult Intelligence Scale (WAIS-III) is widely used in clinical practice but has been subject to criticism due to lack of theoretical foundation. Particularly, the disproportionate assessment of cristallized intelligence (Gc), in comparison to fluid intelligence (Gf) is repeatedly noticed. Gf is in fact a reflection of executive functioning (EF) a set of abilities that includes mental flexibility, planning and problem solving, and (social) decision making. A more balanced assessment of Gc and Gf is important because Gf has significant impact on overall cognitive functioning.
Gaining insight in the degree to which WAIS-III variables are saturated with EF.
Examining the relationship between subtests of the WAIS-III and executive functions in a heterogeneous sample consisting both psychiatric patients and healthy volunteers.
The Behavioural Assessment of the Dysexecutive Syndrome, Wisconsin Card Sorting Test, and Stroop Color-Word Test were administered to a heterogeneous group of 234 psychiatric patients and 24 healthy volunteers. Maximum likelihood procedures with promax rotation were applied to two, three and four factor solutions.
The four factor model fitted the data best, confirming the four factor indices of the WAIS-III. All three executive tasks had their highest loading on the factor corresponding to the perceptual organization index of the WAIS-III.
Present study results confirm the overload of crystallized intelligence in the subtests and EF involvement in the Perceptual Organization Index of the WAIS-III. Results are discussed as to the need for an integrated, multifaceted view on cognitive disorders and intellectual (dis)abilities.
Early irritability predicts a broad spectrum of psychopathology spanning both internalizing and externalizing disorders, rather than any particular disorder or group of disorders (i.e. multifinality). Very few studies, however, have examined the developmental mechanisms by which it leads to such phenotypically diverse outcomes. We examined whether variation in the diurnal pattern of cortisol moderates developmental pathways between preschool irritability and the subsequent emergence of internalizing and externalizing symptoms 9 years later.
When children were 3 years old, mothers were interviewed about children's irritability and completed questionnaires about their children's psychopathology. Six years later, children collected saliva samples at wake-up and bedtime on three consecutive days. Diurnal cortisol patterns were modeled as latent difference scores between evening and morning samples. When children were approximately 12 years old, mothers again completed questionnaires about their children's psychopathology.
Among children with higher levels of irritability at age 3, a steeper diurnal cortisol slope at age 9 predicted greater internalizing symptoms and irritability at age 12, whereas a blunted slope at age 9 predicted greater externalizing symptoms at age 12, adjusting for baseline and concurrent symptoms.
Our results suggest that variation in stress system functioning can predict and differentiate developmental trajectories of early irritability that are relatively more internalizing v. those in which externalizing symptoms dominate in pre-adolescence.
There is increasing interest among developmental psychopathologists in broad transdiagnostic factors that give rise to a wide array of clinical presentations (multifinality), but little is known about how these processes lead to particular psychopathological manifestations over the course of development. We examined whether individual differences in the error-related negativity (ΔERN), a neural indicator of error monitoring, predicts whether early persistent irritability, a prototypical transdiagnostic construct, is associated with later internalizing versus externalizing outcomes. When children were 3 years old, mothers were interviewed about children's persistent irritability and completed questionnaires about their children's psychopathology. Three years later, EEG was recorded while children performed a go/no-go task to measure the ΔERN. When children were approximately 9 years old, mothers again completed questionnaires about their children's psychopathology. The results indicated that among children who were persistently irritable at age 3, an enhanced or more negative ΔERN at age 6 predicted the development of internalizing symptoms at age 9, whereas a blunted or smaller ΔERN at age 6 predicted the development of externalizing symptoms. Our results suggest that variation in error monitoring predicts, and may even shape, the expression of persistent irritability and differentiates developmental trajectories from preschool persistent irritability to internalizing versus externalizing outcomes in middle to late childhood.
Little is known about the predictive validity of disruptive mood dysregulation disorder (DMDD). This longitudinal, community-based study examined associations of DMDD at the age of 6 years with psychiatric disorders, functional impairment, peer functioning and service use at the age of 9 years.
A total of 473 children were assessed at the ages of 6 and 9 years. Child psychopathology and functional impairment were assessed at the age of 6 years with the Preschool Age Psychiatric Assessment with parents and at the age of 9 years with the Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS) with parents and children. At the age of 9 years, mothers, fathers and youth completed the Child Depression Inventory (CDI) and the Screen for Child Anxiety Related Disorders, and teachers and K-SADS interviewers completed measures of peer functioning. Significant demographic covariates were included in all models.
