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Perfectionism is a transdiagnostic risk factor across psychopathology. The Clinical Perfectionism Questionnaire (CPQ) was developed to assess change in order to provide clinical utility, but currently the psychometric properties of the CPQ with adolescents is unknown.
To assess the factor structure and construct validity of the CPQ in female adolescents.
The CPQ was administered to 267 females aged 14–19 years of age. Confirmatory factor analysis (CFA) was used to examine the validity of the two-factor model and a second-order factor model. Pearson correlations were used to evaluate the relationships between the CPQ and a wide range of measures of perfectionism, psychopathology and personality traits.
The study demonstrated internal consistency, construct validity and incremental validity of the CPQ in a sample of female adolescents. The CFA in the present study confirmed the two-factor model of the CPQ with Factor 1 relating to perfectionistic strivings and Factor 2 representing perfectionistic concerns. The second-order two factor model indicated no deterioration in fit.
The two-factor model of the CPQ fits with the theoretical definition of clinical perfectionism where the over-dependence of self-worth on achievement and concern over mistakes are key elements. The CPQ is suitable for use with female adolescents in future research that seeks to better understand the role of perfectionism in the range of mental illnesses that impact youth.
Background: Mindfulness-based cognitive therapy (MBCT) has evidence of efficacy in a range of populations, but few studies to date have reported on MBCT for treatment of anxious and depressive symptoms in Parkinson's disease (PD). Aims: The aim of this study was to examine the efficacy of modified MBCT in reducing symptoms of anxiety and depression and improving quality of life in PD. Method: Thirty-six individuals with PD were randomly assigned to either modified MBCT or a waitlist control. Changes in symptoms of anxiety, depression and quality of life were compared at group level using generalized linear mixed models and at individual level using reliable change analysis. Results: At post-treatment, there was a significant reduction in depressive symptoms for people undertaking modified MBCT at both group and individual levels compared with controls. There was no significant effect on anxiety or quality of life at the group level, although significantly more people had reliable improvement in anxiety after modified MBCT than after waitlist. Significantly more waitlist participants had reliable deterioration in symptoms of anxiety and depression than those completing modified MBCT. Most participants stayed engaged in modified MBCT, with only three drop-outs. Discussion: This proof-of-concept study demonstrates the potential efficacy of modified MBCT as a treatment for depressive symptoms in Parkinson's disease and suggests further research is warranted.
Despite increasing evidence for the benefits of psychological treatments (PTs) in low- and middle-income countries, few national health systems have adopted PTs as standard care. We aimed to evaluate the effectiveness of a group interpersonal psychotherapy (IPT-G) intervention, when delivered by lay community health workers (LCHWs) in a low-resource government health system in Uganda. The intended outcome was reduction of depression among caregivers of children with nodding syndrome, a neuropsychiatric condition with high morbidity, mortality and social stigma.
A non-randomized trial design was used. Caregivers in six villages (n = 69) received treatment as usual (TAU), according to government guidelines. Caregivers in seven villages (n = 73) received TAU as well as 12 sessions of IPT-G delivered by LCHWs. Primary outcomes were caregiver and child depression assessed at 1 and 6 months post-intervention.
Caregivers who received IPT-G had a significantly greater reduction in the risk of depression from baseline to 1 month [risk ratio (RR) 0.25, 95% confidence interval (CI) 0.10–0.62] and 6 months (RR 0.33, 95% CI 0.11–0.95) post-intervention compared with caregivers who received TAU. Children of caregivers who received IPT-G had significantly greater reduction in depression scores than children of TAU caregivers at 1 month (Cohen's d = 0.57, p = 0.01) and 6 months (Cohen's d = 0.54, p = 0.03). Significant effects were also observed for psychological distress, stigma and social support among caregivers.
IPT-G delivered within a low-resource health system is an effective PT for common mental health problems in caregivers of children with a severe neuropsychiatric condition and has psychological benefits for the children as well. This supports national health policy initiatives to integrate PTs into primary health care services in Uganda.
