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Sample records for maladaptive cardiomyopathic outcome

  1. When Do Adaptive Developmental Mechanisms Yield Maladaptive Outcomes?

    ERIC Educational Resources Information Center

    Frankenhuis, Willem E.; Del Giudice, Marco

    2012-01-01

    This article discusses 3 ways in which adaptive developmental mechanisms may produce maladaptive outcomes. First, natural selection may favor risky strategies that enhance fitness on average but which have detrimental consequences for a subset of individuals. Second, mismatch may result when organisms experience environmental change during…

  2. When do adaptive developmental mechanisms yield maladaptive outcomes?

    PubMed

    Frankenhuis, Willem E; Del Giudice, Marco

    2012-05-01

    This article discusses 3 ways in which adaptive developmental mechanisms may produce maladaptive outcomes. First, natural selection may favor risky strategies that enhance fitness on average but which have detrimental consequences for a subset of individuals. Second, mismatch may result when organisms experience environmental change during ontogeny, for instance, because they move from one environment to another. Third, organisms may learn about their environment in order to develop an appropriate phenotype; when cues indicate the environmental state probabilistically, as opposed to deterministically, sampling processes may produce mismatch. For each source of maladaptation, we present a selection of the relevant empirical research and illustrate how models from evolutionary biology can be used to make predictions about maladaptation. We also discuss what data can be collected to test these models in humans. Our goal is to show that evolutionary approaches not only yield insights into adaptive outcomes but can also illuminate the conditions leading to maladaptation. This perspective provides additional nuance to the dialectic between the developmental psychopathology model and evolutionary developmental psychology. PMID:21967567

  3. A regressional analysis of maladaptive rumination, illness perception and negative emotional outcomes in Asian patients suffering from depressive disorder.

    PubMed

    Lu, Yanxia; Tang, Catherine; Liow, Chiew Shan; Ng, Winnie Wei Ni; Ho, Cyrus Su Hui; Ho, Roger Chun Mun

    2014-12-01

    Although illness perception has been shown to be associated with illness outcomes in various chronic physical diseases, the association of illness perception and rumination are not well elucidated in mental disorders. This study aims to investigate the mediational effects of adaptive and maladaptive rumination in the relationship between illness perception and negative emotions (depression, anxiety and stress) in male and female patients (N=110) suffering from depressive disorders. The results showed that maladaptive rumination mediated the relationship between illness perception and negative emotions in both male and female depressive patients. However, no mediating effects of adaptive rumination were found in the relationship between illness perception and negative emotion. Maladaptive rumination mediated the relationship between perceived identity, chronicity of illness, consequences of illness and emotional representation of illness and negative emotions in males. It also mediated the relationship between perceived identity and emotional representation of illness and negative emotions in females. The results, possible clinical implications and limitations of this study are also discussed. PMID:25440564

  4. The role of early maladaptive schemas in predicting exposure and response prevention outcome for obsessive-compulsive disorder.

    PubMed

    Haaland, Aashild Tellefsen; Vogel, Patrick A; Launes, Gunvor; Haaland, Vegard Øksendal; Hansen, Bjarne; Solem, Stian; Himle, Joseph A

    2011-11-01

    This is the first study that explores whether early maladaptive schemas are related to treatment outcome for patients with obsessive-compulsive disorder (OCD). The sample consisted of 88 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory and Young Schema Questionnaire - Short Form were administered before and after treatment. Regression analyses using post-treatment Y-BOCS as the dependent variable indicated that higher scores on the abandonment schema at pre-treatment were related to poor outcome and explained 7% of the variance in symptoms at post-treatment. Higher scores on the self-sacrifice schema at pre-treatment were related to good outcome and explained 6% of the variance in obsessive-compulsive symptoms at post-treatment. During treatment, only changes in the failure schema were significantly related to good outcome and explained 18% of the variance in symptoms at post-treatment. PMID:21920500

  5. Modification of aortic contractility in the cardiomyopathic hamster.

    PubMed Central

    Dumont, E. C.; Lambert, C.; Lamontagne, D.

    1996-01-01

    1. The functional arterial response in the cardiomyopathic hamster compared with inbred control, was investigated in thoracic aortae. For this purpose, vessels were cut into 6-mm rings and mounted in 20-ml organ baths. 2. In a first experimental series, the function of the endothelium was evaluated. Dose-response curves to acetylcholine (0.1 nM-10 microM) on phenylephrine (0.3 microM)-preconstricted rings of cardiomyopathic hamsters and inbred age-matched controls were comparable (log[EC50] of -7.08 +/- 0.12 and -7.18 +/- 0.12, respectively; n = 4). 3. Changes in contractility of cardiomyopathic hamster endothelium-denuded aortae were investigated. Dose-response curves to phenylephrine (1 nM-0.1 mM), angiotensin II (10 pM-0.3 microM), 5-hydroxytryptamine (5-HT) (1 nM-0.1 mM) and KCl (1 mM-0.1 M) were performed. Increased sensitivity in cardiomyopathic hamster aortae, compared to controls, was observed with phenylephrine (log[EC50] of -7.25 +/- 0.05 and -6.83 +/- 0.05, respectively, n = 6, P < 0.001) and angiotensin II (log[EC50] of -8.67 +/- 0.07 and -8.26 +/- 0.06, respectively, n = 6, P = 0.001) but not with 5-HT or KCl. A decreased maximum response in cardiomyopathic, compared to control, was observed with 5-HT (1.28 +/- 0.06 g vs 1.56 +/- 0.07 g, respectively, n = 6, P = 0.03). Comparable results were found in aortae with an intact endothelium. 4. No difference in the maximum contractile response to the G-protein activator, NaF (3, 10 and 30 mM) was observed in either group of animals. 5. Phorbol 12-myristate 13-acetate (PMA, 1-10 microM) was used to assess changes in the activity of protein kinase C (PKC). Contractility to PMA was increased in cardiomyopathic hamster aortae compared to controls (0.22 +/- 0.02 g vs 0.07 +/- 0.03 g at 3 microM, respectively, n = 6, P = 0.003). 6. Finally, cardiomyopathic hamsters aortae were found to be less sensitive when exposed to increasing concentrations of Ca2+ (10 microM-1 mM) in KCl-depolarized rings (0.58 +/- 0.04 g in

  6. Predicting Negative Life Outcomes from Early Aggressive-Disruptive Behavior Trajectories: Gender Differences in Maladaptation across Life Domains

    ERIC Educational Resources Information Center

    Bradshaw, Catherine P.; Schaeffer, Cindy M.; Petras, Hanno; Ialongo, Nicholas

    2010-01-01

    Transactional theories of development suggest that displaying high levels of antisocial behavior early in life and persistently over time causes disruption in multiple life domains, which in turn places individuals at risk for negative life outcomes. We used longitudinal data from 1,137 primarily African American urban youth (49.1% female) to…

  7. Complete mitochondrial genome sequence of the heart failure model of cardiomyopathic Syrian hamster (Mesocricetus auratus).

    PubMed

    Hu, Bo; Liu, Dong-Xing; Zhang, Yu-Qing; Song, Jian-Tao; Ji, Xian-Fei; Hou, Zhi-Qiang; Zhang, Zhen-Hai

    2016-05-01

    In this study we sequenced the complete mitochondrial genome sequencing of a heart failure model of cardiomyopathic Syrian hamster (Mesocricetus auratus) for the first time. The total length of the mitogenome was 16,267 bp. It harbored 13 protein-coding genes, 2 ribosomal RNA genes, 22 transfer RNA genes and 1 non-coding control region. PMID:25469817

  8. Family Functioning and Maladaptive Schemas: The Moderating Effects of Optimism

    ERIC Educational Resources Information Center

    Buri, John R.; Gunty, Amy L.

    2008-01-01

    Authoritarian parenting is often shown to be associated with negative outcomes for children, including the development of maladaptive schemas. However, this is not the case for all children who experience Authoritarian parenting. Optimism is examined as a moderator in the relationship between Authoritarian parenting and maladaptive schemas that…

  9. Dual tracer autoradiographic study with thallium-201 and radioiodinated fatty acid in cardiomyopathic hamsters

    SciTech Connect

    Kurata, C.; Kobayashi, A.; Yamazaki, N.

    1989-01-01

    To investigate the usefulness of myocardial scintigraphy with radioiodinated 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) in cardiomyopathy, quantitative dual tracer autoradiographic study with /sup 201/Tl and (/sup 125/I)BMIPP was performed in 27 cardiomyopathic Bio 14.6 Syrian hamsters and eight normal hamsters. Furthermore, 16 Bio 14.6 Syrian hamsters aged 21 days were divided into verapamil-treated (during 70 days) and control groups (respectively, n = 8), and autoradiography with /sup 201/Tl and (/sup 125/I)BMIPP was performed. Quantitative autoradiography demonstrated an uncoupling of /sup 201/Tl and (/sup 125/I)BMIPP distributions and a regional heterogeneity of (/sup 125/I)BMIPP distribution in cardiomyopathic hamsters aged more than 2 mo, while normal hamsters showed only mild heterogeneity of (/sup 125/I)BMIPP distribution without an uncoupling of tracers. Age-matched comparison between normal and cardiomyopathic hamsters (5-8 mo old) demonstrated that a difference between their (/sup 125/I)BMIPP distributions are more marked than that between their /sup 201/Tl distributions. Furthermore, (/sup 125/I)BMIPP visualized effects of verapamil on cardiomyopathy more distinctly than did /sup 201/Tl. In conclusion, myocardial imaging with (/sup 123/I)BMIPP could be useful for investigating cardiomyopathy and evaluating the efficacy of therapeutic intervention in patients with cardiomyopathy.

  10. Maladaptive Repetition and Career Construction

    ERIC Educational Resources Information Center

    Cardoso, Paulo

    2012-01-01

    The role of repeated maladaptive relationship patterns established early in life has been widely studied with the goal of understanding the various factors and processes that contribute to and occur during development and psychological adaptation. The effects of maladaptive patterns have also been studied with regard to the goal of guiding…

  11. Molecular cloning of hamster brain and atrial natriuretic peptide cDNAs. Cardiomyopathic hamsters are useful models for brain and atrial natriuretic peptides.

    PubMed Central

    Tamura, N; Ogawa, Y; Itoh, H; Arai, H; Suga, S; Nakagawa, O; Komatsu, Y; Kishimoto, I; Takaya, K; Yoshimasa, T

    1994-01-01

    Brain and atrial natriuretic peptides (BNP and ANP) are cardiac hormones with diuretic, natriuretic, and vasodilatory activities. Cardiomyopathic hamsters are widely used animal models of heart failure. Due to the structural divergence of BNP among species, examination on pathophysiological roles of BNP using cardiomyopathic hamsters is so far impossible. We therefore isolated hamster BNP and ANP cDNAs, and investigated synthesis and secretion of these peptides in normal and cardiomyopathic hamsters. The COOH-terminal 32-residue peptide of cloned hamster preproBNP with 122 amino acids, preceded by a single arginine residue, supposedly represents hamster BNP showing < 50% homology to rat BNP. Alpha-hamster ANP, 28-residue peptide, is identical to alpha-rat ANP. In hamsters, BNP and ANP occur mainly in the ventricle and the atrium, respectively. The 32-wk-old hypertrophic cardiomyopathic BIO14.6 strain exhibited ventricular hypertrophy. The 32-wk-old dilated cardiomyopathic BIO53.58 strain remained at the stage without apparent heart failure. In BIO14.6 and BIO53.58 strains at this age, ventricular BNP and ANP gene expressions are augmented, and the plasma BNP concentration is elevated to 136 and 108 fmol/ml, respectively, three times greater than the elevated plasma ANP concentration, which well mimics changes of the plasma BNP and ANP concentrations in human heart failure. Cardiomyopathic hamsters, therefore, are useful models to investigate the implication of BNP in human cardiovascular diseases. Images PMID:8083346

  12. Abnormalities of ADP/ATP carrier protein in J-2-N cardiomyopathic hamsters.

    PubMed

    Kato, M; Yang, J; Iwai, T; Tanamura, A; Arino, T; Kawashima, O; Takeda, N

    1993-02-17

    ADP/ATP carrier protein (AAC) is located in the mitochondrial inner membrane and has an important function in mitochondrial energy supply. This protein transports ATP to the cytoplasm and counter transports ADP into the mitochondria. J-2-N cardiomyopathic hamsters were investigated to determine the AAC content in cardiac mitochondria. After recording an electrocardiogram and collecting blood, the cardiac mitochondria were isolated. The mitochondrial membranes were labelled with eosin-5-maleimide (EMA) and separated on SDS polyacrylamide gels. The position of the AAC component was identified by exposing the gel under UV light, and the AAC content was determined by densitometry after staining with Coomassie blue. The AAC content ratio was significantly decreased in both 10-week-old and 1-year survived J-2-N hamsters when compared to control Golden hamster. Among 10-week-old J-2-N hamsters, the decrease in the AAC content ratio was more marked for the animals with more severe myocardial damage. The H(+)-ATPase activities of mitochondrial membrane were higher in 10-week-old J-2-N hamsters than in control hamsters. These results suggest that the decrease of AAC in J-2-N hamster plays an important role in the pathogenesis of cardiomyopathy in J-2-N hamsters. PMID:8455591

  13. Maladaptive eating patterns in children.

    PubMed

    Wildermuth, Sarah A; Mesman, Glenn R; Ward, Wendy L

    2013-01-01

    Given the increasing frequency of obesity and related maladaptive eating patterns in pediatric populations, health care professionals in a variety of settings must find ways to treat persons who are obese and have maladaptive eating patterns. The authors summarized literature related to binge eating disorder, boredom eating, emotional eating, and night eating syndrome and developed educational handouts designed for children/adolescents and their families who present with these eating problems. These educational handouts may be used by primary care physicians, psychologists, psychiatrists, nurses, and other specialists in medical settings. They are free for use in educational purposes, with permission from the authors, but are not intended to replace appropriate health care and follow-up. PMID:23414976

  14. Modulation of Vascular ACE by Oxidative Stress in Young Syrian Cardiomyopathic Hamsters: Therapeutic Implications.

    PubMed

    Cruz, Nildris; Miranda, Jorge D; Crespo, Maria J

    2016-01-01

    Increased vascular angiotensin-converting enzyme (ACE) activity and oxidative stress are present in young Syrian cardiomyopathic hamsters (SCH) before the clinical manifestation of heart failure (HF). The developmental time-course of these alterations and their potential interactions, however, are still unknown. We evaluated mRNA and protein levels of ACE, endothelial nitric oxide synthase (eNOS), and inducible nitric oxide synthase (iNOS) in the vasculature of SCH from one to four months of age. Total RNA and proteins were quantified with real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot, respectively. The role of nitric oxide (NO) on vascular ACE activity was also assessed. ACE mRNA and protein levels were up-regulated in SCH at two months of age compared with controls (CT) (p < 0.05). At this two-month stage, eNOS protein levels were lower in SCH (87%) than in CT (100%) (p < 0.05), although iNOS protein levels increased significantly (482%) compared to CT (100%; p < 0.05). In addition, ACE mRNA expression and activity were modulated by NO at two months of age. Thus, the combination of low eNOS and high iNOS protein levels may underlie vascular renin-angiotensin system (RAS) over-activation. Altogether, these factors may contribute to the development of endothelial dysfunction and vascular hyper-reactivity in the early stages of heart failure, and eventually trigger cardiac deterioration in this animal model of HF. PMID:27420103

  15. Modulation of Vascular ACE by Oxidative Stress in Young Syrian Cardiomyopathic Hamsters: Therapeutic Implications

    PubMed Central

    Cruz, Nildris; Miranda, Jorge D.; Crespo, Maria J.

    2016-01-01

    Increased vascular angiotensin-converting enzyme (ACE) activity and oxidative stress are present in young Syrian cardiomyopathic hamsters (SCH) before the clinical manifestation of heart failure (HF). The developmental time-course of these alterations and their potential interactions, however, are still unknown. We evaluated mRNA and protein levels of ACE, endothelial nitric oxide synthase (eNOS), and inducible nitric oxide synthase (iNOS) in the vasculature of SCH from one to four months of age. Total RNA and proteins were quantified with real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot, respectively. The role of nitric oxide (NO) on vascular ACE activity was also assessed. ACE mRNA and protein levels were up-regulated in SCH at two months of age compared with controls (CT) (p < 0.05). At this two-month stage, eNOS protein levels were lower in SCH (87%) than in CT (100%) (p < 0.05), although iNOS protein levels increased significantly (482%) compared to CT (100%; p < 0.05). In addition, ACE mRNA expression and activity were modulated by NO at two months of age. Thus, the combination of low eNOS and high iNOS protein levels may underlie vascular renin-angiotensin system (RAS) over-activation. Altogether, these factors may contribute to the development of endothelial dysfunction and vascular hyper-reactivity in the early stages of heart failure, and eventually trigger cardiac deterioration in this animal model of HF. PMID:27420103

  16. Pharmacological disruption of maladaptive memory.

    PubMed

    Taylor, Jane R; Torregrossa, Mary M

    2015-01-01

    Many psychiatric disorders are characterized by intrusive, distracting, and disturbing memories that either perpetuate the illness or hinder successful treatment. For example, posttraumatic stress disorder (PTSD) involves such strong reemergence of memories associated with a traumatic event that the individual feels like the event is happening again. Furthermore, drug addiction is characterized by compulsive use and repeated relapse that is often driven by internal memories of drug use and/or by exposure to external stimuli that were associated with drug use. Therefore, identifying pharmacological methods to weaken the strength of maladaptive memories is a major goal of research efforts aimed at finding new treatments for these disorders. The primary mechanism by which memories could be pharmacologically disrupted or altered is through manipulation of memory reconsolidation. Reconsolidation occurs when an established memory is remembered or reactivated, reentering a labile state before again being consolidated into long-term memory storage. Memories are subject to disruption during this labile state. In this chapter we will discuss the preclinical and clinical studies identifying potential pharmacological methods for disrupting the integrity of maladaptive memory to treat mental illness. PMID:25977090

  17. Improving Maladaptive Behaviors Using Sensory Integration Techniques.

    ERIC Educational Resources Information Center

    Shuman, Theresa

    A study examined the use of sensory integration techniques to reduce the maladaptive behaviors that interfered with the learning of nine high school students with mental impairments attending a special school. Maladaptive behaviors identified included rocking, toe walking, echolalia, resistance to change, compulsive behaviors, aggression,…

  18. The Enduring Impact of Maladaptive Personality Traits on Relationship Quality and Health in Later Life

    PubMed Central

    Gleason, Marci E. J.; Weinstein, Yana; Balsis, Steve; Oltmanns, Thomas F.

    2013-01-01

    Over the past five years, the St. Louis Personality and Aging Network (SPAN) has been collecting data on personality in later life with an emphasis on maladaptive personality, social integration, and health outcomes in a representative sample of 1630 adults aged 55–64 living in the St. Louis area. This program has confirmed the importance of considering both the normal range of personality and in particular the role of maladaptive traits in order to understand individuals’ relationships, life events, and health outcomes. In the current paper we discuss the explanatory benefits of considering maladaptive traits or traits associated with personality disorders when discussing the role of personality on social and health outcomes with an emphasis on adults in middle to later life, and integrate these findings into the greater literature. PMID:23998798

  19. Maladaptive coping strategies and glaucoma progression.

    PubMed

    Freeman, Ellen E; Lesk, Mark R; Harasymowycz, Paul; Desjardins, Daniel; Flores, Veronica; Kamga, Hortence; Li, Gisèle

    2016-08-01

    The identification of modifiable risk factors for glaucoma progression is needed. Our objective was to determine whether maladaptive coping styles are associated with recent glaucoma progression or worse visual field mean deviation.A hospital-based case-control study was conducted in the Glaucoma Service of Maisonneuve-Rosemont Hospital in Montreal, Canada. Patients with primary open angle glaucoma or normal tension glaucoma with ≥4 years of follow-up and ≥5 Humphrey visual fields were included. Cases had recent visual field progression as defined according to the Early Manifest Glaucoma Trial pattern change probability maps. Controls had stable visual fields. The Brief Cope questionnaire, a 28-item questionnaire about 14 different ways of coping with the stress of a chronic disease, was asked. Questions were also asked about demographic and medical factors, and the medical chart was examined. Outcomes included glaucoma progression (yes, no) and visual field mean deviation. Logistic and linear regressions were used.A total of 180 patients were included (82 progressors and 98 nonprogressors). Although none of the 14 coping scales were associated with glaucoma progression (P > 0.05), higher denial was correlated with worse visual field mean deviation (r = -0.173, P = 0.024). In a linear regression model including age, sex, education, depression, intraocular pressure, and family history of glaucoma, greater levels of denial (β = -1.37, 95% confidence interval [CI] -2.32, -0.41), Haitian ethnicity (β = -7.78, 95% CI -12.52, -3.04), and the number of glaucoma medications (β = -1.20, 95% CI -2.00, -0.38) were statistically significantly associated with visual field mean deviation.The maladaptive coping mechanism of denial was a risk factor for worse visual field mean deviation. Further prospective research will be required to verify the pathways by which denial may exert an effect on glaucomatous visual field loss. PMID:27583929

  20. Maladaptive coping strategies and glaucoma progression

    PubMed Central

    Freeman, Ellen E.; Lesk, Mark R.; Harasymowycz, Paul; Desjardins, Daniel; Flores, Veronica; Kamga, Hortence; Li, Gisèle

    2016-01-01

    Abstract The identification of modifiable risk factors for glaucoma progression is needed. Our objective was to determine whether maladaptive coping styles are associated with recent glaucoma progression or worse visual field mean deviation. A hospital-based case–control study was conducted in the Glaucoma Service of Maisonneuve-Rosemont Hospital in Montreal, Canada. Patients with primary open angle glaucoma or normal tension glaucoma with ≥4 years of follow-up and ≥5 Humphrey visual fields were included. Cases had recent visual field progression as defined according to the Early Manifest Glaucoma Trial pattern change probability maps. Controls had stable visual fields. The Brief Cope questionnaire, a 28-item questionnaire about 14 different ways of coping with the stress of a chronic disease, was asked. Questions were also asked about demographic and medical factors, and the medical chart was examined. Outcomes included glaucoma progression (yes, no) and visual field mean deviation. Logistic and linear regressions were used. A total of 180 patients were included (82 progressors and 98 nonprogressors). Although none of the 14 coping scales were associated with glaucoma progression (P > 0.05), higher denial was correlated with worse visual field mean deviation (r = −0.173, P = 0.024). In a linear regression model including age, sex, education, depression, intraocular pressure, and family history of glaucoma, greater levels of denial (β = −1.37, 95% confidence interval [CI] −2.32, −0.41), Haitian ethnicity (β = −7.78, 95% CI −12.52, −3.04), and the number of glaucoma medications (β = −1.20, 95% CI −2.00, −0.38) were statistically significantly associated with visual field mean deviation. The maladaptive coping mechanism of denial was a risk factor for worse visual field mean deviation. Further prospective research will be required to verify the pathways by which denial may exert an effect on glaucomatous visual

  1. Understanding College Students' Problems: Dysfunctional Thinking, Mental Health, and Maladaptive Behavior

    ERIC Educational Resources Information Center

    Mandracchia, Jon T.; Pendleton, Shandrea

    2015-01-01

    Many college students experience mental health problems and engage in risky behavior. These problems perpetuate negative outcomes such as poor academic performance and health problems, which may ultimately result in dropping out of college. Maladaptive cognitions, such as criminogenic thinking, have been established as an important contributor to…

  2. The Detrimental Impact of Maladaptive Personality on Public Mental Health: A Challenge for Psychiatric Practice

    PubMed Central

    Hengartner, Michael Pascal

    2015-01-01

    Experts in personality psychology and personality disorders have long emphasized the pervasive and persistent detrimental impact of maladaptive personality traits on mental health and functioning. However, in routine psychiatric practice, maladaptive personality is readily ignored and personality traits are seldom incorporated into clinical guidelines. The aim of this narrative review is to outline how pervasively personality influences public mental health and how personality thereby challenges common psychiatric practice. A comprehensive search and synthesis of the scientific literature demonstrates that maladaptive personality traits and personality disorders, in particular high neuroticism and negative affectivity, first, are risk factors for divorce, unemployment, and disability pensioning; second, relate to the prevalence, incidence, and co-occurrence of common mental disorders; third, impair functioning, symptom remission, and recovery in co-occurring common mental disorders; and fourth, predispose to treatment resistance, non-response and poor treatment outcome. In conclusion, maladaptive personality is not only involved in the development and course of mental disorders but also predisposes to chronicity and re-occurrence of psychopathology and reduces the efficacy of psychiatric treatments. The pernicious impact of maladaptive personality on mental health and functioning demands that careful assessment and thorough consideration of personality should be compulsory in psychiatric practice. PMID:26106335

  3. The Looming Maladaptive Style in Social Anxiety

    ERIC Educational Resources Information Center

    Brown, Michael A.; Stopa, Luisa

    2008-01-01

    This exploratory study examined the relationship between the looming maladaptive style (i.e., an enduring and traitlike cognitive pattern to appraise threat as rapidly rising in risk, progressively worsening, or actively speeding up and accelerating) and three different aspects of trait social anxiety (i.e., fear of negative evaluation, social…

  4. A Screen for Identifying Maladaptive Internet Use

    ERIC Educational Resources Information Center

    Chow, Siu L.; Leung, G. M.; Ng, Cecilia; Yu, Effie

    2009-01-01

    A screening tool (in Chinese) for maladaptive internet use was developed in two stages. Thirty-five factors were first extracted from data obtained from 378 adolescents with a 179-item questionnaire. Nine higher-order factors were then obtained from 35 factors. A 26-item screen that measures both endogenous and exogenous factors was constructed on…

  5. The Adaptive/Maladaptive Perfectionism Scale.

    ERIC Educational Resources Information Center

    Rice, Kenneth G.; Preusser, Karen J.

    2002-01-01

    Describes the development of the Adaptive/Maladaptive Perfectionism Scale (AMPS) for children. Expert reviewers and samples of 4th- and 5th-grade students were used to develop items and evaluate the internal structure and reliability of scores for the resulting instrument. Results supported 4 dimensions of perfectionism that could be reliably…

  6. Early Maladaptive Schemas in a Sample of Airline Pilots seeking Residential Substance Use Treatment: An Initial Investigation

    PubMed Central

    Shorey, Ryan C.; Brasfield, Hope; Anderson, Scott; Stuart, Gregory L.

    2014-01-01

    Background Recent research has begun to examine the early maladaptive schemas of substance abusers, as it is believed that targeting these core beliefs in treatment may result in improved substance use outcomes. One special population that has received scant attention in the research literature, despite high levels of substance use, is airline pilots. Aims The current study examined the early maladaptive schemas of a sample of airline pilots (n = 64) who were seeking residential treatment for alcohol dependence and whether they differed in early maladaptive schemas from non-pilot substance abusers who were also seeking residential treatment for alcohol dependence (n = 45). Method Pre-existing medical records from patients of a residential substance abuse treatment facility were reviewed for the current study. Results Of the 18 early maladaptive schemas, results demonstrated that pilots scored higher than non-pilots on the early maladaptive schema of unrelenting standards (high internalized standards of behavior), whereas non-pilots scored higher on insufficient self-control (low frustration tolerance and self-control). Conclusions Early maladaptive schemas may be a relevant treatment target for substance abuse treatment seeking pilots and non-pilots. PMID:24701252

  7. Humans In Hypoxia: A Conspiracy Of Maladaptation?!

    PubMed

    Dempsey, Jerome A; Morgan, Barbara J

    2015-07-01

    We address adaptive vs. maladaptive responses to hypoxemia in healthy humans and hypoxic-tolerant species during wakefulness, sleep, and exercise. Types of hypoxemia discussed include short-term and life-long residence at high altitudes, the intermittent hypoxemia attending sleep apnea, or training regimens prescribed for endurance athletes. We propose that hypoxia presents an insult to O2 transport, which is poorly tolerated in most humans because of the physiological cost. PMID:26136544

  8. Humans In Hypoxia: A Conspiracy Of Maladaptation?!

    PubMed Central

    Morgan, Barbara J.

    2015-01-01

    We address adaptive vs. maladaptive responses to hypoxemia in healthy humans and hypoxic-tolerant species during wakefulness, sleep, and exercise. Types of hypoxemia discussed include short-term and life-long residence at high altitudes, the intermittent hypoxemia attending sleep apnea, or training regimens prescribed for endurance athletes. We propose that hypoxia presents an insult to O2 transport, which is poorly tolerated in most humans because of the physiological cost. PMID:26136544

  9. Birth Order and Maladaptive Behavior in School-Aged Children.

    ERIC Educational Resources Information Center

    Carmichael, Karla D.

    Drawing on Alfred Adler's theories on the effect of birth order on maladaptive behavior in children, this study focused on the relationship between birth order and the referral to counseling of school-aged children with maladaptive disorder. School-aged children (N=217) with academic or behavioral problems, ages 5 to 18, were referred to the staff…

  10. Developmental Trajectories of Maladaptive Perfectionism among African American Adolescents

    ERIC Educational Resources Information Center

    Herman, Keith C.; Wang, Kenneth; Trotter, Reid; Reinke, Wendy M.; Ialongo, Nicholas

    2013-01-01

    This study examined the developmental trajectories of maladaptive perfectionism over a 7-year period among African American youth living in an urban setting (N = 547). In particular, the study attempted to determine whether two maladaptive aspects of perfectionism (socially prescribed and self-critical) changed over time and could be distinguished…

  11. Alexithymia and Early Maladaptive Schemas in chronic pain patients.

    PubMed

    Saariaho, Anita S; Saariaho, Tom H; Mattila, Aino K; Karukivi, Max; Joukamaa, Matti I

    2015-08-01

    Psychological factors have an impact on subjective pain experience. The aim of this study was to explore the occurrence of alexithymia and Early Maladaptive Schemas in a sample of 271 first visit chronic pain patients of six pain clinics. The patients completed the study questionnaire consisting of the Toronto Alexithymia Scale-20, the Finnish version of the Young Schema Questionnaire short form-extended, the Beck Depression Inventory-II, and pain variables. Alexithymic patients scored higher on Early Maladaptive Schemas and had more pain intensity, pain disability and depression than nonalexithymic patients. Both alexithymia and depression correlated significantly with most Early Maladaptive Schemas. The co-occurrence of alexithymia, Early Maladaptive Schemas and depression seems to worsen the pain experience. Screening of alexithymia, depression and Early Maladaptive Schemas may help to plan psychological treatment interventions for chronic pain patients. PMID:26040835

  12. Early maladaptive schemas of personality disorder subtypes.

    PubMed

    Petrocelli, J V; Glaser, B A; Calhoun, G B; Campbell, L F

    2001-12-01

    This investigation attempted to examine the cognitive schemas of five distinct clusters that emerged from a cluster analysis of the personality disorder scales of the Millon Clinical Multiaxial Inventory-II (Millon, 1987). Specifically, the degree to which early maladaptive schemas, as measured by the Cognitive Schema Questionnaire-Short Form (Young, 1994), could correctly identify empirically derived patterns of personality disorders was examined. Between-cluster differences centered on five personality components and five schemas. Discriminant analyses revealed two significant functions composed of cognitive schemas, which correctly identified 61.2% of the entire sample in terms of cluster group membership. The total proportion of variance in the two significant functions associated with cluster group differences was 76.8%. Findings are discussed in relation to the domain theory of personality disorders posited by Millon and Davis (1996). PMID:11778396

  13. [Characteristics of oxidative stress in mental maladaptation].

    PubMed

    Smirnova, L P; Ivanova, S A; Krotenko, N M; Levchuk, L A; Gutkevich, E V; Semke, V Ia

    2012-01-01

    Changes in the balance of pro and antioxidant systems were studied in persons in state of mental maladaptation, developed under the influence of emotional stress. Activation of lipid peroxidation has been revealed associated with increase of amount of malondialdehyde in erythrocytes and blood serum in persons surveyed. Activity of catalase and glutathione peroxidase in erythrocytes in persons in state of mental stress was increased and glutathione preductase, glutathione-S-transferase and glucose-6-phosphate dehydrogenase has been reliably reduced as compared with group of healthy people. Comparative chemiluminiscent analysis of common antioxidant properties of serum of blood of studied groups has also revealed decrease of antioxidant properties of blood under influence of mental stress. PMID:23101248

  14. Circuit dynamics of adaptive and maladaptive behaviour

    PubMed Central

    Deisseroth, Karl

    2014-01-01

    The recent development of technologies for investigating specific components of intact biological systems has allowed elucidation of the neural circuitry underlying adaptive and maladaptive behaviours. Investigators are now able to observe and control, with high spatio-temporal resolution, structurally defined intact pathways along which electrical activity flows during and after the performance of complex behaviours. These investigations have revealed that control of projection-specific dynamics is well suited to modulating behavioural patterns that are relevant to a broad range of psychiatric diseases. Structural dynamics principles have emerged to provide diverse, unexpected and causal insights into the operation of intact and diseased nervous systems, linking form and function in the brain. PMID:24429629

  15. Adaptive and maladaptive mechanisms of cellular priming.

    PubMed Central

    Meldrum, D R; Cleveland, J C; Moore, E E; Partrick, D A; Banerjee, A; Harken, A H

    1997-01-01

    OBJECTIVE: The mechanisms of cellular priming resulting in both adaptive and maladaptive responses to subsequent injury and strategies for manipulating this priming to constructive therapeutic advantage are explored. BACKGROUND DATA: A cell is prepared or educated by an initial insult (priming stimulus). Investigations in both laboratory animals and humans indicate that cells, organs, and perhaps even whole patients respond differently to a proximal second insult ("second hit") by virtue of this prior environmental history. The opportunity to achieve the primed state appears to be conserved across almost all cell types. The initial stimulus transmits a message to the cellular machinery that influences the cell's response to a subsequent challenge. This response may result in an exaggerated inflammatory response in the case of the neutrophil (an often maladaptive process) or an improved tolerance to injury by the myocyte (adaptive response). Our global hypothesis is that cellular priming is a conserved, receptor-dependent process that invokes common intracellular targets across multiple cell types. We further postulate that these targets create a language based on the transient phosphorylation and dephosphorylation of intracellular enzymes that is therapeutically accessible. CONCLUSIONS: Priming is a conserved, receptor-dependent process transduced by means of intracellular targets across multiple cell types. The potential therapeutic strategies outlined involve the receptor-mediated manipulation of cellular events. These events are transmitted through an intracellular language that instructs the cell regarding its behavior in response to subsequent stimulation. Understanding these intracellular events represents a realistic goal of priming and preconditioning biology and will likely lead to clinical control of the primed state. PMID:9389392

  16. Maladaptive autonomic regulation in PTSD accelerates physiological aging

    PubMed Central

    Williamson, John B.; Porges, Eric C.; Lamb, Damon G.; Porges, Stephen W.

