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Misinformation presents a significant societal problem. To measure individuals’ susceptibility to misinformation and study its predictors, researchers have used a broad variety of ad-hoc item sets, scales, question framings, and response modes. Because of this variety, it remains unknown whether results from different studies can be compared (e.g., in meta-analyses). In this preregistered study (US sample; N = 2,622), we compare five commonly used question framings (eliciting perceived headline accuracy, manipulativeness, reliability, trustworthiness, and whether a headline is real or fake) and three response modes (binary, 6-point and 7-point scales), using the psychometrically validated Misinformation Susceptibility Test (MIST). We test 1) whether different question framings and response modes yield similar responses for the same item set, 2) whether people’s confidence in their primary judgments is affected by question framings and response modes, and 3) which key psychological factors (myside bias, political partisanship, cognitive reflection, and numeracy skills) best predict misinformation susceptibility across assessment methods. Different response modes and question framings yield similar (but not identical) responses for both primary ratings and confidence judgments. We also find a similar nomological net across conditions, suggesting cross-study comparability. Finally, myside bias and political conservatism were strongly positively correlated with misinformation susceptibility, whereas numeracy skills and especially cognitive reflection were less important (although we note potential ceiling effects for numeracy). We thus find more support for an “integrative” account than a “classical reasoning” account of misinformation belief.
It is widely acknowledged that co-occurring symptoms in patients with a psychosocial and spiritual aspects should also be considered. However, this multidimensional approach is difficult to integrate into daily practice, especially for generalist clinicians not specialized in palliative care. We aimed to identify the barriers and facilitators to multidimensional symptom management.
Methods
Focus group meetings were conducted with the following stakeholders: (1) patient representatives, (2) generalist community nurses, (3) generalist hospital nurses, (4) general practitioners, (5) generalist hospital physicians, and (6) palliative care specialists. Audiotapes were transcribed verbatim and thematically analyzed.
Results
Fifty-one participants (6–12 per group) reported barriers and facilitators with 3 main themes: multidimensional symptom assessment, initiating management of nonphysical problems, and multidisciplinary collaboration. As barriers, generalist clinicians and palliative care specialists reported that generalist clinicians often lack the communication skills to address nonphysical problems and are unaware of available resources for multidimensional symptom management. Palliative care specialists felt that generalist clinicians may be unaware that assessing nonphysical problems is important and focus on pharmacological interventions. Generalist nurses and palliative care specialists indicated that hierarchical difficulties between them and generalist physicians are barriers to multidisciplinary collaboration. Reported facilitators included using symptom assessment scales and standardized questions on nonphysical problems.
Significance of results
Generalist clinicians can be supported by improving their communication skills, increasing their awareness of available resources for multidimensional symptom management, and by using a standardized approach to assess all 4 dimensions of palliative care.
Many mental disorders take a chronic course, associated with disability and/or participation restrictions. This is well recognized in social psychiatry. It is assumed that in psychotherapy milder disorders are seen, but there are no data available in this regard. In a survey in outpatient psychotherapy the rate of patients with chronic disorders and associated impairment was assessed.
Objectives
Goal of the present study was to assess the prevalence and meaning of long term and prevailing disorders in psychotherapy
Methods
A total of 131 psychotherapists (43.5% psychodynamic, 55.7% cognitive behavior therapy) reported about 322 outpatients. Therapists were interviewed in person by two research psychotherapists in regard to illness characteristics of unselected patients.
Results
The duration of illness was longer than 1 year in 98.1% of patients or longer than a decade in 54.5%. In the judgement of the therapists 79% of disorders had a chronic or recurrent course. In 25% there were relevant participation impairments in regard to daily activities, leisure time, social relations, or work. About one quarter had already been in inpatient treatment.
Conclusions
The data show that chronic disorders are the rule rather than the exception in psychotherapy. This requires a multidimensional and interdisciplinary treatment approach, including sociomedical interventions in order to sustain participation in life. This should be recognized in the treatment concepts and also get proper attention in the education and reimbursement of psychotherapists.
Embitterment is an emotion which is known to everybody in reaction to injustice, humiliation, and breach of trust. In greater intensity it can cause severe suffering for the affected person and the social envirnment, can result in lasting impairment, and even lead to dysfunctional behavior, including aggression. Embittered patients need therapeutic help and are regularly seen in psychotherapy. The problem is often not properly recognized, because of the multiple accompanying symptoms and accusations against the environment.