Background: The evidence regarding whether co-morbid obsessive compulsive personality disorder (OCPD) is associated with treatment outcomes in obsessive compulsive disorder (OCD) is mixed, with some research indicating that OCPD is associated with poorer response, and some showing that it is associated with improved response. Aims: We sought to explore the role of OCPD diagnosis and the personality domain of conscientiousness on treatment outcomes for exposure and response prevention for OCD. Method: The impact of co-morbid OCPD and conscientiousness on treatment outcomes was examined in a clinical sample of 46 participants with OCD. Results: OCPD diagnosis and scores on conscientiousness were not associated with poorer post-treatment OCD severity, as indexed by Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, although the relative sample size of OCPD was small and thus generalizability is limited. Conclusion: This study found no evidence that OCPD or conscientiousness were associated with treatment outcomes for OCD. Further research with larger clinical samples is required.
Background: Perfectionism is strongly associated with obsessive compulsive disorder (OCD). Cognitive behavioural therapy for perfectionism (CBT-P) has been found to result in reductions in a range of symptoms in individuals with anxiety disorders, depression and eating disorders. Aim: To pilot-test the efficacy of group CBT for perfectionism in participants with OCD and elevated perfectionism. Method: Participants were randomized to receive immediate 8-week group CBT-P (n = 4) or an 8-week waitlist followed by CBT-P (n = 7). Results: Reliable reductions and a large effect size indicated that CBT-P was associated with improvements in perfectionism and OCD severity at post-test. However, these changes were not clinically significant and drop-out was high, resulting in a small final sample. Conclusions: CBT-P may be effective in reducing perfectionism and disorder-specific OCD symptoms. However, the high drop-out rate and lack of clinically significant findings suggest that further research needs to be conducted to determine the efficacy of CBT for perfectionism in OCD.
Perfectionism is a risk and maintaining factor across psychopathology and has been proposed to be a transdiagnostic process. The aim of this study was to examine the reliability and validity of the Clinical Perfectionism Questionnaire (CPQ) in 32 adults (75% female, M age = 35.54 years, SD = 9.71) with a range of psychological disorders, presenting for treatment of clinical perfectionism. There was evidence that the CPQ was correlated with established measures of perfectionism and theoretically related constructs including self-criticism and dichotomous thinking. The CPQ was also able to predict treatment outcome. The internal consistency was not adequate in the current study; however, the sample size was small. Future studies should examine the psychometric properties of the CPQ in a larger sample of individuals with a range of psychological disorders.
Ketamine and non-ketamine N-methyl-d-aspartate receptor antagonists (NMDAR antagonists) recently demonstrated antidepressant efficacy for the treatment of refractory depression, but effect sizes, trajectories and possible class effects are unclear.
We searched PubMed/PsycINFO/Web of Science/clinicaltrials.gov until 25 August 2015. Parallel-group or cross-over randomized controlled trials (RCTs) comparing single intravenous infusion of ketamine or a non-ketamine NMDAR antagonist v. placebo/pseudo-placebo in patients with major depressive disorder (MDD) and/or bipolar depression (BD) were included in the analyses. Hedges’ g and risk ratios and their 95% confidence intervals (CIs) were calculated using a random-effects model. The primary outcome was depressive symptom change. Secondary outcomes included response, remission, all-cause discontinuation and adverse effects.
A total of 14 RCTs (nine ketamine studies: n = 234; five non-ketamine NMDAR antagonist studies: n = 354; MDD = 554, BD = 34), lasting 10.0 ± 8.8 days, were meta-analysed. Ketamine reduced depression significantly more than placebo/pseudo-placebo beginning at 40 min, peaking at day 1 (Hedges' g = −1.00, 95% CI −1.28 to −0.73, p < 0.001), and loosing superiority by days 10–12. Non-ketamine NMDAR antagonists were superior to placebo only on days 5–8 (Hedges' g = −0.37, 95% CI −0.66 to −0.09, p = 0.01). Compared with placebo/pseudo-placebo, ketamine led to significantly greater response (40 min to day 7) and remission (80 min to days 3–5). Non-ketamine NMDAR antagonists achieved greater response at day 2 and days 3–5. All-cause discontinuation was similar between ketamine (p = 0.34) or non-ketamine NMDAR antagonists (p = 0.94) and placebo. Although some adverse effects were more common with ketamine/NMDAR antagonists than placebo, these were transient and clinically insignificant.
A single infusion of ketamine, but less so of non-ketamine NMDAR antagonists, has ultra-rapid efficacy for MDD and BD, lasting for up to 1 week. Development of easy-to-administer, repeatedly given NMDAR antagonists without risk of brain toxicity is of critical importance.