    2015-01-01

    A core manifestation of post-traumatic stress disorder (PTSD) is a disconnection between physiological state and psychological or behavioral processes necessary to adequately respond to environmental demands. Patients with PTSD experience abnormal oscillations in autonomic states supporting either fight and flight behaviors or withdrawal, immobilization, and dissociation without an intervening “calm” state that would provide opportunities for positive social interactions. This defensive autonomic disposition is adaptive in dangerous and life threatening situations, but in the context of every-day life may lead to significant psychosocial distress and deteriorating social relationships. The perpetuation of these maladaptive autonomic responses may contribute to the development of comorbid mental health issues such as depression, loneliness, and hostility that further modify the nature of cardiovascular behavior in the context of internal and external stressors. Over time, changes in autonomic, endocrine, and immune function contribute to deteriorating health, which is potently expressed in brain dysfunction and cardiovascular disease. In this theoretical review paper, we present an overview of the literature on the chronic health effects of PTSD. We discuss the brain networks underlying PTSD in the context of autonomic efferent and afferent contributions and how disruption of these networks leads to poor health outcomes. Finally, we discuss treatment approaches based on our theoretical model of PTSD. PMID:25653631

  17. Microgeographic maladaptive performance and deme depression in response to roads and runoff.

    PubMed

    Brady, Steven P

    2013-01-01

    Despite theoretical understanding and empirical detection of local adaptation in natural environments, our knowledge of such divergence in fragmented habitats remains limited, especially in the context of microgeographic spatial scales and contemporary time scales. I used a combination of reciprocal transplant and common garden exposure experiments to evaluate potential microgeographic divergence in a pool-breeding amphibian occupying a landscape fragmented by roads. As indicated by reduced rates of survival and increased rates of malformation, I found evidence for maladaptation in road adjacent populations. This response is in direct counterpoint to recently described local adaption by a cohabiting species of amphibian. These results suggest that while divergence might commonly follow habitat modification, the direction of its outcome cannot be generalized even in identical habitats. Further, maladaptive responses can be associated with a more generalized depression effect that transcends the local environment. Alongside recent reports, these results suggest that maladaptive responses may be an emerging consequence of human-induced environmental change. Thus future studies should carefully consider the population unit as a key level for inference. PMID:24109548

  18. Microgeographic maladaptive performance and deme depression in response to roads and runoff

    PubMed Central

    2013-01-01

    Despite theoretical understanding and empirical detection of local adaptation in natural environments, our knowledge of such divergence in fragmented habitats remains limited, especially in the context of microgeographic spatial scales and contemporary time scales. I used a combination of reciprocal transplant and common garden exposure experiments to evaluate potential microgeographic divergence in a pool-breeding amphibian occupying a landscape fragmented by roads. As indicated by reduced rates of survival and increased rates of malformation, I found evidence for maladaptation in road adjacent populations. This response is in direct counterpoint to recently described local adaption by a cohabiting species of amphibian. These results suggest that while divergence might commonly follow habitat modification, the direction of its outcome cannot be generalized even in identical habitats. Further, maladaptive responses can be associated with a more generalized depression effect that transcends the local environment. Alongside recent reports, these results suggest that maladaptive responses may be an emerging consequence of human-induced environmental change. Thus future studies should carefully consider the population unit as a key level for inference. PMID:24109548

  19. Developmental Trajectories of Maladaptive Perfectionism among African American Adolescents

    PubMed Central

    Herman, Keith C.; Wang, Kenneth; Trotter, Reid; Reinke, Wendy M.; Ialongo, Nicholas

    2013-01-01

    The present study examined the developmental trajectories of maladaptive perfectionism over a seven-year period among African American youth living in an urban setting (N=547). In particular, the study attempted to determine whether two maladaptive aspects of perfectionism (socially-prescribed and self-critical) changed over time and could be distinguished by variables in 6th and 12th grade (mean age at study entry (first grade) was 6.22 years (SD = 0.34)). Four classes best described the developmental trajectories on both measures of maladaptive perfectionism: high; low; increasing; and decreasing. Sixth and twelfth grade correlates, including measures of internalizing symptoms mostly confirmed the distinctiveness of these classes. Parallel process analyses suggested that the two processes are complementary, yet distinct. Implications regarding the prevention of maladaptive perfectionism are discussed. PMID:23480846

  20. Familial Accumulation of Social Anxiety Symptoms and Maladaptive Emotion Regulation

    PubMed Central

    Asbrand, Julia; Svaldi, Jennifer; Krämer, Martina; Breuninger, Christoph; Tuschen-Caffier, Brunna

    2016-01-01

    Background Social anxiety is thought to be strongly related to maladaptive emotion regulation (ER). As social anxiety symptoms accumulate in families, we hypothesize that maladaptive ER is also more prevalent in families with anxious children. Thus, we analyze differences in emotion regulation of both child and mother in relation to social anxiety, as well as both their ER strategies in dealing with anxiety. Further, a positive relation between child and maternal ER strategies is assumed. Method Children (aged 9 to 13 years) with social, anxiety disorder (SAD; n = 25) and healthy controls (HC, n = 26) as well as their mothers completed several measures of social anxiety and trait ER strategies towards anxiety. As ER of children is still in development, age is considered as covariate. Results SAD children and their mothers reported more maladaptive ER strategies than HC dyads. Maternal maladaptive ER was related negatively to child adaptive ER which was further moderated by the child’s age. Discussion Maladaptive ER strategies seem to contribute to the exacerbation of social anxiety in both mother and child. Mothers reporting maladaptive ER may have difficulties supporting their child in coping with social anxiety while simultaneously also experiencing heightened levels of anxiety. Deeper understanding of interactional processes between mothers and children during development can assist the comprehension of factors maintaining SAD. Implications for future research and possible consequences for interventions are discussed. PMID:27055278

  1. The mediating roles of stress and maladaptive behaviors on self-harm and suicide attempts among runaway and homeless youth.

    PubMed

    Moskowitz, Amanda; Stein, Judith A; Lightfoot, Marguerita

    2013-07-01

    Runaway and homeless youth often have a constellation of background behavioral, emotional, and familial problems that contribute to stress and maladaptive behaviors, which, in turn, can lead to self-harming and suicidal behaviors. The current study examined the roles of stress and maladaptive behaviors as mediators between demographic and psychosocial background characteristics and self-injurious outcomes through the lens of the stress process paradigm. The model was tested in a sample of runaway and homeless youth from Los Angeles County (N = 474, age 12-24, 41 % female, 17 % White, 32.5 % African American, 21.5 % Hispanic/Latino). Background variables (gender, age, sexual minority status, parental drug use history, and emotional distress) predicted hypothesized mediators of maladaptive behaviors and recent stress. In turn, it was hypothesized that the mediators would predict self-harming behaviors and suicide attempts in the last 3 months. Females and LGBT (lesbian, gay, bisexual, transgender) youth were more likely to have self-harmed and attempted suicide; younger participants reported more self-harming. The mediating constructs were associated more highly with self-harming than suicide attempts bivariately, although differences were modest. Maladaptive behaviors and recent stress were significant predictors of self-harm, whereas only recent stress was a significant predictor of suicide attempts. All background factors were significant predictors of recent stress. Older age, a history of parental drug use, and greater emotional distress predicted problem drug use. Males, younger participants, and participants with emotional distress reported more delinquent behaviors. Significant indirect effects on self-harming behaviors were mediated through stress and maladaptive behaviors. The hypothesized paradigm was useful in explaining the associations among background factors and self-injurious outcomes and the influence of mediating factors on these

  2. In vitro and in vivo effects of kinin B1 and B2 receptor agonists and antagonists in inbred control and cardiomyopathic hamsters

    PubMed Central

    Hallé, S; Gobeil, F; Ouellette, J; Lambert, C; Regoli, D

    2000-01-01

    The aims of this study were to examine the possible alterations occurring in the effects of kinins on isolated aortae of inbred control (CHF 148) and cardiomyopathic (CHF 146) hamsters of 150–175 and 350–375 days of age.Bradykinin (BK) and desArg9BK contracted isolated aortae (with or without endothelium) of hamsters of both strains and ages. After tissue equilibration (90 min), responses elicited by both kinin agonists were stable over the time of experiments. The patterns of isometric contractions of BK and desArg9BK were however found to be different; desArg9BK had a slower onset and a longer duration of action than BK.Potencies (pEC50 values) of BK in all groups of hamsters were significantly increased by preincubating the tissues with captopril (10−5 M).No differences in the pEC50 values and the Emax values for BK or desArg9BK were seen between isolated vessels from inbred control and cardiomyopathic hamsters.The myotropic effect of BK was inhibited by the selective non peptide antagonist, FR 173657 (pIC50 7.25±0.12 at the bradykinin B2 receptor subtype (B2 receptor)). Those of desArg9BK, at the bradykinin B1 receptor subtype (B1 receptor) were abolished by either R 715 (pIC50 of 7.55±0.05; αE=0), Lys[Leu8]desArg9BK (pIC50 of 7.21±0.01; αE=0.22) or [Leu8]desArg9BK (pIC50 of 7.25±0.02; αE=0.18).FR 173657 had no agonistic activity, exerted a non competitive type of antagonism and was poorly reversible (lasting more than 5 h) from B2 receptor. In vivo, FR 173657 (given per os at 1 and 5 mg kg−1, 1 h before the experiment) antagonized the acute hypotensive effect of BK in anaesthetized hamsters.It is concluded that aging and/or the presence of a congenital cardiovascular disorder in hamsters are not associated with changes in the in vitro aortic responses to either BK or desArg9BK. PMID:10780969

  3. Maladaptively high and low openness: the case for experiential permeability.

    PubMed

    Piedmont, Ralph L; Sherman, Martin F; Sherman, Nancy C

    2012-12-01

    The domain of Openness within the Five-Factor Model (FFM) has received inconsistent support as a source for maladaptive personality functioning, at least when the latter is confined to the disorders of personality included within the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; APA, ). However, an advantage of the FFM relative to the DSM-IV-TR is that the former was developed to provide a reasonably comprehensive description of general personality structure. Rather than suggest that the FFM is inadequate because the DSM-IV-TR lacks much representation of Openness, it might be just as reasonable to suggest that the DSM-IV-TR is inadequate because it lacks an adequate representation of maladaptive variants of both high and low Openness. This article discusses the development and validation of a measure of these maladaptive variants, the Experiential Permeability Inventory. PMID:22320184

  4. How maladaptation can structure biodiversity: eco-evolutionary island biogeography.

    PubMed

    Farkas, Timothy E; Hendry, Andrew P; Nosil, Patrik; Beckerman, Andrew P

    2015-03-01

    Current research on eco-evolutionary dynamics is mainly concerned with understanding the role of rapid (or 'contemporary') evolution in structuring ecological patterns. We argue that the current eco-evolutionary research program, which focuses largely on natural selection, should be expanded to more explicitly consider other evolutionary processes such as gene flow. Because multiple evolutionary processes interact to generate quantitative variation in the degree of local maladaptation, we focus on how studying the ecological effects of maladaptation will lead to a more comprehensive view of how evolution can influence ecology. We explore how maladaptation can influence ecology through the lens of island biogeography theory, which yields some novel predictions, such as patch isolation increasing species richness. PMID:25666433

  5. Cortisol Reactivity to Social Stress as a Mediator of Early Adversity on Risk and Adaptive Outcomes

    ERIC Educational Resources Information Center

    Conradt, Elisabeth; Abar, Beau; Lester, Barry M.; LaGasse, Linda L.; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles R.; Whitaker, Toni M.; Hammond, Jane A.

    2014-01-01

    Children chronically exposed to stress early in life are at increased risk for maladaptive outcomes, though the physiological mechanisms driving these effects are unknown. Cortisol reactivity was tested as a mediator of the relation between prenatal substance exposure and/or early adversity on adaptive and maladaptive outcomes. Data were drawn…

  6. Associations between belief in conspiracy theories and the maladaptive personality traits of the personality inventory for DSM-5.

    PubMed

    Swami, Viren; Weis, Laura; Lay, Alixe; Barron, David; Furnham, Adrian

    2016-02-28

    Conspiracy theories can be treated as both rational narratives of the world as well as outcomes of underlying maladaptive traits. Here, we examined associations between belief in conspiracy theories and individual differences in personality disorders. An Internet-based sample (N=259) completed measures of belief in conspiracy theories and the 25 facets of the Personality Inventory for DSM-5 (PID-5). Preliminary analyses showed no significant differences in belief in conspiracy theories across participant sex, ethnicity, and education. Regression analyses showed that the PID-5 facets of Unusual Beliefs and Experiences and, to a lesser extent, Suspiciousness, significantly predicted belief in conspiracy theories. These findings highlight a role for maladaptive personality traits in understanding belief in conspiracy theories, but require further investigation. PMID:26776299

  7. Cardiac calcium release channel (ryanodine receptor) in control and cardiomyopathic human hearts: mRNA and protein contents are differentially regulated.

    PubMed

    Sainte Beuve, C; Allen, P D; Dambrin, G; Rannou, F; Marty, I; Trouvé, P; Bors, V; Pavie, A; Gandgjbakch, I; Charlemagne, D

    1997-04-01

    Abnormal intracellular calcium handling in cardiomyopathic human hearts has been associated with an impaired function of the sarcoplasmic reticulum, but previous reports on the gene expression of the ryanodine receptors (Ry2) are contradictory. We measured the mRNA levels, the protein levels and the number of high affinity [3H]ryanodine binding sites in the left ventricle of non-failing (n = 9) and failing human hearts [idiopathic dilated (IDCM n = 16), ischemic (ICM n = 7) or mixed (MCM n = 8) cardiomyopathies]. Ry2 mRNA levels were significantly reduced in IDCM (-30%) and unchanged in MCM and ICM and Ry2 protein levels were similar. In contrast, we observed a two-fold increase in the number of high affinity Ry2 (B(max) = 0.43 +/- 0.11 v 0.22 +/- 0.13 pmol/mg protein, respectively; P<0.01) and an unchanged K(d). Furthermore, levels of myosin heavy chain mRNA and protein per g of tissue were similar in failing and non-failing hearts, suggesting that the observed differences in Ry2 are not caused by the increase in fibrosis in failing heart. Therefore, the dissociation between the two-fold increase in the number of high affinity ryanodine receptors observed in all failing hearts and the slightly decreased mRNA level or unchanged protein level suggests that the ryanodine binding properties are affected in failing myocardium and that such modifications rather than a change in gene expression alter the channel activity and could contribute to abnormalities in intracellular Ca2+ handling. PMID:9160875

  8. Parental Practices and the Development of Maladaptive Schemas

    ERIC Educational Resources Information Center

    Gunty, Amy L.; Buri, John R.

    2008-01-01

    The relationship between Young's (1999) Early Maladaptive Schemas (EMSs) and several parental variables was investigated. The parental variables of interest were: (a) Nurturance, (b) Authority, (c) Intrusiveness, (d) Psychological Control, (e) Overprotection, and (f) Parentification. Regression analyses revealed that these parental practices…

  9. Maladaptive Plasticity for Motor Recovery after Stroke: Mechanisms and Approaches

    PubMed Central

    Takeuchi, Naoyuki; Izumi, Shin-Ichi

    2012-01-01

    Many studies in human and animal models have shown that neural plasticity compensates for the loss of motor function after stroke. However, neural plasticity concerning compensatory movement, activated ipsilateral motor projections and competitive interaction after stroke contributes to maladaptive plasticity, which negatively affects motor recovery. Compensatory movement on the less-affected side helps to perform self-sustaining activity but also creates an inappropriate movement pattern and ultimately limits the normal motor pattern. The activated ipsilateral motor projections after stroke are unable to sufficiently support the disruption of the corticospinal motor projections and induce the abnormal movement linked to poor motor ability. The competitive interaction between both hemispheres induces abnormal interhemispheric inhibition that weakens motor function in stroke patients. Moreover, widespread disinhibition increases the risk of competitive interaction between the hand and the proximal arm, which results in an incomplete motor recovery. To minimize this maladaptive plasticity, rehabilitation programs should be selected according to the motor impairment of stroke patients. Noninvasive brain stimulation might also be useful for correcting maladaptive plasticity after stroke. Here, we review the underlying mechanisms of maladaptive plasticity after stroke and propose rehabilitation approaches for appropriate cortical reorganization. PMID:22792492

  10. Posttraumatic Maladaptive Beliefs Scale: Evolution of the Personal Beliefs and Reactions Scale

    ERIC Educational Resources Information Center

    Vogt, Dawne S.; Shipherd, Jillian C.; Resick, Patricia A.

    2012-01-01

    The Posttraumatic Maladaptive Beliefs Scale (PMBS) was developed to measure maladaptive beliefs about current life circumstances that may occur following trauma exposure. This scale assesses maladaptive beliefs within three domains: (a) Threat of Harm, (b) Self-Worth and Judgment, and (c) Reliability and Trustworthiness of Others. Items for the…

  11. Maladaptive Behavior in Autism Spectrum Disorder: The Role of Emotion Experience and Emotion Regulation

    ERIC Educational Resources Information Center

    Samson, Andrea C.; Hardan, Antonio Y.; Lee, Ihno A.; Phillips, Jennifer M.; Gross, James J.

    2015-01-01

    Maladaptive behavior is common in Autism Spectrum Disorder (ASD). However, the factors that give rise to maladaptive behavior in this context are not well understood. The present study examined the role of emotion experience and emotion regulation in maladaptive behavior in individuals with ASD and typically developing (TD) participants.…

  12. Self-Compassion as a Mediator of Maladaptive Perfectionism and Depressive Symptoms in College Students

    ERIC Educational Resources Information Center

    Mehr, Kristin E.; Adams, Aimee C.

    2016-01-01

    The purpose of the study was to examine the relationships among maladaptive perfectionism, self-compassion, and depressive symptoms in college students. It was hypothesized that self-compassion would mediate the relationship between maladaptive perfectionism and depressive symptoms, with maladaptive perfectionism related to lower levels of…

  13. Gang Membership and Pathways to Maladaptive Parenting

    PubMed Central

    Augustyn, Megan Bears; Thornberry, Terence P.; Krohn, Marvin D.

    2014-01-01

    A limited amount of research examines the short-term consequences of gang membership. Rarer, though, is the examination of more distal consequences of gang membership. This is unfortunate because it understates the true detrimental effect of gang membership across the life course, as well as the effects it may have on children of former gang members. Using data from the Rochester Youth Development Study, this work investigates the impact of gang membership in adolescence (ages 12-18) on a particularly problematic style of parenting, child maltreatment. Using discrete time survival analysis, this study finds that gang membership increases the likelihood of child maltreatment and this relationship is mediated by the more proximal outcomes of gang membership during adolescence, precocious transitions to adulthood. PMID:24883000

  14. Coping with Jealousy: The Association between Maladaptive Aspects of Jealousy and Drinking Problems are Mediated by Drinking to Cope

    PubMed Central

    DiBello, Angelo M.; Neighbors, Clayton; Rodriguez, Lindsey M.; Lindgren, Kristen

    2013-01-01

    Previous research has shown that both alcohol use and jealousy are related to negative relationship outcomes. Little work, however, has examined direct associations between alcohol use and jealousy. The current study aimed to build upon existing research examining alcohol use and jealousy. More specifically, findings from current jealousy literature indicate that jealousy is a multifaceted construct with both maladaptive and adaptive aspects. The current study examined the association between maladaptive and adaptive feelings of jealousy and alcohol-related problems in the context of drinking to cope. Given the relationship between coping motives and alcohol-related problems, our primary interest was in predicting alcohol-related problems, but alcohol consumption was also investigated. Undergraduate students at a large Northwestern university (N = 657) in the US participated in the study. They completed measures of jealousy, drinking to cope, alcohol use, and alcohol-related problems. Analyses examined associations between jealousy subscales, alcohol use, drinking to cope, and drinking problems. Results indicated that drinking to cope mediated the association between some, but not all, aspects of jealousy and problems with alcohol use. In particular, the more negative or maladaptive aspects of jealousy were related to drinking to cope and drinking problems, while the more adaptive aspects were not, suggesting a more complex view of jealousy than previously understood. PMID:24138965

  15. Adaptive and maladaptive personality traits in high-risk gamblers.

    PubMed

    Carlotta, Davide; Krueger, Robert F; Markon, Kristian E; Borroni, Serena; Frera, Fernanda; Somma, Antonella; Maffei, Cesare; Fossati, Andrea

    2015-06-01

    Gambling Disorder (GD) is an addictive disorder resulting in significant impairment in occupational and social functioning. The aim of the present study was to investigate the relationship of GD risk to adaptive and maladaptive personality dimensions in a sample of nonreferred Italian gamblers. The authors found the risk for GD to show significant associations with the Openness and Conscientiousness scales of the Big Five Inventory (BFI); however, these effects were not significant after controlling for alcohol and drug use. GD risk showed significant associations with the Detachment and Antagonism domains of the Personality Inventory for DSM-5 (PID-5), as well as with the PID-5 facet scales of Hostility, Callousness, Deceitfulness, Manipulativeness, Irresponsibility, and (low) Rigid Perfectionism, even when controlling for alcohol and drug use. Maladaptive personality dispositions may serve as risk factors for pathological gambling, even beyond their impact on frequently concomitant problems with alcohol and other drugs. PMID:25248017

  16. Neural Mechanisms Supporting Maladaptive Food Choices in Anorexia Nervosa

    PubMed Central

    Foerde, Karin; Steinglass, Joanna; Shohamy, Daphna; Walsh, B. Timothy

    2015-01-01

    People routinely make poor choices, despite knowledge of negative consequences. We found that individuals with Anorexia Nervosa, who make maladaptive food choices to the point of starvation, engaged the dorsal striatum more than healthy controls when making choices about what to eat, and that activity in fronto-striatal circuits was correlated with their actual food consumption in a meal the next day. PMID:26457555

  17. Development and validation of the Maladaptive Daydreaming Scale (MDS).

    PubMed

    Somer, Eli; Lehrfeld, Jonathan; Bigelsen, Jayne; Jopp, Daniela S

    2016-01-01

    This study describes the development of the Maladaptive Daydreaming Scale (MDS), a 14-item self-report instrument designed to gauge abnormal fantasizing. Our sample consisted of 447 English-speaking individuals from 45 different countries. A 3-correlated-factors model best presented the underlying dimensions Yearning, Kinesthesia and Impairment, capturing related rewarding experiences as well as psychological impairment of maladaptive daydreaming. MDS scores were associated with obsessive-compulsive behavior and thoughts, dissociative absorption, attention deficit, and high sense of presence during daydreaming, but less with psychotic symptoms. The MDS and its subscale demonstrated good validity, sound internal consistency and temporal stability and discriminated well between self-identified individuals with and without maladaptive daydreaming. Considering the instrument's high sensitivity and specificity levels, it seems an excellent measure for future investigation of MD that will, hopefully, shed light on the etiology and psycho-biological mechanisms involved in this mental condition, as well as on the development of effective MD treatment methods. PMID:26707384

  18. Maladaptive Behavior and Gastrointestinal Disorders in Children with Autism Spectrum Disorder

    PubMed Central

    Pusponegoro, Hardiono D.; Ismael, Sofyan; Sastroasmoro, Sudigdo; Firmansyah, Agus

    2015-01-01

    Purpose Various gastrointestinal factors may contribute to maladaptive behavior in children with autism spectrum disorders (ASD). To determine the association between maladaptive behavior in children with ASD and gastrointestinal symptoms such as severity, intestinal microbiota, inflammation, enterocyte damage, permeability and absorption of opioid peptides. Methods This observational cross-sectional study compared children with ASD to healthy controls, aged 2-10 years. Maladaptive behavior was classified using the Approach Withdrawal Problems Composite subtest of the Pervasive Developmental Disorder Behavior Inventory. Dependent variables were gastrointestinal symptom severity index, fecal calprotectin, urinary D-lactate, urinary lactulose/mannitol excretion, urinary intestinal fatty acids binding protein (I-FABP) and urinary opioid peptide excretion. Results We did not find a significant difference between children with ASD with severe or mild maladaptive behavior and control subjects for gastrointestinal symptoms, fecal calprotectin, urinary D-lactate, and lactulose/mannitol ratio. Urinary opioid peptide excretion was absent in all children. Children with ASD with severe maladaptive behavior showed significantly higher urinary I-FABP levels compared to those with mild maladaptive behavior (p=0.019) and controls (p=0.015). Conclusion In our series, maladaptive behavior in ASD children was not associated with gastrointestinal symptoms, intestinal inflammation (no difference in calprotectin), microbiota (no difference in urinary D-lactate) and intestinal permeability (no difference in lactulose/manitol ratio). ASD children with severe maladaptive behavior have significantly more enterocyte damage (increased urinary I-FABP) than ASD children with mild maladaptive behavior and normal children. PMID:26770897

  19. The Role of Maladaptive Cognitions in Hypersexuality among Highly Sexually Active Gay and Bisexual Men

    PubMed Central

    Pachankis, John E.; Rendina, H. Jonathon; Ventuneac, Ana; Grov, Christian; Parsons, Jeffrey T.

    2014-01-01

    Cognitive appraisals about sex may represent an important component of the maintenance and treatment of hypersexuality, but they are not currently represented in conceptual models of hypersexuality. Therefore, we validated a measure of maladaptive cognitions about sex and examined its unique ability to predict hypersexuality. Qualitative interviews with a pilot sample of 60 highly sexually active gay and bisexual men and expert review of items yielded a pool of 17 items regarding maladaptive cognitions about sex. A separate sample of 202 highly sexually active gay and bisexual men completed measures of sexual inhibition and excitation, impulsivity, emotional dysregulation, depression and anxiety, sexual compulsivity, the Hypersexual Disorder Screening Inventory proposed by the American Psychiatric Association’s DSM-5 Workgroup on Sexual and Gender Identity Disorders (2010). Factor analysis confirmed the presence of three subscales: perceived sexual needs, sexual costs, and sexual control efficacy. Structural equation modeling results were consistent with a cognitive model of hypersexuality whereby magnifying the necessity of sex and disqualifying the benefits of sex partially predicted minimized self-efficacy for controlling one’s sexual behavior, all of which predicted problematic hypersexuality. In multivariate logistic regression, disqualifying the benefits of sex predicted unique variance in hypersexuality, even after adjusting for the role of core constructs of existing research on hypersexuality, AOR = 1.78, 95% CI 1.02, 3.10. Results suggest the utility of a cognitive approach for better understanding hypersexuality and the importance of developing treatment approaches that encourage adaptive appraisals regarding the outcomes of sex and one’s ability to control his sexual behavior. PMID:24558123

  20. Elucidating the role of Early Maladaptive Schemas for psychotic symptomatology.

    PubMed

    Sundag, Johanna; Ascone, Leonie; de Matos Marques, Anna; Moritz, Steffen; Lincoln, Tania M

    2016-04-30

    Although cognitive accounts postulate negative self-concepts as a causal factor in the emergence of psychotic symptoms, little is known about the role of specific self-schemas for psychotic symptomatology. Building on a differentiated and treatment-informed schema model, we aimed to elucidate the role of Early Maladaptive Schemas (EMS) for psychotic symptomatology, particularly their specificity to patients with psychosis and their association with positive versus negative symptoms. We assessed EMS with the Young Schema Questionnaire in patients with psychosis (n=81), patients with depression (n=28) as well as healthy participants (n=60). In the psychosis sample symptoms were rated using the Positive and Negative Syndrome Scale. In comparison to healthy participants, patients with either psychosis or depression showed a higher overall number and intensity of EMS whereas the psychosis and the depression sample did not significantly differ. The overall number and intensity of EMS were significantly associated with positive but not with negative symptoms. Contrary to previous findings, patients with psychosis and patients with depression did not differ in the EMS subscale Mistrust/Abuse. The results suggest that EMS are particularly relevant to positive symptoms. Our findings imply that addressing maladaptive schemas in patients with psychosis by making use of the schema-concept holds potential. PMID:27086211

  1. Predicting Early Maladaptive Schemas Using Baumrind’s Parenting Styles

    PubMed Central

    Esmali Kooraneh, Ahmad; Amirsardari, Leili

    2015-01-01

    Background: Families play an essential role in maintaining children’s mental, social, and physical health. The family provides the first and the most important social context for human development. Objectives: The present study aimed to predict early maladaptive schemas using Baumrind’s parenting styles (root development). Patients and Methods: A total of 357 undergraduate students of Islamic Azad University, Urmia Branch, Iran, were selected through random cluster sampling during 2013 and 2014. The students were assessed using the Schema Questionnaire-Short Form (SQ-SF) and the Baumrind’s parenting styles inventories. Results: The result of regression analysis showed that Baumrind’s parenting styles are significant predictors of early maladaptive schemas (P < 0.001). Conclusions: The authoritative parenting style has some features such as showing high levels of warmth or encouraging kids to express their own possibly divergent opinions. The authoritarian parenting style, however, possesses traits such as heartlessness, impassiveness, strictness, and lack of attention to the children’s developmental needs, which is not acceptable. PMID:26288648

  2. Individual differences in cocaine addiction: maladaptive behavioural traits.

    PubMed

    Homberg, Judith R; Karel, Peter; Verheij, Michel M M

    2014-07-01

    Cocaine use leads to addiction in only a subset of individuals. Understanding the mechanisms underlying these individual differences in the transition from cocaine use to cocaine abuse is important to develop treatment strategies. There is agreement that specific behavioural traits increase the risk for addiction. As such, both high impulsivity and high anxiety have been reported to predict (compulsive) cocaine self-administration behaviour. Here, we set out a new view explaining how these two behavioural traits may affect addictive behaviour. According to psychological and psychiatric evolutionary views, organisms flourish well when they fit (match) their environment by trait and genotype. However, under non-fit conditions, the need to compensate the failure to deal with this environment increases, and, as a consequence, the functional use of rewarding drugs like cocaine may also increase. It suggests that neither impulsivity nor anxiety are bad per se, but that the increased risk to develop cocaine addiction is dependent on whether behavioural traits are adaptive or maladaptive in the environment to which the animals are exposed. This 'behavioural (mal)adaptation view' on individual differences in vulnerability to cocaine addiction may help to improve therapies for addiction. PMID:24835358

  3. Imprinting can cause a maladaptive preference for infectious conspecifics.

    PubMed

    Stephenson, Jessica F; Reynolds, Michael

    2016-04-01

    Recognizing and associating with specific individuals, such as conspecifics or kin, brings many benefits. One mechanism underlying such recognition is imprinting: the long-term memory of cues encountered during development. Typically, juveniles imprint on cues of nearby individuals and may later associate with phenotypes matching their 'recognition template'. However, phenotype matching could lead to maladaptive social decisions if, for instance, individuals imprint on the cues of conspecifics infected with directly transmitted diseases. To investigate the role of imprinting in the sensory ecology of disease transmission, we exposed juvenile guppies,Poecilia reticulata, to the cues of healthy conspecifics, or to those experiencing disease caused by the directly transmitted parasite Gyrodactylus turnbulli In a dichotomous choice test, adult 'disease-imprinted' guppies preferred to associate with the chemical cues of G. turnbulli-infected conspecifics, whereas 'healthy-imprinted' guppies preferred to associate with cues of uninfected conspecifics. These responses were only observed when stimulus fish were in late infection, suggesting imprinted fish responded to cues of disease, but not of infection alone. We discuss how maladaptive imprinting may promote disease transmission in natural populations of a social host. PMID:27072405

  4. The Early Maladaptive Schema Questionnaire-Short Form: A Construct Validity Study.

    ERIC Educational Resources Information Center

    Glaser, Brian A.; Campbell, Linda F.; Calhoun, Georgia B.; Bates, Jeffrey M.; Petrocelli, John V.

    2002-01-01

    N.B. Schmidt, T.E. Joiner, J.E. Young, and M.J. Telch (1995) provided preliminary construct validity for scores from J.E. Young's (1990) 205-item Early Maladaptive Schema Questionnaire. The present study extends this work by examining the construct validity of scores from the shorter 75-item version of this instrument-the Early Maladaptive Schema…

  5. Evaluating a Web-Based Cognitive-Behavioral Therapy for Maladaptive Perfectionism in University Students

    ERIC Educational Resources Information Center

    Radhu, Natasha; Daskalakis, Zafiris J.; Arpin-Cribbie, Chantal A.; Irvine, Jane; Ritvo, Paul

    2012-01-01

    Objective: This study assessed a Web-based cognitive-behavioral therapy (CBT) for maladaptive perfectionism, investigating perfectionism, anxiety, depression, negative automatic thoughts, and perceived stress. Participants: Participants were undergraduate students defined as maladaptive perfectionists through a screening questionnaire at an urban…

  6. Maladaptive Behaviors Related to Adaptive Decline in Aging Adults with Mental Retardation.

    ERIC Educational Resources Information Center

    Urv, Tiina K.; Zigman, Warren B.; Silverman, Wayne

    2003-01-01

    Changes in patterns of maladaptive behavior related to age-associated adaptive declines were investigated in 529 adults with mental retardation (ages 30 to 84), 202 with Down syndrome. Certain maladaptive behaviors were related to the onset of adaptive declines, (e.g., lack of boundaries). Findings suggest similarities in the course of…

  7. Maladaptive and Compulsive Behavior in Prader-Willi Syndrome: New Insights from Older Adults

    ERIC Educational Resources Information Center

    Dykens, Elisabeth M.