DMDD at the age of 6 years predicted a current diagnosis of DMDD at the age of 9 years. DMDD at the age of 6 years also predicted current and lifetime depressive disorder and attention-deficit/hyperactivity disorder (ADHD) at the age of 9 years, after controlling for all age 6 years psychiatric disorders. In addition, DMDD predicted depressive, ADHD and disruptive behavior disorder symptoms on the K-SADS, and maternal and paternal reports of depressive symptoms on the CDI, after controlling for the corresponding symptom scale at the age of 6 years. Last, DMDD at the age of 6 years predicted greater functional impairment, peer problems and educational support service use at the age of 9 years, after controlling for all psychiatric disorders at the age of 6 years.
Children with DMDD are at high risk for impaired functioning across childhood, and this risk is not accounted for by co-morbid conditions.
Backgound: Limited data suggest that crime may have a devastating impact on older people. Although identification and treatment may be beneficial, no well-designed studies have investigated the prevalence of mental disorder and the potential benefits of individual manualized CBT in older victims of crime. Aims: To identify mental health problems in older victims of common crime, provide preliminary data on its prevalence, and conduct a feasibility randomized controlled trial (RCT) using mixed methods. Method: Older victims, identified through police teams, were screened for symptoms of anxiety, depression or post-traumatic stress disorder (PTSD) one (n = 581) and 3 months (n = 486) after experiencing a crime. Screen positive participants were offered diagnostic interviews. Of these, 26 participants with DSM-IV diagnoses agreed to be randomized to Treatment As Usual (TAU) or TAU plus our manualized CBT informed Victim Improvement Package (VIP). The latter provided feedback on the VIP. Results: Recruitment, assessment and intervention are feasible and acceptable. At 3 months 120/486 screened as cases, 33 had DSM-IV criteria for a psychiatric disorder; 26 agreed to be randomized to a pilot trial. There were trends in favour of the VIP in all measures except PTSD at 6 months post crime. Conclusions: This feasibility RCT is the first step towards improving the lives of older victims of common crime. Without intervention, distress at 3 and 6 months after a crime remains high. However, the well-received VIP appeared promising for depressive and anxiety symptoms, but possibly not posttraumatic stress disorder.
Silicon heterojunction solar cells (SHJ) with thin intrinsic layers are well known for their high efficiencies. A promising way to further enhance their excellent characteristics is to enable more light to enter the crystalline silicon (c-Si) absorber of the cell while maintaining a simple cell configuration. Our approach is to replace the amorphous silicon (a-Si:H) emitter layer with a more transparent nanocrystalline silicon oxide (nc-SiOx:H) layer. In this work, we focus on optimizing the p-type nc-SiOx:H material properties, grown by radio frequency plasma enhanced chemical vapor deposition (rf PECVD), on an amorphous silicon layer.
20 nm thick nanocrystalline layers were successfully grown on a 5 nm a-Si:H layer. The effect of different ratios of trimethylboron to silane gas flow rates on the material properties were investigated, yielding an optimized material with a conductivity in the lateral direction of 7.9×10-4 S/cm combined with a band gap of E04 = 2.33 eV. Despite its larger thickness as compared to a conventional window a-Si:H p-layer, the novel layer stack of a-Si:H(i)/nc-SiOx:H(p) shows significantly enhanced transmission compared to the stack with a conventional a-Si:H(p) emitter. Altogether, the chosen material exhibits promising characteristics for implementation in SHJ solar cells.
Many individuals who sustain moderate–severe traumatic brain injuries (TBI) are poor at recognizing emotional expressions, with a greater impairment in recognizing negative (e.g., fear, disgust, sadness, and anger) than positive emotions (e.g., happiness and surprise). It has been questioned whether this “valence effect” might be an artifact of the wide use of static facial emotion stimuli (usually full-blown expressions) which differ in difficulty rather than a real consequence of brain impairment. This study aimed to investigate the valence effect in TBI, while examining emotion recognition across different intensities (low, medium, and high).