Objectives
Goal of the present study was to learn about the prevalence of embitterment in psychotherapy patients
Methods
Outpatients in routine psychotherapy filled in the PTED scale (post-traumatic embitterment disorder selfrating scale), the K-FAF (short assessment of aggression) and the SCL-90 (symptom-checklist-90). Additionally, sociodemographic data were available.
Results
Included were 118 patients, of whom 22% showed a relevant severity of embitterment, 23.7% a relevant score for reactive aggression, and 54.2% a relevant score for irritable aggression. There was a significant correlation between the PTED scale and the aggression scale.
Conclusions
The data show that embitterment and related aggression are frequent phenomena in psychotherapy patients. Therapists should be aware of this emotion and take proper action to diagnose embitterment and aggressive ideation, which are often covered by other complaints. Special treatments are needed, as the aggressive and negativistic features of embitterment complicate the psychotherapy process.
Copy number variants (CNVs) have been associated with the risk of schizophrenia, autism and intellectual disability. However, little is known about their spectrum of psychopathology in adulthood.
Methods
We investigated the psychiatric phenotypes of adult CNV carriers and compared probands, who were ascertained through clinical genetics services, with carriers who were not. One hundred twenty-four adult participants (age 18–76), each bearing one of 15 rare CNVs, were recruited through a variety of sources including clinical genetics services, charities for carriers of genetic variants, and online advertising. A battery of psychiatric assessments was used to determine psychopathology.
Results
The frequencies of psychopathology were consistently higher for the CNV group compared to general population rates. We found particularly high rates of neurodevelopmental disorders (NDDs) (48%), mood disorders (42%), anxiety disorders (47%) and personality disorders (73%) as well as high rates of psychiatric multimorbidity (median number of diagnoses: 2 in non-probands, 3 in probands). NDDs [odds ratio (OR) = 4.67, 95% confidence interval (CI) 1.32–16.51; p = 0.017) and psychotic disorders (OR = 6.8, 95% CI 1.3–36.3; p = 0.025) occurred significantly more frequently in probands (N = 45; NDD: 39[87%]; psychosis: 8[18%]) than non-probands (N = 79; NDD: 20 [25%]; psychosis: 3[4%]). Participants also had somatic diagnoses pertaining to all organ systems, particularly conotruncal cardiac malformations (in individuals with 22q11.2 deletion syndrome specifically), musculoskeletal, immunological, and endocrine diseases.
Conclusions
Adult CNV carriers had a markedly increased rate of anxiety and personality disorders not previously reported and high rates of psychiatric multimorbidity. Our findings support in-depth psychiatric and medical assessments of carriers of CNVs and the establishment of multidisciplinary clinical services.
We present experiments and theory relating to transpiration through unrestrained hydrogel beads in contact with a water reservoir below and air above. Experimentally, we find that saturated hydrogel beads shrink until a steady state is reached in which water flows continuously through the beads. The size of the bead in steady state is sensitive to the evaporation rate, which depends on the relative humidity and speed of the surrounding air, and to the pressure head imposed by the fluid reservoir. Specifically, the bead size decreases with increasing pressure head or evaporation rate. Our one-dimensional model proposes that transport in the hydrogel is driven by gradients in osmotic pressure, caused by gradients in polymer concentration in the hydrogel that correspond to gradients in swelling. If the evaporation rate or the pressure head changes, the adjustment of this gradient requires the bead to change shape and size. Smaller beads have larger gradients of osmotic pressure, which drive higher transpiration rates and can draw water against larger pressure heads.
Through laboratory experiments and numerical simulations, we examine the evolution of buoyant plumes as they are influenced by background rotation in a uniform density ambient fluid. The source Rossby number is sufficiently large that rotation does not directly affect the plume at early times. However, on a time scale of the order of half a rotation period, the plume becomes deflected from the vertical axis. For some experiments and simulations, the deflection persists and the flow precesses about the vertical axis. In other cases, shortly after being deflected, the plume laminarizes near the source to form a near-vertical columnar vortex, which we refer to as a ‘tornado’. Tornado formation occurs in some experiments and not in others even if the source and background rotation parameters are identical. However, their formation is more likely if the plumes are ‘lazy’. Simulations reveal that this is a consequence of the competing dynamics that occurs on comparable time scales. As a consequence of entrainment, vertical vorticity builds up within the plume reducing the Rossby number and suppressing vertical motion at distances progressively closer to the source. Meanwhile, the swirl (the ratio of the azimuthal to vertical flow) around the vicinity of the source increases, which tends to suppress three-dimensional turbulence in the near-source flow. Although the former process ultimately acts to deflect the plume off axis, in some instances, the swirl around the source succeeds in laminarizing the flow, resulting in tornado formation.