    2004-01-01

    Although maladaptive and compulsive behaviors are increasingly well-described in young persons with Prader-Willi syndrome, it is unclear how these problems manifest in older adults with this syndrome. In Part I, I compared maladaptive and compulsive behaviors in 45 older adults with Prader-Willi syndrome (ages 30 to 50 years) to 195 children,…

  8. Prevalence and Risk Factors of Maladaptive Behaviour in Young Children with Autistic Disorder

    ERIC Educational Resources Information Center

    Hartley, S. L.; Sikora, D. M.; McCoy, R.

    2008-01-01

    Background: Children with Autistic Disorder (AD) evidence more co-occurring maladaptive behaviours than their typically developing peers and peers with intellectual disability because of other aetiologies. The present study investigated the prevalence of Clinically Significant maladaptive behaviours during early childhood and identified at-risk…

  9. Maladaptive Behaviors Related to Dementia Status in Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Urv, Tiina K.; Zigman, Warren B.; Silverman, Wayne

    2008-01-01

    Changes in maladaptive behaviors related to specific stages of dementia were investigated in 251 adults 45 years of age and older with Down syndrome. Findings indicate clear differences in maladaptive behaviors at various stages of dementia. Generally, individuals with no signs or symptoms of dementia displayed fewer and less severe maladaptive…

  10. Adaptive Perfectionism, Maladaptive Perfectionism and Statistics Anxiety in Graduate Psychology Students

    ERIC Educational Resources Information Center

    Comerchero, Victoria; Fortugno, Dominick

    2013-01-01

    The current study examined if correlations between statistics anxiety and dimensions of perfectionism (adaptive and maladaptive) were present amongst a sample of psychology graduate students (N = 96). Results demonstrated that scores on the APS-R Discrepancy scale, corresponding to maladaptive perfectionism, correlated with higher levels of…

  11. Adaptive and Maladaptive Perfectionism as Mediators of Adult Attachment Styles and Depression, Hopelessness, and Life Satisfaction

    ERIC Educational Resources Information Center

    Gnilka, Philip B.; Ashby, Jeffrey S.; Noble, Christina M.

    2013-01-01

    This study examined the relationships between adaptive and maladaptive perfectionism, anxious and avoidant adult attachment styles, depression, hopelessness, and life satisfaction among a sample of 180 undergraduate students. Maladaptive perfectionism mediated the relationship between both forms of adult attachment and depression, hopelessness,…

  12. The Relationships of Personal and Ethnic Identity Exploration to Indices of Adaptive and Maladaptive Psychosocial Functioning

    ERIC Educational Resources Information Center

    Schwartz, Seth J.; Zamboanga, Byron L.; Weisskirch, Robert S.; Rodriguez, Liliana

    2009-01-01

    Identity exploration has often been associated with maladaptive aspects of psychosocial functioning such as anxiety and depression. It is not known, however, whether maladaptive psychosocial functioning is related to both personal and ethnic identity exploration. In the present study, we examined the relationships of personal and ethnic identity…

  13. Medical/Behavioral Treatment Perspectives: Case Studies of Mentally Retarded Persons with Maladaptive Behavior Problems.

    ERIC Educational Resources Information Center

    Antonelli, Charles J.

    Five case studies of mentally retarded persons with maladaptive behavior problems are presented to demonstrate an interdisciplinary approach which emphasized coordination between medical and behavioral input in client treatment plans. Case studies involve persons in group home settings who engaged in such maladaptive behaviors as aggression…

  14. Childhood Antecedents and Maintaining Factors in Maladaptive Daydreaming.

    PubMed

    Somer, Eli; Somer, Liora; Jopp, Daniela S

    2016-06-01

    This study explored the fantasy activity of 16 individuals who were seeking online peer-support and advice for maladaptive daydreaming (MD). MD is an under-researched mental activity described as persistent vivid fantasy activity that replaces human interaction and/or interferes with important areas of functioning. We employed a grounded theory methodology that yielded seven common themes presented as a sequential descriptive narrative about the nature, precursors, and consequences of MD. The presented "storyline" included the following themes: (1) daydreaming as an innate talent for vivid fantasy; (2) daydreaming and social isolation-a two-way street; (3) the role of trauma in the development of MD; (4) the rewards of daydreaming; (5) the insatiable yearning for daydreaming; (6) shame and concealment; (7) unsuccessful treatment attempts. A main conclusion of our study is that there is an urgent need for early identification of MD and its correct diagnoses in adulthood. PMID:27002749

  15. Trouble ahead, trouble behind: Narcissism and early maladaptive schemas.

    PubMed

    Zeigler-Hill, Virgil; Green, Bradley A; Arnau, Randolph C; Sisemore, Teddi B; Myers, Erin M

    2011-03-01

    Narcissism is a multifaceted construct that is inconsistently defined and assessed between clinical psychology and social-personality psychology. The purpose of the present study was to examine the similarities and differences in the cognitive schemas underlying various forms of narcissism. This was accomplished by examining the associations of normal and pathological forms of narcissism with the early maladaptive schemas. The results showed important similarities in these associations (e.g., all of the narcissism scales were positively associated with the entitlement schema) as well as differences (e.g., vulnerable narcissism was the only form of narcissism that was positively associated with subjugation). Discussion focuses on the implications of these results for the ways in which individuals with these forms of narcissism perceive and navigate their social environments. PMID:20705282

  16. Trait mindfulness and early maladaptive schemas in women seeking residential substance use treatment: A preliminary investigation

    PubMed Central

    Shorey, Ryan C.; Anderson, Scott; Stuart, Gregory L.

    2015-01-01

    Mindfulness has received an abundance of research attention in recent years, largely due to mindfulness-based interventions demonstrating positive mental and physical health outcomes. However, less research has examined individual’s trait levels of mindfulness and how it is related to mental health, particularly among individuals seeking substance use treatment. Therefore, in the current study, we examined the relation between trait mindfulness and early maladaptive schemas (EMS), which are dysfunctional cognitive and behavioural patterns that theoretically underlie the development of mental health problems, among women seeking residential substance use treatment. Pre-existing, adult female, patient records from a residential substance abuse treatment facility were reviewed (N = 67). Results demonstrated that higher trait mindfulness was negatively associated with 12 of the 18 EMS. Moreover, patients who endorsed multiple EMS reported lower trait mindfulness than patients who endorsed zero (or one) EMS. These findings are the first to examine the relation between trait mindfulness and EMS among women seeking substance use treatment. Findings suggest that EMS and trait mindfulness are robustly related and future research should examine whether mindfulness-based interventions reduce EMS. PMID:26366142

  17. Maladaptive rumination moderates the effects of written emotional disclosure on ambulatory blood pressure levels in females

    PubMed Central

    O'Connor, Daryl B.; Ashley, Laura; Jones, Fiona; Ferguson, Eamonn

    2014-01-01

    Written emotional disclosure (WED) has beneficial effects on health outcomes. However, its effectiveness is influenced by a number of variables. This exploratory study tested whether trait rumination, which comprises brooding, a maladaptive component, and reflection, an adaptive component, moderated the effects of WED on ambulatory blood pressure (ABP) in female participants. Fifty-two participants were randomized to write about their most stressful/traumatic life experience(s) or non-emotive topics, for 20 minutes, on 3 consecutive days. Two weeks and 14 weeks later, ABP was recorded over a single day. Using hierarchical linear modelling, an effect of condition was found at 2 weeks but not at 14 weeks indicating that higher levels of ABP were observed following WED. There was also a significant condition by brooding interaction at two weeks such that higher ABP was observed in low brooders in the WED condition compared with low brooders in the control condition. However, within the WED condition, the lowest ABP was exhibited by participants high in brooding. The findings indicated that WED led to short-lived increases in ABP which disappeared in the medium term. Researchers ought to build upon this exploratory study and investigate further the potential moderating role of brooding within WED. Individual differences in brooding may account for (some of) the mixed and inconsistent findings in past WED research. PMID:25750835

  18. Combinations of resting RSA and RSA reactivity impact maladaptive mood repair and depression symptoms

    PubMed Central

    Yaroslavsky, Ilya; Bylsma, Lauren M.; Rottenberg, Jonathan; Kovacs, Maria

    2013-01-01

    We examined whether the combined indices of respiratory sinus arrhythmia at rest (resting RSA) and in response to a sad film (RSA reactivity) predict effective and ineffective responses to reduce sadness (adaptive vs. maladaptive mood repair) in women with histories of juvenile-onset depression (n = 74) and no history of major mental disorders (n = 75). Structural equation models were used to estimate latent resting RSA, depression, and adaptive and maladaptive mood repair and to test the study hypotheses. Results indicated that combinations of resting RSA+RSA reactivity (RSA patterns) predicted maladaptive mood repair, which in turn, mediated the effects of RSA pattern on depression. Further, RSA patterns moderated the depressogenic effects of maladaptive mood repair. RSA patterns were unrelated to adaptive mood repair. Our findings suggest that mood repair is one mechanism through which physiological vulnerabilities adversely affect mental health. PMID:23827087

  19. Stress Response and Perinatal Reprogramming: Unraveling (Mal)adaptive Strategies.

    PubMed

    Musazzi, Laura; Marrocco, Jordan

    2016-01-01

    Environmental stressors induce coping strategies in the majority of individuals. The stress response, involving the activation of the hypothalamic-pituitary-adrenocortical axis and the consequent release of corticosteroid hormones, is indeed aimed at promoting metabolic, functional, and behavioral adaptations. However, behavioral stress is also associated with fast and long-lasting neurochemical, structural, and behavioral changes, leading to long-term remodeling of glutamate transmission, and increased susceptibility to neuropsychiatric disorders. Of note, early-life events, both in utero and during the early postnatal life, trigger reprogramming of the stress response, which is often associated with loss of stress resilience and ensuing neurobehavioral (mal)adaptations. Indeed, adverse experiences in early life are known to induce long-term stress-related neuropsychiatric disorders in vulnerable individuals. Here, we discuss recent findings about stress remodeling of excitatory neurotransmission and brain morphology in animal models of behavioral stress. These changes are likely driven by epigenetic factors that lie at the core of the stress-response reprogramming in individuals with a history of perinatal stress. We propose that reprogramming mechanisms may underlie the reorganization of excitatory neurotransmission in the short- and long-term response to stressful stimuli. PMID:27057367

  20. Early maladaptive schemas in convicted sexual offenders: preliminary findings.

    PubMed

    Carvalho, Joana; Nobre, Pedro J

    2014-01-01

    Core cognitive schemas may play a role in the vulnerability for sexual offending. Identifying these schemas could help to conceptualize sexual crimes and rehabilitate convicted sexual offenders. The aim of this preliminary study was to explore the relationship between early maladaptive schemas (EMSs) and sexual offending, as well as how rapists and child sex molesters differ in terms of these schemas. Thirty-two men convicted for rape, 33 convicted for child sexual abuse, and 30 non-offenders were evaluated using the Young Schema Questionnaire (YSQ-S3) and the Brief Symptom Inventory (BSI). Results showed that participants convicted for child sexual abuse presented significantly more schemas from the disconnection/rejection, impaired autonomy/performance, other directness, and over vigilance/inhibition domains than non-offenders, whereas rapists presented more schemas from the impaired autonomy/performance domain than non-offenders. Differences between sex offenders showed that child molesters presented more schemas of pessimism than rapists. Preliminary findings suggested that EMSs may impact sex offender's perceptions about themselves and about the world. Schema-focused therapy (Young, 1990, 1999) may thus be an acceptable approach to sex offender's psychological assessment and intervention. PMID:24268826

  1. Specific dysphoric symptoms are predicted by early maladaptive schemas.

    PubMed

    Trincas, Roberta; Ottaviani, Cristina; Couyoumdjian, Alessandro; Tenore, Katia; Spitoni, Grazia; Mancini, Francesco

    2014-01-01

    Early maladaptive schemas (EMSs) are cognitive patterns resulting from unmet core emotional needs in childhood that have been linked to the development of psychopathology. As depression is a multifaceted phenomenon, we hypothesized that specific dysphoric symptoms would be predicted by different EMSs. Four hundred and fifty-six participants completed a measure of EMSs (Young Schema Questionnaire) and reported on the severity of the symptoms of criterion A for major depression in DSM-IV during the occurrence of a dysphoric episode in the previous 12 months. A series of stepwise multiple regression analyses were performed to investigate the predictive power of the EMSs for the severity of each specific depressive symptom. When controlling for gender and current levels of depression, specific symptoms were predicted by different EMSs: sadness by Negativity/Pessimism; anhedonia by Failure; self-harm by Emotional Deprivation and Vulnerability to Harm or Illness; worthlessness by Failure and Negativity/Pessimism; psychomotor retardation/restlessness by Vulnerability to Harm or Illness and Entitlement/Grandiosity; and poor concentration by Insufficient Self-Control/Self-Discipline. The more physical symptoms of fatigue, insomnia/hypersomnia, and appetite loss/appetite gain were not predicted by any of the EMSs. Although the cross-sectional design of the study does not allow for conclusions about the direction of effects, results suggest that depression is not a unitary phenomenon and provide a possible explanation for previous inconsistent findings. PMID:24511281

  2. Stress Response and Perinatal Reprogramming: Unraveling (Mal)adaptive Strategies

    PubMed Central

    Musazzi, Laura; Marrocco, Jordan

    2016-01-01

    Environmental stressors induce coping strategies in the majority of individuals. The stress response, involving the activation of the hypothalamic-pituitary-adrenocortical axis and the consequent release of corticosteroid hormones, is indeed aimed at promoting metabolic, functional, and behavioral adaptations. However, behavioral stress is also associated with fast and long-lasting neurochemical, structural, and behavioral changes, leading to long-term remodeling of glutamate transmission, and increased susceptibility to neuropsychiatric disorders. Of note, early-life events, both in utero and during the early postnatal life, trigger reprogramming of the stress response, which is often associated with loss of stress resilience and ensuing neurobehavioral (mal)adaptations. Indeed, adverse experiences in early life are known to induce long-term stress-related neuropsychiatric disorders in vulnerable individuals. Here, we discuss recent findings about stress remodeling of excitatory neurotransmission and brain morphology in animal models of behavioral stress. These changes are likely driven by epigenetic factors that lie at the core of the stress-response reprogramming in individuals with a history of perinatal stress. We propose that reprogramming mechanisms may underlie the reorganization of excitatory neurotransmission in the short- and long-term response to stressful stimuli. PMID:27057367

  3. Maladaptive plasticity in tinnitus--triggers, mechanisms and treatment.

    PubMed

    Shore, Susan E; Roberts, Larry E; Langguth, Berthold

    2016-03-01

    Tinnitus is a phantom auditory sensation that reduces quality of life for millions of people worldwide, and for which there is no medical cure. Most cases of tinnitus are associated with hearing loss caused by ageing or noise exposure. Exposure to loud recreational sound is common among the young, and this group are at increasing risk of developing tinnitus. Head or neck injuries can also trigger the development of tinnitus, as altered somatosensory input can affect auditory pathways and lead to tinnitus or modulate its intensity. Emotional and attentional state could be involved in the development and maintenance of tinnitus via top-down mechanisms. Thus, military personnel in combat are particularly at risk owing to combined risk factors (hearing loss, somatosensory system disturbances and emotional stress). Animal model studies have identified tinnitus-associated neural changes that commence at the cochlear nucleus and extend to the auditory cortex and other brain regions. Maladaptive neural plasticity seems to underlie these changes: it results in increased spontaneous firing rates and synchrony among neurons in central auditory structures, possibly generating the phantom percept. This Review highlights the links between animal and human studies, and discusses several therapeutic approaches that have been developed to target the neuroplastic changes underlying tinnitus. PMID:26868680

  4. Maladaptive plasticity in tinnitus-triggers, mechanisms and treatment

    PubMed Central

    Shore, Susan E; Roberts, Larry E.; Langguth, Berthold

    2016-01-01

    Tinnitus is a phantom auditory sensation that reduces quality of life for millions worldwide and for which there is no medical cure. Most cases are associated with hearing loss caused by the aging process or noise exposure. Because exposure to loud recreational sound is common among youthful populations, young persons are at increasing risk. Head or neck injuries can also trigger the development of tinnitus, as altered somatosensory input can affect auditory pathways and lead to tinnitus or modulate its intensity. Emotional and attentional state may play a role in tinnitus development and maintenance via top-down mechanisms. Thus, military in combat are particularly at risk due to combined hearing loss, somatosensory system disturbances and emotional stress. Neuroscience research has identified neural changes related to tinnitus that commence at the cochlear nucleus and extend to the auditory cortex and brain regions beyond. Maladaptive neural plasticity appears to underlie these neural changes, as it results in increased spontaneous firing rates and synchrony among neurons in central auditory structures that may generate the phantom percept. This review highlights the links between animal and human studies, including several therapeutic approaches that have been developed, which aim to target the neuroplastic changes underlying tinnitus. PMID:26868680

  5. Non-invasive Brain Stimulation, a Tool to Revert Maladaptive Plasticity in Neuropathic Pain.

    PubMed

    Naro, Antonino; Milardi, Demetrio; Russo, Margherita; Terranova, Carmen; Rizzo, Vincenzo; Cacciola, Alberto; Marino, Silvia; Calabro, Rocco S; Quartarone, Angelo

    2016-01-01

    Neuromodulatory effects of non-invasive brain stimulation (NIBS) have been extensively studied in chronic pain. A hypothetic mechanism of action would be to prevent or revert the ongoing maladaptive plasticity within the pain matrix. In this review, the authors discuss the mechanisms underlying the development of maladaptive plasticity in patients with chronic pain and the putative mechanisms of NIBS in modulating synaptic plasticity in neuropathic pain conditions. PMID:27512368

  6. Non-invasive Brain Stimulation, a Tool to Revert Maladaptive Plasticity in Neuropathic Pain

    PubMed Central

    Naro, Antonino; Milardi, Demetrio; Russo, Margherita; Terranova, Carmen; Rizzo, Vincenzo; Cacciola, Alberto; Marino, Silvia; Calabro, Rocco S.; Quartarone, Angelo

    2016-01-01

    Neuromodulatory effects of non-invasive brain stimulation (NIBS) have been extensively studied in chronic pain. A hypothetic mechanism of action would be to prevent or revert the ongoing maladaptive plasticity within the pain matrix. In this review, the authors discuss the mechanisms underlying the development of maladaptive plasticity in patients with chronic pain and the putative mechanisms of NIBS in modulating synaptic plasticity in neuropathic pain conditions. PMID:27512368

  7. Early Maladaptive Schemas and Aggression in Men Seeking Residential Substance Use Treatment

    PubMed Central

    Shorey, Ryan C.; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L.

    2015-01-01

    Social-cognitive theories of aggression postulate that individuals who perpetrate aggression are likely to have high levels of maladaptive cognitive schemas that increase risk for aggression. Indeed, recent research has begun to examine whether early maladaptive schemas may increase the risk for aggression. However, no known research has examined this among individuals in substance use treatment, despite aggression and early maladaptive schemas being more prevalent among individuals with a substance use disorder than the general population. Toward this end, we examined the relationship between early maladaptive schemas and aggression in men in a residential substance use treatment facility (N = 106). Utilizing pre-existing patient records, results demonstrated unique associations between early maladaptive schema domains and aggression depending on the type of aggression and schema domain examined, even after controlling for substance use, antisocial personality, age, and education. The Impaired Limits domain was positively associated with verbal aggression, aggressive attitude, and overall aggression, whereas the Disconnection and Rejection domain was positively associated with physical aggression. These findings are consistent with social-cognitive models of aggression and advance our understanding of how early maladaptive schemas may influence aggression. The implications of these findings for future research are discussed. PMID:25897180

  8. Adventitious Reinforcement of Maladaptive Stimulus Control Interferes with Learning.

    PubMed

    Saunders, Kathryn J; Hine, Kathleen; Hayashi, Yusuke; Williams, Dean C

    2016-09-01

    Persistent error patterns sometimes develop when teaching new discriminations. These patterns can be adventitiously reinforced, especially during long periods of chance-level responding (including baseline). Such behaviors can interfere with learning a new discrimination. They can also disrupt already learned discriminations, if they re-emerge during teaching procedures that generate errors. We present an example of this process. Our goal was to teach a boy with intellectual disabilities to touch one of two shapes on a computer screen (in technical terms, a simple simultaneous discrimination). We used a size-fading procedure. The correct stimulus was at full size, and the incorrect-stimulus size increased in increments of 10 %. Performance was nearly error free up to and including 60 % of full size. In a probe session with the incorrect stimulus at full size, however, accuracy plummeted. Also, a pattern of switching between choices, which apparently had been established in classroom instruction, re-emerged. The switching pattern interfered with already-learned discriminations. Despite having previously mastered a fading step with the incorrect stimulus up to 60 %, we were unable to maintain consistently high accuracy beyond 20 % of full size. We refined the teaching program such that fading was done in smaller steps (5 %), and decisions to "step back" to a smaller incorrect stimulus were made after every 5-instead of 20-trials. Errors were rare, switching behavior stopped, and he mastered the discrimination. This is a practical example of the importance of designing instruction that prevents adventitious reinforcement of maladaptive discriminated response patterns by reducing errors during acquisition. PMID:27622128

  9. Integrating the theories of Darwin and Bernoulli: maladaptive baroreceptor network dysfunction may explain the pathogenesis of aortic aneurysms.

    PubMed

    Conley, Buford R; Doux, John D; Lee, Patrick Y; Bazar, Kimberly A; Daniel, Stephanie M; Yun, Anthony J

    2005-01-01

    Current treatment options for aortic aneurysms are suboptimal and their pathogenic mechanisms remain unclear. We propose the existence of a coordinated multi-node baroreceptor network that measures pressures at all vascular bifurcations and enables system-wide hemodynamic coordination and vasomotor regulation, in accordance with the principle of Bernoulli. While the presence of baroreceptors at bifurcations remains unknown, behavior at the level of systems predicts their existence, possibly as glomus cell derivatives. We propose that pressure misregistration among sensor nodes at different vascular bifurcations can precipitate feed-forward dysfunctions that promote thrombosis, inflammation, and vasomotor dysregulation resulting in aneurysm formation. One example of this phenomenon is aortic aneurysm, which is currently attributed to focal anatomic defects. As plaque builds in the infrarenal aorta, the increased blood velocity through this segment can widen the difference between pressures sensed at the iliac and the renal artery bifurcations. Due to the Bernoulli effect, this change creates an incorrect impression of reduced dynamic pressure at the kidneys. The erroneous perception of hypovolemia can induce a pernicious cycle of maladaptive adrenergia and associated coagulation and thrombosis, particularly in the infrarenal aortic segment as the body attempts to normalize renal perfusion. Atherosclerosis can further exacerbate baroreceptor dysfunction by interfering with sensor biology in feed-forward fashion. Hypertension may be a consequence as well as a source of atherosclerosis and aneurysm. The described system may have evolved when trauma-related hypovolemia was a far more prevalent driver of natural selection but may be rendered maladaptive in the setting of modern stressors. Failure to address these factors may explain the suboptimal long-term outcomes with current surgical and endovascular treatments for aneurysms. Implications for other potential sensor

  10. Maladaptive health beliefs, illness-related self-regulation and the role of the information provided by physicians.

    PubMed

    Karademas, Evangelos C; Paschali, Antonia; Hadjulis, Michael; Papadimitriou, Angela

    2016-06-01

    This prospective study in 119 patients with cardiovascular diseases aimed to examine whether (a) illness representations mediate the relation of general maladaptive health beliefs to patients' coping behaviours and (b) these relations are moderated by the patients' perception of the amount of information provided by their physicians. Personal control and illness coherence mediated the relation of maladaptive health beliefs to coping behaviour. The amount of the provided information buffered the negative relation of maladaptive health beliefs to illness representations and coping. Thus, the detrimental effect of general maladaptive health beliefs may be counterbalanced by the amount of information provided by physicians. PMID:25104783

  11. Maladaptive effects of learning with the less-affected forelimb after focal cortical infarcts in rats

    PubMed Central

    Allred, Rachel P.; Jones, Theresa A.

    2009-01-01

    It is common following stroke to focus early rehabilitation efforts on developing compensatory use of the less-affected body side. Here we used a rat model of focal cortical infarct to examine how motor skill acquisition with the less-affected (“intact”) forelimb influences sensorimotor function of the infarct-impaired forelimb and neural activity in peri-infarct cortex. Rats proficient in skilled reaching with one forelimb were given focal ischemic lesions in the contralateral sensorimotor cortex (SMC). Recovery in this forelimb was tested following a period of reach training focused on the intact forelimb or control procedures. Quantitative measures of the cumulatively expressed transcription factor, FosB/ΔFosB, were used to assay intact forelimb training effects on neuronal activity in remaining SMC of the infarcted hemisphere. Intact forelimb training worsened behavioral recovery in the impaired forelimb following unilateral focal ischemia. Furthermore, it decreased neuronal FosB/ΔFosB expression in layer II/III of peri-infarct SMC. These effects were not found in sham-operated rats trained sequentially with both forelimbs or in animals receiving bilateral forelimb training after unilateral infarcts. Thus, focused use of the intact forelimb has detrimental effects on recovery of impaired forelimb function following a focal ischemic injury and this is linked to reduced neuronal activation in remaining cortex. These results suggest that peri-infarct cortex becomes vulnerable to early post-stroke experience with the less-affected forelimb and that this experience may drive neural plasticity here in a direction that is maladaptive for functional outcome. PMID:18054917

  12. Relationship between maladaptive cognitions about sleep and recovery in patients with borderline personality disorder

    PubMed Central

    Plante, David T.; Frankenburg, Frances R.; Fitzmaurice, Garrett M.; Zanarini, Mary C.

    2013-01-01

    Borderline personality disorder (BPD) has been associated with maladaptive cognitive processes including dysfunctional attitudes and a negative attribution style. Comorbid insomnia affects the course of multiple psychiatric disorders, and has been associated with absence of recovery from BPD. Because dysfunctional beliefs and attitudes are common among patients with insomnia, the purpose of this study was to evaluate the association between maladaptive sleep-related cognitions and recovery status (symptomatic remission plus good concurrent psychosocial functioning) in patients with BPD. 223 BPD patients participating in the McLean Study of Adult Development (MSAD) were administered the Dysfunctional Beliefs and Attitudes about Sleep questionnaire (DBAS-16) as part of the 16-year follow-up wave. Maladaptive sleep cognitions were compared between recovered (n=105) and non-recovered (n=118) BPD participants, in analyses that adjusted for age, sex, depression, anxiety, and primary sleep disorders. Results demonstrated non-recovered BPD patients had significantly more severe maladaptive sleep-related cognitions as measured by the overall DBAS-16 score. These results demonstrate an association between dysfunctional beliefs and attitudes about sleep and recovery status among BPD patients. Further research is warranted to evaluate treatments targeted towards maladaptive sleep-related cognitions, and their subsequent effects on the course of BPD. PMID:23972789

  13. Coevolution of adaptive technology, maladaptive culture and population size in a producer–scrounger game

    PubMed Central

    Lehmann, Laurent; Feldman, Marcus W.

    2009-01-01

    Technology (i.e. tools, methods of cultivation and domestication, systems of construction and appropriation, machines) has increased the vital rates of humans, and is one of the defining features of the transition from Malthusian ecological stagnation to a potentially perpetual rising population growth. Maladaptations, on the other hand, encompass behaviours, customs and practices that decrease the vital rates of individuals. Technology and maladaptations are part of the total stock of culture carried by the individuals in a population. Here, we develop a quantitative model for the coevolution of cumulative adaptive technology and maladaptive culture in a ‘producer–scrounger’ game, which can also usefully be interpreted as an ‘individual–social’ learner interaction. Producers (individual learners) are assumed to invent new adaptations and maladaptations by trial-and-error learning, insight or deduction, and they pay the cost of innovation. Scroungers (social learners) are assumed to copy or imitate (cultural transmission) both the adaptations and maladaptations generated by producers. We show that the coevolutionary dynamics of producers and scroungers in the presence of cultural transmission can have a variety of effects on population carrying capacity. From stable polymorphism, where scroungers bring an advantage to the population (increase in carrying capacity), to periodic cycling, where scroungers decrease carrying capacity, we find that selection-driven cultural innovation and transmission may send a population on the path of indefinite growth or to extinction. PMID:19692409

  14. Neuronal Correlates of Maladaptive Coping: An EEG-Study in Tinnitus Patients

    PubMed Central

    Vanneste, Sven; Joos, Kathleen; Langguth, Berthold; To, Wing Ting; De Ridder, Dirk

    2014-01-01

    Here we aimed to investigate the neuronal correlates of different coping styles in patients suffering from chronic tinnitus. Adaptive and maladaptive coping styles were determined in 85 tinnitus patients. Based on resting state EEG recordings, coping related differences in brain activity and connectivity were found. Maladaptive coping behavior was related to increases in subjective tinnitus loudness and distress, higher tinnitus severity and higher depression scores. EEG recordings demonstrated increased alpha activity over the left dorsolateral prefrontal cortex (DLPFC) and subgenual anterior cingulate cortex (sgACC) as well as increased connectivity in the default (i.e. resting state) network in tinnitus patients with a maladaptive coping style. Correlation analysis revealed that the changes in the DLPFC correlate primarily with maladaptive coping behavior, whereas the changes in the sgACC correlate with tinnitus severity and depression. Our findings are in line with previous research in the field of depression that during resting state a alpha band hyperconnectivity exists within the default network for patients who use a maladaptive coping style, with the sgACC as the dysfunctional node and that the strength of the connectivity is related to focusing on negative mood and catastrophizing about the consequences of tinnitus. PMID:24558383

  15. Coevolution of adaptive technology, maladaptive culture and population size in a producer-scrounger game.

    PubMed

    Lehmann, Laurent; Feldman, Marcus W

    2009-11-01

    Technology (i.e. tools, methods of cultivation and domestication, systems of construction and appropriation, machines) has increased the vital rates of humans, and is one of the defining features of the transition from Malthusian ecological stagnation to a potentially perpetual rising population growth. Maladaptations, on the other hand, encompass behaviours, customs and practices that decrease the vital rates of individuals. Technology and maladaptations are part of the total stock of culture carried by the individuals in a population. Here, we develop a quantitative model for the coevolution of cumulative adaptive technology and maladaptive culture in a 'producer-scrounger' game, which can also usefully be interpreted as an 'individual-social' learner interaction. Producers (individual learners) are assumed to invent new adaptations and maladaptations by trial-and-error learning, insight or deduction, and they pay the cost of innovation. Scroungers (social learners) are assumed to copy or imitate (cultural transmission) both the adaptations and maladaptations generated by producers. We show that the coevolutionary dynamics of producers and scroungers in the presence of cultural transmission can have a variety of effects on population carrying capacity. From stable polymorphism, where scroungers bring an advantage to the population (increase in carrying capacity), to periodic cycling, where scroungers decrease carrying capacity, we find that selection-driven cultural innovation and transmission may send a population on the path of indefinite growth or to extinction. PMID:19692409

  16. Inhibitory neurotransmission in animal models of tinnitus: maladaptive plasticity.

    PubMed

    Wang, Hongning; Brozoski, Thomas J; Caspary, Donald M

    2011-09-01

    Tinnitus is a phantom auditory sensation experienced by up to 14% of the United States population with a smaller percentage experiencing decreased quality of life. A compelling hypothesis is that tinnitus results from a maladaptive plastic net down-regulation of inhibitory amino acid neurotransmission in the central auditory pathway. This loss of inhibition may be a compensatory response to loss of afferent input such as that caused by acoustic insult and/or age-related hearing loss, the most common causes of tinnitus in people. Compensatory plastic changes may result in pathologic neural activity that underpins tinnitus. The neural correlates include increased spontaneous spiking, increased bursting and decreased variance of inter-spike intervals. This review will examine evidence for chronic plastic neuropathic changes in the central auditory system of animals with psychophysically-defined tinnitus. Neurochemical studies will focus on plastic tinnitus-related changes of inhibitory glycinergic neurotransmission in the adult dorsal cochlear nucleus (DCN). Electrophysiological studies will focus on functional changes in the DCN and inferior colliculus (IC). Tinnitus was associated with increased spontaneous activity and altered response properties of fusiform cells, the major output neurons of DCN. Coincident with these physiologic alterations were changes in glycine receptor (GlyR) subunit composition, its anchoring/trafficking protein, gephyrin and the number and affinity of membrane GlyRs revealed by receptor binding. In the IC, the primary afferent target of DCN fusiform cells, multi-dimensional alterations in unit-spontaneous activity (rate, burst rate, bursting pattern) were found in animals with behavioral evidence of chronic tinnitus more than 9 months following the acoustic/cochlear insult. In contrast, immediately following an intense sound exposure, acute alterations in IC spontaneous activity resembled chronic tinnitus-related changes but were not

  17. Maladaptive daydreaming: Evidence for an under-researched mental health disorder.

    PubMed

    Bigelsen, Jayne; Lehrfeld, Jonathan M; Jopp, Daniela S; Somer, Eli

    2016-05-01

    This study explores the recently described phenomenon of Maladaptive Daydreaming (MD) and attempts to enhance the understanding of its features. It documents the experiences of 340 self-identified maladaptive daydreamers who spend excessive amounts of time engaged in mental fantasy worlds, in comparison to 107 controls. Our sample included a total of 447 individuals, aged 13-78, from 45 countries who responded to online announcements. Participants answered quantitative and qualitative questions about their daydreaming habits and completed seven questionnaires assessing mental health symptoms. Findings demonstrated that MD differs significantly from normative daydreaming in terms of quantity, content, experience, controllability, distress, and interference with life functioning. Results also demonstrated that Maladaptive Daydreamers endorsed significantly higher rates of attention deficit, obsessive compulsive and dissociation symptoms than controls. In sum, findings suggested that MD represents an under-acknowledged clinical phenomenon that causes distress, hinders life functioning and requires more scientific and clinical attention. PMID:27082138

  18. Mechanisms of Change in Cognitive Therapy for Obsessive Compulsive Disorder: Role of Maladaptive Beliefs and Schemas

    PubMed Central

    Wilhelm, Sabine; Berman, Noah C.; Keshaviah, Aparna; Schwartz, Rachel A.; Steketee, Gail

    2015-01-01

    Objective To identify mechanisms of change in individuals with moderately severe obsessive-compulsive disorder (OCD) receiving cognitive therapy (CT). Method Thirty-six adults with OCD received CT over 24 weeks. At weeks 0, 4/6, 12, 16/18, and 24, independent evaluators assessed OCD severity, along with obsessive beliefs and maladaptive schemas. To examine mechanisms of change, we utilized a time-varying lagged regression model with a random intercept and slope. Results Perfectionism and certainty obsessive beliefs and maladaptive schemas related to dependency and incompetence significantly mediated (improved) treatment response. Conclusions Cognitive changes in perfectionism/certainty beliefs and maladaptive schemas related to dependency/incompetence precede behavioral symptom reduction for OCD patients. Targeting these mechanisms in future OCD treatment trials will emphasize the most relevant processes and facilitate maximum improvement. PMID:25544403

  19. A Description of Adaptive and Maladaptive Behaviour in Children and Adolescents with Cri-du-Chat Syndrome

    ERIC Educational Resources Information Center

    Teixeira, M. C. T. V.; Emerich, D. R.; Orsati, F. T.; Rimerio, R. C.; Gatto, K. R.; Chappaz, I. O.; Kim, C. A.