Method: Twenty-seven individuals with TBI and 28 matched control participants were tested on the Emotion Recognition Task (ERT). The TBI group was more impaired in overall emotion recognition, and less accurate recognizing negative emotions. However, examining the performance across the different intensities indicated that this difference was driven by some emotions (e.g., happiness) being much easier to recognize than others (e.g., fear and surprise). Our findings indicate that individuals with TBI have an overall deficit in facial emotion recognition, and that both people with TBI and control participants found some emotions more difficult than others. These results suggest that conventional measures of facial affect recognition that do not examine variance in the difficulty of emotions may produce erroneous conclusions about differential impairment. They also cast doubt on the notion that dissociable neural pathways underlie the recognition of positive and negative emotions, which are differentially affected by TBI and potentially other neurological or psychiatric disorders. (JINS, 2014, 20, 1–10)
Previous studies of neurocognitive performance in bipolar disorder (BD) have demonstrated impairments in visuo-spatial memory. The aim of the present study was to use an object-location memory (OLM) paradigm to assess specific, dissociable processes in visuo-spatial memory and examine their relationship with broader neurocognitive performance.
Fifty participants (25 patients with BD in a current depressive episode and 25 matched healthy controls) completed the OLM paradigm which assessed three different aspects of visuo-spatial memory: positional memory, object-location binding, and a combined process. Secondary neurocognitive measures of visuo-spatial memory, verbal memory, attention and executive function were also administered.
BD patients were significantly impaired on all three OLM processes, with the largest effect in exact positional memory (d = 1.18, p < 0.0001). General deficits were also found across the secondary neurocognitive measures. Using hierarchical regression, verbal learning was found to explain significant variance on the OLM measures where object-identity was present (the object-location binding and combined processes) and accounted for the group difference. The group difference in precise positional memory remained intact.
This study demonstrates that patients with bipolar depression manifest deficits in visuo-spatial memory, with substantial impairment in fine-grain, positional memory. The differential profile of processes underpinning the visuo-spatial memory impairment suggests a form of ‘cognitive scaffolding’, whereby performance on some measures can be supported by verbal memory. These results have important implications for our understanding of the functional cognitive architecture of mood disorder.
Noonan syndrome (NS) is a common genetic disorder, characterized by short stature, facial dysmorphia, congenital heart defects and a mildly lowered IQ. Impairments in psychosocial functioning have often been suggested, without, however, systematic investigation in a clinical group. In this study, different aspects of affective processing, social cognition and behaviour, in addition to personal well-being, were assessed in a large group of patients with NS.
Forty adult patients with NS were compared with 40 healthy controls, matched with respect to age, sex, intelligence and education level. Facial emotion recognition was measured with the Emotion Recognition Task (ERT), alexithymia with both the 20-item Toronto Alexithymia Scale (TAS-20) and the Bermond–Vorst Alexithymia Questionnaire (BVAQ), and mentalizing with the Theory of Mind (ToM) test. The Symptom Checklist-90 Revised (SCL-90-R) and the Scale for Interpersonal Behaviour (SIB) were used to record aspects of psychological well-being and social interaction.
Patients showed higher levels of cognitive alexithymia than controls. They also experienced more social distress, but the frequency of engaging in social situations did not differ. Facial emotion recognition was only slightly impaired.
Higher levels of alexithymia and social discomfort are part of the behavioural phenotype of NS. However, patients with NS have relatively intact perception of emotions in others and unimpaired mentalizing. These results provide insight into the underlying mechanisms of social daily life functioning in this patient group.
Chronic fatigue is a common symptom of multiple sclerosis (MS). A randomized controlled trial (RCT) showed that cognitive behavioural therapy (CBT) was more effective in reducing MS fatigue than relaxation training (RT). The aim of the current study was to analyse additional data from this trial to determine whether (1) CBT compared to RT leads to significantly greater changes in cognitions and behaviours hypothesized to perpetuate MS fatigue; (2) changes in these variables mediate the effect of CBT on MS fatigue; and (3) these mediation effects are independent of changes in mood.
Seventy patients (CBT, n=35; RT, n=35) completed the Cognitive and Behavioural Responses to Symptoms Questionnaire (CBSQ), the Brief Illness Perception Questionnaire (B-IPQ) modified to measure negative representations of fatigue, the Hospital Anxiety and Depression Scale (HADS), and the Chalder Fatigue Questionnaire (CFQ), pre- and post-therapy. Multiple mediation analysis was used to determine which variables mediated the change in fatigue.