Just like group actions are represented by group automorphisms, Lie algebra actions are represented by derivations: up to isomorphism, a split extension of a Lie algebra $B$ by a Lie algebra $X$ corresponds to a Lie algebra morphism $B\to {\mathit {Der}}(X)$ from $B$ to the Lie algebra ${\mathit {Der}}(X)$ of derivations on $X$. In this article, we study the question whether the concept of a derivation can be extended to other types of non-associative algebras over a field ${\mathbb {K}}$, in such a way that these generalized derivations characterize the ${\mathbb {K}}$-algebra actions. We prove that the answer is no, as soon as the field ${\mathbb {K}}$ is infinite. In fact, we prove a stronger result: already the representability of all abelian actions – which are usually called representations or Beck modules – suffices for this to be true. Thus, we characterize the variety of Lie algebras over an infinite field of characteristic different from $2$ as the only variety of non-associative algebras which is a non-abelian category with representable representations. This emphasizes the unique role played by the Lie algebra of linear endomorphisms $\mathfrak {gl}(V)$ as a representing object for the representations on a vector space $V$.
We describe here efforts to create and study magnetized electron–positron pair plasmas, the existence of which in astrophysical environments is well-established. Laboratory incarnations of such systems are becoming ever more possible due to novel approaches and techniques in plasma, beam and laser physics. Traditional magnetized plasmas studied to date, both in nature and in the laboratory, exhibit a host of different wave types, many of which are generically unstable and evolve into turbulence or violent instabilities. This complexity and the instability of these waves stem to a large degree from the difference in mass between the positively and the negatively charged species: the ions and the electrons. The mass symmetry of pair plasmas, on the other hand, results in unique behaviour, a topic that has been intensively studied theoretically and numerically for decades, but experimental studies are still in the early stages of development. A levitated dipole device is now under construction to study magnetized low-energy, short-Debye-length electron–positron plasmas; this experiment, as well as a stellarator device that is in the planning stage, will be fuelled by a reactor-based positron source and make use of state-of-the-art positron cooling and storage techniques. Relativistic pair plasmas with very different parameters will be created using pair production resulting from intense laser–matter interactions and will be confined in a high-field mirror configuration. We highlight the differences between and similarities among these approaches, and discuss the unique physics insights that can be gained by these studies.
Although the relative importance of airborne transmission of the SARS-CoV-2 virus is controversial, increasing evidence suggests that understanding airflows is important for estimation of the risk of contracting COVID-19. The data available so far indicate that indoor transmission of the virus far outstrips outdoor transmission, possibly due to longer exposure times and the decreased turbulence levels (and therefore dispersion) found indoors. In this paper we discuss the role of building ventilation on the possible pathways of airborne particles and examine the fluid mechanics of the processes involved.
Households in Canada and Australia have exhibited similar trends in the gendered allocation of additional child care responsibilities resulting from policy responses to the COVID-19 pandemic. In this article, we employ survey data to analyze the extent to which policy interventions related to COVID-19 have exacerbated gender disparities in child care obligations. We find that existing asymmetrical distributions of child care obligations in Canada and Australia have been amplified during the pandemic, resulting in a disproportionate burden on women. During the pandemic we also find that, in households with children, women tend to report experiencing poorer mental health than men.
We give a list of statements on the geometry of elliptic threefolds phrased only in the language of topology and homological algebra. Using only notions from topology and homological algebra, we recover existing results and prove new results on torsion pairs in the category of coherent sheaves on an elliptic threefold.
Negative life events can result in adjustment disorders. If there are feelings of having been treated unfair, been let down or been humiliated one type of reaction are prolonged states of embitterment, which has been described as Posttraumatic Embitterment Disorder, PTED. A new approach in the treatment of PTED is cognitive behavioral psychotherapy which uses special strategies based on wisdom psychology. Wisdom has been defined as the capacity to cope with unsolvable and serious problems and questions in life.
Method
In a controlled clinical trial psychosomatic inpatients which suffered from PTED, were randomly assigned to “wisdom therapy” (N=28), which focusses on the reframing of the traumatic event and to “wisdom and headonia therapy” (N=29), which additionally encourages patients to focus on positive aspects in life. Another group of PTED patients (N=50) and patients with other mental disorders (N=50) received treatment as usual.