    2011-01-01

    Background: Psychological tests can be useful to record adaptive and maladaptive behaviours of children with intellectual disability. The objective of this study was to describe the adaptive and maladaptive behaviour of children and adolescents with Cri-du-chat syndrome. Methods: The sample consisted of 10 children and adolescents with Cri-du-chat…

  20. The Mediating Roles of Stress and Maladaptive Behaviors on Self-Harm and Suicide Attempts among Runaway and Homeless Youth

    ERIC Educational Resources Information Center

    Moskowitz, Amanda; Stein, Judith A.; Lightfoot, Marguerita

    2013-01-01

    Runaway and homeless youth often have a constellation of background behavioral, emotional, and familial problems that contribute to stress and maladaptive behaviors, which, in turn, can lead to self-harming and suicidal behaviors. The current study examined the roles of stress and maladaptive behaviors as mediators between demographic and…

  1. The Maladaptive Behavior Record (MBR): A Scale for the Analysis and Prediction of Community Adjustment and Recidivism of Offenders.

    ERIC Educational Resources Information Center

    Barton, Marlin; Jenkins, W. O.

    This report describes the Maladaptive Behavior Record (MBR), a behavioral assessment scale developed for use in a longitudinal follow-up study of released adult offenders. The scale focused upon the identification and specification of maladaptive behaviors that are associated with postrelease success or failure, and is valid for and predictive of…

  2. The Predictive Utility of Narcissism among Children and Adolescents: Evidence for a Distinction between Adaptive and Maladaptive Narcissism

    ERIC Educational Resources Information Center

    Barry, Christopher T.; Frick, Paul J.; Adler, Kristy K.; Grafeman, Sarah J.

    2007-01-01

    We examined the predictive utility of narcissism among a community sample of children and adolescents (N=98) longitudinally. Analyses focused on the differential utility between maladaptive and adaptive narcissism for predicting later delinquency. Maladaptive narcissism significantly predicted self-reported delinquency at one-, two-, and…

  3. The Relation between Early Maladaptive Schemas, Depression, and Generalized Anxiety among Adults Seeking Residential Treatment for Substance Use Disorders

    PubMed Central

    Shorey, Ryan C.; Elmquist, Joanna; Anderson, Scott; Stuart, Gregory L.

    2015-01-01

    Objective Previous research has shown that early maladaptive schemas (EMS) play an important role in substance use, depression, and anxiety. However, little work has examined the role of EMS within the context of all three concurrently. The goal of this study was to determine the role of EMS in predicting symptoms of Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) among adults in residential treatment for substance dependence. Method We used pre-existing patient records of adults diagnosed with a substance use disorder from a residential substance use treatment facility (N = 122). Results The EMS domains of disconnection and rejection and impaired limits were associated with symptoms of MDD and the domain of impaired autonomy and performance was associated with symptoms of GAD even after controlling for age, gender, years of education, alcohol use, drug use, and symptoms of MDD (when predicting GAD) and GAD (when predicting MDD). Conclusions Findings suggest that EMS may play an important role in comorbid mental health problems among men and women in residential substance use treatment. Continued treatment outcome research is needed to examine whether modification of EMS results in improved mental health and substance use outcomes. PMID:26099037

  4. Central Role of Maladapted Astrocytic Plasticity in Ischemic Brain Edema Formation.

    PubMed

    Wang, Yu-Feng; Parpura, Vladimir

    2016-01-01

    Brain edema formation and the ensuing brain damages are the major cause of high mortality and long term disability following the occurrence of ischemic stroke. In this process, oxygen and glucose deprivation and the resulting reperfusion injury play primary roles. In response to the ischemic insult, the neurovascular unit experiences both intracellular and extracellular edemas, associated with maladapted astrocytic plasticity. The astrocytic plasticity includes both morphological and functional plasticity. The former involves a reactive gliosis and the subsequent glial retraction. It relates to the capacity of astrocytes to buffer changes in extracellular chemical levels, particularly K(+) and glutamate, as well as the integrity of the blood-brain barrier (BBB). The latter involves the expression and activity of a series of ion and water transport proteins. These molecules are grouped together around glial fibrillary acidic protein (GFAP) and water channel protein aquaporin 4 (AQP4) to form functional networks, regulate hydromineral balance across cell membranes and maintain the integrity of the BBB. Intense ischemic challenges can disrupt these capacities of astrocytes and result in their maladaptation. The maladapted astrocytic plasticity in ischemic stroke cannot only disrupt the hydromineral homeostasis across astrocyte membrane and the BBB, but also leads to disorders of the whole neurovascular unit. This review focuses on how the maladapted astrocytic plasticity in ischemic stroke plays the central role in the brain edema formation. PMID:27242440

  5. Testing Three-Item Versions for Seven of Young's Maladaptive Schema

    ERIC Educational Resources Information Center

    Blau, Gary; DiMino, John; Sheridan, Natalie; Pred, Robert S.; Beverly, Clyde; Chessler, Marcy

    2015-01-01

    The Young Schema Questionnaire (YSQ) in either long-form (205- item) or short-form (75-item or 90-item) versions has demonstrated its clinical usefulness for assessing early maladaptive schemas. However, even a 75 or 90-item "short form", particularly when combined with other measures, can represent a lengthy…

  6. Role and treatment of early maladaptive schemas in Vietnam Veterans with PTSD.

    PubMed

    Cockram, David M; Drummond, Peter D; Lee, Christopher W

    2010-01-01

    The role of early maladaptive schemas in understanding and treating post-traumatic stress disorder (PTSD) was investigated. The first study examined the role of perceived adverse parenting and early maladaptive schemas in the development of PTSD in Australian and New Zealand Vietnam war veterans (n = 220). Veterans diagnosed with PTSD scored higher on the Young Schema Questionnaire (L3) and had higher scores on the Measure of Parental Style than veterans not diagnosed with PTSD. The results suggest that early maladaptive schemas have an important role in the development or maintenance of PTSD in Vietnam veterans. The second study measured at baseline, termination and 3 months the early maladaptive schemas, PTSD, anxiety and depression of war veterans (n = 54) participating in a PTSD group treatment programme that included schema-focused therapy. Scores on the PTSD Checklist, the Hospital Anxiety and Depression Scale, and 17 schemas decreased significantly after treatment. Change scores for the schema treatment were compared with change scores of war veterans (n = 127) who had completed a manualized cognitive-behavioural therapy programme without schema-focused therapy. Pre-treatment measures were similar in both groups. Nevertheless, PTSD and anxiety improved more significantly for the schema-focused therapy group. Together, these findings support the feasibility of schema-focused therapy to assist veterans with PTSD. PMID:20486158

  7. Early Maladaptive Schemas in a Sample of British Adolescent Sexual Abusers: Implications for Therapy

    ERIC Educational Resources Information Center

    Richardson, Graeme

    2005-01-01

    This study describes the results of the administration of the Young Schema Questionnaire in a British sample of 54 sexually abusive adolescents. This questionnaire is a measurement of the 16 Early Maladaptive Schemas (EMSs) as conceptualized by Young in his schema model of psychopathology. A clinical group of 40 was differentiated from a…

  8. Maladaptive perfectionism's link to aggression and self-harm: Emotion regulation as a mechanism.

    PubMed

    Chester, David S; Merwin, Lauren M; DeWall, C Nathan

    2015-01-01

    The negative affect that results from negative feedback is a substantial, proximal cause of aggression. People high in maladaptive perfectionism, the tendency to focus on the discrepancy between one's standards and performance, are characterized by an exaggerated negative affective response to negative feedback. This exacerbated affective response to failure may then dispose them to hurt others and themselves as aggression and self-harm are often perceived as a means to regulate negative affect. In Study 1, we demonstrated that maladaptive perfectionism was linked to greater aggressive behavior towards others after receiving negative feedback. Suggesting the presence of an emotion regulation strategy, this effect was mediated by the motivation to use aggression to improve mood. In Study 2, maladaptive perfectionism was linked to self-harm, an effect exacerbated by negative feedback and mediated by negative affect. These findings suggest that maladaptive perfectionists are at risk for greater harm towards others and the self because negative feedback has a stronger affective impact and harming others and the self is perceived a means to alleviate this aversive state. PMID:26918433

  9. Adaptive Skills and Maladaptive Behavior of Adolescents with Autism Spectrum Disorders Attending Special Schools in Singapore

    ERIC Educational Resources Information Center

    Poon, Kenneth K.

    2011-01-01

    This study describes the profile of and relationships between adaptive skills and the maladaptive behaviors exhibited by adolescents with autism spectrum disorders (ASD) attending special schools in Singapore. Parents of 20 adolescents with ASD attending special schools completed the Development Behavior Checklist (DBC; Einfeld & Tonge, 1995;…

  10. Adaptive and Maladaptive Behavior in Children with Smith-Magenis Syndrome

    ERIC Educational Resources Information Center

    Martin, Staci C.; Wolters, Pamela L.; Smith, Ann C. M.

    2006-01-01

    Children with Smith-Magenis Syndrome (SMS) exhibit deficits in adaptive behavior but systematic studies using objective measures are lacking. This descriptive study assessed adaptive functioning in 19 children with SMS using the Vineland Adaptive Behavior Scales (VABS). Maladaptive behavior was examined through parent questionnaires and the…

  11. The Association between Epilepsy and Autism Symptoms and Maladaptive Behaviors in Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Viscidi, Emma W.; Johnson, Ashley L.; Spence, Sarah J.; Buka, Stephen L.; Morrow, Eric M.; Triche, Elizabeth W.

    2014-01-01

    Epilepsy is common in children with autism spectrum disorder (ASD) but little is known about how seizures impact the autism phenotype. The association between epilepsy and autism symptoms and associated maladaptive behaviors was examined in 2,645 children with ASD, of whom 139 had epilepsy, from the Simons Simplex Collection. Children with ASD and…

  12. Relax and Try This Instead: Abbreviated Habit Reversal for Maladaptive Self-Biting.

    ERIC Educational Resources Information Center

    Jones, Kevin M.; Swearer, Susan M.; Friman, Patrick C.

    1997-01-01

    A study evaluated the effectiveness of an abbreviated habit reversal procedure to reduce maladaptive oral self-biting in an adolescent boy in residential care. Treatment involved a combination of relaxation and two competing responses (gum chewing and tongue-lip rubbing). The intervention eliminated the biting and the tissue damage it caused.…

  13. Relations among Chronic Peer Group Rejection, Maladaptive Behavioral Dispositions, and Early Adolescents' Peer Perceptions

    ERIC Educational Resources Information Center

    Ladd, Gary W.; Ettekal, Idean; Kochenderfer-Ladd, Becky; Rudolph, Karen D.; Andrews, Rebecca K.

    2014-01-01

    Adolescents' perceptions of peers' relational characteristics (e.g., support, trustworthiness) were examined for subtypes of youth who evidenced chronic maladaptive behavior, chronic peer group rejection, or combinations of these risk factors. Growth mixture modeling was used to identify subgroups of participants within a normative…

  14. Child Abuse, Early Maladaptive Schemas, and Risky Sexual Behavior in College Women

    ERIC Educational Resources Information Center

    Roemmele, Melissa; Messman-Moore, Terri L.

    2011-01-01

    Previous research suggests that individuals abused as children are more likely to engage in risky sexual behavior during adulthood. The present study examined early maladaptive schemas as mediators of the child abuse-risky sexual behavior relationship among 653 college women. Self-report surveys assessed three forms of child abuse: Sexual,…

  15. Childhood Emotional Maltreatment and Later Psychological Distress among College Students: The Mediating Role of Maladaptive Schemas

    ERIC Educational Resources Information Center

    Wright, Margaret O'Dougherty; Crawford, Emily; Del Castillo, Darren

    2009-01-01

    Objective: Theoretically, exposure to experiences of emotional abuse (EA) and emotional neglect (EN) in childhood may threaten the security of attachment relationships and result in maladaptive models of self and self-in-relation to others. The purpose of this study was to explore the extent to which EA and EN treatment by parents contributed…

  16. Impact of Language Deficits on Maladaptive Behavior of Inner-City Early Adolescents: A Longitudinal Analysis.

    ERIC Educational Resources Information Center

    Marcon, Rebecca A.

    This study examined language development as a precursor of maladaptive behavior in inner-city early adolescents. Participating were 256 adolescents from the graduation classes of 2000 and 2001 who had previously attended District of Columbia prekindergarten/Head Start and kindergarten. The sample was 98 percent African American and 56 percent…

  17. Group Counseling to Reduce Maladaptive Behavior and Enhance Self-Esteem in the Middle School.

    ERIC Educational Resources Information Center

    Trumbull, Leon

    Counselors at one middle school would see the same students repeatedly for disruptive behavior in the classroom. The counselors' efforts did not appear to reduce these repetitive referrals. This study used group counseling to address the maladaptive behavior of the students and to improve their self-esteem. Students were selected by six teachers…

  18. Mutual Best Friendship Involvement, Best Friends' Rejection Sensitivity, and Psychological Maladaptation

    ERIC Educational Resources Information Center

    Bowker, Julie C.; Thomas, Katelyn K.; Norman, Kelly E.; Spencer, Sarah V.

    2011-01-01

    Rejection sensitivity (RS) refers to the tendency to anxiously expect, readily perceive, and overreact to experiences of possible rejection. RS is a clear risk factor for psychological maladaptation during early adolescence. However, there is growing evidence of significant heterogeneity in the psychological correlates of RS. To investigate when…

  19. What changes in cognitive therapy for depression? An examination of cognitive therapy skills and maladaptive beliefs.

    PubMed

    Adler, Abby D; Strunk, Daniel R; Fazio, Russell H

    2015-01-01

    This study examined effortful cognitive skills and underlying maladaptive beliefs among patients treated with cognitive therapy (CT) for depression. Depressed patients (n=44) completed cognitive measures before and after 16 weeks of CT. Measures included an assessment of CT skills (Ways of Responding Scale; WOR), an implicit test of maladaptive beliefs (Implicit Association Test; IAT), and a self-report questionnaire of maladaptive beliefs (Dysfunctional Attitude Scale; DAS). A matched sample of never-depressed participants (n=44) also completed study measures. Prior to treatment, depressed patients endorsed significantly more undesirable cognitions on the WOR, IAT, and DAS compared with never-depressed participants. Patients displayed improvement on the WOR and DAS over the course of treatment, but showed no change on the IAT. Additionally, improvements on the WOR and DAS were each related to greater reductions in depressive symptoms. Results suggest that the degree of symptom reduction among patients participating in CT is related to changes in patients' acquisition of coping skills requiring deliberate efforts and reflective thought, but not related to reduced endorsement of implicitly assessed maladaptive beliefs. PMID:25526838

  20. The Treatment of Maladaptive Shame in Borderline Personality Disorder: A Pilot Study of "Opposite Action"

    ERIC Educational Resources Information Center

    Rizvi, Shireen L.; Linehan, Marsha M.

    2005-01-01

    This study sought to pilot test a short-term intervention for maladaptive shame in borderline personality disorder (BPD) based on the skill of "opposite action" from dialectical behavior therapy. Five women with BPD were treated with the intervention using a single-subject, multiple-baseline design. Results indicate that, although state ratings of…

  1. Maladaptive Perfectionism, Adult Attachment, and Self-Esteem in College Students

    ERIC Educational Resources Information Center

    Rice, Kenneth G.; Lopez, Frederick G.

    2004-01-01

    Extending an earlier study that found high self-esteem to modify the impact of otherwise maladaptive perfectionism on depression, the current study used adult attachment theory to explore the link between perfectionism, self-esteem, and depression in college students. Results indicated that self-esteem buffered the effects of maladaptive…

  2. Adaptive Flexibility and Maladaptive Routines in Selecting Fast and Frugal Decision Strategies

    ERIC Educational Resources Information Center

    Broder, Arndt; Schiffer, Stefanie

    2006-01-01

    Decision routines unburden the cognitive capacity of the decision maker. In changing environments, however, routines may become maladaptive. In 2 experiments with a hypothetical stock market game (n = 241), the authors tested whether decision routines tend to persist at the level of decision strategies rather than at the level of options in…

  3. Does Experiential Avoidance Mediate the Effects of Maladaptive Coping Styles on Psychopathology and Mental Health?

    ERIC Educational Resources Information Center

    Fledderus, Martine; Bohlmeijer, Ernst T.; Pieterse, Marcel E.

    2010-01-01

    Experiential avoidance (EA) is considered a risk factor for psychopathology. This study explores whether EA mediates the relationship between maladaptive coping styles (palliative, avoidance, and passive coping) and psychopathology and positive mental health. A total of 93 adults with mild to moderate psychological distress completed measures…

  4. Central Role of Maladapted Astrocytic Plasticity in Ischemic Brain Edema Formation

    PubMed Central

    Wang, Yu-Feng; Parpura, Vladimir

    2016-01-01

    Brain edema formation and the ensuing brain damages are the major cause of high mortality and long term disability following the occurrence of ischemic stroke. In this process, oxygen and glucose deprivation and the resulting reperfusion injury play primary roles. In response to the ischemic insult, the neurovascular unit experiences both intracellular and extracellular edemas, associated with maladapted astrocytic plasticity. The astrocytic plasticity includes both morphological and functional plasticity. The former involves a reactive gliosis and the subsequent glial retraction. It relates to the capacity of astrocytes to buffer changes in extracellular chemical levels, particularly K+ and glutamate, as well as the integrity of the blood-brain barrier (BBB). The latter involves the expression and activity of a series of ion and water transport proteins. These molecules are grouped together around glial fibrillary acidic protein (GFAP) and water channel protein aquaporin 4 (AQP4) to form functional networks, regulate hydromineral balance across cell membranes and maintain the integrity of the BBB. Intense ischemic challenges can disrupt these capacities of astrocytes and result in their maladaptation. The maladapted astrocytic plasticity in ischemic stroke cannot only disrupt the hydromineral homeostasis across astrocyte membrane and the BBB, but also leads to disorders of the whole neurovascular unit. This review focuses on how the maladapted astrocytic plasticity in ischemic stroke plays the central role in the brain edema formation. PMID:27242440

  5. Functions of Maladaptive Behavior in Intellectual and Developmental Disabilities: Behavior Categories and Topographies

    ERIC Educational Resources Information Center

    Rojahn, Johannes; Zaja, Rebecca H.; Turygin, Nicole; Moore, Linda; van Ingen, Daniel J.

    2012-01-01

    Research has shown that different maladaptive behavior categories may be maintained by different contingencies. We examined whether behavior categories or behavior topographies determine functional properties. The "Questions about Behavioral Function" with its five subscales ("Attention", "Escape", "Nonsocial", "Physical", and "Tangible") was…

  6. The Effects of Sociodrama on the Adaptive and Maladaptive Behaviors of Elementary School Boys.

    ERIC Educational Resources Information Center

    Bell, Steven Harvey

    The effects of sociodrama on the adaptive and maladaptive behaviors of elementary school boys were examined in three groups of six boys each. One group was used as a control for the Hawthorne effect; the second, as a control for teacher expectation effects and for changes as a function of involvement with a male counselor. In the experimental…

  7. Maladaptive Perfectionism and Disordered Eating in College Women: The Mediating Role of Self-Compassion

    ERIC Educational Resources Information Center

    Stuart, Jennifer

    2009-01-01

    Disordered eating has been recognized as a concern on college campuses, particularly among college women. Maladaptive perfectionism has consistently been identified as a risk factor for disordered eating, and may present challenges to effective treatment and intervention. As a result, increased effort has gone into developing intervention…

  8. [The early maladaptive schemas: a study in adult patients with anxiety disorders].

    PubMed

    Delattre, V; Servant, D; Rusinek, S; Lorette, C; Parquet, P-J; Goudemand, M; Hautekeete, M

    2004-01-01

    The theory of early maladaptive schemas was initiated by Young, who postulated that each pathology is supported by one or several schemas. Adults with anxiety disorders more activate schemas that controls. This hyper activate schemas would go back the childhood. In this study, we measure some cognitive schema's activation, with the Schmidt and al. Questionnaire: this schema's questionnaire measures the dysfunctional schemas in actual way. Our purpose was to compare early maladaptive schema's activation of adults with anxiety disorders and adults healthy. The results indicate that each dysfunctional schema is more significatively activate by the adults with anxiety disorders that adults healthy. He doesn't exist schema typical of anxiety, but just a more important activation of all schemas of adults with -anxiety disorders. All subjects (with anxiety disorder and healthy) activate the schemas in the same order. It would appear that schema who imply an action of subject was more activate. So, in our study, we doesn't observe schema typical of anxiety, as opposed to postulate of Young and Klosko. In fact, in comparison with healthy subjects, all early maladaptive schemas of subjects with anxiety disorders were hypervalent. The order of schema's activation was the same in the two groups, but the activation in the anxious is always more important that in the healthy. All early maladaptive schemas would so hyperactivate in the anxious and a important activation of this schemas in the infancy would predispose to adult's anxious pathology. We consider this research as a preliminary work about early maladaptive schemas. In order to specify the research about schemas in the anxious, il will be interesting to observe this schemas according to different anxious disorders and to study prospectively the evolution of child's schemas. PMID:15235523

  9. Cortisol Reactivity to Social Stress as a Mediator of Early Adversity on Risk and Adaptive Outcomes

    PubMed Central

    Conradt, Elisabeth; Abar, Beau; Lester, Barry M.; LaGasse, Linda L.; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles R.; Whitaker, Toni M.; Hammond, Jane A.

    2014-01-01

    Children chronically exposed to stress early in life are at increased risk for maladaptive outcomes, though the physiological mechanisms driving these effects are unknown. Cortisol reactivity was tested as a mediator of the relation between prenatal substance exposure and/or early adversity on adaptive and maladaptive outcomes. Data were drawn from a prospective longitudinal study of prenatal substance exposure (N = 860). Cortisol reactivity was assessed at age 11. Among African-Americans, prenatal substance exposure exerted an indirect effect through early adversity and cortisol reactivity to predict externalizing behavior, delinquency, and a positive student-teacher relationship at age 11. Decreased cortisol reactivity was related to maladaptive outcomes, and increased cortisol reactivity predicted better executive functioning and a more positive student-teacher relationship. PMID:25376131

  10. Relationships among maladaptive cognitive content, dysfunctional cognitive processes, and borderline personality features.

    PubMed

    Geiger, Paul J; Peters, Jessica R; Sauer-Zavala, Shannon E; Baer, Ruth A

    2013-08-01

    Previous research has demonstrated that maladaptive cognitive content, including dysfunctional attitudes and negative automatic thoughts, is associated with emotional distress. Similarly, dysfunctional cognitive processes, including thought suppression and rumination, have been shown to intensify psychological difficulties. Although maladaptive cognitive content and dysfunctional processes have been linked to borderline personality disorder (BPD), most research has been conducted with Axis I disorders. This study examined the incremental validity of dysfunctional cognitive content and processes in predicting BPD symptom severity, controlling for trait negative affect, in a sample of undergraduate students (N = 85), including many with high levels of BPD features. Although nearly all variables were significantly correlated with BPD features, final regression models suggest that rumination and thought suppression are stronger independent predictors of BPD features than automatic thoughts, dysfunctional attitudes, and trait negative affect. These results suggest the importance of targeting thought suppression and rumination in BPD. PMID:23586932

  11. Gender differences in maladaptive cognitive schema in orphans in Dakahlia, Egypt.

    PubMed

    El-Gilany, Abdel-Hady; El-Bilsha, Mona A; Ibrahim, Azza

    2013-01-01

    The objective of this study was to assess the gender differences of maladaptive cognitive schema among orphans in Dakahlia governorate orphanages. A cross-sectional comparative study included 152 orphan boys and 48 orphan girls in all orphanages homes in Dakahlia governorate, Egypt. Data collection tools included a structured interview questionnaire for personal data; early maladaptive schema questionnaire-short form (EMSQ-SF). The mean score of the total YSQ and all the subscales, except self-sacrifice and unrelenting standards, are significantly higher among females than males. Attention should be given to the psychological care of the orphans especially security, trust, confidence, and autonomy with more attention to orphan girls. PMID:24453839

  12. Eating disorder behavior and early maladaptive schemas in subgroups of eating disorders.

    PubMed

    Unoka, Zsolt; Tölgyes, Tamás; Czobor, Pál; Simon, Lajos

    2010-06-01

    To examine relationship between Eating Disorder Behaviors (EDB) and Early Maladaptive Schemas (EMS) across eating disorder (ED) subgroups. EMS and ED behaviors were measured by Young Schema Questionnaire and Eating Behavior Severity Scale, respectively, among patients diagnosed with Restrictive or Binge/purging Anorexia, or bulimia nervosa. Canonical component analysis showed significant association between ED behaviors and EMSs. Canonical factor-pairs (EDB and EMS) revealed specific associations between certain patterns of EDBs, including binge-purging and physical exercise, and certain patterns of maladaptive cognitive schema, including Emotional deprivation, Abandonment, Enmeshments, Subjugation, and Emotional inhibition. ED subgroups significantly differred between the EMS and EDB canonical factors, respectively. Our findings indicate that EMS and EDB are associated, and that the factors that potentially mediate the association differ significantly among ED subgroups. These results are consistent with the notion that EMSs play a specific role in the development and maintenance of ED behaviors. PMID:20531121

  13. [Adaptive and Maladaptive Strategies of Emotion Regulation in Adolescents with ADHD].

    PubMed

    Lange, Sarah; Tröster, Heinrich

    2016-01-01

    The present study investigated differences between adolescents with ADHD and control subjects in their adaptive und maladaptive regulation of negative emotions. We assessed emotion regulation strategies using the German self-report questionnaire FEEL-KJ in a sample of adolescents (between 11 and 18 years) with ADHD (disturbance of activity, impulsivity and attention: n = 32, hyperkinetic conduct disorder: n = 26) and controls (n = 58). We found that adolescents with ADHD reported using less adaptive strategies for dealing with negative emotions than control subjects. No effects were found for maladaptive emotion regulation strategies for anger, fear and sadness. Our findings indicate that adolescents with ADHD should be encouraged in the development of adaptive emotion regulation. PMID:27184787

  14. Adolescent insecure attachment as a predictor of maladaptive coping and externalizing behaviors in emerging adulthood

    PubMed Central

    Dawson, Anne E.; Allen, Joseph P.; Marston, Emily G.; Hafen, Christopher A.; Schad, Megan M.

    2014-01-01

    This study investigated whether insecure adolescent attachment organization (i.e., preoccupied and dismissing) longitudinally predicted self- and peer-reported externalizing behavior in emerging adulthood. Secondarily, maladaptive coping strategies were examined for their potential role in mediating the relationship between insecure attachment and future externalizing behaviors. Target participants (N = 184) were given the Adult Attachment Interview (AAI) at age 14 and re-interviewed seven and eight years later with their closest peer. Qualities of both preoccupied and dismissing attachment organization predicted self-reported externalizing behaviors in emerging adulthood eight years later, but only preoccupation was predictive of close-peer reports of emerging adult externalizing behavior. Maladaptive coping strategies only mediated the relationship between a dismissing stance toward attachment and future self-reported externalizing behaviors. Understanding the role of coping and emotional regulation in attachment may help us to understand the unique aspects of both dismissing and preoccupied stances toward attachment. PMID:24995478

  15. Body image inflexibility mediates the relationship between body image evaluation and maladaptive body image coping strategies.

    PubMed

    Mancuso, Serafino G

    2016-03-01

    Body image inflexibility, the unwillingness to experience negative appearance-related thoughts and emotions, is associated with negative body image and eating disorder symptoms. The present study investigated whether body image inflexibility mediated the relationship between body image evaluation and maladaptive body image coping strategies (appearance-fixing and experiential avoidance) in a college and community sample comprising 156 females aged 18-51 years (M=22.76, SD=6.96). Controlling for recruitment source (college vs. community), body image inflexibility fully mediated the relationship between body image evaluation and maladaptive body image coping strategies. Results indicated that an unwillingness to experience negative appearance-related thoughts and emotions is likely responsible for negative body image evaluation's relationship to appearance-fixing behaviours and experiential avoidance. Findings support extant evidence that interventions that explicitly target body image inflexibility, such as Acceptance and Commitment Therapy, may have utility in treating body dissatisfaction in nonclinical populations. PMID:26595857

  16. Gender Differences in Maladaptive Cognitive Schema in Orphans in Dakahlia, Egypt

    PubMed Central

    El-Bilsha, Mona A.; Ibrahim, Azza

    2013-01-01

    The objective of this study was to assess the gender differences of maladaptive cognitive schema among orphans in Dakahlia governorate orphanages. A cross-sectional comparative study included 152 orphan boys and 48 orphan girls in all orphanages homes in Dakahlia governorate, Egypt. Data collection tools included a structured interview questionnaire for personal data; early maladaptive schema questionnaire-short form (EMSQ-SF). The mean score of the total YSQ and all the subscales, except self-sacrifice and unrelenting standards, are significantly higher among females than males. Attention should be given to the psychological care of the orphans especially security, trust, confidence, and autonomy with more attention to orphan girls. PMID:24453839

  17. Adolescent insecure attachment as a predictor of maladaptive coping and externalizing behaviors in emerging adulthood.

    PubMed

    Dawson, Anne E; Allen, Joseph P; Marston, Emily G; Hafen, Christopher A; Schad, Megan M

    2014-01-01

    This study investigated whether insecure adolescent attachment organization (i.e., preoccupied and dismissing) longitudinally predicted self- and peer-reported externalizing behavior in emerging adulthood. Secondarily, maladaptive coping strategies were examined for their potential role in mediating the relationship between insecure attachment and future externalizing behaviors. Target participants (N = 184) were given the Adult Attachment Interview (AAI) at age 14 and re-interviewed seven and eight years later with their closest peer. Qualities of both preoccupied and dismissing attachment organization predicted self-reported externalizing behaviors in emerging adulthood eight years later, but only preoccupation was predictive of close-peer reports of emerging adult externalizing behavior. Maladaptive coping strategies only mediated the relationship between a dismissing stance toward attachment and future self-reported externalizing behaviors. Understanding the role of coping and emotional regulation in attachment may help us to understand the unique aspects of both dismissing and preoccupied stances toward attachment. PMID:24995478

  18. Child abuse, early maladaptive schemas, and risky sexual behavior in college women.

    PubMed

    Roemmele, Melissa; Messman-Moore, Terri L

    2011-05-01

    Previous research suggests that individuals abused as children are more likely to engage in risky sexual behavior during adulthood. The present study examined early maladaptive schemas as mediators of the child abuse-risky sexual behavior relationship among 653 college women. Self-report surveys assessed three forms of child abuse: Sexual, physical, and emotional, and assessed early maladaptive schemas within two domains: Disconnection/rejection and Other-Directedness. Disconnection/rejection schemas fully mediated the relation between child emotional abuse and number of sexual partners and partially mediated the relationship for sexual and physical abuse. However, when frequency of specific risky sexual acts (e.g., sex without contraception) was examined in the previous six months, only abandonment was a partial mediator. Implications for intervention and future research are discussed. PMID:21660814

  19. Adaptive and Maladaptive Correlates of Repetitive Behavior and Restricted Interests in Persons with Down Syndrome and Developmentally-Matched Typical Children: A Two-Year Longitudinal Sequential Design

    PubMed Central

    Evans, David W.; Kleinpeter, F. Lee; Slane, Mylissa M.; Boomer, K. B.

