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Impaired metacognition is associated with difficulties in the daily functioning of people with psychosis. Metacognition can be divided into four domains: Self-Reflection, Understanding the Other's Mind, Decentration, and Mastery. This study investigated whether Metacognitive Reflection and Insight Therapy (MERIT) can be used to improve metacognition.
This study is a randomized controlled trial. Patients in the active condition (n = 35) received forty MERIT sessions, the control group (n = 35) received treatment as usual. Multilevel intention-to-treat and completers analyses were performed for metacognition and secondary outcomes (psychotic symptomatology, cognitive insight, Theory of Mind, empathy, depression, self-stigma, quality of life, social functioning, and work readiness).
Eighteen out of 35 participants finished treatment, half the drop-out stemmed from therapist attrition (N = 5) or before the first session (N = 4). Intention-to-treat analysis demonstrated that in both groups metacognition improved between pre- and post-measurements, with no significant differences between the groups. Patients who received MERIT continued to improve, while the control group returned to baseline, leading to significant differences at follow-up. Completers analysis (18/35) showed improvements on the Metacognition Assessment Scale (MAS-A) scales Self Reflectivity and metacognitive Mastery at follow-up. No effects were found on secondary outcomes.
On average, participants in the MERIT group were, based on MAS-A scores, at follow-up more likely to recognize their thoughts as changeable rather than as facts. MERIT might be useful for patients whose self-reflection is too limited to benefit from other therapies. Given how no changes were found in secondary measures, further research is needed. Limitations and suggestions for future research are discussed.
The vulnerability hypothesis suggests that impairments after remission of depressive episodes reflect a pre-existing vulnerability, while the scar hypothesis proposes that depression leaves residual impairments that confer risk of subsequent episodes. We prospectively examined vulnerability and scar effects in mental and physical functioning in a representative Dutch population sample.
Three waves were used from the Netherlands Mental Health Survey and Incidence Study-2, a population-based study with a 6-years follow-up. Mental and physical functioning were assessed with the Medical Outcomes Study Short Form (SF-36). Major depressive disorder (MDD) was assessed with the Composite International Diagnostic Interview 3.0. Vulnerability effects were examined by comparing healthy controls (n = 2826) with individuals who developed a first-onset depressive episode during first follow-up but did not have a lifetime diagnosis of MDD at baseline (n = 181). Scarring effects were examined by comparing pre- and post-morbid functioning in individuals who developed a depressive episode after baseline that was remitted at the third wave (n = 108).
Both mental (B = −5.4, s.e. = 0.9, p < 0.001) and physical functioning (B = −8.2, s.e. = 1.1, p < 0.001) at baseline were lower in individuals who developed a first depressive episode after baseline compared with healthy controls. This effect was most pronounced in people who developed a severe episode. No firm evidence of scarring in mental or physical functioning was found. In unadjusted analyses, physical functioning was still lowered post-morbidly (B = −5.1, s.e. = 2.1, p = 0.014), but this effect disappeared in adjusted analyses.
Functional impairments after remission of depression seem to reflect a pre-existing vulnerability rather than a scar.
A substantial proportion of persons with mental disorders seek treatment from complementary and alternative medicine (CAM) professionals. However, data on how CAM contacts vary across countries, mental disorders and their severity, and health care settings is largely lacking. The aim was therefore to investigate the prevalence of contacts with CAM providers in a large cross-national sample of persons with 12-month mental disorders.
In the World Mental Health Surveys, the Composite International Diagnostic Interview was administered to determine the presence of past 12 month mental disorders in 138 801 participants aged 18–100 derived from representative general population samples. Participants were recruited between 2001 and 2012. Rates of self-reported CAM contacts for each of the 28 surveys across 25 countries and 12 mental disorder groups were calculated for all persons with past 12-month mental disorders. Mental disorders were grouped into mood disorders, anxiety disorders or behavioural disorders, and further divided by severity levels. Satisfaction with conventional care was also compared with CAM contact satisfaction.
An estimated 3.6% (standard error 0.2%) of persons with a past 12-month mental disorder reported a CAM contact, which was two times higher in high-income countries (4.6%; standard error 0.3%) than in low- and middle-income countries (2.3%; standard error 0.2%). CAM contacts were largely comparable for different disorder types, but particularly high in persons receiving conventional care (8.6–17.8%). CAM contacts increased with increasing mental disorder severity. Among persons receiving specialist mental health care, CAM contacts were reported by 14.0% for severe mood disorders, 16.2% for severe anxiety disorders and 22.5% for severe behavioural disorders. Satisfaction with care was comparable with respect to CAM contacts (78.3%) and conventional care (75.6%) in persons that received both.
CAM contacts are common in persons with severe mental disorders, in high-income countries, and in persons receiving conventional care. Our findings support the notion of CAM as largely complementary but are in contrast to suggestions that this concerns person with only mild, transient complaints. There was no indication that persons were less satisfied by CAM visits than by receiving conventional care. We encourage health care professionals in conventional settings to openly discuss the care patients are receiving, whether conventional or not, and their reasons for doing so.
Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors.
The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD.