Avoidance behaviour and three cognitive variables (symptom focusing, believing symptoms are a sign of damage and a negative representation of fatigue) improved significantly more in the CBT than the RT group. Mediation analysis showed that changing negative representations of fatigue mediated the decrease in severity of fatigue. Change in anxiety covaried with reduction in fatigue but the mediation effect for negative representations of fatigue remained when controlling for improvements in mood.
Change in beliefs about fatigue play a crucial role in CBT for MS fatigue. These beliefs and the role of anxiety deserve more attention in the further development of this intervention.
Medium-chain fatty acids (MCFAs) are found at higher levels in milk lipids of many animal species and in the oil fraction of several plants, including coconuts, palm kernels and certain Cuphea species. Medium-chain triglycerides (MCTs) and fatty acids are efficiently absorbed and metabolized and are therefore used for piglet nutrition. They may provide instant energy and also have physiological benefits beyond their energetic value contributing to several findings of improved performance in piglet-feeding trials. MCTs are effectively hydrolyzed by gastric and pancreatic lipases in the newborn and suckling young, allowing rapid provision of energy for both enterocytes and intermediary hepatic metabolism. MCFAs affect the composition of the intestinal microbiota and have inhibitory effects on bacterial concentrations in the digesta, mainly on Salmonella and coliforms. However, most studies have been performed in vitro up to now and in vivo data in pigs are still scarce. Effects on the gut-associated and general immune function have been described in several animal species, but they have been less studied in pigs. The addition of up to 8% of a non-esterified MCFA mixture in feed has been described, but due to the sensory properties this can have a negative impact on feed intake. This may be overcome by using MCTs, allowing dietary inclusion rates up to 15%. Feeding sows with diets containing 15% MCTs resulted in a lower mortality of newborns and better development, particularly of underweight piglets. In conclusion, MCFAs and MCTs offer advantages for the improvement of energy supply and performance of piglets and may stabilize the intestinal microbiota, expanding the spectrum of feed additives supporting piglet health in the post-weaning period.
Background: The aim of the study was to explore the value of a daily observation scale in the assessment of patients' memory function by nurses on a geriatric ward.
Methods: An observational study of 50 geriatric inpatients was carried out. The relationship between the memory items of the Nurses' Behavioral Rating Scale for Geriatric Inpatients (GIP) and four types of neuropsychological memory tests was examined: visual paired-associate learning (Visual Association Test, VAT), word-list learning (Eight Word Test, 8WT from the Amsterdam Dementia Screening, ADS), and the subtests Route Recall and Story Recall from the Rivermead Behavioural Memory Test (RBMT). Correlations with the overall measures assessing level of dementia such as the Mini-mental State Examination (MMSE), Clinical Dementia Rating scale (CDR) and the 15-item Geriatric Depression Scale (GDS-15) were examined as well.
Results: The Pearson's correlation coefficients between GIP and the four memory tests were between 0.45 and 0.71 (p < 0.01). The GIP correlations with the MMSE and CDR were 0.63 and 0.46, respectively (p < 0.01). No significant correlation was found with the GDS-15. Statistically significant differences in GIP memory scores between patients with dementia and non-demented patients were found (p < 0.01).
Conclusions: Results indicate that an observation scale of memory function may have value for providing information about the underlying memory impairment. The results of nurses' observations may be used in triage contributing to the diagnostic process by selecting patients requiring further neuropsychological assessment.