    2014-01-01

    We examined the course of repetitive behavior and restricted interests (RBRI) in children with and without Down syndrome (DS) over a two-year time period. Forty-two typically-developing children and 43 persons with DS represented two mental age (MA) levels: “younger” 2–4 years; “older” 5–11 years. For typically developing younger children some aspects of RBRI increased from Time 1 to Time 2. In older children, these aspects remained stable or decreased over the two-year period. For participants with DS, RBRI remained stable or increased over time. Time 1 RBRI predicted Time 2 adaptive behavior (measured by the Vineland Scales) in typically developing children, whereas for participants with DS, Time 1 RBRI predicted poor adaptive outcome (Child Behavior Checklist) at Time 2. The results add to the body of literature examining the adaptive and maladaptive nature of repetitive behavior. PMID:24710387

  20. Maladaptive Plasticity in Aphasia: Brain Activation Maps Underlying Verb Retrieval Errors.

    PubMed

    Spielmann, Kerstin; Durand, Edith; Marcotte, Karine; Ansaldo, Ana Inés

    2016-01-01

    Anomia, or impaired word retrieval, is the most widespread symptom of aphasia, an acquired language impairment secondary to brain damage. In the last decades, functional neuroimaging techniques have enabled studying the neural basis underlying anomia and its recovery. The present study aimed to explore maladaptive plasticity in persistent verb anomia, in three male participants with chronic nonfluent aphasia. Brain activation maps associated with semantic verb paraphasia occurring within an oral picture-naming task were identified with an event-related fMRI paradigm. These maps were compared with those obtained in our previous study examining adaptive plasticity (i.e., successful verb naming) in the same participants. The results show that activation patterns related to semantic verb paraphasia and successful verb naming comprise a number of common areas, contributing to both maladaptive and adaptive neuroplasticity mechanisms. This finding suggests that the segregation of brain areas provides only a partial view of the neural basis of verb anomia and successful verb naming. Therefore, it indicates the importance of network approaches which may better capture the complexity of maladaptive and adaptive neuroplasticity mechanisms in anomia recovery. PMID:27429808

  1. Resident and attending physician perception of maladaptive response to stress in residents

    PubMed Central

    Riesenberg, Lee Ann; Berg, Katherine; Berg, Dale; Morgan, Charity J.; Davis, Joshua; Davis, Robyn; Schaeffer, Arielle; Hargraves, Robert; Little, Brian W.

    2014-01-01

    Background Residency stress has been shown to interfere with resident well-being and patient safety. We developed a survey research study designed to explore factors that may affect perception of a maladaptive response to stress. Methods A 16-item survey with 12 Likert-type perception items was designed to determine how often respondents agreed or disagreed with statements regarding the resident on the trigger tape. A total of 438 respondents from multiple institutions completed surveys. Results Attending physicians were more likely than residents to agree that the resident on the trigger tape was impaired, p<0.0001; needed to seek professional counseling, p=0.0003; should be removed from the service, p=0.002; was not receiving adequate support from the attending physician, p=0.007; and was a risk to patient safety, p=0.02. Attending physicians were also less likely to agree that the resident was a good role model, p=0.001, and that the resident should be able to resolve these issues herself/himself, p<0.0001. Conclusion Our data suggest that resident physicians may not be able to adequately detect maladaptive responses to stress and that attending physicians may be more adept at recognizing this problem. More innovative faculty and resident development workshops should be created to teach and encourage physicians to better observe and detect residents who are displaying maladaptive responses to stress. PMID:25407054

  2. Maladaptive dependency schemas, posttraumatic stress hyperarousal symptoms, and intimate partner aggression perpetration.

    PubMed

    Kachadourian, Lorig K; Taft, Casey T; Holowka, Darren W; Woodward, Halley; Marx, Brian P; Burns, Anthony

    2013-10-01

    This study examined the associations between maladaptive dependency-related schemas, posttraumatic stress disorder (PTSD) hyperarousal symptoms, and intimate-partner psychological and physical aggression in a sample of court-referred men (N = 174) participating in a domestic-abuser-intervention program. The men were largely African American; average age was 33.5 years. The extent to which hyperarousal symptoms moderated the association between dependency schemas and aggression was also examined. Maladaptive dependency-related schemas were positively associated with severe psychological, and mild and severe physical aggression perpetration. Hyperarousal symptoms were positively associated with mild and severe psychological aggression, and mild physical aggression perpetration. Multiple regression analyses showed a significant interaction for mild physical aggression: For those with high levels of hyperarousal symptoms, greater endorsement of maladaptive dependency schemas was associated with the perpetration of aggression (B = 0.98, p = .001). For those with low levels of hyperarousal symptoms, there was no association between dependency schemas and aggression (B = 0.04, ns). These findings suggest that focusing on problematic dependency and PTSD-hyperarousal symptoms in domestic-abuser-intervention programs may be helpful, and that examining related variables as possible moderators between dependency schemas and intimate aggression would be a fruitful area for future research. PMID:24030885

  3. Maladaptive Plasticity in Aphasia: Brain Activation Maps Underlying Verb Retrieval Errors

    PubMed Central

    Durand, Edith; Marcotte, Karine; Ansaldo, Ana Inés

    2016-01-01

    Anomia, or impaired word retrieval, is the most widespread symptom of aphasia, an acquired language impairment secondary to brain damage. In the last decades, functional neuroimaging techniques have enabled studying the neural basis underlying anomia and its recovery. The present study aimed to explore maladaptive plasticity in persistent verb anomia, in three male participants with chronic nonfluent aphasia. Brain activation maps associated with semantic verb paraphasia occurring within an oral picture-naming task were identified with an event-related fMRI paradigm. These maps were compared with those obtained in our previous study examining adaptive plasticity (i.e., successful verb naming) in the same participants. The results show that activation patterns related to semantic verb paraphasia and successful verb naming comprise a number of common areas, contributing to both maladaptive and adaptive neuroplasticity mechanisms. This finding suggests that the segregation of brain areas provides only a partial view of the neural basis of verb anomia and successful verb naming. Therefore, it indicates the importance of network approaches which may better capture the complexity of maladaptive and adaptive neuroplasticity mechanisms in anomia recovery. PMID:27429808

  4. On the equivalence of host local adaptation and parasite maladaptation: an experimental test.

    PubMed

    Lemoine, Mélissa; Doligez, Blandine; Richner, Heinz

    2012-02-01

    In spatiotemporally varying environments, host-parasite coevolution may lead to either host or parasite local adaptation. Using reciprocal infestations over 11 pairs of plots, we tested local adaptation in the hen flea and its main host, the great tit. Flea reproductive success (number of adults at host fledging) was lower on host individuals from the same plot compared with foreign hosts (from another plot), revealing flea local maladaptation. Host reproductive success (number of fledged young) for nests infested by foreign fleas was lower compared with the reproductive success of controls, with an intermediate success for nests infested by local fleas. This suggests host local adaptation although the absence of local adaptation could not be excluded. However, fledglings were heavier and larger when reared with foreign fleas than when reared with local fleas, which could also indicate host local maladaptation if the fitness gain in offspring size offsets the potential cost in offspring number. Our results therefore challenge the traditional view that parasite local maladaptation is equivalent to host local adaptation. The differences in fledgling morphology between nests infested with local fleas and those with foreign fleas suggest that flea origin affects host resource allocation strategy between nestling growth and defense against parasites. Therefore, determining the mechanisms that underlie these local adaptation patterns requires the identification of the relevant fitness measures and life-history trade-offs in both species. PMID:22218315

  5. Maladaptive Schemas as Mediators in the Relationship Between Child Sexual Abuse and Displaced Aggression.

    PubMed

    Estévez, Ana; Ozerinjauregi, Nagore; Herrero-Fernández, David

    2016-01-01

    Child sexual abuse is one of the most serious forms of abuse due to the psychological consequences that persist even into adulthood. Expressions of anger among child sexual abuse survivors remain common even years after the event. While child sexual abuse has been extensively studied, the expression of displaced aggression has been studied less. Some factors, such as the maladaptive early schemas, might account for this deficiency. The objective of this study was to analyze the relationships between child sexual abuse, displaced aggression, and these schemas according to gender and determine if these early schemas mediate the relationship between child sexual abuse and displaced aggression. A total of 168 Spanish subjects who were victims of child sexual abuse completed measures of childhood trauma, displaced aggression, and early maladaptive schemas. The results depict the relationship between child sexual abuse, displaced aggression, and early maladaptive schemas. Women scored higher than men in child sexual abuse, emotional abuse, disconnection or rejection and impaired autonomy. Mediational analysis found a significant mediation effect of disconnection or rejection on the relationship between child sexual abuse and displaced aggression; however, impaired autonomy did not mediate significantly. PMID:27266539

  6. HLA antigens in cardiomyopathic Chilean chagasics.

    PubMed Central

    Llop, E; Rothhammer, F; Acuña, M; Apt, W

    1988-01-01

    The distribution of HLA antigens in a sample of 124 Chagas serologically positive Chilean individuals was studied. The sample was subdivided according to the presence or absence of chagasic cardiomyopathy, in order to search for genetic differences associated with this pathological condition. The frequency of antigen B40 in the presence of antigen Cw3 was found to be significantly lower in subjects with cardiomyopathy. We tentatively suggest that the presence of these antigens among noncardiomyopathics is associated with a decreased susceptibility to develop chagasic cardiomyopathy in the Chilean population. PMID:3189340

  7. Maladaptive spinal plasticity opposes spinal learning and recovery in spinal cord injury

    PubMed Central

    Ferguson, Adam R.; Huie, J. Russell; Crown, Eric D.; Baumbauer, Kyle M.; Hook, Michelle A.; Garraway, Sandra M.; Lee, Kuan H.; Hoy, Kevin C.; Grau, James W.

    2012-01-01

    Synaptic plasticity within the spinal cord has great potential to facilitate recovery of function after spinal cord injury (SCI). Spinal plasticity can be induced in an activity-dependent manner even without input from the brain after complete SCI. A mechanistic basis for these effects is provided by research demonstrating that spinal synapses have many of the same plasticity mechanisms that are known to underlie learning and memory in the brain. In addition, the lumbar spinal cord can sustain several forms of learning and memory, including limb-position training. However, not all spinal plasticity promotes recovery of function. Central sensitization of nociceptive (pain) pathways in the spinal cord may emerge in response to various noxious inputs, demonstrating that plasticity within the spinal cord may contribute to maladaptive pain states. In this review we discuss interactions between adaptive and maladaptive forms of activity-dependent plasticity in the spinal cord below the level of SCI. The literature demonstrates that activity-dependent plasticity within the spinal cord must be carefully tuned to promote adaptive spinal training. Prior work from our group has shown that stimulation that is delivered in a limb position-dependent manner or on a fixed interval can induce adaptive plasticity that promotes future spinal cord learning and reduces nociceptive hyper-reactivity. On the other hand, stimulation that is delivered in an unsynchronized fashion, such as randomized electrical stimulation or peripheral skin injuries, can generate maladaptive spinal plasticity that undermines future spinal cord learning, reduces recovery of locomotor function, and promotes nociceptive hyper-reactivity after SCI. We review these basic phenomena, how these findings relate to the broader spinal plasticity literature, discuss the cellular and molecular mechanisms, and finally discuss implications of these and other findings for improved rehabilitative therapies after SCI. PMID

  8. The effect of self-distancing on adaptive versus maladaptive self-reflection in children.

    PubMed

    Kross, Ethan; Duckworth, Angela; Ayduk, Ozlem; Tsukayama, Eli; Mischel, Walter

    2011-10-01

    Although children and adolescents vary in their chronic tendencies to adaptively versus maladaptively reflect over negative feelings, the psychological mechanisms underlying these different types of self-reflection among youngsters are unknown. We addressed this issue in the present research by examining the role that self-distancing plays in distinguishing adaptive versus maladaptive self-reflection among an ethnically and socioeconomically diverse sample of fifth-grade public schoolchildren. Children were randomly assigned to analyze their feelings surrounding a recent anger-related interpersonal experience from either a self-immersed or self-distanced perspective. They then rated their negative affect and described in writing the stream of thoughts they experienced when they analyzed their feelings. Children's stream-of-thought essays were content analyzed for the presence of recounting statements, reconstruing statements, and blame attributions. Path analyses indicated that children who analyzed their feelings from a self-distanced perspective focused significantly less on recounting the "hot," emotionally arousing features of their memory (i.e., what happened to me?) and relatively more on reconstruing their experience. This shift in thought content--less recounting and more reconstruing--led children in the self-distanced group to blame the other person involved in their recalled experience significantly less, which in turn led them to display significantly lower levels of emotional reactivity. These findings help delineate the psychological mechanisms that distinguish adaptive versus maladaptive forms of self-reflection over anger experiences in children. Their basic findings and clinical implications are discussed. PMID:21728415

  9. An Act of Balance Between Adaptive and Maladaptive Immunity in Depression: a Role for T Lymphocytes.

    PubMed

    Toben, Catherine; Baune, Bernhard T

    2015-12-01

    Historically the monoaminergic neurotransmitter system, in particular the serotonergic system, was seen as being responsible for the pathophysiology of major depressive disorder (MDD). With the advent of psychoneuroimmunology an important role of the immune system in the interface between the central nervous systems (CNS) and peripheral organ systems has emerged. In addition to the well-characterised neurobiological activities of cytokines, T cell function in the context of depression has been neglected so far. In this review we will investigate the biological roles of T cells in depression. Originally it was thought that the adaptive immune arm including T lymphocytes was excluded from the CNS. It is now clear that peripheral naïve T cells not only carry out continuous surveillance within the brain but also maintain neural plasticity. Furthermore animal studies demonstrate that regulatory T lymphocytes can provide protection against maladaptive behavioural responses associated with depression. Psychogenic stress as a major inducer of depression can lead to transient trafficking of T lymphocytes into the brain stimulating the secretion of certain neurotrophic factors and cytokines. The separate and combined mechanism of CD4 and CD8 T cell activation is likely to determine the response pattern of CNS specific neurokines and neurotrophins. Under chronic stress-induced neuroinflammatory conditions associated with depression, T cell responses may become maladaptive and can be involved in neurodegeneration. Additionally, intracellular adhesion and MHC molecule expression as well as glucocorticoid receptor expression within the brain may play a role in determining T lymphocyte functionality in depression. Taken together, T lymphocyte mechanisms, which confer susceptibility or resilience to MDD, are not yet fully understood. Further insight into the cellular and molecular mechanisms which balance the adaptive and maladaptive roles of T lymphocytes may provide a better

  10. Human-assisted spread of a maladaptive behavior in a critically endangered bird.

    PubMed

    Massaro, Melanie; Sainudiin, Raazesh; Merton, Don; Briskie, James V; Poole, Anthony M; Hale, Marie L

    2013-01-01

    Conservation management often focuses on counteracting the adverse effects of human activities on threatened populations. However, conservation measures may unintentionally relax selection by allowing the 'survival of the not-so-fit', increasing the risk of fixation of maladaptive traits. Here, we report such a case in the critically-endangered Chatham Island black robin (Petroica traversi) which, in 1980, was reduced to a single breeding pair. Following this bottleneck, some females were observed to lay eggs on the rims of their nests. Rim eggs left in place always failed to hatch. To expedite population recovery, rim eggs were repositioned inside nests, yielding viable hatchlings. Repositioning resulted in rapid growth of the black robin population, but by 1989 over 50% of all females were laying rim eggs. We used an exceptional, species-wide pedigree to consider both recessive and dominant models of inheritance over all plausible founder genotype combinations at a biallelic and possibly sex-linked locus. The pattern of rim laying is best fitted as an autosomal dominant Mendelian trait. Using a phenotype permutation test we could also reject the null hypothesis of non-heritability for this trait in favour of our best-fitting model of heritability. Data collected after intervention ceased shows that the frequency of rim laying has strongly declined, and that this trait is maladaptive. This episode yields an important lesson for conservation biology: fixation of maladaptive traits could render small threatened populations completely dependent on humans for reproduction, irreversibly compromising the long term viability of populations humanity seeks to conserve. PMID:24348992

  11. Mediation of early maladaptive schemas between perceptions of parental rearing style and personality disorder symptoms.

    PubMed

    Thimm, Jens C

    2010-03-01

    In schema therapy (ST), early maladaptive schemas (EMS) are proposed to be the defining core of personality disorders. Adverse relational experiences in childhood are assumed to be the main cause for the development of EMS. The present study explored the links between perceived parental rearing behaviours, EMS, and personality disorder symptoms in a clinical sample (N=108). Results from mediation analyses suggest that EMS mediate the relationships between recalled parenting rearing behaviours and personality disorder symptoms. Findings give support to the theoretical model ST is based on. PMID:19896642

  12. [Adaptol in the treatment of anxiety disorders in children with school maladaptation].

    PubMed

    Chutko, L S; Surushkina, S Iu; Nikishena, I S; Iakovenko, E A; Anisimova, T I; Livinskaia, A M; Sidorova, Iu I; Kuzovenkova, M P; Aĭtbekov, K A; Mamaeva, Iu V

    2010-01-01

    We examined 336 children, aged 7-14 years, with signs of school maladaptation (SM). Anxiety disorders were found in 167 (49.7%), including generalized anxiety disorder - 87 children (25.9%), phobic disorder - 40 children (11.3%), anxiety disorder - 14 (4.2%), social anxiety disorder - 26 (7.7%). These indices differed significantly from those in the comparison group of children without SM. The children with generalized anxiety disorder were treated with adaptol (1000 mg/d during 30 days). The clinical and psychological examination revealed the high efficacy of this drug. Adaptol was well-tolerated, with no side-effects observed. PMID:20436449

  13. Adult Attention Deficit Hyperactivity Disorder Symptoms, Perceived Stress, and Well-Being: The Role of Early Maladaptive Schemata.

    PubMed

    Miklósi, Mónika; Máté, Orsolya; Somogyi, Klára; Szabó, Marianna

    2016-05-01

    Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent chronic neuropsychiatric disorders, severely affecting the emotional well-being of children as well as of adults. It has been suggested that individuals who experience symptoms of ADHD develop maladaptive schemata of failure, impaired self-discipline, social isolation, and shame. These schemata may then contribute to impaired emotional well-being by increasing unhelpful responses to stressful life events. However, to date, no empirical research has tested this theoretical proposition. In a sample of 204 nonclinical adults, we conducted a serial multiple mediator analysis, which supported the proposed model. More severe ADHD symptoms were associated with higher levels of perceived stress both directly and indirectly through stronger maladaptive schemata, which, in turn, were related to lower levels of emotional well-being. Results suggest that identifying and modifying maladaptive schemata may be an important addition to psychotherapy for adult ADHD patients. PMID:26825377

  14. Comparison of Early Maladaptive Schemas and Parenting Origins in Patients with Opioid Abuse and Non-Abusers

    PubMed Central

    Zargar, Mohammad; Salavati, Mojgan; Kakavand, Ali Reza

    2011-01-01

    Objective The aim of this study was to examine the difference of early maladaptive schemas and parenting origins in opioid abusers and non-opioid abusers. Method The early maladaptive schemas and parenting origins were compared in 56 opioid abusers and 56 non-opioids abusers. Schemas were assessed by the Young Schema Questionnaire 3rd (short form); and parenting origins were assessed by the Young Parenting Inventory. Results Data were analyzed by multivariate analysis of variance (MANOVA). The analysis showed that the means for schemas between opioid abusers and non-opioid abusers were different. Chi square test showed that parenting origins were significantly associated with their related schemas. Conclusion The early maladaptive schemas and parenting origins in opioid abusers were more than non-opioid abusers; and parenting origins were related to their Corresponding schemas. PMID:22952522

  15. Danger-early maladaptive schemas at work!: The role of early maladaptive schemas in career choice and the development of occupational stress in health workers.

    PubMed

    Bamber, Martin; McMahon, Rachel

    2008-01-01

    The schema-focused model of occupational stress and work dysfunctions (Bamber & Price, 2006; Bamber, 2006) hypothesizes that individuals with EMS (unconsciously) gravitate toward occupations with similar dynamics and structures to the toxic early environments and relationships that created them. They subsequently re-enact these EMS and their associated maladaptive coping styles in the workplace. For most individuals, this results in 'schema healing', but for some individuals with more rigid and severe EMS, schema healing is not achieved and the structures and relationships of the workplace, together with the utilization of maladaptive coping styles, serve to perpetuate their EMS. The model hypothesizes that it is these individuals who are most vulnerable to developing occupational stress syndromesTo date, this model has been subjected to very little empirical investigation, so the main aim of this study was to address this gap in the literature by testing out some of its main assumptions and to provide empirical data, which would either support or reject the model using a population of health workers. Specifically, it was hypothesized that 'occupation-specific' EMS would be found in health workers from a range of different healthcare professions. It was also hypothesized that the presence of higher levels of EMS would be predictive of raised levels of occupational stress, psychiatric caseness and increased sickness absence in those individuals.A cross-sectional study design was employed and a total of 249 staff working within a NHS Trust, belonging to one of five occupational groups (medical doctors, nurses, clinical psychologists, IT staff and managers), participated in the study. All participants completed the Young Schema Questionnaire-Short Form (Young, 1998); the Maslach Burnout Inventory-Human Services Form (Maslach & Jackson, 1981), and the General Health Questionnaire-28-item version (Goldberg, 1978). A demographic questionnaire and sickness absence data

  16. Early maladaptive schemas activated in patients with obsessive compulsive disorder: A cross-sectional study.

    PubMed

    Atalay, Hakan; Atalay, Figen; Karahan, Dilara; Caliskan, Mecit

    2008-01-01

    Aim. The aim of the present article is to investigate the activation patterns of early maladaptive schemas (EMSs) in patients with obsessive-compulsive disorder (OCD). Method. During the time between 1 January 2006 and 1 April 2006, 45 consecutive patients from an outpatient facility of a general hospital and 45 age- and gender-matched healthy control subjects from the hospital staff were included in the study. They were administered the Structured Clinical Interview for Diagnosis of DSM-IV Mental Disorders (SCID-1), the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-2), the Young Schema Questionnaire-Short Form (YSQ-SF), the Young Parenting Inventory (YPI) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The results were assessed using GraphPad Prisma V.3 statistical program. Results. The YSQ total score of the OCD group was significantly higher than the control group (t=3.62, P<0.0001). The average scores of the patients with OCD on certain schemas were significantly higher than the average scores of the control group, although the others did not make any difference between the OCD and control groups. Conclusion. The study demonstrates that, in the patients with OCD, most of the early maladaptive schemas including social isolation, vulnerability and pessimism, are prominently activated. PMID:24937713

  17. One of early maladaptive schemas’ causal relationship through metacognitive beliefs with borderline and antisocial personality patterns

    PubMed Central

    Zirakbash, Amin; Naderi, Farah; Enayati, Mir Salahedin

    2015-01-01

    Introduction: This study aimed at determining the causal relationship of metacognitive beliefs as a mediator between one of early maladaptive schemas including (emotional deprivation, abandonment, mistrust/abuse, social isolation/alienation and defectiveness/shame) and borderline and antisocial personality patterns. Materials and Methods: The study type has been relational and seeking causal modeling of path analysis has been used. The population used in this study included outpatients in counseling, psychological and psychiatric centers in 2012–2013. We randomly distributed 350 questionnaires in five centers out of three parts in Isfahan, and finally 230 valid questionnaires were evaluated and analyzed. Data collection tool has been Millon Clinical Multiaxial Inventory-III's (MCMI-III's) personality questionnaire, Yang's schema questionnaire (75 items), Metacognition Questionnaire-30 (30 items). Reliability of the Yang's Schema Questionnaire in this study was calculated by Cronbach's alpha (α =96%), and that of metacognition was calculated the same way (α =87%). Data analysis has been done using MCMI-III's software for Millon's personality questionnaire, and SPSS-16 and AMOS-18 software. We used path analysis method for testing each model in statistical data analysis. Result: The results of this study suggest a possible causal relationship between the number of one of the early maladaptive schemas and the patterns of anti-social and borderline personalities through some metacognitive beliefs. Conclusion: This study showed that cognitive beliefs can be activators of the early schema and continuation's coping behaviors in personality patterns. PMID:26430689

  18. Interrelations between psychosocial functioning and adaptive- and maladaptive-range personality traits.

    PubMed

    Ro, Eunyoe; Clark, Lee Anna

    2013-08-01

    Decrements in one or more domains of psychosocial functioning (e.g., poor job performance, poor interpersonal relations) are commonly observed in psychiatric patients. The purpose of this study is to increase understanding of psychosocial functioning as a broad, multifaceted construct as well as its associations with both adaptive- and maladaptive-range personality traits in both nonclinical and psychiatric outpatient samples. The study was conducted in two phases. In Study 1, a nonclinical sample (N = 429) was administered seven psychosocial functioning and adaptive-range personality trait measures. In Study 2, psychiatric outpatients (N = 181) were administered the same psychosocial functioning measures, and maladaptive- as well as adaptive-range personality trait measures. Exploratory (both studies) and confirmatory (Study 2) factor analyses indicated a common three-factor, hierarchical structure of psychosocial functioning-Well Being, Social/Interpersonal Functioning, and Basic Functioning. These psychosocial functioning domains were closely--and differentially--linked with personality traits, especially strongly so in patients. Across samples, Well Being was associated with both Neuroticism/Negative Affectivity and Extraversion/Positive Affectivity, Social/Interpersonal Functioning was associated with both Agreeableness and Conscientiousness/Disinhibition, and Basic Functioning was associated with Conscientiousness/Disinhibition, although only modestly in the nonclinical sample. These relations generally were maintained even after partialing out current general dysphoric symptoms. These findings have implications for considering psychosocial functioning as an important third domain in a tripartite model together with personality and psychopathology. PMID:24016019

  19. Maladaptive cognitions and physical health of the caregivers of dementia: An interpretative phenomenological analysis

    PubMed Central

    Ali, Sidra; Bokharey, Iram Z.

    2015-01-01

    The aim of the study was to conduct in-depth analyses of the lived experiences of the caregivers of dementia and their maladaptive thinking patterns and how their physical health was influenced and compromised. The main method used was interpretative phenomenological analysis and involved in-depth analysis of eight participants screened through homogenous purposive sampling. After taking written consent from the participants, semi-structured interviews were conducted to gather the data that were transcribed later on to carry out free textual analysis. The themes were generated from the transcripts through the funneling approach in order to arrive at the themes that were common, frequent, and reflected the experiences shared by the participants. The verification was done through peer review and rich thick description. The most significant themes regarding maladaptive cognitions were catastrophizing, overgeneralizing, and blaming, whereas fatigue and sleep disturbances were the most significant themes regarding physical health. The emergent themes point towards a need to devise indigenous therapeutic intervention for the caregivers of dementia in the Pakistani sociocultural context as the literature available on caregiving is quite scanty in our culture. PMID:26384522

  20. Genetic Correlates of Maladaptive Beliefs: COMT VAL(158)MET and Irrational Cognitions Linked Depending on Distress.

    PubMed

    Podina, Ioana; Popp, Radu; Pop, Ioan; David, Daniel

    2015-11-01

    Maladaptive/irrational beliefs are significant cognitive vulnerability mechanisms in psychopathology. They are more likely to be associated with a genetic vulnerability marker under conditions of emotional distress when irrational beliefs are more salient. Therefore, in the current study we investigated the COMT Val(158)Met gene variation in relation to irrational beliefs, assuming this relationship depended on the level of emotional distress. Two hundred and sixty-seven genotyped volunteers were assessed for core/general maladaptive beliefs, as well as trait emotional distress. We focused on context-independent measures of irrational beliefs and emotional distress in the absence of a stressor. As expected, the relationship between COMT Val(158)Met and irrational beliefs depended on the level of emotional distress (f(2)=.314). The COMT Val(158)Met-irrationality association was significant only when individuals fell in the average to above average range of emotional distress. Furthermore, within this range the Met allele seemed to relate to higher irrational beliefs. These results were significant for overall irrational beliefs and its subtypes, but not for rational beliefs, the functional counterpart of irrationality. In light of the study's limitations, the results should be considered as preliminary. If replicable, these findings have potential implications for therapygenetics, changing the view that COMT Val(158)Met might be of greater relevance when treatment modality does not rely on cognitive variables. PMID:26520222

  1. Maladaptive interpersonal schemas as sensitive and specific markers of borderline personality disorder among psychiatric inpatients.

    PubMed

    Cohen, Lisa J; Tanis, Thachell; Ardalan, Firouz; Yaseen, Zimri; Galynker, Igor

    2016-08-30

    Diagnostic criteria for borderline personality disorder (BPD) and mood and psychotic disorders characterized by major mood episodes (i.e., major depressive, bipolar and schizoaffective disorder) share marked overlap in symptom presentation, complicating differential diagnosis. The current study tests the hypothesis that maladaptive interpersonal schemas (MIS) are characteristic of BPD, but not of the major mood disorders. One hundred psychiatric inpatients were assessed by SCID I, SCID II and the Young Schema Questionnaire (YSQ-S2). Logistic regression analyses tested the association between MIS (measured by the YSQ-S2) and BPD, bipolar, major depressive and schizoaffective disorder. Receiver operator characteristic (ROC) curve analyses assessed the sensitivity and specificity of MIS as a marker of BPD. After covariation for comorbidity with each of the 3 mood disorders, BPD was robustly associated with 4 out of 5 schema domains. In contrast, only one of fifteen regression analyses demonstrated a significant association between any mood disorder and schema domain after covariation for comorbid BPD. ROC analyses of the 5 schema domains suggested Disconnection/Rejection had the greatest power for identification of BPD cases. These data support the specific role of maladaptive interpersonal schemas in BPD and potentially contribute to greater conceptual clarity about the distinction between BPD and the major mood disorders. PMID:27394052

  2. Maladaptive cognitions and physical health of the caregivers of dementia: An interpretative phenomenological analysis.

    PubMed

    Ali, Sidra; Bokharey, Iram Z

    2015-01-01

    The aim of the study was to conduct in-depth analyses of the lived experiences of the caregivers of dementia and their maladaptive thinking patterns and how their physical health was influenced and compromised. The main method used was interpretative phenomenological analysis and involved in-depth analysis of eight participants screened through homogenous purposive sampling. After taking written consent from the participants, semi-structured interviews were conducted to gather the data that were transcribed later on to carry out free textual analysis. The themes were generated from the transcripts through the funneling approach in order to arrive at the themes that were common, frequent, and reflected the experiences shared by the participants. The verification was done through peer review and rich thick description. The most significant themes regarding maladaptive cognitions were catastrophizing, overgeneralizing, and blaming, whereas fatigue and sleep disturbances were the most significant themes regarding physical health. The emergent themes point towards a need to devise indigenous therapeutic intervention for the caregivers of dementia in the Pakistani sociocultural context as the literature available on caregiving is quite scanty in our culture. PMID:26384522

  3. Microglia-Induced Maladaptive Plasticity Can Be Modulated by Neuropeptides In Vivo

    PubMed Central

    Morara, Stefano; Colangelo, Anna Maria; Provini, Luciano

    2015-01-01

    Microglia-induced maladaptive plasticity is being recognized as a major cause of deleterious self-sustaining pathological processes that occur in neurodegenerative and neuroinflammatory diseases. Microglia, the primary homeostatic guardian of the central nervous system, exert critical functions both during development, in neural circuit reshaping, and during adult life, in the brain physiological and pathological surveillance. This delicate critical role can be disrupted by neural, but also peripheral, noxious stimuli that can prime microglia to become overreactive to a second noxious stimulus or worsen underlying pathological processes. Among regulators of microglia, neuropeptides can play a major role. Their receptors are widely expressed in microglial cells and neuropeptide challenge can potently influence microglial activity in vitro. More relevantly, this regulator activity has been assessed also in vivo, in experimental models of brain diseases. Neuropeptide action in the central nervous system has been associated with beneficial effects in neurodegenerative and neuroinflammatory pathological experimental models. This review describes some of the mechanisms of the microglia maladaptive plasticity in vivo and how neuropeptide activity can represent a useful therapeutical target in a variety of human brain pathologies. PMID:26273481

  4. Psychiatric Diagnostic Screening of Social Maladaptive Behaviour in Children with Mild Intellectual Disability: Differentiating Disordered Attachment and Pervasive Developmental Disorder Behaviour

    ERIC Educational Resources Information Center

    Giltaij, H. P.; Sterkenburg, P. S.; Schuengel, C.