20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2–0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66–55% v. 43%) and later-recovery (75–68% v. 39%).
We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.
4MOST is a new wide-field, high-multiplex spectroscopic survey facility for the VISTA telescope of ESO. Starting in 2022, 4MOST will deploy 2400 fibres in a 4.1 square degree field-of-view using a positioner based on the tilting spine principle. In this contribution we give an outline of the major science goals we wish to achieve with 4MOST in the area of Galactic Archeology. The 4MOST Galactic Archeology surveys have been designed to address long-standing and far-reaching problems in Galactic science. They are focused on four major themes: 1) Near-field cosmology tests, 2) Chemo-dynamical characterisation of the major Milky Way stellar components, 3) The Galactic Halo and beyond, and 4) Discovery and characterisation of extremely metal-poor stars. In addition to a top-level description of the Galactic surveys we provide information about how the community will be able to join 4MOST via a call for Public Spectroscopic Surveys that ESO will launch.
Sexual assault is a global concern with post-traumatic stress disorder (PTSD), one of the common sequelae. Early intervention can help prevent PTSD, making identification of those at high risk for the disorder a priority. Lack of representative sampling of both sexual assault survivors and sexual assaults in prior studies might have reduced the ability to develop accurate prediction models for early identification of high-risk sexual assault survivors.
Data come from 12 face-to-face, cross-sectional surveys of community-dwelling adults conducted in 11 countries. Analysis was based on the data from the 411 women from these surveys for whom sexual assault was the randomly selected lifetime traumatic event (TE). Seven classes of predictors were assessed: socio-demographics, characteristics of the assault, the respondent's retrospective perception that she could have prevented the assault, other prior lifetime TEs, exposure to childhood family adversities and prior mental disorders.
Prevalence of Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) PTSD associated with randomly selected sexual assaults was 20.2%. PTSD was more common for repeated than single-occurrence victimization and positively associated with prior TEs and childhood adversities. Respondent's perception that she could have prevented the assault interacted with history of mental disorder such that it reduced odds of PTSD, but only among women without prior disorders (odds ratio 0.2, 95% confidence interval 0.1–0.9). The final model estimated that 40.3% of women with PTSD would be found among the 10% with the highest predicted risk.
Whether counterfactual preventability cognitions are adaptive may depend on mental health history. Predictive modelling may be useful in targeting high-risk women for preventive interventions.
Although specific phobia is highly prevalent, associated with impairment, and an important risk factor for the development of other mental disorders, cross-national epidemiological data are scarce, especially from low- and middle-income countries. This paper presents epidemiological data from 22 low-, lower-middle-, upper-middle- and high-income countries.
Data came from 25 representative population-based surveys conducted in 22 countries (2001–2011) as part of the World Health Organization World Mental Health Surveys initiative (n = 124 902). The presence of specific phobia as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition was evaluated using the World Health Organization Composite International Diagnostic Interview.
The cross-national lifetime and 12-month prevalence rates of specific phobia were, respectively, 7.4% and 5.5%, being higher in females (9.8 and 7.7%) than in males (4.9% and 3.3%) and higher in high- and higher-middle-income countries than in low-/lower-middle-income countries. The median age of onset was young (8 years). Of the 12-month patients, 18.7% reported severe role impairment (13.3–21.9% across income groups) and 23.1% reported any treatment (9.6–30.1% across income groups). Lifetime co-morbidity was observed in 60.5% of those with lifetime specific phobia, with the onset of specific phobia preceding the other disorder in most cases (72.6%). Interestingly, rates of impairment, treatment use and co-morbidity increased with the number of fear subtypes.
Specific phobia is common and associated with impairment in a considerable percentage of cases. Importantly, specific phobia often precedes the onset of other mental disorders, making it a possible early-life indicator of psychopathology vulnerability.
Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations.
We assessed CAs, PEs and DSM-IV mental disorders in 23 998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models.
Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.9–2.6]. CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR 8.5, 95% CI 3.6–20.2), whereas Other CA types were associated with PE onset in adolescence. Associations of other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF).
Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood-onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population.
Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20–40% range in disaster-focused studies but considerably lower (3–5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies.
Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders).
Disaster-related PTSD prevalence was 0.0–3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk.
Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.
In the radiocarbon accelerator mass spectrometry (14C AMS) analysis of gases obtained in a dry extraction from a 52–m Antarctic ice core, we observed 14CO2 and 14CO concentrations decreasing with depth. The concentrations are explained in terms of in-situ production by neutrons and captured muons in ablating ice. The ratio of the 14CO2 concentration to that of 14CO has been found to be constant at 1.9 ± 0.3. The ablation rates obtained of 42 ± 18 cm.yr−1 and 40 ± 13 cm.yr−1 for the neutron and muon components, respectively, are about three times higher than observed from stake readings. The discrepancy may point to an incomplete extraction of the dry extraction method. Using the constant ratio in 14CO2 and 14CO concentrations we correct for the in-situ component in the trapped 14CO2 and deduce an age of 10,300 ± 900 BP for the ice core.