Growth of GaN on Si(111) and Ge coated Si(111) using pulsed electron beam deposition (PED) process is reported. GaN was deposited on Si(111) and Ge/Si(111) at 600°C in an N2 environment without any surface pre-treatment such as pre-nitridation. X-ray diffraction confirmed that c-plane oriented GaN was grown. Photoluminescence showed near-band-edge emission, the intensity of which was improved with hydrogen passivation. Electrical characterization showed n-type conductivity with room temperature electron mobilities in the range of 300 cm2/V-sec.
Background: To date no research has investigated the link between Post Traumatic Stress Disorder (PTSD) and perfectionism in a clinical sample. Aims: The aim of the current study was to examine whether there is a relationship between PTSD and perfectionism. This is important to address as many studies have demonstrated a link between other anxiety disorders, eating disorders, depression and perfectionism. The research also aimed to examine whether rumination was a mediator of the relationship between PTSD and perfectionism. Method: The sample consisted of 30 participants who were currently in treatment for PTSD. Results: The results suggest that perfectionism and PTSD symptoms were significantly correlated. In addition, rumination was a significant mediator of the relationship between Concern over Mistakes and PTSD. Conclusions: These findings help increase understanding about the relationships of perfectionism and rumination in PTSD and have implications for the treatment of PTSD.
To determine (1) the accuracy of positron emission tomography – computed tomography in the diagnosis of head and neck cancer, (2) the learning curve involved, and (3) whether its use alters patient management.
Materials and methods:
A retrospective study including 80 patients with head and neck cancer who underwent positron emission tomography – computed tomography image fusion at Blackpool Victoria Hospital.
Fifty-three patients underwent positron emission tomography – computed tomography for staging (32 for detection of a primary tumour and 21 for detection of distant metastasis) and 27 for detection of loco-regional recurrence. Ten primary tumours and 20 recurrences were accurately diagnosed by this method. Eighteen patients had their tumour stage and management modified as a result of this method of imaging. The effect of the learning curve resulted in better true positive detection rates, one year after introduction (81 versus 61 per cent). The sensitivity and specificity of this method in detecting head and neck cancer were 70 and 42 per cent, respectively, whereas those of conventional imaging were 73 and 51 per cent, respectively.
Compared with magnetic resonance imaging, the benefits of positron emission tomography – computed tomography may be limited to diagnosis of recurrence, as it is less hindered by tissue fibrosis, radiotherapy-related oedema, scarring and inflammation.
Using 16 non-clinical adults from the community, this study examined the effects on well-being of a group intervention consisting of a 4-week behavioural activation component followed by a 3-week mindfulness component, finishing with an integrating closure session. Results from intention-to-treat analyses showed moderate and significant improvements in psychological distress and several indices of well-being after the behavioural activation component. These improvements continued through the mindfulness component of the intervention such that effects were greater after participants had received the complete intervention. Half of the participants reported reliable and clinically significant improvement in the amount of time they felt happy after the intervention and a quarter of participants reported improvement at follow-up. Behavioural activation and mindfulness interventions may provide a useful framework for further research with non-clinical populations who wish to enhance their well-being and learn skills that may protect them against depression and other mental health problems.
Fifty-two Australian couples who had experienced the death of at least one member of a multiple birth (twin or higher order), with at least one survivor of that birth, were interviewed about their experiences at the time of the death, and since. This study compared parents' coping after the twins' deaths using the Beck Depression Inventory II, Perinatal Grief Scale, and unstructured interviews with some structured queries. Parents provided information on the influence of family, community and medical staff. According to retrospective reports, mothers experienced significantly more depression and grief than fathers at the time of loss. Both parents found the death of their twins grievous, but fathers, unlike mothers, were not encouraged to express their emotions. Although parents generally agreed about what helped them cope, fathers believed that they should be able to cope regardless of their grief. The strength of parents' spiritual beliefs had increased significantly since their loss, and there was some evidence that depressed and grieving mothers turned to spiritual support. Parents whose children died earlier reported levels of depression similar to those reported by parents whose children died later. To date, this is the largest study of grief in couples who have experienced the death of a twin and who have a surviving twin or higher order multiple.