    2015-01-01

    Background: Children with intellectual disability (ID) are at risk for maladaptive development of social relatedness. Controversy exists whether Pervasive Developmental Disorder (PDD) takes precedence over disordered attachment for describing maladaptive social behaviour. The aim of this study was to assess the prevalence of disordered attachment…

  5. Gender Differences in the Relationship between Maladaptive Behaviors and Post-Traumatic Stress Disorder. A Study on 900 L’ Aquila 2009 Earthquake Survivors

    PubMed Central

    Dell’Osso, Liliana; Carmassi, Claudia; Stratta, Paolo; Massimetti, Gabriele; Akiskal, Kareen K.; Akiskal, Hagop S.; Maremmani, Icro; Rossi, Alessandro

    2013-01-01

    Background: Post-traumatic stress disorder (PTSD) represents one of the most frequently psychiatric sequelae to earthquake exposure. Increasing evidence suggests the onset of maladaptive behaviors among veterans and adolescents with PTSD, with specific gender differences emerging in the latter. Aims of the present study were to investigate the relationships between maladaptive behaviors and PTSD in earthquake survivors, besides the gender differences in the type and prevalence of maladaptive behaviors and their association with PTSD. Methods: 900 residents of the town of L’Aquila who experienced the earthquake of April 6th 2009 (Richter Magnitude 6.3) were assessed by means of the Trauma and Loss Spectrum-Self Report (TALS-SR). Results: Significantly higher maladaptive behavior prevalence rates were found among subjects with PTSD. A statistically significant association was found between male gender and the presence of at least one maladaptive behavior among PTSD survivors. Further, among survivors with PTSD significant correlations emerged between maladaptive coping and symptoms of re-experiencing, avoidance and numbing, and arousal in women, while only between maladaptive coping and avoidance and numbing in men. Conclusions: Our results show high rates of maladaptive behaviors among earthquake survivors with PTSD suggesting a greater severity among men. Interestingly, post-traumatic stress symptomatology appears to be a better correlate of these behaviors among women than among men, suggesting the need for further studies based on a gender approach. PMID:23293608

  6. In Search of the Sources of Psychologically Controlling Parenting: The Role of Parental Separation Anxiety and Parental Maladaptive Perfectionism

    ERIC Educational Resources Information Center

    Soenens, Bart; Vansteenkiste, Maarten; Duriez, Bart; Goossens, Luc

    2006-01-01

    This study investigated the role of two dimensions of parental separation anxiety--Anxiety about Adolescent Distancing (AAD) and Comfort with Secure Base Role (CSBR)--and parental maladaptive perfectionism in the prediction of psychologically controlling parenting. In a sample of middle adolescents and their parents (N=677), it was found that…

  7. Effects of Experimentally Manipulated Peer Rejection on Children's Negative Affect, Self-Esteem, and Maladaptive Social Behavior

    ERIC Educational Resources Information Center

    Nesdale, Drew; Lambert, Anne

    2007-01-01

    Children (n = 88) aged 8 and 10 years participated in a minimal group study in which their rejection versus acceptance, by one other person versus a group of three people, was experimentally manipulated. Analysis of their self-reported negative affect, self-esteem, and maladaptive social behavior, revealed that, regardless of the source of the…

  8. An Annotated Bibliography of the Literature Concerning Students' Adaptive and Maladaptive Behavior Patterns in Response to Failure in Achievement Situations.

    ERIC Educational Resources Information Center

    Moriarty, Kathleen Pelletier

    An examination of the dynamics of academic failure is presented in this monograph in the form of an annotated bibliography of current literature. The writings cited offer a cross-section of research on what factors affect students' choices of adaptive or maladaptive behavior patterns in the classroom and in relation to their peers. Section one of…

  9. Maladaptive Behavioral Consequences of Conditioned Fear-Generalization: A Pronounced, Yet Sparsely Studied, Feature of Anxiety Pathology

    PubMed Central

    van Meurs, Brian; Wiggert, Nicole; Wicker, Isaac; Lissek, Shmuel

    2016-01-01

    Fear-conditioning experiments in the anxiety disorders focus almost exclusively on passive-emotional, Pavlovian conditioning, rather than active-behavioral, instrumental conditioning. Paradigms eliciting both types of conditioning are needed to study maladaptive, instrumental behaviors resulting from Pavlovian abnormalities found in clinical anxiety. One such Pavlovian abnormality is generalization of fear from a conditioned danger-cue (CS+) to resembling stimuli. Though lab-based findings repeatedly link overgeneralized Pavlovian-fear to clinical anxiety, no study assesses the degree to which Pavlovian overgeneralization corresponds with maladaptive, overgeneralized instrumental-avoidance. The current effort fills this gap by validating a novel fear-potentiated startle paradigm including Pavlovian and instrumental components. The paradigm is embedded in a computer game during which shapes appear on the screen. One shape paired with electric-shock serves as CS+, and other resembling shapes, presented in the absence of shock, serve as generalization stimuli (GSs). During the game, participants choose whether to behaviorally avoid shock at the cost of poorer performance. Avoidance during CS+ is considered adaptive because shock is a real possibility. By contrast, avoidance during GSs is considered maladaptive because shock is not a realistic prospect and thus unnecessarily compromises performance. Results indicate significant Pavlovian-instrumental relations, with greater generalization of Pavlovian fear associated with overgeneralization of maladaptive instrumental-avoidance. PMID:24768950

  10. The Role of Career Stress in the Relationship between Maladaptive Perfectionism and Career Attitude Maturity in South Korean Undergraduates

    ERIC Educational Resources Information Center

    Park, Heerak; Choi, Bo Young; Nam, Suk Kyung; Lee, Sang Min

    2011-01-01

    Given the central role of career stress in college students' lives, this research examined whether career stress mediated the relationship between maladaptive perfectionism and career attitude maturity in a sample of 185 undergraduate students in South Korea. The results indicated that career ambiguity stress, as measured by a career stress…

  11. Psychological Distress as a Mediator of the Relation between Perceived Maternal Parenting and Normative Maladaptive Eating among Adolescent Girls

    ERIC Educational Resources Information Center

    Blodgett Salafia, Elizabeth H.; Gondoli, Dawn M.; Corning, Alexandra F.; McEnery, Amanda M.; Grundy, Amber M.

    2007-01-01

    Burgeoning research on the adolescent (e.g., middle-school) years suggests that this is a particularly vulnerable period for the development of maladaptive eating patterns. Prior research has established a link between perceptions of maternal parenting practices and adolescent onset of problematic eating behaviors. The authors hypothesized that…

  12. Personality and early maladaptive schemas: a five-factor model perspective.

    PubMed

    Thimm, Jens C

    2010-12-01

    According to Young's schema model (Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. New York: Guilford Press), innate personality tendencies are important for the understanding of early maladaptive schemas (EMS). The current study examined the relations between EMS and the dimensions of the five-factor model of personality (FFM). One hundred and forty-seven adult outpatients completed the NEO PI-R, the Schema Questionnaire-Short Form (SQ-SF), and the Beck Depression Inventory (BDI). Correlational analyses showed a substantial overlap between EMS and the FFM, neuroticism in particular. EMS predicted depressive symptoms above and beyond the FFM personality dimensions. Implications of these findings are discussed. PMID:20435297

  13. Maladaptive schemas in adolescent females with anorexia nervosa and implications for treatment.

    PubMed

    Damiano, Stephanie R; Reece, John; Reid, Sophie; Atkins, Linsey; Patton, George

    2015-01-01

    Recent research has highlighted the presence of Young's Early Maladaptive Schemas (EMSs) in individuals with an eating disorder (ED). This study assessed the EMSs reported by adolescent females with Anorexia Nervosa (AN) compared with a community group. Thirty-six adolescent females diagnosed with AN or subthreshold AN and 111 female secondary school students completed a questionnaire that included the Young Schema Questionnaire, the Behavior Assessment System for Children Self-report of Personality, and the Eating Disorder Screen for Primary Care. Two independent AN subtypes and two community subtypes were derived from responses to the questionnaire, and significant differences between the four comparison groups were found. High Pathology AN participants reported the highest level of psychological maladjustment. Social Isolation and Emotional Inhibition appeared to be most characteristic of adolescent AN in this sample. The results suggest that EMSs may require attention in the treatment of AN in adolescent females, and that different AN subtypes may require individualized treatment approaches. PMID:25464069

  14. Early Maladaptive Schemas in Bipolar Disorder Patients With and Without Suicide Attempts.

    PubMed

    Nilsson, Kristine Kahr

    2016-03-01

    Patients with bipolar disorder (BD) are at an increased risk of attempted and completed suicide. To elucidate the beliefs and assumptions associated with suicidality in BD, the present study compared BD patients with and without a history of suicide attempt in terms of early maladaptive schemas (EMSs). The sample consisted of 49 remitted BD patients who completed the Young Schema Questionnaire-Short Version. Information on suicide attempts was obtained through interviews combined with medical records. Compared with BD patients without suicide attempts, the BD patients with suicide attempts scored significantly higher on 3 EMSs: social isolation, practical incompetence, and entitlement. The findings suggest that specific EMSs may be implicated in suicidal behaviors in BD. These results have implications for the assessment and treatment of suicidality in BD. PMID:26919302

  15. Distinctions Between Two Expectancies in the Prediction of Maladaptive Eating Behavior

    PubMed Central

    Combs, Jessica L.; Smith, Gregory T.; Simmons, Jean R.

    2010-01-01

    In this longitudinal study, the authors provide support for the validity of the claim that differences in the nature of the reinforcement that adolescent girls expect from eating contribute to the development of different forms of maladaptive eating. The learned expectancy that eating is pleasurable and rewarding predicted higher levels of social/celebratory overeating across the first year of middle school but did not predict higher levels of clinical binge eating. In contrast, the expectancy that eating helps one manage negative affect predicted higher levels of binge eating but not of social/celebratory overeating across the same time period (n = 394). The results also supported a reciprocal model in which binge eating predicted higher levels of the expectancy that eating will manage negative affect but not that eating is pleasurable and rewarding; conversely, social/celebratory overeating predicted higher levels of the expectancy that eating is pleasurable and rewarding but not that eating will manage negative affect. PMID:21127719

  16. Measures to assess maladaptive variants of the five-factor model.

    PubMed

    Widiger, Thomas A; Lynam, Donald R; Miller, Joshua D; Oltmanns, Thomas F

    2012-01-01

    The five-factor model (FFM) is the predominant dimensional model of general personality structure. A considerable body of research supports the hypothesis that personality disorders can be conceptualized as extreme or maladaptive variants of the domains and facets of the FFM. However, existing measures of the FFM are confined largely to the normal variants. The purpose of this special section of the Journal of Personality Assessment is to provide the development and initial validation of self-report inventory scales to assess obsessive-compulsive, borderline, narcissistic, avoidant, and dependent personality traits from the perspective of the FFM, which complement the similarly constructed existing measures for psychopathic, histrionic, and schizotypal personality traits. PMID:22519804

  17. Impact of rumination versus distraction on anxiety and maladaptive self-beliefs in socially anxious individuals.

    PubMed

    Wong, Quincy J J; Moulds, Michelle L

    2009-10-01

    A large body of experimental evidence has demonstrated the adverse effects of rumination on depressive mood and cognitions. In contrast, while prominent models of social phobia (Clark & Wells, 1995; Rapee & Heimberg, 1997) have proposed rumination as a key maintaining factor, the effects of rumination in social anxiety have not been extensively explored. In a sample of (N = 93) undergraduates, this study investigated the impact of rumination versus distraction following a social-evaluative task on anxiety and another key component of social phobia: maladaptive self-beliefs. Relative to distraction, rumination maintained anxiety in both high and low socially anxious individuals, and maintained unconditional beliefs in high socially anxious individuals. The results support models of social phobia and also suggest important theoretical extensions. Implications for the treatment of social anxiety are discussed. PMID:19608157

  18. Development of Maladaptive Coping: A Functional Adaptation to Chronic, Uncontrollable Stress

    PubMed Central

    Wadsworth, Martha E.

    2015-01-01

    Health disparities are rooted in childhood and stem from adverse early environments that damage physiologic stress-response systems. Developmental psychobiological models of the effects of chronic stress account for both the negative effects of a stress-response system calibrated to a dangerous and unpredictable environment from a health perspective, and the positive effects of such an adaptively calibrated stress response from a functional perspective. Our research suggests that contexts that produce functionally adapted physiologic responses to stress also encourage a functionally adapted coping response—coping that can result in maladjustment in physical and mental health, but enables children to grow and develop within those contexts. In this article, I highlight the value of reframing maladaptive coping as functional adaptation to understand more completely the development of children’s coping in different contexts, and the value of such a conceptual shift for coping-based theory, research, and intervention. PMID:26019717

  19. Can settlement in natal-like habitat explain maladaptive habitat selection?

    PubMed Central

    Piper, Walter H.; Palmer, Michael W.; Banfield, Nathan; Meyer, Michael W.

    2013-01-01

    The study of habitat selection has long been influenced by the ideal free model, which maintains that young adults settle in habitat according to its inherent quality and the density of conspecifics within it. The model has gained support in recent years from the finding that conspecifics produce cues inadvertently that help prebreeders locate good habitat. Yet abundant evidence shows that animals often fail to occupy habitats that ecologists have identified as those of highest quality, leading to the conclusion that young animals settle on breeding spaces by means not widely understood. Here, we report that a phenomenon virtually unknown in nature, natal habitat preference induction (NHPI), is a strong predictor of territory settlement in both male and female common loons (Gavia immer). NHPI causes young animals to settle on natal-like breeding spaces, but not necessarily those that maximize reproductive success. If widespread, NHPI might explain apparently maladaptive habitat settlement. PMID:23804619

  20. Adaptive and maladaptive emotion regulation strategies: interactive effects during CBT for social anxiety disorder.

    PubMed

    Aldao, Amelia; Jazaieri, Hooria; Goldin, Philippe R; Gross, James J

    2014-05-01

    There has been a increasing interest in understanding emotion regulation deficits in social anxiety disorder (SAD; e.g., Hofmann, Sawyer, Fang, & Asnaani, 2012). However, much remains to be understood about the patterns of associations among regulation strategies in the repertoire. Doing so is important in light of the growing recognition that people's ability to flexibly implement strategies is associated with better mental health (e.g., Kashdan et al., 2014). Based on previous work (Aldao & Nolen-Hoeksema, 2012), we examined whether putatively adaptive and maladaptive emotion regulation strategies interacted with each other in the prediction of social anxiety symptoms in a sample of 71 participants undergoing CBT for SAD. We found that strategies interacted with each other and that this interaction was qualified by a three-way interaction with a contextual factor, namely treatment study phase. Consequently, these findings underscore the importance of modeling contextual factors when seeking to understand emotion regulation deficits in SAD. PMID:24742755

  1. Nrf2-Mediated Cardiac Maladaptive Remodeling and Dysfunction in a Setting of Autophagy Insufficiency.

    PubMed

    Qin, Qingyun; Qu, Chen; Niu, Ting; Zang, Huimei; Qi, Lei; Lyu, Linmao; Wang, Xuejun; Nagarkatti, Mitzi; Nagarkatti, Prakash; Janicki, Joseph S; Wang, Xing Li; Cui, Taixing

    2016-01-01

    Nuclear factor erythroid-2-related factor 2 (Nrf2) appears to exert either a protective or detrimental effect on the heart; however, the underlying mechanism remains poorly understood. Herein, we uncovered a novel mechanism for turning off the Nrf2-mediated cardioprotection and switching on Nrf2-mediated cardiac dysfunction. In a murine model of pressure overload-induced cardiac remodeling and dysfunction via transverse aortic arch constriction, knockout of Nrf2 enhanced myocardial necrosis and death rate during an initial stage of cardiac adaptation when myocardial autophagy function is intact. However, knockout of Nrf2 turned out to be cardioprotective throughout the later stage of cardiac maladaptive remodeling when myocardial autophagy function became insufficient. Transverse aortic arch constriction -induced activation of Nrf2 was dramatically enhanced in the heart with impaired autophagy, which is induced by cardiomyocyte-specific knockout of autophagy-related gene (Atg)5. Notably, Nrf2 activation coincided with the upregulation of angiotensinogen (Agt) only in the autophagy-impaired heart after transverse aortic arch constriction. Agt5 and Nrf2 gene loss-of-function approaches in combination with Jak2 and Fyn kinase inhibitors revealed that suppression of autophagy inactivated Jak2 and Fyn and nuclear translocation of Fyn, while enhancing nuclear translocation of Nrf2 and Nrf2-driven Agt expression in cardiomyocytes. Taken together, these results indicate that the pathophysiological consequences of Nrf2 activation are closely linked with the functional integrity of myocardial autophagy during cardiac remodeling. When autophagy is intact, Nrf2 is required for cardiac adaptive responses; however, autophagy impairment most likely turns off Fyn-operated Nrf2 nuclear export thus activating Nrf2-driven Agt transcription, which exacerbates cardiac maladaptation leading to dysfunction. PMID:26573705

  2. Maladaptive Sex Ratio Adjustment in the Invasive Brine Shrimp Artemia franciscana.

    PubMed

    Lievens, Eva J P; Henriques, Gil J B; Michalakis, Yannis; Lenormand, Thomas

    2016-06-01

    Sex allocation theory is often hailed as the most successful area of evolutionary theory due to its striking success as a predictor of empirical observations [1]. Most naturally occurring sex ratios can be explained by the principle of equal investment in the sexes [2-4] or by cases of "extraordinary" sex allocation [5]. Deviations from the expected sex ratio are often correlated with weak selection or low environmental predictability (e.g., [6, 7]); true cases of aberrant sex allocation are surprisingly rare [8]. Here, we present a case of long-lasting maladaptive sex allocation, which we discovered in invasive populations of the exclusively sexual brine shrimp Artemia franciscana. A. franciscana was introduced to Southern France roughly 500 generations ago [9]; since then, it has coexisted with the native asexual species Artemia parthenogenetica [10]. Although we expect A. franciscana to produce balanced offspring sex ratios, we regularly observed extremely male-biased sex ratios in invasive A. franciscana, which were significantly correlated to the proportion of asexuals in the overall population. We experimentally proved that both invasive- and native-range A. franciscana overproduced sons when exposed to excess females, without distinguishing between conspecific and asexual females. We conclude that A. franciscana adjust their offspring sex ratio in function of the adult sex ratio but are information limited in the presence of asexual females. Their facultative adjustment trait, which is presumably adaptive in their native range, has thus become maladaptive in the invasive range where asexuals occur. Despite this, it has persisted unchanged for hundreds of generations. PMID:27185556

  3. Muscle RING Finger-1 Promotes a Maladaptive Phenotype in Chronic Hypoxia-Induced Right Ventricular Remodeling

    PubMed Central

    Campen, Matthew J.; Paffett, Michael L.; Colombo, E. Sage; Lucas, Selita N.; Anderson, Tamara; Nysus, Monique; Norenberg, Jeffrey P.; Gershman, Ben; Hesterman, Jacob; Hoppin, Jack; Willis, Monte

    2014-01-01

    Exposure to chronic hypoxia (CH) induces elevated pulmonary artery pressure/resistance, leading to an eventual maladaptive right ventricular hypertrophy (RVH). Muscle RING finger-1 (MuRF1) is a muscle-specific ubiquitin ligase that mediates myocyte atrophy and has been shown to play a role in left ventricular hypertrophy and altered cardiac bioenergetics in pressure overloaded hearts. However, little is known about the contribution of MuRF1 impacting RVH in the setting of CH. Therefore, we hypothesized that MuRF1 deletion would enhance RVH compared to their wild-type littermates, while cardiac-specific overexpression would reduce hypertrophy following CH-induced pulmonary hypertension. We assessed right ventricular systolic pressure (RVSP), right ventricle to left ventricle plus septal weight ratio (RV/LV+S) and hematocrit (Hct) following a 3-wk isobaric CH exposure. Additionally, we conducted dual-isotope SPECT/CT imaging with cardiac function agent 201Tl-chloride and cell death agent 99mTc-annexin V. Predictably, CH induced pulmonary hypertension, measured by increased RVSP, RV/LV+S and Hct in WT mice compared to normoxic WT mice. Normoxic WT and MuRF1-null mice exhibited no significant differences in RVSP, RV/LV+S or Hct. CH-induced increases in RVSP were also similar between WT and MuRF1-null mice; however, RV/LV+S and Hct were significantly elevated in CH-exposed MuRF1-null mice compared to WT. In cardiac-specific MuRF1 overexpressing mice, RV/LV+S increased significantly due to CH exposure, even greater than in WT mice. This remodeling appeared eccentric, maladaptive and led to reduced systemic perfusion. In conclusion, these results are consistent with an atrophic role for MuRF1 regulating the magnitude of right ventricular hypertrophy following CH-induction of pulmonary hypertension. PMID:24811453

  4. Muscle RING finger-1 promotes a maladaptive phenotype in chronic hypoxia-induced right ventricular remodeling.

    PubMed

    Campen, Matthew J; Paffett, Michael L; Colombo, E Sage; Lucas, Selita N; Anderson, Tamara; Nysus, Monique; Norenberg, Jeffrey P; Gershman, Ben; Hesterman, Jacob; Hoppin, Jack; Willis, Monte

    2014-01-01

    Exposure to chronic hypoxia (CH) induces elevated pulmonary artery pressure/resistance, leading to an eventual maladaptive right ventricular hypertrophy (RVH). Muscle RING finger-1 (MuRF1) is a muscle-specific ubiquitin ligase that mediates myocyte atrophy and has been shown to play a role in left ventricular hypertrophy and altered cardiac bioenergetics in pressure overloaded hearts. However, little is known about the contribution of MuRF1 impacting RVH in the setting of CH. Therefore, we hypothesized that MuRF1 deletion would enhance RVH compared to their wild-type littermates, while cardiac-specific overexpression would reduce hypertrophy following CH-induced pulmonary hypertension. We assessed right ventricular systolic pressure (RVSP), right ventricle to left ventricle plus septal weight ratio (RV/LV+S) and hematocrit (Hct) following a 3-wk isobaric CH exposure. Additionally, we conducted dual-isotope SPECT/CT imaging with cardiac function agent 201Tl-chloride and cell death agent 99mTc-annexin V. Predictably, CH induced pulmonary hypertension, measured by increased RVSP, RV/LV+S and Hct in WT mice compared to normoxic WT mice. Normoxic WT and MuRF1-null mice exhibited no significant differences in RVSP, RV/LV+S or Hct. CH-induced increases in RVSP were also similar between WT and MuRF1-null mice; however, RV/LV+S and Hct were significantly elevated in CH-exposed MuRF1-null mice compared to WT. In cardiac-specific MuRF1 overexpressing mice, RV/LV+S increased significantly due to CH exposure, even greater than in WT mice. This remodeling appeared eccentric, maladaptive and led to reduced systemic perfusion. In conclusion, these results are consistent with an atrophic role for MuRF1 regulating the magnitude of right ventricular hypertrophy following CH-induction of pulmonary hypertension. PMID:24811453

  5. Intergenerational Transmission of Maladaptive Parenting Strategies in Families of Adolescent Mothers: Effects from Grandmothers to Young Children.

    PubMed

    Seay, Danielle M; Jahromi, Laudan B; Umaña-Taylor, Adriana J; Updegraff, Kimberly A

    2016-08-01

    The current longitudinal study examined the effect of the transmission of maladaptive parenting strategies from grandmothers to adolescent mothers on children's subsequent development. Mexican-origin adolescent mothers (N = 204) participated in home interviews when the adolescent's child (89 boys, 60 girls) was 2, 3, 4, and 5 years old. Grandmothers' psychological control toward the adolescent mother was positively related to adolescents' potential for abuse 1 year later, which was subsequently positively related to adolescents' punitive discipline toward their young child. In addition, adolescent mothers' punitive discipline subsequently predicted greater externalizing problems and less committed compliance among their children. Adolescent mothers' potential for abuse and punitive discipline mediated the effects of grandmothers' psychological control on children's externalizing problems. Finally, adolescent mothers' potential for abuse mediated the effect of grandmothers' psychological control on adolescent mothers' punitive discipline. Results highlight the salience of long-term intergenerational effects of maladaptive parenting on children's behavior. PMID:26521948

  6. Adaptive, maladaptive, mediational, and bidirectional processes of relational and physical aggression, relational and physical victimization, and peer liking.

    PubMed

    Kawabata, Yoshito; Tseng, Wan-Ling; Crick, Nicki R

    2014-01-01

    A three-wave longitudinal study among ethnically diverse preadolescents (N = 597 at Time 1, ages 9-11) was conducted to examine adaptive, maladaptive, mediational, and bidirectional processes of relational and physical aggression, victimization, and peer liking indexed by peer acceptance and friendships. A series of nested structural equation models tested the hypothesized links among these peer-domain factors. It was hypothesized that (1) relational aggression trails both adaptive and maladaptive processes, linking to more peer victimization and more peer liking, whereas physical aggression is maladaptive, resulting in more peer victimization and less peer liking; (2) physical and relational victimization is maladaptive, relating to more aggression and less peer liking; (3) peer liking may be the social context that promotes relational aggression (not physical aggression), whereas peer liking may protect against peer victimization, regardless of its type; and (4) peer liking mediates the link between forms of aggression and forms of peer victimization. Results showed that higher levels of peer liking predicted relative increases in relational aggression (not physical aggression), which in turn led to more peer liking. On the other hand, more peer liking was predictive of relative decreases in relational aggression and relational victimization in transition to the next grade (i.e., fifth grade). In addition, relational victimization predicted relative increases in relational aggression and relative decreases in peer liking. Similarly, physical aggression was consistently and concurrently associated more physical victimization and was marginally predictive of relative increases in physical victimization in transition to the next grade. More peer liking predicted relative decreases in physical victimization, which resulted in lower levels of peer liking. The directionality and magnitude of these paths did not differ between boys and girls. PMID:24318459

  7. Assessment of dependency by the FFDI: Comparisons to the PID-5 and maladaptive agreeableness.

    PubMed

    Gore, Whitney L; Widiger, Thomas A

    2015-11-01

    The present study explores the validity of the Five Factor Dependency Inventory (FFDI), a measure of dependent personality traits from the perspective of the five factor model, examined across three separate samples and two studies. The first study examined the FFDI with respect to the traits assigned to assess dependent personality disorder (DPD) by the DSM-5 work group, two measures of DSM-IV-TR DPD and three measures of dependent traits, sampling 184 Mechanical Turk participants and 83 students (the latter oversampled for DPD features). Based on responses from an additional 137 students, the second study investigated the role of maladaptive agreeableness in dependency by examining the FFDI in relation to the interpersonal circumplex using three alternative measures. Discriminant validity was provided with respect to DSM-5 traits and the interpersonal circumplex. Incremental validity was provided with respect to the ability of the FFDI to account for variance within DPD measures beyond the variance explained by DSM-5 traits. Implications for the assessment of dependency and the proposed DSM-5 dimensional trait model are discussed. PMID:26333624

  8. Early maladaptive schemas in children: development and validation of the Schema Inventory for Children.

    PubMed

    Rijkeboer, Marleen M; de Boo, Gerly M

    2010-06-01

    A Schema Inventory for Children (SIC) was developed, based on Young's schema model. Its psychometric properties were investigated in a non-clinical multi-ethnic sample of children, aged 8-13 years. The latent structure of the SIC was explored using a cross-validation design. Confirmatory factor analyses yielded satisfying fits for a modified model, that included 8 of the original 15 schema factors, as well as 3 new factors, each containing a theoretically meaningful combination of 2 or 3 original schema factors. Our data suggest that, to a certain extent, children present with the same schemas as identified in adolescents and adults, although some unique, children-specific schemas occurred. SIC item loadings were moderate to good, and all factors showed adequate discriminant validity. However, factor reliability estimates were mediocre, but in most cases still acceptable. Furthermore, results suggest adequate stability for all SIC scales. Finally, strong relations between most of the SIC scales and measures of psychopathology were found, although an opposite pattern of associations emerged for two scales (i.e., Enmeshment and Self-Sacrifice), suggesting that these schemas are not maladaptive -yet- at this young age. PMID:19944408

  9. Early maladaptive schemas and personality disorder traits in perpetrators of intimate partner violence.

    PubMed

    Corral, Carmen; Calvete, Esther

    2014-01-01

    Personality disorders (PDs) are highly prevalent among perpetrators of intimate partner violence (IPV). Schema Therapy proposes a number of early maladaptive schemas (EMSs) that are involved in the development of PDs. This study examined the prevalence of PD traits in a sample of men who committed violence against their partners and the relationship between EMSs domains and PD traits. With this aim, a sample of 119 convicted men completed the Young Schema Questionnaire-Short Form (YSQ-SF; Young & Brown, 1994) and the Millon Clinical Multiaxial Inventory (MCMI-III; Millon, Millon, & Davis, 1994). The results showed that the most prevalent PD traits were narcissistic (24.6%), obsessive-compulsive (21.9%), and paranoid (17.5%). These PD traits were linked to several EMSs in ways consistent with the Schema Therapy model. Namely, narcissistic PD traits were positively associated with schemas of the impaired limits domain and were negatively associated with the other-directedness domain. The paranoid PD traits were associated with the disconnection and rejection domain and the impaired autonomy and performance domain. Finally, both borderline and antisocial PD traits were associated with the disconnection and rejection domain and the impaired limits domain. These findings suggest that the assessment and modification of EMSs should be a factor to consider for inclusion in the treatment programs for perpetrators of IPV in order to provide comprehensive intervention of this population. PMID:24553172

  10. Early Maladaptive Schemas in Eating Disordered Patients With or Without Non-Suicidal Self-Injury.

    PubMed

    Pauwels, Els; Dierckx, Eva; Schoevaerts, Katrien; Claes, Laurence

    2016-09-01

    This study investigates early maladaptive schemas (EMSs) in function of eating disorder (ED) subtypes (restrictive/bulimic) and the presence/absence of non-suicidal self-injury (NSSI). Female inpatients (N = 491) completed the Young Schema Questionnaire and the Self-Injury Questionnaire. The influence of ED subtype and the presence/absence of NSSI and their interaction on the EMS were investigated by means of a MANCOVA. The results showed main effects of ED subtype and the presence of NSSI on EMS. Patients with bulimia scored significantly higher on insufficient self-control and emotional deprivation, which are more related to cluster B compared with restrictive patients, whereas restrictive patients scored significantly higher on social undesirability, failure to achieve, subjugation and unrelenting standards compared with patients with bulimia that are more related to cluster C. Patients with ED with NSSI reported significantly higher EMS levels compared with patients without NSSI, suggesting that they could be of particular interest to benefit from schema therapy. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. PMID:27349211

  11. Early maladaptive schemas in Finnish adult chronic pain patients and a control sample.

    PubMed

    Saariaho, Tom Harri; Saariaho, Anita Sylvia; Karila, Irma Anneli; Joukamaa, Matti I

    2011-04-01

    Engel (1959) suggested that negative physical or emotional experiences in childhood predispose to the development of chronic pain. Studies have shown that physical and sexual abuse in early life is connected with chronic pain. Emotional adversities are much less studied causes contributing to the development of chronic pain and disability. Early emotional abuse, neglect, maltreatment and other adversities are deleterious childhood experiences which, according to Young's schema theory (1990), produce early maladaptive schemas (EMSs). The primary goal of this study was to examine whether early adversities were more common in chronic pain patients than in a control group. A total of 271 (53% women) first-visit chronic pain patients and 331 (86% women) control participants took part in the study. Their socio-demographic data, pain variables and pain disability were measured. To estimate EMSs the Young Schema Questionnaire was used. Chronic pain patients scored higher EMSs reflecting incapacity to perform independently, catastrophic beliefs and pessimism. The most severely disabled chronic pain patients showed an increase in all the EMSs in the Disconnection and Rejection schema domain, namely Abandonment/Instability, Mistrust/Abuse, Emotional Deprivation, Defectiveness/Shame and Social Isolation/Alienation EMSs. The results of the study suggested that chronic pain patients had suffered early emotional maltreatment. PMID:21054422

  12. Relationship between early maladaptive schemas and symptom dimensions in patients with obsessive-compulsive disorder.