We quantified the rate of carbonate dissolution with increasing water depth by taking the difference in the carbonate mass accumulation rate of deep (3393–4375 m) core top sediments from the shallowest one (3208 m), which we assumed was unaffected by dissolution. This method depends on high quality 14C dates that we calibrated to calendar years for calculating sedimentation rates. Our results show low (ranging from 0 to 0.3 g cm−2 ka−1) and high (ranging from 1.5 to 1.7 g cm−2 ka−1) carbonate dissolution rates, above and below 4000 m, respectively. Therefore, we interpret the sudden increase in the carbonate dissolution rate at 4000-m water depth to mark the lysocline.
Detailed stable oxygen isotope analyses coupled with AMS 14C measurements on an eastern Mediterranean sapropel S1 sequence indicate that adverse bottom conditions persisted for ca 8000 years. AMS dates on additional sequences show that complete bottom anoxia lasted for 300-800 years. The S1 event is not synchronous throughout the eastern Mediterranean, but started earlier in the deeper parts of the basin.
AMS 14C measurements on pteropod shells from eastern North Atlantic deep-sea cores reveal distinct periods of aragonite preservation during the last 16,000 years. Most preservation spikes coincide with documented periods of climatic change on a scale of 2 × 101 to 2 × 103 years.
Variability in surface and deep ocean circulation in the North Atlantic is inferred from grain-size characteristics and the composition of terrigenous sediments from a deep-sea core taken on Reykjanes Ridge, south of Iceland. End-member modeling of grain size data shows that deep-ocean circulation in this area decreased significantly during periods of maximum iceberg discharge. The episodes of reduced circulation correlate with the cold and abrupt warming phases of the Dansgaard-Oeschger cycles as recognized in the Greenland ice cores.
We report on the final microlensing result from one survey (VATT/Columbia) monitoring stars in M31, and the initial results of a larger study (MEGA), which together seem to indicate the presence of a microlensing halo component comprising a significant fraction of the dark matter in M31.
Two classes of elliptical galaxies are now recognised (Kormendy & Bender 1996). Luminous ellipticals rotate slowly (Davies et al. 1983and tend to have boxy isophotes. Ellipticals fainter than L∗ exhibit an increasing tendency to be rotationally supported and to possess a stellar disk component. This dichotomy led Bender, Burstein & Faber (1992) to suggest that the physical variable that controls the ultimate nature of a forming galaxy is the degree of gaseous dissipation that occurs in the final merger it experiences. Low luminosity systems experience more dissipative mergers which generate high rotation, disky end products. As bigger galaxies are formed, the mergers become increasingly stellar, producing the classical slow rotating ellipticals. They termed this the gas/stellar continuum. This global dichotomy is also reflected in the bimodality of core morphologies of the heterogeneous sample of local ellipticals observed with HST. The low luminosity disky galaxies have ‘hard’ cores with a steep slope in the luminosity profile at small radii, whereas the luminous galaxies have ‘soft’ cores with flat profiles at small radii (e.g. Faber et al. 1997).
High-resolution optical and NIR observations are used to constrain a dynamical model of the circumnuclear star forming (SF) region in the barred galaxy M100 (NGC 4321). Small leading arms observed in our K-band image of the nuclear region have been reproduced in numerical modeling of M100, a galaxy with a double inner Lindblad resonance (ILR). We also present preliminary optical and NIR observations of NGC 6951: a barred galaxy with circumnuclear SF showing a distinctly different behavior to M100 at 2.2µm.
Models of galaxy formation in a hierarchical universe predict substantial scatter in the halo-to-halo stellar properties, owing to stochasticity in galaxies’ merger histories. Currently, only few detailed observations of galaxy’s halos are available, mainly for the Milky Way and M31. The Galaxy Halos, Outer disks, Substructure, Thick disks and Star clusters (GHOSTS) HST survey is the largest study to date of the resolved stellar populations in the outskirts of disk galaxies and its observations offer a direct test of model predictions. Here we present the results we obtain for six highly inclined nearby Milky Way-mass spiral galaxies. We find a great diversity in the properties of their stellar halos.
The EDTA-soluble fractions extracted from rostra of two late Cretaceous belemnites (Cephalopoda), Gonioteuthis and Belemnitella, were divided into an humic acid and a fulvic acid fraction (the latter was absent in Belemnitella). The extracts are compared with preparations from shells of two recent cephalopods, Nautilus pompilius and Sepia officinalis. Use was made of immunology, amino acid analysis, pyrolysis mass spectrometry and some other techniques.
The fulvic acid fraction of Gonioteuthis, a mixed peptide-like saccharide-like substance, produced confluent immunodiffusion patterns with an EDTA-soluble Nautilus extract against anti-Nautilus rabbit serum. The humic acid of Gonioteuthis did not contain D-alloisoleucine and its amino acid composition was very similar to that of the EDTA-insoluble fraction of Nautilus. This humic acid was enriched in polyphenol, which may be due to chemical reaction of peptides and carbohydrates during diagenesis. It is concluded that both fractions of Gonioteuthis are original belemnite materials that have undergone only minor alterations during diagenesis.
This is an exploratory study of biochemical compounds derived from fossils, with particular emphasis on immunological methods.