Results
PTED patients who were treated with wisdom psychotherapy showed a reduction in the SCL-90-PST score of initially 55,7 and at the end of 40,1 and those treated with hedonia therapy of initially 58,7 and at the end of 41,3. Measures of therapist adherence showed that therapists in both groups used wisdom strategies. PTED controls started initially with a SCL-90-PST score of 52,2 and ended with 50,2. Other patients started treatment with 39,3 and finished with 25,9.
Discussion
This first treatment study on cognitive wisdom therapy suggests that wisdom can be helpful in the treatment of adjustment and embitterment disorders.
Pathological anxiety is characterized by the absence of a reason for anxiety. However, the presence of fear provoking stimuli does not exclude the possibility for a pathological course of anxiety, i.e. “Pathological Realangst”. An example are hypochondriac anxieties in patients with severe somatic disorders. An open question is to what degree severity of somatic morbidity is related with anxiety.
Method
In 209 patients (37,8% women) from a cardiology inpatient unit general anxiety, heart-related anxiety, progression anxiety, and job-anxiety were measured. Physicians rated the degree of severity of the somatic (heart-)disorder using the Multidimensional Severity of Morbidity Rating (MSM rating). Relationships between the degree of anxiety and somatic morbidity parameters were investigated.
Results
Anxiety did not or to a very low degree correlate with objective indicators of somatic morbidity. Subjective suffering showed a moderate significant correlation with heart-related anxiety and progression anxiety, and was also correlated with sick leave duration.
Conclusion
Severity of somatic illness is a multidimensional phenomenon and not regularly related in a special way with anxiety, except the dimension of subjective suffering. Pathological fears, even when occurring in the context of somatic disorders, are not related to objective endangerment, but have to be described as mental problems.
Health problems are often associated with activity limitations and participation restrictions (ICF, WHO, 2001). An example are problems at work or sick leave. The research question has been whether in these cases activity limitations and participation restrictions refer only to the workplace, or whether and to which degree other areas of life are similarly affected.
Method
Type and degree of participation restrictions in different domains of life were assessed in 382 primary health care patients (aged 18-65) with the IMET, a questionnaire which measures participation restrictions across several domains of life. Additionally, the patients were interviewed about health-related problems at work. IMET scores were compared between patients with and without health related problems at work.
Results
27% of 299 presently employed patients were suffering from workplace problems. These patients had significantly longer durations of sick leave than patients without problems at work and also reported significantly more problems in functioning in general daily activities.
Conclusion
Workplace problems are a frequent topic in primary health care and related to sick leave. Health related problems at work are indicative for problems in functioning in other areas of life as well. Participation restrictions in non-work areas can be early indicators for participation problems at work.
Generalized anxiety disorders (GAD) are characterized by persistent excessive worrying about minor hassles. GAD patients are high utilizers of medical services and medication.
According to an analysis of 21 double-blind placebo-controlled trials by of Hidalgo et al. (2007) highest effect sizes are reproted for pregabalin (0.50), hydroxyzine (0.45), venlafaxine XR (0.42), benzodiazepines (0.38), SSRIs (0.36), buspirone (0.17) and herbal medicines (-0.31). The question is how GAD is treated under conditions of routine treatment. This was studied in patients were admitted to inpatient treatment.
Method
Psychotropic premedication and changes in medication during the inpatient treatment were analyzed in 107 patients.
Results
Before admission, 27,1% of GAD patients got tricyclic antidepressants, 25,2% SSRI, 8,4% benzodiazepines, 7,4% atypical antidepressants, 1,9% anticonvulsants/pregabaline, 1,9% herbal drugs. Furthermore, 20,6% got betablocker, preferably because of hypertension.
During the inpatient stay changes in medication were made according to the clinical discretion of the therapist. At discharge 41,1% of GAD patients received SSRI, 23,4% tricyclic antidepressants, 22,4% pregabaline, 9,4% atypical antidepressants.
Conclusion
SSRI and tricyclic antidepressants play the major role in the drug treatment of GAD. Under clinical conditions there has been an optimization of treatment by increasing preferably the rate of SSRI treatments and of pregabaline treatment, while reducing benzodiazepine treatment and to some degree tricyclic antidepressants.
Literature
Hidalgo RB, Tupler LA, Davidson JRT (2007): An effect-size analysis of pharmacologic treatments for generalized anxiety disorder. J Psychopharmacol 21(8):864-872.