An experiment was conducted to evaluate the effects of cereal carbohydrate form (isolated v. cereal matrix) and level, especially mixed-linked β-glucan (hereafter referred to as β-glucan) and starch amylase/amylopectin ratio on nutrient digestibility and fermentation parameters in the intestines of weaned pigs. Four hulless barley cultivars containing varying β-glucan levels (41 to 84 g/kg) were compared with hulled barley, supplemented or not with a β-glucan concentrate (BBG; 270 g/kg β-glucan) and two oat cultivars for digestibility and fermentation metabolites. Seventy-two weaned piglets (BW = 12.8 ± 1.9 kg) were assigned to one of nine diets composed of 815 g/kg cereal, 60 g/kg whey, 90 g/kg soy protein isolate and 35 g/kg minerals. After 15 days, the pigs were killed, and digesta collected from ileum and colon were analyzed for proximate nutrients, short-chain fatty acids (SCFAs), lactic acid (LA) and ammonia. Ileal and total tract digestibility of proximate nutrients and non-starch polysaccharides (NSPs) were determined using HCl-insoluble ash as a marker. Organic matter (OM) ileal digestibility was greater (P < 0.05) for diets based on hulless barley (77% ± 1.1% on average), as compared with hulled barley (64% ± 1.4%) and oat (58% ± 1.5%). Similar trends were found for total tract OM digestibility, varying from 90% ± 0.3% for hulless barley to 67% ± 0.4% for oat, on average. NSP digestibility differed (P < 0.05) within and between cereal types, ranging from 20% (hulled barley plus 163 g/kg BBG or ∼40 g/kg β-glucan) to 51% (SB94893 hulless barley cultivar with high β-glucan and high amylose ratio) at the ileum and from 44% (hulled barley) to 84% (SB94893 cultivar) at the total tract level. No dietary effect (P > 0.05) was found for SCFA concentration in ileal contents, whereas in colonic contents, SCFA was lower in pigs fed oat (P < 0.001). LA concentration was greater (P < 0.001) in the colon of pigs fed hulless barley than in pigs fed hulled barley and oat. Expressed per kg carbohydrate (NSP + starch) fermented, the ammonia concentration at the colon was lowest for hulled barley diets (supplemented with β-glucan) and the highest for oat diets. In conclusion, the interaction of both form and level of β-glucan impacted nutrient digestibility and fermentation. Hulless barleys with high soluble NSP such as β-glucan and resistant starch yielded, in general higher SCFA and LA and lower ammonia. Hulless barleys may, therefore, have potential for use in feeding strategies designed to improve gut health in pigs.
An integrated multidisciplinary approach to dementia is often recommended
but has rarely been evaluated.
To evaluate the clinical effects of an integrated multidisciplinary
diagnostic facility for psychogeriatric patients.
Patients suspected of having complex psychogeriatric problems were
randomly allocated to the intervention (n=137) or to
treatment as usual (n=93). They were assessed at
baseline, and at 6 months and 12 months follow-up by means of personal
interviews with the patient's proxy. The primary outcome was
health-related quality of life, assessed using the visual analogue scale
(VAS) of the EuroQd measure, EQ-5D.
Health-related quality of life had improved at 6 months in the
intervention group, whereas that of the control group had decreased.
Furthermore, more patients in the intervention group experienced a
clinically relevant improvement of 10 points or more on the VAS at both
An integrated multidisciplinary approach improves dementia care.
The effect of process parameters on the plasma deposition of μc-Si:H solar cells is reviewed in this article. Several in situ diagnostics are presented, which can be used to study the process stability as an additional parameter in the deposition process. The diagnostics were used to investigate the stability of the substrate temperature during deposition at elevated power and the gas composition during deposition at decreased hydrogen dilution. Based on these investigations, an updated view on the role of the process parameters of plasma power, heater temperature, total gas flow rate, and hydrogen dilution is presented.
We developed a mathematical model of the transmission dynamics of salmonella to describe an outbreak of S. Cerro infection that occurred in a Pennsylvania dairy herd. The data were collected as part of a cooperative research project between the Regional Dairy Quality Management Alliance and the Agricultural Research Service. After the initial detection of a high prevalence of S. Cerro infection in the herd, a frequent and intensive sampling was conducted and the outbreak was followed for 1 year. The data showed a persistent presence of S. Cerro with a high prevalence of infection in the herd. The dynamics of host and pathogen were modelled using a set of nonlinear differential equations. A more realistically distributed (gamma-distributed) infectious period using multiple stages of infection was considered. The basic reproduction number was calculated and relevance to the intervention strategies is discussed.
The effect of conventional process parameters on the deposition of μc-Si:H solar cells is reviewed. Then, an approach to solar cell optimization is presented in which hidden, internal parameters are adjusted rather than conventional, external process parameters. The investigation focuses on deposition at low H2 dilution ratio and low total gas flow. A hidden parameter is identified through time resolved optical emission spectroscopy on SiH emission: Transient depletion of the SiH4 source gas leads to uncontrolled deposition conditions during the first 90 s after plasma ignition. There hardly is any effect on plasma properties and deposited film properties for the remainder of deposition after the transient depletion phase. As demonstrator a 9.5 % efficient single junction μc-Si:H solar cell was deposited from a pure SiH4 flow. A reinterpretation of the role of H2 dilution is discussed.