Dressage competitions consist of the subjective scoring of a number of set movements performed in a specific order within an arena. Hinnemann and van Baalen (2003) suggested that the ‘collective’ marks awarded are a good judgement of the relative behaviour of a horse performing a dressage test. Those animals that are observed to be more relaxed, calm and appear comfortable in their work are generally awarded higher collective marks. The aim of this study was to examine the relationship between collective marks and overall score (i.e. level of performance) within a dressage competition.
In the context of the pursuit of a dilute magnetic semiconductor for spintronic applications, a set of GaMnN samples with varying Mn concentration and Si or Mg co-doping was investigated by optical and electron spin resonance spectroscopy. The results clearly demonstrate how the charge state of Mn is changed between 2+, 3+ and 4+ by Mg and Si co-doping. For p-type GaMnN we show that the introduction of the Mn3+/4+ donor can be compensated by Mg co-doping lowering the Fermi energy below the Mn3+/4+ level. While our results are in agreement with the hypothesis that the infrared photoluminescence appearing in GaMnN upon Mg doping originates from Mn4+, an unambiguous proof is still to be presented. Under this assumption, our measurements show that the Mn4+ center must be excited via an extra-center process at 2.54 eV.
In the context of ferromagnetic spin-coupling in dilute magnetic semiconductors, we present optical investigations on Mg co-doped GaMnN and Fe doped GaN. A complex luminescence feature occurring in Mg co-doped GaMnN around 1 eV was previously attributed to the internal 4T2(F)—4T1(F) transition of Mn4+ involved in different complexes. Selective excitation studies indicate the presence of at least three different complexes. Photoluminescence excitation spectra suggest that the internal Mn3+ transition may represent an excitation mechanism. Magneto photoluminescence spectra indicate equal g values for the ground and excited state. Low temperature infrared absorption spectra of Fe doped GaN allow to unambiguously establish the electronic structure of the Fe2+ center in GaN. Our results suggest that the Fe2+(5T2) state is stabilized against Jahn-Teller coupling by the reduced site-symmetry of the hexagonal lattice.
Transition metal-doped ZnO bulk crystals and thin films have been investigated to determine the effects of transition metal incorporation on optical, magnetic, and structural properties of ZnO. A modified melt growth technique was used to grow bulk Zn1-xMnxO, Zn1-xCoxO, and Zn1-xFexO. Optical transmission measurements show an apparent shift in absorption edge with increasing transition metal incorporation. Raman spectroscopy also shows increasing lattice disorder with increasing transition metal concentration. ZnO thin films doped with Ni, Co, and Gd were grown by metalorganic chemical vapor deposition (MOCVD). While the Co-doped thin films showed antiferromagnetic behavior, magnetic hysteresis was observed in the Ni-doped and Gd-doped thin films. Structural quality was verified with X-ray diffraction (XRD), and optical properties were investigated using room temperature photoluminescence (PL) and optical transmission measurements. Properties of ZnO:TM bulk crystals and thin films are compared and used to discuss possible origins of ferromagnetism in these materials.
The incorporation of transition metals in GaN has long been of interest in spintronics due to theoretical predictions of room temperature ferromagnetism in these materials. However, the mechanism of the observed ferromagnetism of the nitride-based DMS is still controversial, and may originate from a carrier-mediated, defect-related or nanoscale clustering mechanism. In this work, we present a comparative study of the incorporation of various transition metals and their effect on the optical, structural, and magnetic properties of GaN. Metal-organic chemical vapor deposition (MOCVD) has been employed to produce epitaxial films of varying thickness and manganese and iron doping using bis-cyclopentyldienyl(magnanese,iron) as the transition metal sources. High-resolution X-ray diffraction reveals no secondary phases under optimized growth conditions. Magnetic hysteresis is observed at room temperature in both GaMnN and GaFeN, though the strength of the magnetic ordering is roughly an order of magnitude weaker in the Fe-alloyed samples. Increasing Mn concentrations significantly affect long-range lattice ordering, and the observation of local vibrational modes (LVMs) supports the formation of nitrogen vacancies, even under optimized MOCVD growth conditions. Such vacancies form shallow donor complexes and thus contribute to self-compensation. A disorder-induced mode at 300 cm−1 and a LVM due to vacancies at 669 cm-1 were revealed by Raman spectroscopy.