In neuroleptic long-term medication, only part of the patients accept regular intake of neuroleptic drugs. The question is whether an interval medication regimen as opposed to continuous medication can help to reduce drop outs in patients with critical attitudes towards long-term medication. In a 2-year prospective study, 122 patients were randomised to an interval and 164 to a continuous neuroleptic medication regimen. The drop out rates were 62.5% in the interval and 53.7% in the continuous medication group. Drop outs generally show more negative attitudes towards treatment. Patients with negative attitudes do not do better under interval medication. Moreover, this regimen even requires more cooperation and trust in terms of the necessity of medication on the part of the patient compared to the continuous medication regimen. Interval medication therefore is a strategy which can only be successful in highly cooperative, but not in treatment-reluctant patients.
In an interim evaluation on baseline data of the German PADRE observational study the correlation between physician- and patient assessment of emotional and physical symptoms of depressed patients was evaluated.
Methods:
This multicenter, prospective, 6-month observational study focused on adult outpatients with a depressive episode as diagnosed according to ICD-10 criteria, chosen by their physician to start new anti-depressive treatment with duloxetine. Correlations between the applied depression and/or pain scales were calculated via Spearman's correlation coefficient. Symptoms were evaluated via clinician rated 'Inventory for Depressive Symptomatology' ([IDS-C], total score, including item 25), patient rated 5-item scale 'KUSTA', (rating mood, activity, tension-relaxation, sleep and appetite on visual analog scales [VAS]), and patient rated VAS for 'Pain'.
Results:
All participating physicians are psychiatrists/neurologists. 2.748 patients (71% female, mean age 52.7 yrs) were evaluated. Any pain symptoms were documented in 88.9% of patients at baseline. When comparing patient- with physician-assessments, correlation of PPS scales was low to moderate and varied for different pain types: IDS-C item 25 (="somatic disorders") vs. overall pain-VAS: r=0.421 (95% CI 0.390, 0.452), IDS-C item 25 vs. abdominal pain: r=0.189; IDS-C item 25 vs. chest-pain: r=0.179. When comparing IDS-C total vs. the KUSTA items, correlation was moderate in all cases (e.g.: r= -0.510 for IDS total vs. KUSTA mood).
Conclusions:
Only a low to moderate correlation was observed between physician- and patient assessment for PPS in depressed patients. Therefore, patient pain ratings should explicitly be included in the assessment of depressed patients.
Negative public reactions concerning mental illness, and in particular schizophrenia, may result in a number of negative consequences, including aggravating their clinical condition and making it even more difficult for patients to assimilate into society. The present study examined young people's attitudes about schizophrenia and furthermore evaluated the effect of a documentary film (that depicts the lives of schizophrenia patients) on reducing stigmatization about schizophrenia. One hundred and fifteen undergraduate psychology students first provided information concerning their attitudes and knowledge about schizophrenia, in addition to filling out a questionnaire assessing their degree of acceptance of stereotypes and degree of social distance towards schizophrenia patients. One week later, participants viewed the documentary film and completed the same questionnaire. The film significantly and positively influenced participants’ attitudes concerning schizophrenia. In particular, after having watched the film, participants revealed less stereotypical attitudes about schizophrenia and desired less social distance with schizophrenia patients. This change was not related to social desirability or to age, sex or years of education.
Pathological anxiety is typically characterized by the absence of a real threat or danger. But, a persistent reason for anxiety, such as a severe life threatening illness, does not prevent the development of additional pathological anxieties, which has been described as “Pathological Realangst”.
The question is to what degree pathological realangst can be explained by the real threat or preexisting anxiety.
Method:
209 patients (37,8% female) of a cardiology inpatient unit were given the State-Trait-Anxiety-Inventory, the Heart-Anxiety-Questionnaire, and the Progression Anxiety Questionnaire. Treating physicians gave a rating on the severity of somatic morbidity including subjective suffering, short and long term prognosis, impairment in daily living, degree of acute and chronic multimorbitity, and objective parameters of the cardiac condition.
Result:
Global or specific ratings on the severity of somatic morbidity did not correlate with general or heart related anxiety. Correlation coefficients ranged between .001 and a maximum of .22 (heart anxiety and subjective suffering).
Conclusion:
The results speak against the assumption that the threat by the illness is the explanation for the present anxiety. Instead, anxious patients who are suffering from a somatic illness are also afraid of their health status and present this as cause of their anxiety. Inspite of the persistent threat this anxiety is pathological i.e. realangst. It should be treated like other anxiety disorders, although it is more difficult to convince the patient and possibly their treating physicians that the present anxiety is not “normal” but pathological and in need of treatment.