    PubMed

    Kim, Ji Eun; Lee, Sang Won; Lee, Seung Jae

    2014-01-30

    The aims of this study were to evaluate early maladaptive schemas (EMSs) of patients with obsessive-compulsive disorder (OCD) and to clarify relationships between particular EMSs and the five factor-analyzed symptom dimensions and other clinical variables. Fifty-seven patients with OCD and 70 normal controls completed the Young Schema Questionnaire, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Y-BOCS symptom checklist, and the Beck Depression Inventory. Patients with OCD had significantly higher scores for schema related to defectiveness/shame, social isolation/alienation, and failure than did normal controls. Among the five OCD symptom dimensions, the sexual/religious dimension was only significantly correlated with two schemas of vulnerability to harm or illness and enmeshment/undeveloped self. These two schemas were significant predictors of the sexual/religious dimension, accounting for 33% of the total variance in this dimension. Any EMSs in patients with OCD were not related to clinical variables such as severity of OCD and duration of illness. These findings may constitute evidence to improve our understandings of OCD from a perspective of schema theory. PMID:23962740

  13. Early maladaptive schemas predict positive symptomatology in schizophrenia: a cross-sectional study.

    PubMed

    Bortolon, Catherine; Capdevielle, Delphine; Boulenger, Jean-Philippe; Gely-Nargeot, Marie-Christine; Raffard, Stéphane

    2013-10-30

    Recent literature has shown the role of social factors, such as childhood negative experiences and attachment styles, in the genesis of psychotic symptoms. So far, despite this association with childhood negative experiences and a wide range of psychiatric disorders, no study has yet attempted to assess early maladaptive schemas (EMSs) in patients with schizophrenia as primary diagnosis. A sample of 48 patients diagnosed with schizophrenia and 44 control participants answered the schema questionnaire short form's French validation, and were assessed with the positive and negative syndrome scale as well as a scale of depression symptomatology. Results showed that, after controlling for depression, patients with schizophrenia achieved higher scores than control subjects on six EMSs. The EMSs were associated with positive, but not negative, symptomatology. After controlling for depression, only the Mistrust/Abuse schema was a significant predictor of positive symptoms accounting for a small portion (12.4%) of the variance. The results highlight the importance of focusing not only on the schizophrenic symptoms but also on the person and his or her subjective development of self. Therefore, these results suggest that Young's schema theory may be applied to schizophrenic patients. PMID:23623454

  14. A comparative study of early maladaptive schemas in obsessive-compulsive disorder and panic disorder.

    PubMed

    Kwak, Kyung-Hwa; Lee, Seung Jae

    2015-12-30

    Schema theory and therapy may be an additional therapeutic approach to identify and treat chronic psychological problems, namely early maladaptive schemas (EMSs), in patients with obsessive-compulsive disorder (OCD) and panic disorder (PAD). In the current study, we investigated the characteristics in EMSs between patients with OCD and PAD. Fifty-one patients with OCD, 46 patients with PAD, and 70 normal controls participated in this study. EMSs and depressive symptoms were measured using the Young Schema Questionnaire and the Beck Depression Inventory (BDI), respectively. Analysis of covariance was conducted with age, sex, BDI score, and education level as covariates to assess group differences. Direct comparisons among the three groups revealed that the defectiveness/shame and social isolation/alienation schemas were prominently activated in patients with OCD, whereas the vulnerability to harm or illness and self-sacrifice were activated in patients with PAD. In subgroup analysis, these differences were observed between subgroups with lower BDI scores, but not between the patient subgroups with higher BDI scores. However, the differences between the patient groups in the defectiveness/shame and vulnerability to harm or illness schemas almost reached significance. Patients with OCD and PAD differed in particular EMS characteristics, which could have potential therapeutic implications. PMID:26599390

  15. Rape-related cognitive distortions: Preliminary findings on the role of early maladaptive schemas.

    PubMed

    Sigre-Leirós, Vera; Carvalho, Joana; Nobre, Pedro J

    2015-01-01

    Despite the important focus on the notion of cognitive distortions in the sexual offending area, the relevance of underlying cognitive schemas in sexual offenders has also been suggested. The aim of the present study was to investigate a potential relationship between Early Maladaptive Schemas (EMSs) and cognitive distortions in rapists. A total of 33 men convicted for rape completed the Bumby Rape Scale (BRS), the Young Schema Questionnaire - Short form-3 (YSQ-S3), the Brief Symptom Inventory (BSI), and the Socially Desirable Response Set Measure (SDRS-5). Results showed a significant relationship between the impaired limits schematic domain and the Justifying Rape dimension of the BRS. Specifically, after controlling for psychological distress levels and social desirability tendency, the entitlement/grandiosity schema from the impaired limits domain was a significant predictor of cognitive distortions related to Justifying Rape themes. Overall, despite preliminary, there is some evidence that the Young's Schema-Focused model namely the impaired limits dimension may contribute for the conceptualization of cognitive distortions in rapists and further investigation is recommended. PMID:25864410

  16. Maladaptive connectivity of Broca's area in schizophrenia during audiovisual speech perception: an fMRI study.

    PubMed

    Szycik, G R; Ye, Z; Mohammadi, B; Dillo, W; Te Wildt, B T; Samii, A; Frieling, H; Bleich, S; Münte, T F

    2013-12-01

    Speech comprehension relies on auditory as well as visual information, and is enhanced in healthy subjects, when audiovisual (AV) information is present. Patients with schizophrenia have been reported to have problems regarding this AV integration process, but little is known about which underlying neural processes are altered. Functional magnetic resonance imaging was performed in 15 schizophrenia patients (SP) and 15 healthy controls (HC) to study functional connectivity of Broca's area by means of a beta series correlation method during perception of audiovisually presented bisyllabic German nouns, in which audio and video either matched or did not match. Broca's area of SP showed stronger connectivity with supplementary motor cortex for incongruent trials whereas HC connectivity was stronger for congruent trials. The right posterior superior temporal sulcus (RpSTS) area showed differences in connectivity for congruent and incongruent trials in HC in contrast to SP where the connectivity was similar for both conditions. These smaller differences in connectivity in SP suggest a less adaptive processing of audiovisually congruent and incongruent speech. The findings imply that AV integration problems in schizophrenia are associated with maladaptive connectivity of Broca's and RpSTS area in particular when confronted with incongruent stimuli. Results are discussed in light of recent AV speech perception models. PMID:23994183

  17. Mechanisms of maladaptive repair after AKI leading to accelerated kidney ageing and CKD

    PubMed Central

    Ferenbach, David A.; Bonventre, Joseph V.

    2015-01-01

    Acute kidney injury is an increasingly common complication of hospital admission and is associated with high levels of morbidity and mortality. A hypotensive, septic, or toxic insult can initiate a cascade of events, resulting in impaired microcirculation, activation of inflammatory pathways and tubular cell injury or death. These processes ultimately result in acutely impaired kidney function and initiation of a repair response. This Review explores the various mechanisms responsible for the initiation and propagation of acute kidney injury, the prototypic mechanisms by which a substantially damaged kidney can regenerate its normal architecture, and how the adaptive processes of repair can become maladaptive. These mechanisms, which include G2/M cell-cycle arrest, cell senescence, profibrogenic cytokine production, and activation of pericytes and interstitial myofibroblasts, contribute to the development of progressive fibrotic kidney disease. The end result is a state that mimics accelerated kidney ageing. These mechanisms present important opportunities for the design of targeted therapeutic strategies to promote adaptive renal recovery and minimize progressive fibrosis and chronic kidney disease after acute insults. PMID:25643664

  18. Biomechanical strain mediated maladaptive gene regulation as a contributing factor in Alport glomerular disease

    PubMed Central

    Meehan, Daniel T.; Delimont, Duane; Cheung, Linda; Zallocchi, Marisa; Sansom, Steven C.; Holzclaw, J. David; Rao, Velidi; Cosgrove, Dominic

    2009-01-01

    Alport glomerular disease is associated with dysregulation of pro-inflammatory cytokines and matrix metalloproteinases, promoting progressive glomerulonephritis. Changes in composition and structure of Alport GBM resulting from mutations in type IV collagen genes likely alter cell adhesion and cell signaling. Enhanced biomechanical strain on the capillary tuft, resulting from a thinner and less crosslinked GBM may be a source of insult which contributes to gene dysregulation. To test this we subjected cultured podocytes to cyclic biomechanical strain. We observed robust induction of MMP-3, −9, −10, and −14, but not MMP-2 or MMP-12. IL-6 was induced by biomechanical strain, and neutralizing antibodies against IL-6 attenuated induction of MMP-3 and MMP-10. Alport mice given L-NAME salts, which resulted in a significant rise in systolic blood pressure, showed Induction of MMP-3, MMP-10, and IL-6 in glomeruli relative to normotensive Alport mice. Hypertensive Alport mice also had elevated proteinuria, and more advanced GBM disease histologically and ultrastucturally. Collectively these data suggest MMP and cytokine dysregulation may constitute a maladaptive response to biomechanical strain in Alport podocytes, and that this response may contribute to the mechanism of glomerular disease initiation and progression. PMID:19710627

  19. Maladaptive and adaptive emotion regulation through music: a behavioral and neuroimaging study of males and females

    PubMed Central

    Carlson, Emily; Saarikallio, Suvi; Toiviainen, Petri; Bogert, Brigitte; Kliuchko, Marina; Brattico, Elvira

    2015-01-01

    Music therapists use guided affect regulation in the treatment of mood disorders. However, self-directed uses of music in affect regulation are not fully understood. Some uses of music may have negative effects on mental health, as can non-music regulation strategies, such as rumination. Psychological testing and functional magnetic resonance imaging (fMRI) were used explore music listening strategies in relation to mental health. Participants (n = 123) were assessed for depression, anxiety and Neuroticism, and uses of Music in Mood Regulation (MMR). Neural responses to music were measured in the medial prefrontal cortex (mPFC) in a subset of participants (n = 56). Discharge, using music to express negative emotions, related to increased anxiety and Neuroticism in all participants and particularly in males. Males high in Discharge showed decreased activity of mPFC during music listening compared with those using less Discharge. Females high in Diversion, using music to distract from negative emotions, showed more mPFC activity than females using less Diversion. These results suggest that the use of Discharge strategy can be associated with maladaptive patterns of emotional regulation, and may even have long-term negative effects on mental health. This finding has real-world applications in psychotherapy and particularly in clinical music therapy. PMID:26379529

  20. Maladaptive and adaptive emotion regulation through music: a behavioral and neuroimaging study of males and females.

    PubMed

    Carlson, Emily; Saarikallio, Suvi; Toiviainen, Petri; Bogert, Brigitte; Kliuchko, Marina; Brattico, Elvira

    2015-01-01

    Music therapists use guided affect regulation in the treatment of mood disorders. However, self-directed uses of music in affect regulation are not fully understood. Some uses of music may have negative effects on mental health, as can non-music regulation strategies, such as rumination. Psychological testing and functional magnetic resonance imaging (fMRI) were used explore music listening strategies in relation to mental health. Participants (n = 123) were assessed for depression, anxiety and Neuroticism, and uses of Music in Mood Regulation (MMR). Neural responses to music were measured in the medial prefrontal cortex (mPFC) in a subset of participants (n = 56). Discharge, using music to express negative emotions, related to increased anxiety and Neuroticism in all participants and particularly in males. Males high in Discharge showed decreased activity of mPFC during music listening compared with those using less Discharge. Females high in Diversion, using music to distract from negative emotions, showed more mPFC activity than females using less Diversion. These results suggest that the use of Discharge strategy can be associated with maladaptive patterns of emotional regulation, and may even have long-term negative effects on mental health. This finding has real-world applications in psychotherapy and particularly in clinical music therapy. PMID:26379529

  1. Dimethyl α-ketoglutarate inhibits maladaptive autophagy in pressure overload-induced cardiomyopathy.

    PubMed

    Mariño, Guillermo; Pietrocola, Federico; Kong, Yongli; Eisenberg, Tobias; Hill, Joseph A; Madeo, Frank; Kroemer, Guido

    2014-05-01

    It has been a longstanding problem to identify specific and efficient pharmacological modulators of autophagy. Recently, we found that depletion of acetyl-coenzyme A (AcCoA) induced autophagic flux, while manipulations designed to increase cytosolic AcCoA efficiently inhibited autophagy. Thus, the cell permeant ester dimethyl α-ketoglutarate (DMKG) increased the cytosolic concentration of α-ketoglutarate, which was converted into AcCoA through a pathway relying on either of the 2 isocitrate dehydrogenase isoforms (IDH1 or IDH2), as well as on ACLY (ATP citrate lyase). DMKG inhibited autophagy in an IDH1-, IDH2- and ACLY-dependent fashion in vitro, in cultured human cells. Moreover, DMKG efficiently prevented autophagy induced by starvation in vivo, in mice. Autophagy plays a maladaptive role in the dilated cardiomyopathy induced by pressure overload, meaning that genetic inhibition of autophagy by heterozygous knockout of Becn1 suppresses the pathological remodeling of heart muscle responding to hemodynamic stress. Repeated administration of DMKG prevents autophagy in heart muscle responding to thoracic aortic constriction (TAC) and simultaneously abolishes all pathological and functional correlates of dilated cardiomyopathy: hypertrophy of cardiomyocytes, fibrosis, dilation of the left ventricle, and reduced contractile performance. These findings indicate that DMKG may be used for therapeutic autophagy inhibition. PMID:24675140

  2. Non-Homicidal and Homicidal Sexual Offenders: Prevalence of Maladaptive Personality Traits and Paraphilic Behaviors.

    PubMed

    Chan, Heng Choon Oliver; Beauregard, Eric

    2016-08-01

    This study aims to examine the psychopathological profile of non-homicidal sexual offenders (NHSOs) and homicidal sexual offenders (HSOs). Using an incarcerated sample of 96 NHSOs and 74 HSOs in a federal penitentiary in Canada, these offenders are compared in terms of their offending process, maladaptive personality traits, and paraphilic behaviors. A number of cross-tabular and sequential logistic regression analyses are performed. Relative to their counterpart, findings indicate that a higher percentage of HSOs select a victim of choice, report deviant sexual fantasies, mutilate their victim, and admit to their offense upon apprehension, whereas a higher percentage of NHSOs select victims with distinctive characteristics. In addition, a higher percentage of HSOs manifest paranoid, schizotypal, borderline, histrionic, narcissistic, obsessive-compulsive, and impulsive personality traits, and overall odd and eccentric personality traits compared with NHSOs. Similarly, a higher percentage of HSOs engage in exhibitionism, fetishism, frotteurism, homosexual pedophilia, sexual masochism, and partialism compared with NHSO. These findings are discussed with their implications for offender profiling. PMID:25818862

  3. Animal Models of Maladaptive Traits: Disorders in Sensorimotor Gating and Attentional Quantifiable Responses as Possible Endophenotypes.

    PubMed

    Vargas, Juan P; Díaz, Estrella; Portavella, Manuel; López, Juan C

    2016-01-01

    Traditional diagnostic scales are based on a number of symptoms to evaluate and classify mental diseases. In many cases, this process becomes subjective, since the patient must calibrate the magnitude of his/her symptoms and therefore the severity of his/her disorder. A completely different approach is based on the study of the more vulnerable traits of cognitive disorders. In this regard, animal models of mental illness could be a useful tool to characterize indicators of possible cognitive dysfunctions in humans. Specifically, several cognitive disorders such as schizophrenia involve a dysfunction in the mesocorticolimbic dopaminergic system during development. These variations in dopamine levels or dopamine receptor sensibility correlate with many behavioral disturbances. These behaviors may be included in a specific phenotype and may be analyzed under controlled conditions in the laboratory. The present study provides an introductory overview of different quantitative traits that could be used as a possible risk indicator for different mental disorders, helping to define a specific endophenotype. Specifically, we examine different experimental procedures to measure impaired response in attention linked to sensorimotor gating as a possible personality trait involved in maladaptive behaviors. PMID:26925020

  4. Animal Models of Maladaptive Traits: Disorders in Sensorimotor Gating and Attentional Quantifiable Responses as Possible Endophenotypes

    PubMed Central

    Vargas, Juan P.; Díaz, Estrella; Portavella, Manuel; López, Juan C.

    2016-01-01

    Traditional diagnostic scales are based on a number of symptoms to evaluate and classify mental diseases. In many cases, this process becomes subjective, since the patient must calibrate the magnitude of his/her symptoms and therefore the severity of his/her disorder. A completely different approach is based on the study of the more vulnerable traits of cognitive disorders. In this regard, animal models of mental illness could be a useful tool to characterize indicators of possible cognitive dysfunctions in humans. Specifically, several cognitive disorders such as schizophrenia involve a dysfunction in the mesocorticolimbic dopaminergic system during development. These variations in dopamine levels or dopamine receptor sensibility correlate with many behavioral disturbances. These behaviors may be included in a specific phenotype and may be analyzed under controlled conditions in the laboratory. The present study provides an introductory overview of different quantitative traits that could be used as a possible risk indicator for different mental disorders, helping to define a specific endophenotype. Specifically, we examine different experimental procedures to measure impaired response in attention linked to sensorimotor gating as a possible personality trait involved in maladaptive behaviors. PMID:26925020

  5. Looking Inside the Matrix: Perineuronal Nets in Plasticity, Maladaptive Plasticity and Neurological Disorders.

    PubMed

    De Luca, Ciro; Papa, Michele

    2016-07-01

    The integrity of the central nervous system (CNS) matrix is crucial for its proper function. Loss of the lattice-like structure compromise synaptic stability and can lead to the disruption of the excitatory/inhibitory balance, astrocytosis, maladaptive plasticity and neuronal death. Perineuronal nets (PNNs) in the extracellular matrix (ECM) provide synaptic integration and control the functional wiring between neurons. These nets are significantly modified during CNS disorders, such as neurodegenerative, cerebrovascular and inflammatory diseases. The breakdown or the modification of PNNs could be due to the activity of matrix metalloproteinases (MMPs) or to the deposition of proteoglycans, glycoproteins, and hyaluronic acid. The expression and the activity of ECM-degrading enzymes can be regulated with tissue inhibitors of MMPs or via transcriptional and epigenetic silencing or enhancement (i.e. via histone deacetylases). The identification of molecules and mechanisms able to modify these processes will be essential for a new perspective on brain functioning in health and disease, leading to a target-directed approach with drugs directly interfering with the molecular mechanism underlying neurological disorders. PMID:26935742

  6. Differences in maladaptive schemas between patients suffering from chronic and acute posttraumatic stress disorder and healthy controls

    PubMed Central

    Ahmadian, Alireza; Mirzaee, Jafar; Omidbeygi, Maryam; Holsboer-Trachsler, Edith; Brand, Serge

    2015-01-01

    Background War, as a stressor event, has a variety of acute and chronic negative consequences, such as posttraumatic stress disorder (PTSD). In this context, early maladaptive schema-based problems in PTSD have recently become an important research area. The aim of this study was to assess early maladaptive schemas in patients with acute and chronic PTSD. Method Using available sampling methods and diagnostic criteria, 30 patients with chronic PTSD, 30 patients with acute PTSD, and 30 normal military personnel who were matched in terms of age and wartime experience were selected and assessed with the Young Schema Questionnaire-Long Form, Beck Depression Inventory second version (BDI-II), the Beck Anxiety Inventory (BAI), and the Impact of Events Scale (IES). Results Both acute and chronic PTSD patients, when compared with normal military personnel, had higher scores for all early maladaptive schemas. Additionally, veterans suffering from chronic PTSD, as compared with veterans suffering from acute PTSD and veterans without PTSD, reported more impaired schemas related, for instance, to Self-Control, Social Isolation, and Vulnerability to Harm and Illness. Discussion The results of the present study have significant preventative, diagnostic, clinical, research, and educational implications with respect to PTSD. PMID:26203249

  7. A Reevaluation of the Role of the Unfolded Protein Response in Islet Dysfunction: Maladaptation or a Failure to Adapt?

    PubMed

    Herbert, Terence P; Laybutt, D Ross

    2016-06-01

    Endoplasmic reticulum (ER) stress caused by perturbations in ER homeostasis activates an adaptive response termed the unfolded protein response (UPR) whose function is to resolve ER stress. If unsuccessful, the UPR initiates a proapoptotic program to eliminate the malfunctioning cells from the organism. It is the activation of this proapoptotic UPR in pancreatic β-cells that has been implicated in the onset of type 2 diabetes and thus, in this context, is considered a maladaptive response. However, there is growing evidence that β-cell death in type 2 diabetes may not be caused by a maladaptive UPR but by the inhibition of the adaptive UPR. In this review, we discuss the evidence for a role of the UPR in β-cell dysfunction and death in the development of type 2 diabetes and ask the following question: Is β-cell dysfunction the result of a maladaptive UPR or a failure of the UPR to adequately adapt? The answer to this question is critically important in defining potential therapeutic strategies for the treatment and prevention of type 2 diabetes. In addition, we discuss the potential role of the adaptive UPR in staving off type 2 diabetes by enhancing β-cell mass and function in response to insulin resistance. PMID:27222391

  8. Maladaptive Coping Mediates the Influence of Childhood Trauma on Depression and PTSD among Pregnant Women in South Africa

    PubMed Central

    Choi, Karmel W.; Sikkema, Kathleen J.; Velloza, Jennifer; Marais, Adele; Jose, Cicyn; Stein, Dan J.; Watt, Melissa H.; Joska, John A.

    2015-01-01

    Antenatal mental disorders compromise maternal and child health, and women who have experienced childhood trauma may be at increased risk for such disorders. One hypothesis is that early trauma leads to the development and use of maladaptive coping strategies as an adult, which in turn could predict mental health difficulties during stressful transitions such as pregnancy. To test this hypothesis, this study examined the relationship between childhood trauma and mental health (depression, PTSD) in a sample of 84 pregnant women seeking antenatal care in Cape Town, South Africa, and explored whether maladaptive coping mediated this relationship. The majority of women (62%) met established criteria for antenatal depression and 30% for antenatal PTSD; in addition, 40% reported a history of childhood trauma. Childhood trauma, especially childhood sexual abuse and emotional abuse, was significantly associated with depression and PTSD. The relationships between childhood trauma and depression and PTSD were significantly mediated by maladaptive coping, even when adjusted for the woman’s age, gestational age, and HIV status. Findings highlight the need for coping-based interventions to prevent and treat antenatal mental disorders among women with childhood trauma, particularly in high-trauma settings such as South Africa. PMID:25578632

  9. Maladaptive coping mediates the influence of childhood trauma on depression and PTSD among pregnant women in South Africa.

    PubMed

    Choi, Karmel W; Sikkema, Kathleen J; Velloza, Jennifer; Marais, Adele; Jose, Cicyn; Stein, Dan J; Watt, Melissa H; Joska, John A

    2015-10-01

    Antenatal mental disorders compromise maternal and child health, and women who have experienced childhood trauma may be at increased risk for such disorders. One hypothesis is that early trauma leads to the development and use of maladaptive coping strategies as an adult, which in turn could predict mental health difficulties during stressful transitions such as pregnancy. To test this hypothesis, this study examined the relationship between childhood trauma and mental health (depression, PTSD) in a sample of 84 pregnant women seeking antenatal care in Cape Town, South Africa, and explored whether maladaptive coping mediated this relationship. The majority of women (62 %) met established criteria for antenatal depression and 30 % for antenatal PTSD; in addition, 40 % reported a history of childhood trauma. Childhood trauma, especially childhood sexual abuse and emotional abuse, was significantly associated with depression and PTSD. The relationships between childhood trauma and depression and PTSD were significantly mediated by maladaptive coping, even when adjusted for the woman's age, gestational age, and HIV status. Findings highlight the need for coping-based interventions to prevent and treat antenatal mental disorders among women with childhood trauma, particularly in high-trauma settings such as South Africa. PMID:25578632

  10. A Comparison of Positive Outcome Expectancies: A Review of the Theories of M. F. Scheier, C. S. Carver, M. E. P. Seligman, and C. R. Snyder.

    ERIC Educational Resources Information Center

    Bird, William A.

    Research has shown that optimistic and pessimistic outcome expectancy evaluations are associated with adaptive and maladaptive levels of psychological functioning, physical wellness, and health recovery issues. The research of M. F. Scheier, C. S. Carver, M. E. P. Seligman, and C. R. Snyder supports the hypothesis that elevated optimism or…

  11. Children’s Experiences of Maternal Incarceration-Specific Risks: Predictions to Psychological Maladaptation

    PubMed Central

    Dallaire, Danielle H.; Zeman, Janice L.; Thrash, Todd M.

    2014-01-01

    Children of incarcerated mothers are at increased risk for social and emotional difficulties, yet few studies have investigated potential mechanisms of risk within this population. This research simultaneously examined the association of children’s experience of incarceration-specific risk factors (e.g., witness mother’s arrest) and environmental risks (e.g., low educational attainment) to children’s psychological maladaptation using a multi-informant design and a latent variable analytic approach. Participants were 117 currently incarcerated mothers (64.1% African American), their 151 children (53.6% boys, M age =9.8 years, range =6–12 years, 61.7% African American), and the 118 caregivers (74.8% female, 61.9% grandparents, 62.2% African American) of the children. Mothers, children, and caregivers each provided accounts of children’s experiences related to maternal incarceration and children’s internalizing and externalizing behavior problems. Mothers and caregivers each supplied information about 10 environmental risk factors. Findings from structural equation modeling indicate that children’s incarceration-specific risk experiences predict internalizing and externalizing behavior problems whereas the influence of environmental risks was negligible. Follow-up analyses examining the contribution of specific risks indicate that significant predictors differ by reporter and separate into effects of family incarceration history and direct experiences of maternal incarceration. Incarceration-specific experiences place children at higher risk for maladjustment than exposure to general environmental risk factors. These findings indicate the need to critically examine children’s exposure to experiences related to maternal incarceration and family incarceration history to help to clarify the multifaceted stressor of maternal incarceration. PMID:24871820

  12. Molecular proxies for climate maladaptation in a long-lived tree (Pinus pinaster Aiton, Pinaceae).

    PubMed

    Jaramillo-Correa, Juan-Pablo; Rodríguez-Quilón, Isabel; Grivet, Delphine; Lepoittevin, Camille; Sebastiani, Federico; Heuertz, Myriam; Garnier-Géré, Pauline H; Alía, Ricardo; Plomion, Christophe; Vendramin, Giovanni G; González-Martínez, Santiago C

    2015-03-01

    Understanding adaptive genetic responses to climate change is a main challenge for preserving biological diversity. Successful predictive models for climate-driven range shifts of species depend on the integration of information on adaptation, including that derived from genomic studies. Long-lived forest trees can experience substantial environmental change across generations, which results in a much more prominent adaptation lag than in annual species. Here, we show that candidate-gene SNPs (single nucleotide polymorphisms) can be used as predictors of maladaptation to climate in maritime pine (Pinus pinaster Aiton), an outcrossing long-lived keystone tree. A set of 18 SNPs potentially associated with climate, 5 of them involving amino acid-changing variants, were retained after performing logistic regression, latent factor mixed models, and Bayesian analyses of SNP-climate correlations. These relationships identified temperature as an important adaptive driver in maritime pine and highlighted that selective forces are operating differentially in geographically discrete gene pools. The frequency of the locally advantageous alleles at these selected loci was strongly correlated with survival in a common garden under extreme (hot and dry) climate conditions, which suggests that candidate-gene SNPs can be used to forecast the likely destiny of natural forest ecosystems under climate change scenarios. Differential levels of forest decline are anticipated for distinct maritime pine gene pools. Geographically defined molecular proxies for climate adaptation will thus critically enhance the predictive power of range-shift models and help establish mitigation measures for long-lived keystone forest trees in the face of impending climate change. PMID:25549630

  13. Maladaptive sex ratio adjustment by a sex-changing shrimp in selective-fishing environments.

    PubMed

    Chiba, Susumu; Yoshino, Kenji; Kanaiwa, Minoru; Kawajiri, Toshifumi; Goshima, Seiji

    2013-05-01

    must be considered in efforts to conserve wild animal resources, because such responses can become maladaptive. PMID:23163795

  14. Molecular Proxies for Climate Maladaptation in a Long-Lived Tree (Pinus pinaster Aiton, Pinaceae)

    PubMed Central

    Jaramillo-Correa, Juan-Pablo; Rodríguez-Quilón, Isabel; Grivet, Delphine; Lepoittevin, Camille; Sebastiani, Federico; Heuertz, Myriam; Garnier-Géré, Pauline H.; Alía, Ricardo; Plomion, Christophe; Vendramin, Giovanni G.; González-Martínez, Santiago C.

    2015-01-01

    Understanding adaptive genetic responses to climate change is a main challenge for preserving biological diversity. Successful predictive models for climate-driven range shifts of species depend on the integration of information on adaptation, including that derived from genomic studies. Long-lived forest trees can experience substantial environmental change across generations, which results in a much more prominent adaptation lag than in annual species. Here, we show that candidate-gene SNPs (single nucleotide polymorphisms) can be used as predictors of maladaptation to climate in maritime pine (Pinus pinaster Aiton), an outcrossing long-lived keystone tree. A set of 18 SNPs potentially associated with climate, 5 of them involving amino acid-changing variants, were retained after performing logistic regression, latent factor mixed models, and Bayesian analyses of SNP–climate correlations. These relationships identified temperature as an important adaptive driver in maritime pine and highlighted that selective forces are operating differentially in geographically discrete gene pools. The frequency of the locally advantageous alleles at these selected loci was strongly correlated with survival in a common garden under extreme (hot and dry) climate conditions, which suggests that candidate-gene SNPs can be used to forecast the likely destiny of natural forest ecosystems under climate change scenarios. Differential levels of forest decline are anticipated for distinct maritime pine gene pools. Geographically defined molecular proxies for climate adaptation will thus critically enhance the predictive power of range-shift models and help establish mitigation measures for long-lived keystone forest trees in the face of impending climate change. PMID:25549630

  15. Exposure to Gulf War Illness chemicals induces functional muscarinic receptor maladaptations in muscle nociceptors.

    PubMed

    Cooper, B Y; Johnson, R D; Nutter, T J

    2016-05-01

    Chronic pain is a component of the multisymptom disease known as Gulf War Illness (GWI). There is evidence that pain symptoms could have been a consequence of prolonged and/or excessive exposure to anticholinesterases and other GW chemicals. We previously reported that rats exposed, for 8 weeks, to a mixture of anticholinesterases (pyridostigmine bromide, chlorpyrifos) and a Nav (voltage activated Na(+) channel) deactivation-inhibiting pyrethroid, permethrin, exhibited a behavior pattern that was consistent with a delayed myalgia. This myalgia-like behavior was accompanied by persistent changes to Kv (voltage activated K(+)) channel physiology in muscle nociceptors (Kv7, KDR). In the present study, we examined how exposure to the above agents altered the reactivity of Kv channels to a muscarinic receptor (mAChR) agonist (oxotremorine-M). Comparisons between muscle nociceptors harvested from vehicle and GW chemical-exposed rats revealed that mAChR suppression of Kv7 activity was enhanced in exposed rats. Yet in these same muscle nociceptors, a Stromatoxin-insensitive component of the KDR (voltage activated delayed rectifier K(+) channel) exhibited decreased sensitivity to activation of mAChR. We have previously shown that a unique mAChR-induced depolarization and burst discharge (MDBD) was exaggerated in muscle nociceptors of rats exposed to GW chemicals. We now provide evidence that both muscle and vascular nociceptors of naïve rats exhibit MDBD. Examination of the molecular basis of the MDBD in naïve animals revealed that while the mAChR depolarization was independent of Kv7, the action potential burst was modulated by Kv7 status. mAChR depolarizations were shown to be dependent, in part, on TRPA1. We argue that dysfunction of the MDBD could be a functional convergence point for maladapted ion channels and receptors consequent to exposure to GW chemicals. PMID:27058124

  16. Comparing the Early Maladaptive Schemas, Attachment and Coping Styles in Opium and Stimulant Drugs Dependent Men in Kerman, Iran

    PubMed Central

    Hosseinifard, Seyed Mehdi; Kaviani, Narjes

    2015-01-01

    Background Today, the society’s need to find the roots of a few thousand-year old substance abuse and the drugs addiction crisis has increased to the extent that it has become a problem within our country. The problem of substance dependence is not only about drug abuse, but it is actually the interrelationship of the person and the dependency on drugs. This study aimed to compare early maladaptive schemas, attachment styles, and coping styles in men dependent on opiates and stimulants in Kerman, Iran. Methods This was a comparative descriptive study. The study population consisted of men dependent on opiates and stimulants who referred to addiction treatment clinics in Kerman. Therefore, 150 patients (75 opium addicted men and 75 men dependent on drugs) were selected. The participants completed the Young schema questionnaire-short form (YSQ-SF), adult attachment scale (AAS), and Young coping styles questionnaire (YCSQ). The research data were analyzed using independent t-test and SPSS software. Findings Mean age of patients using opium was 27.9 ± 3.35 years and mean age of patients using stimulant drugs was 25.6 ± 3.41 years (18-60 years old). The results showed that there was no difference between the early maladaptive schemas and coping styles in men dependent on opium and stimulants. However, there was a significant difference between attachment styles in men dependent on opium and stimulants. The mean score of avoidant and ambivalent styles in men dependent on stimulants was higher. Conclusion Knowledge on the distinctions of early maladaptive schemas, attachment styles, and coping styles in substance abuse patients helps the therapists to conduct more effective treatment strategies tailored to the type of substance used in order to provide behavior modification. PMID:26322208

  17. The relationship of self-injurious behavior and other maladaptive behaviors among individuals with severe and profound intellectual disability.

    PubMed

    Matson, Johnny L; Cooper, Christopher; Malone, Carrie J; Moskow, Sheree L

    2008-01-01

    Participants were 101 individuals with self-injurious behavior (SIB) and severe or profound intellectual disability who were matched by gender, age, and level of intellectual disability to controls. Persons with SIB were more likely to exhibit the challenging behaviors of physical aggression, property destruction, sexually inappropriate behaviors and stereotypies when compared to controls, suggestive of co-occurring behaviors. Moreover, the maladaptive behavior of irritability, as assessed by the aberrant behavior checklist (ABC) was able to correctly classify 72.8% of the sample into their respective group memberships. Implications of these findings are discussed. PMID:17350800

  18. Exploring Correlation Between Perceived Parenting Styles, Early Maladaptive Schemas, and Depression Among Women With Depressive Symptoms in Iran and India- Role of Early Maladaptive Schemas as Mediators and Moderatos

    PubMed Central

    Khajouei Nia, Maryam; Sovani, Anuradha; Sarami Forooshani, Gholam Reza

    2014-01-01

    Background: Many studies have reported that inadequate parental styles can contribute to depressive symptoms through dysfunctional cognitive styles. Objectives: This study aimed to investigate the association of dysfunctional schemas and parenting style with depression, as well as the role of maladaptive schemas such as moderators and mediators in Iran and India. Patients and Methods:: The study sample was selected randomly and consisted of 200 (age group 16-60 y) depressed females (mild to moderate); 100 from Tehran (Iran) and another 100 from Pune (India). The type of the research was causal-comparative. The data collection took place in hospitals and clinics in the targeted cities. Descriptive statistic tests and hierarchical multiple regression were executed (for the purpose of analyzing data) by SPSS 17. Results: It was demonstrated that the association between parenting and depression was not moderated by early maladaptive schemas. On the contrary, the results supported meditational models in which parenting styles are associated with the cognitive schemas, and these in turn are related to depressive symptoms. It was also found that abandonment mediates the impacts of maternal style on depression in Iran. On the other hand, abandonment and punitiveness schemas mediated the relation between paternal style and depression in India. Conclusions: These findings suggest that the correlation between childhood experiences and depression in adulthood are mediated by dysfunctional schemas. PMID:25763238

  19. Multiple-Family Group Intervention for Incarcerated Male Adolescents Who Sexually Offend and Their Families: Change in Maladaptive Emotion Regulation Predicts Adaptive Change in Adolescent Behaviors.

    PubMed

    Keiley, Margaret K; Zaremba-Morgan, Ali; Datubo-Brown, Christiana; Pyle, Raven; Cox, Milira

    2015-07-01

    The multiple-family group intervention is an effective, yet affordable, 8-week treatment that is conducted in a juvenile correctional institution in Alabama with adolescents who sexually offend and their families. Data from 115 incarcerated male adolescents and their male and female caregivers collected at pre-, post-, and 1-year follow-up were used to determine that problem behaviors (internalizing, externalizing) decreased over pre- and posttest and the significant decreases in maladaptive emotion regulation predicted those changes. Adolescent-reported anxiety over abandonment and attachment dependence on parents increased significantly; these changes were predicted by decreases in maladaptive emotion regulation. Linear growth models were also fit over the 3 time points and indicate decreases in adolescent problem behavior and maladaptive emotion regulation. PMID:24809985

  20. Chronic stress and brain plasticity: Mechanisms underlying adaptive and maladaptive changes and implications for stress-related CNS disorders.

    PubMed

    Radley, Jason; Morilak, David; Viau, Victor; Campeau, Serge

    2015-11-01

    Stress responses entail neuroendocrine, autonomic, and behavioral changes to promote effective coping with real or perceived threats to one's safety. While these responses are critical for the survival of the individual, adverse effects of repeated exposure to stress are widely known to have deleterious effects on health. Thus, a considerable effort in the search for treatments to stress-related CNS disorders necessitates unraveling the brain mechanisms responsible for adaptation under acute conditions and their perturbations following chronic stress exposure. This paper is based upon a symposium from the 2014 International Behavioral Neuroscience Meeting, summarizing some recent advances in understanding the effects of stress on adaptive and maladaptive responses subserved by limbic forebrain networks. An important theme highlighted in this review is that the same networks mediating neuroendocrine, autonomic, and behavioral processes during adaptive coping also comprise targets of the effects of repeated stress exposure in the development of maladaptive states. Where possible, reference is made to the similarity of neurobiological substrates and effects observed following repeated exposure to stress in laboratory animals and the clinical features of stress-related disorders in humans. PMID:26116544

  1. The Mediating Role of Early Maladaptive Schemas in the Relation between Co-Rumination and Depression in Young Adults

    PubMed Central

    Sergi, Maria Rita; Klein Murdock, Karla; Saggino, Aristide

    2015-01-01

    Research on co-rumination has investigated its relationship with internalizing symptoms, but few studies have addressed underlying maladaptive cognitive-affective processes that may play an important role in the maintenance of this relation. This study examines if Young’s schema domains mediate the relation between co-rumination and depression in a community sample of non-clinical young adults. Participants completed the Co-Rumination Questionnaire, Young Schema Questionnaire-L3, and Teate Depression Inventory. Correlations and path analysis were calculated for the full sample and separately by gender. The schema domains of Overvigilance/Inhibition and Other-Directedness fully mediated the relation between co-rumination and depression. When analyses were performed separately for males and females, mediation persisted only for females. Findings suggest that among young women, co-rumination with a friend may be associated with depressive symptoms because of its activation of specific maladaptive cognitive schemas. Better understanding of the content and processes underpinning co-rumination may have important implications for the prevention and treatment of depression. PMID:26488748

  2. The Mediating Role of Early Maladaptive Schemas in the Relation between Co-Rumination and Depression in Young Adults.

    PubMed

    Balsamo, Michela; Carlucci, Leonardo; Sergi, Maria Rita; Klein Murdock, Karla; Saggino, Aristide

    2015-01-01

    Research on co-rumination has investigated its relationship with internalizing symptoms, but few studies have addressed underlying maladaptive cognitive-affective processes that may play an important role in the maintenance of this relation. This study examines if Young's schema domains mediate the relation between co-rumination and depression in a community sample of non-clinical young adults. Participants completed the Co-Rumination Questionnaire, Young Schema Questionnaire-L3, and Teate Depression Inventory. Correlations and path analysis were calculated for the full sample and separately by gender. The schema domains of Overvigilance/Inhibition and Other-Directedness fully mediated the relation between co-rumination and depression. When analyses were performed separately for males and females, mediation persisted only for females. Findings suggest that among young women, co-rumination with a friend may be associated with depressive symptoms because of its activation of specific maladaptive cognitive schemas. Better understanding of the content and processes underpinning co-rumination may have important implications for the prevention and treatment of depression. PMID:26488748

  3. Novel insights into maladaptive behaviours in Prader–Willi syndrome: serendipitous findings from an open trial of vagus nerve stimulation

    PubMed Central

    McAllister, C. J.; Ring, H. A.; Finer, N.; Kelly, C. L.; Sylvester, K. P.; Fletcher, P. C.; Morrell, N. W.; Garnett, M. R.; Manford, M. R. A.; Holland, A. J.

    2015-01-01

    Abstract Background We report striking and unanticipated improvements in maladaptive behaviours in Prader–Willi syndrome (PWS) during a trial of vagus nerve stimulation (VNS) initially designed to investigate effects on the overeating behaviour. PWS is a genetically determined neurodevelopmental disorder associated with mild–moderate intellectual disability (ID) and social and behavioural difficulties, alongside a characteristic and severe hyperphagia. Methods Three individuals with PWS underwent surgery to implant the VNS device. VNS was switched on 3 months post‐implantation, with an initial 0.25 mA output current incrementally increased to a maximum of 1.5 mA as tolerated by each individual. Participants were followed up monthly. Results Vagal nerve stimulation in these individuals with PWS, within the stimulation parameters used here, was safe and acceptable. However, changes in eating behaviour were equivocal. Intriguingly, unanticipated, although consistent, beneficial effects were reported by two participants and their carers in maladaptive behaviour, temperament and social functioning. These improvements and associated effects on food‐seeking behaviour, but not weight, indicate that VNS may have potential as a novel treatment for such behaviours. Conclusions We propose that these changes are mediated through afferent and efferent vagal projections and their effects on specific neural networks and functioning of the autonomic nervous system and provide new insights into the mechanisms that underpin what are serious and common problems affecting people with IDs more generally. PMID:26018613

  4. The curse of motor expertise: Use-dependent focal dystonia as a manifestation of maladaptive changes in body representation.

    PubMed

    Furuya, Shinichi; Hanakawa, Takashi

    2016-03-01

    Focal task-specific dystonia (FTSD) impairs not only motor dexterity, but also somatosensory perception involved in well-trained behavioral tasks. Occupations that carry a risk of developing FTSD include musician, writer, painter, surgeon, and golfer, which are characterized by repetitive and precise motor actions over a prolonged period. Behavioral studies have uncovered various undesirable effects of FTSD on sensorimotor functions, such as a loss of independent movement control, unintended muscular co-activation, awkward limb posture, and impairment of fine discrimination of tactile and proprioceptive sensations. Studies using neuroimaging and noninvasive brain stimulation techniques have related such sensorimotor malfunctions to maladaptive neuroplastic changes in the sensorimotor system, including the primary motor and somatosensory areas, premotor area, cerebellum, and basal ganglia. In this review, we summarize recent empirical findings regarding phenomenological and pathophysiological abnormalities associated with the development of FTSD. We particularly focused on maladaptive alterations of body representations underlying the degradation of fine motor control and somatosensory perception in FTSD patients. PMID:26689332

  5. Children's Development through Sports Competition: Derivative, Adjustive, Generative, and Maladaptive Approaches

    ERIC Educational Resources Information Center

    Choi, Hong Suk; Johnson, Britton; Kim, Young K.

    2014-01-01

    Sports competition can play an important role for children because it contributes to developmental outcomes for a healthy lifestyle. Through sports competition, children can learn about physical, social, and cognitive skills. Sports competition can be either positive or negative in terms of development, depending on how experiences are perceived…

  6. Coping styles moderate the relationships between exposure to community violence and work-related outcomes.

    PubMed

    Cox, Cody B; Johnson, Jennie; Coyle, Tom

    2015-07-01

    The purpose of this study was to identify coping strategies used by employees exposed to community violence and their relationships to work-related outcomes. In study 1, Mexican Maquiladora employees who experienced community violence reported their coping strategies. Results identified 3 strategies: social, solitary, and maladaptive coping. In study 2, another sample completed measures of violence exposure, strain, coping, and turnover intention. Supervisors provided performance evaluations. Community violence predicted the use of all 3 strategies. Social coping lessened the effects of community violence on turnover while maladaptive strategies predicted increased psychological strain. Results indicate that workers use a variety of coping strategies in response to community violence that both lessen and magnify the effects of violence exposure and impact their psychological strain, turnover intention, and job performance. (PsycINFO Database Record PMID:25528686

  7. How Adaptive and Maladaptive Perfectionism Relate to Positive and Negative Psychological Functioning: Testing a Stress-Mediation Model in Black and White Female College Students

    ERIC Educational Resources Information Center

    Chang, Edward C.; Watkins, Angela; Banks, Kira Hudson

    2004-01-01

    This study assessed racial variations in how adaptive and maladaptive perfectionism relate to psychological functioning in a sample of 150 Black and 150 White female college students. Comparative results indicated that Black women, as compared with White women, reported less adaptive perfectionism, less life satisfaction, greater stress, and…

  8. [The Verbal Peer Adult Emotional (VPAE) Scale and Manual. A Behavioral Rating Scale for Measuring the Progress of Severely Maladaptive Children.

    ERIC Educational Resources Information Center

    Streedbeck, Darlene; Hughes, Robert B.

    The Verbal Peer Adult Emotional Scale (VPAE), a behavioral rating scale for measuring the progress of severely maladaptive children, covers four areas: verbal behavior, peer interaction, interaction with adults, and emotional behavior. The 16-item scale is designed for use with children between the chronological ages of two and nine years, who are…

  9. The Role of Self-Compassion and Emotional Approach Coping in the Relationship between Maladaptive Perfectionism and Psychological Distress among East Asian International Students

    ERIC Educational Resources Information Center

    Seo, Heweon

    2012-01-01

    This study investigated the mediating and moderating roles of self-compassion and emotional approach coping in the relationship between maladaptive perfectionism and psychological distress among East Asian international students. Data were collected through an online survey completed by 255 East Asian international students in a large public…

  10. "Western" diet, but not high fat diet, causes maladaptation of cardiac fatty acid metabolism and cardiac dysfunction in the Wistar rat

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Obesity and diabetes are associated with increased fatty acid availability in excess of fatty acid oxidation capacity. This mismatch is implicated in the pathogenesis of cardiac contractile dysfunction. We tested the hypothesis that a "western" or a high fat diet will lead to maladaptation of cardia...

  11. Western diet, but not high fat diet, causes maladaptation of cardiac fatty acid metabolism and cardiac dysfunction in the Wistar rat

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Obesity and diabetes are associated with increased fatty acid availability in excess of fatty acid oxidation capacity. This mismatch is implicated in the pathogenesis of cardiac contractile dysfunction. We tested the hypothesis that a "western" or a high fat diet will lead to maladaptation of cardia...

  12. Mineral (Mal)Adaptation to Kidney Disease--Young Investigator Award Address: American Society of Nephrology Kidney Week 2014.

    PubMed

    Wolf, Myles

    2015-10-01

    In the short time since its initial discovery as the cause of rare hypophosphatemic disorders, fibroblast growth factor-23 (FGF-23) has emerged as a major regulator of mineral metabolism and critical component of the bone and mineral adaptation to CKD. However, because elevated FGF-23 levels are also a novel biomarker and possible molecular mediator of increased risks of cardiovascular disease and death in CKD, the initially adaptive response to increase FGF-23 levels to maintain neutral phosphate balance in CKD may ultimately become maladaptive. Incorporating FGF-23 into understanding the complex physiology that governs normal bone and mineral metabolism and its alterations in CKD has filled critical knowledge gaps and opened a new landscape of exciting hypotheses and novel therapeutic strategies to be tested in the continued quest to alleviate the burden of CKD. PMID:26350436

  13. An Experimental Examination of Peers’ Influence on Adolescent Girls’ Intent to Engage in Maladaptive Weight-Related Behaviors

    PubMed Central

    Rancourt, Diana; Choukas-Bradley, Sophia; Cohen, Geoffrey L.; Prinstein, Mitchell J.

    2015-01-01

    Objective Social psychological theories provide bases for understanding how social comparison processes may impact peer influence. This study examined two peer characteristics that may impact peer influence on adolescent girls’ weight-related behavior intentions: body size and popularity. Method A school-based sample of 66 9th grade girls (12–15 years old) completed an experimental paradigm in which they believed they were interacting with other students (i.e., “e-confederates”). The body size and popularity of the e-confederates were experimentally manipulated. Participants were randomly assigned to one of the three experimental conditions in which they were exposed to identical maladaptive weight-related behavior norms communicated by ostensible female peers who were either: (1) Thin and Popular; (2) Thin and Average Popularity; or (3) Heavy and Average Popularity. Participants’ intent to engage in weight-related behaviors was measured pre-experiment and during public and private segments of the experiment. Results A significant effect of condition on public conformity was observed. Participants exposed to peers’ maladaptive weight-related behavior norms in the Heavy and Average condition reported significantly less intent to engage in weight-related behaviors than participants in either of the thin-peer conditions (F(2) = 3.93, p = .025). Peer influence on private acceptance of weight-related behavior intentions was similar across conditions (F(2) = .47, p = .63). Discussion Body size comparison may be the most salient component of peer influence processes on weight-related behaviors. Peer influence on weight-related behavior intention also appears to impact private beliefs. Considering peer norms in preventive interventions combined with dissonance-based approaches may be useful. PMID:24482093

  14. Interdisciplinary Treatment of Maladaptive Behaviors Associated with Postural Orthostatic Tachycardia Syndrome (POTS): A Case Report.

    PubMed

    Bruce, Barbara K; Weiss, Karen E; Harrison, Tracy E; Allman, Daniel A; Petersen, Matthew A; Luedkte, Connie A; Fischer, Philip R

    2016-06-01

    The prevalence of postural orthostatic tachycardia syndrome (POTS) in adolescents and young adults has been increasing during the past decade. Despite this increase, documentation regarding treatment of these patients is just beginning to emerge. In addition, despite a call for a multidisciplinary or interdisciplinary approach, no studies have examined the efficacy of such an approach to treatment. This paper describes a case study of a 19-year-old male with debilitating POTS seen at a tertiary clinic for evaluation and subsequent intensive interdisciplinary treatment. The treatment approach is described and outcomes are presented. PMID:26538160

  15. Difficulties in disengaging attentional resources from self-generated thoughts moderate the link between dysphoria and maladaptive self-referential thinking.

    PubMed

    Rochat, Lucien; Billieux, Joël; Van der Linden, Martial

    2012-01-01

    Negative emotions increase self-focused attention, a core feature of depression and anxiety-related disorders. However, the cognitive mechanisms associated with the tendency to self-focus-and, conversely, with the ability to voluntarily disengage attentional resources from the self and direct them towards the external environment-remain poorly understood. Thus, this study aimed to examine whether a specific cognitive control mechanism that directs attention between self-generated thoughts and external information might moderate the relationship between dysphoria and maladaptive self-referential thinking. Results showed that dysphoria increases the frequency of rumination, self-blame, and catastrophising, especially for participants who have more difficulty in switching from self-generated thoughts to information provided by the environment. These results shed new light on the cognitive mechanisms underlying maladaptive self-referential thinking associated with dysphoria. More specifically, this specific cognitive mechanism might play a key role in the maintenance or amplification of a depressed mood. PMID:21972982

  16. AMPA Receptor Phosphorylation and Synaptic Colocalization on Motor Neurons Drive Maladaptive Plasticity below Complete Spinal Cord Injury1,2,3

    PubMed Central

    Stuck, Ellen D.; Irvine, Karen-Amanda; Bresnahan, Jacqueline C.

    2015-01-01

    Abstract Clinical spinal cord injury (SCI) is accompanied by comorbid peripheral injury in 47% of patients. Human and animal modeling data have shown that painful peripheral injuries undermine long-term recovery of locomotion through unknown mechanisms. Peripheral nociceptive stimuli induce maladaptive synaptic plasticity in dorsal horn sensory systems through AMPA receptor (AMPAR) phosphorylation and trafficking to synapses. Here we test whether ventral horn motor neurons in rats demonstrate similar experience-dependent maladaptive plasticity below a complete SCI in vivo. Quantitative biochemistry demonstrated that intermittent nociceptive stimulation (INS) rapidly and selectively increases AMPAR subunit GluA1 serine 831 phosphorylation and localization to synapses in the injured spinal cord, while reducing synaptic GluA2. These changes predict motor dysfunction in the absence of cell death signaling, suggesting an opportunity for therapeutic reversal. Automated confocal time-course analysis of lumbar ventral horn motor neurons confirmed a time-dependent increase in synaptic GluA1 with concurrent decrease in synaptic GluA2. Optical fractionation of neuronal plasma membranes revealed GluA2 removal from extrasynaptic sites on motor neurons early after INS followed by removal from synapses 2 h later. As GluA2-lacking AMPARs are canonical calcium-permeable AMPARs (CP-AMPARs), their stimulus- and time-dependent insertion provides a therapeutic target for limiting calcium-dependent dynamic maladaptive plasticity after SCI. Confirming this, a selective CP-AMPAR antagonist protected against INS-induced maladaptive spinal plasticity, restoring adaptive motor responses on a sensorimotor spinal training task. These findings highlight the critical involvement of AMPARs in experience-dependent spinal cord plasticity after injury and provide a pharmacologically targetable synaptic mechanism by which early postinjury experience shapes motor plasticity. PMID:26668821

  17. Association of parasuicidal behaviour to early maladaptive schemas and schema modes in patients with BPD: The Oulu BPD study.

    PubMed

    Leppänen, Virpi; Vuorenmaa, Elina; Lindeman, Sari; Tuulari, Jyrki; Hakko, Helinä

    2016-02-01

    The present study aimed to examine which early maladaptive schemas (EMSs) and schema modes emerged in parasuicidal and non-parasuicidal patients with BPD participating in the Oulu BPD study. The patients' EMSs were assessed using the Young Schema Questionnaire, and schema modes using the Young Atkinson Mode Inventory. Sixty patients with BPD responded to both the schema and schema mode questionnaires; of these, 46 (76.7%) fulfilled the criteria for parasuicidality. In BPD patients with parasuicidality, the EMSs of emotional deprivation, abandonment/instability, mistrust/abuse and social isolation were the most prevalent, and the schema modes of vulnerable child, angry child, detached protector and compliant surrender were prominent. In patients without parasuicidality, the schema modes of healthy adult and happy child were the most prevalent. Significant correlations were observed between the schema modes of detached protector, vulnerable child, punitive parent and angry child and almost every EMS in BPD patients with parasuicidality. Our preliminary findings suggest that associations between certain EMSs and schema modes to parasuicidality in BPD patients may provide valuable information when planning and implementing their treatment. PMID:26333517

  18. The relationship between early maladaptive schemas and eating-disorder symptomatology among individuals seeking treatment for substance dependence

    PubMed Central

    Elmquist, JoAnna; Shorey, Ryan C.; Anderson, Scott E.; Stuart, Gregory L.

    2016-01-01

    Numerous studies have examined early maladaptive schemas (EMS) and their relationship to psychological disorders, including eating disorders (EDs) and substance use disorders (SUDs). However, to date, there are no empirical investigations that have examined the relationship between EMS and EDs among individuals seeking treatment for substance use. In an attempt to further elucidate this relationship, the purpose of the current, exploratory study was to examine the relationship between EMS, ED symptomatology (i.e., bulimia and binge-eating but not anorexia), and substance use and to directly compare EMS among individuals with and without a probable ED diagnosis. Participants were 387 men and 132 women seeking residential treatment for substance use. Results demonstrated that 11 of the 18 EMS were significantly associated with ED. Moreover, patients with a probable ED scored significantly higher than patients without a probable ED on 8 of the 18 EMS. Results suggest that EMS are prevalent among individuals with ED pathology seeking treatment for substance use. Thus treatment programs could potentially benefit from the assessment and treatment of EMS among dually-diagnosed patients. Given the exploratory and preliminary nature of the study, continued research is needed to further examine the relationship between EMS, EDs, and substance use. PMID:27375373

  19. The Impact of Childhood Emotional Abuse and Experiential Avoidance on Maladaptive Problem Solving and Intimate Partner Violence

    PubMed Central

    Bell, Kathryn M.; Higgins, Lorrin

    2015-01-01

    The purpose of the current study was to examine the joint influences of experiential avoidance and social problem solving on the link between childhood emotional abuse (CEA) and intimate partner violence (IPV). Experiential avoidance following CEA may interfere with a person’s ability to effectively problem solve in social situations, increasing risk for conflict and interpersonal violence. As part of a larger study, 232 women recruited from the community completed measures assessing childhood emotional, physical, and sexual abuse, experiential avoidance, maladaptive social problem solving, and IPV perpetration and victimization. Final trimmed models indicated that CEA was indirectly associated with IPV victimization and perpetration via experiential avoidance and Negative Problem Orientation (NPO) and Impulsivity/Carelessness Style (ICS) social problem solving strategies. Though CEA was related to an Avoidance Style (AS) social problem solving strategy, this strategy was not significantly associated with IPV victimization or perpetration. Experiential avoidance had both a direct and indirect effect, via NPO and ICS social problem solving, on IPV victimization and perpetration. Findings suggest that CEA may lead some women to avoid unwanted internal experiences, which may adversely impact their ability to effectively problem solve in social situations and increase IPV risk. PMID:25893570

  20. Schema change without schema therapy: the role of early maladaptive schemata for a successful treatment of major depression.

    PubMed

    Wegener, Ingo; Alfter, Susanne; Geiser, Franziska; Liedtke, Reinhard; Conrad, Rupert

    2013-01-01

    Early maladaptive schemata (EMS) have repeatedly been shown to be associated with several psychopathological conditions, including depression. Schema therapy proposes interventions that aim at altering EMS. In the present study, we examined the effect of an integrative psychodynamic inpatient therapy without explicit focus on EMS in a sample with major depression. Forty-seven (38 female, 9 male) patients filled out the Symptom Checklist (SCL-90-R) and the Young Schema Questionnaire (YSQ) at the beginning and end of the treatment. Results revealed that EMS were significantly reduced in three out of five schema domains. Strong endorsement of EMS at the beginning of treatment tended to predict symptom reduction. More importantly, the reduction of symptom distress during treatment was strongly associated with a reduction in EMS of the schema domain Impaired Autonomy/Performance. We discuss that changes in EMS are highly relevant for changes in symptom distress but that EMS can not only be changed by schema therapy but also by other approaches, like psychodynamic therapy. PMID:23458112

  1. Stability of dysfunctional attitudes and early maladaptive schemas: a 9-year follow-up study of clinically depressed subjects.

    PubMed

    Wang, Catharina E A; Halvorsen, Marianne; Eisemann, Martin; Waterloo, Knut

    2010-12-01

    The Dysfunctional Attitude Scale (DAS) and the Young Schema Questionnaire (YSQ) have been suggested as relatively stable vulnerability markers for depression and entrenched psychological disorders, respectively. One-hundred-and-forty-nine clinically depressed (CDs), previously depressed (PDs) and never-depressed subjects (NDs) completed the DAS, the YSQ and the Beck Depression Inventory in the index study and were followed-up nine years later. Results showed: (1) Elevated scores in CDs and PDs as compared to NDs; (2) Some stability of depressive symptoms; (3) Significant moderate test-retest correlations for DAS scales and YSQ scales Disconnection and Impaired Limits, also after controlling for depression severity; (4) A significant reduction in mean score for DAS total, Approval by Others and YSQ scales Disconnection and Impaired Limits; (5) Significant correlations between DAS and YSQ scales. Our results support a state-trait vulnerability model of depression comprising stable differences in availability of dysfunctional attitudes and early maladaptive schemas, but also fluctuating differences in accessibility of those schemas during the course of depression. The findings point to the significance of the YSQ scales as vulnerability markers for depression in addition to the more established DAS scales. PMID:20452570

  2. The presence of perforated synapses in the striatum after dopamine depletion, is this a sign of maladaptive brain plasticity?

    PubMed

    Anaya-Martínez, Verónica; Gutierrez-Valdez, Ana Luisa; Ordoñez-Librado, Jose Luis; Montiel-Flores, Enrique; Sánchez-Betancourt, Javier; Sánchez Vázquez del Mercado, César; Reynoso-Erazo, Leonardo; Tron-Alvarez, Rocío; Avila-Costa, Maria Rosa

    2014-12-01

    Synaptic plasticity is the process by which long-lasting changes take place at synaptic connections. The phenomenon itself is complex and can involve many levels of organization. Some authors separate forms into adaptations that have positive or negative consequences for the individual. It has been hypothesized that an increase in the number of synapses may represent a structural basis for the enduring expression of synaptic plasticity during some events that involve memory and learning; also, it has been suggested that perforated synapses increase in number after some diseases and experimental situations. The aim of this study was to analyze whether dopamine depletion induces changes in the synaptology of the corpus striatum of rats after the unilateral injection of 6-OHDA. The findings suggest that after the lesion, both contralateral and ipsilateral striata exhibit an increased length of the synaptic ending in ipsilateral (since third day) and contralateral striatum (since Day 20), loss of axospinous synapses in ipsilateral striatum and a significant increment in the number of perforated synapses, suggesting brain plasticity that might be deleterious for the spines, because this type of synaptic contacts are presumably excitatory, and in the absence of the modulatory effects of dopamine, the neuron could die through excitotoxic mechanisms. Thus, we can conclude that the presence of perforated synapses after striatal dopamine depletion might be a form of maladaptive synaptic plasticity. PMID:25246608

  3. The AP-1 Transcription Factor c-Jun Prevents Stress-Imposed Maladaptive Remodeling of the Heart

    PubMed Central

    Windak, Renata; Müller, Julius; Felley, Allison; Akhmedov, Alexander; Wagner, Erwin F.; Pedrazzini, Thierry; Sumara, Grzegorz; Ricci, Romeo

    2013-01-01

    Systemic hypertension increases cardiac workload and subsequently induces signaling networks in heart that underlie myocyte growth (hypertrophic response) through expansion of sarcomeres with the aim to increase contractility. However, conditions of increased workload can induce both adaptive and maladaptive growth of heart muscle. Previous studies implicate two members of the AP-1 transcription factor family, junD and fra-1, in regulation of heart growth during hypertrophic response. In this study, we investigate the function of the AP-1 transcription factors, c-jun and c-fos, in heart growth. Using pressure overload-induced cardiac hypertrophy in mice and targeted deletion of Jun or Fos in cardiomyocytes, we show that c-jun is required for adaptive cardiac hypertrophy, while c-fos is dispensable in this context. c-jun promotes expression of sarcomere proteins and suppresses expression of extracellular matrix proteins. Capacity of cardiac muscle to contract depends on organization of principal thick and thin filaments, myosin and actin, within the sarcomere. In line with decreased expression of sarcomere-associated proteins, Jun-deficient cardiomyocytes present disarrangement of filaments in sarcomeres and actin cytoskeleton disorganization. Moreover, Jun-deficient hearts subjected to pressure overload display pronounced fibrosis and increased myocyte apoptosis finally resulting in dilated cardiomyopathy. In conclusion, c-jun but not c-fos is required to induce a transcriptional program aimed at adapting heart growth upon increased workload. PMID:24039904

  4. From impulses to maladaptive actions: the insula is a neurobiological gate for the development of compulsive behavior.

    PubMed

    Belin-Rauscent, A; Daniel, M-L; Puaud, M; Jupp, B; Sawiak, S; Howett, D; McKenzie, C; Caprioli, D; Besson, M; Robbins, T W; Everitt, B J; Dalley, J W; Belin, D

    2016-04-01

    Impulsivity is an endophenotype of vulnerability for compulsive behaviors. However, the neural mechanisms whereby impulsivity facilitates the development of compulsive disorders, such as addiction or obsessive compulsive disorder, remain unknown. We first investigated, in rats, anatomical and functional correlates of impulsivity in the anterior insular (AI) cortex by measuring both the thickness of, and cellular plasticity markers in, the AI with magnetic resonance imaging and in situ hybridization of the immediate early gene zif268, respectively. We then investigated the influence of bilateral AI cortex lesions on the high impulsivity trait, as measured in the five-choice serial reaction time task (5-CSRTT), and the associated propensity to develop compulsivity as measured by high drinking levels in a schedule-induced polydipsia procedure (SIP). We demonstrate that the AI cortex causally contributes to individual vulnerability to impulsive-compulsive behavior in rats. Motor impulsivity, as measured by premature responses in the 5-CSRTT, was shown to correlate with the thinness of the anterior region of the insular cortex, in which highly impulsive (HI) rats expressed lower zif268 mRNA levels. Lesions of AI reduced impulsive behavior in HI rats, which were also highly susceptible to develop compulsive behavior as measured in a SIP procedure. AI lesions also attenuated both the development and the expression of SIP. This study thus identifies the AI as a novel neural substrate of maladaptive impulse control mechanisms that may facilitate the development of compulsive disorders. PMID:26370145

  5. 18-HEPE, an n-3 fatty acid metabolite released by macrophages, prevents pressure overload-induced maladaptive cardiac remodeling.

    PubMed

    Endo, Jin; Sano, Motoaki; Isobe, Yosuke; Fukuda, Keiichi; Kang, Jing X; Arai, Hiroyuki; Arita, Makoto

    2014-07-28

    N-3 polyunsaturated fatty acids (PUFAs) have potential cardiovascular benefit, although the mechanisms underlying this effect remain poorly understood. Fat-1 transgenic mice expressing Caenorhabditis elegans n-3 fatty acid desaturase, which is capable of producing n-3 PUFAs from n-6 PUFAs, exhibited resistance to pressure overload-induced inflammation and fibrosis, as well as reduced cardiac function. Lipidomic analysis revealed selective enrichment of eicosapentaenoic acid (EPA) in fat-1 transgenic bone marrow (BM) cells and EPA-metabolite 18-hydroxyeicosapentaenoic acid (18-HEPE) in fat-1 transgenic macrophages. BM transplantation experiments revealed that fat-1 transgenic BM cells, but not fat-1 transgenic cardiac cells, contributed to the antiremodeling effect and that the 18-HEPE-rich milieu in the fat-1 transgenic heart was generated by BM-derived cells, most likely macrophages. 18-HEPE inhibited macrophage-mediated proinflammatory activation of cardiac fibroblasts in culture, and in vivo administration of 18-HEPE reproduced the fat-1 mice phenotype, including resistance to pressure overload-induced maladaptive cardiac remodeling. PMID:25049337

  6. The association of personal resilience with stress, coping, and diabetes outcomes in adolescents with type 1 diabetes: variable- and person-focused approaches.

    PubMed

    Yi-Frazier, Joyce P; Yaptangco, Mona; Semana, Sharla; Buscaino, Emil; Thompson, Valeria; Cochrane, Katie; Tabile, Marissa; Alving, Erin; Rosenberg, Abby R

    2015-09-01

    This study explored the association between personal resilience and distress, coping, and diabetes outcomes in 50 adolescents with type 1 diabetes. Resilience was defined by a factor score derived from validated instruments measuring self-efficacy, optimism, and self-esteem. Variable- and person-focused methodologies were used to explore these associations. Low resilience was associated with higher distress, poor quality of life, and poor glycemic control. Participants with low resilience used more maladaptive coping strategies and were at greatest risk of poor outcomes. Findings suggest that resilience is a promising candidate for interventions designed to reduce distress and improve outcomes for adolescents with type 1 diabetes. PMID:24271691

  7. Early maladaptive schema factors, chronic pain and depressiveness: a study with 271 chronic pain patients and 331 control participants.

    PubMed

    Saariaho, Tom; Saariaho, Anita; Karila, Irma; Joukamaa, Matti

    2012-01-01

    Chronic pain and depression are coexisting entities with high simultaneous prevalence. Both are linked with early adversities. Early maladaptive schemas (EMS) can be seen as a reflection of these adversities. EMSs extensively indicate underlying psychic patterns and provide a good opportunity to detect covert processes and psychic shapes (latent factors), which create the basis of how people rate their schemas. The purpose of this study was to explore these latent, higher order schema factors (SF) and to find out how they are associated with pain intensity or depression in chronic pain patients and a control sample. The study subjects consisted of 271 first-visit pain patients and 331 control participants. Sociodemographic and pain data were gathered by questionnaire; 18 EMSs were measured with the Young Schema Questionnaire (short form) and depressiveness was measured with the Beck Depression Inventory, Version II. Exploratory factor and regression analyses were used. The chronic pain patient group showed two SFs. The first SF showed a shameful, defective, socially isolated, failure, emotionally inhibited, deprived, submissive and resigned pattern. The second SF showed a demanding, approval seeking, self-sacrificing and punitive pattern. SF1 predicted more than half of the depressiveness in the pain patient sample. A three-factor structure was found in the control sample, and SFs 1 and 3 together predicted almost one-third of depressiveness. The pain patient and the control groups had a different, higher order factor structure. We assume that SF1 in the pain patients reflected a rather serious, undefined early psychic trauma and was also associated with their depressiveness. PMID:21210495

  8. Nociceptors as chronic drivers of pain and hyperreflexia after spinal cord injury: an adaptive-maladaptive hyperfunctional state hypothesis

    PubMed Central

    Walters, Edgar T.

    2012-01-01

    Spinal cord injury (SCI) causes chronic peripheral sensitization of nociceptors and persistent generation of spontaneous action potentials (SA) in peripheral branches and the somata of hyperexcitable nociceptors within dorsal root ganglia (DRG). Here it is proposed that SCI triggers in numerous nociceptors a persistent hyperfunctional state (peripheral, synaptic, and somal) that originally evolved as an adaptive response to compensate for loss of sensory terminals after severe but survivable peripheral injury. In this hypothesis, nociceptor somata monitor the status of their own receptive field and the rest of the body by integrating signals received by their peripheral and central branches and the soma itself. A nociceptor switches into a potentially permanent hyperfunctional state when central neural, glial, and inflammatory signal combinations are detected that indicate extensive peripheral injury. Similar signal combinations are produced by SCI and disseminated widely to uninjured as well as injured nociceptors. This paper focuses on the uninjured nociceptors that are altered by SCI. Enhanced activity generated in below-level nociceptors promotes below-level central sensitization, somatic and autonomic hyperreflexia, and visceral dysfunction. If sufficient ascending fibers survive, enhanced activity in below-level nociceptors contributes to below-level pain. Nociceptor activity generated above the injury level contributes to at- and above-level sensitization and pain (evoked and spontaneous). Thus, SCI triggers a potent nociceptor state that may have been adaptive (from an evolutionary perspective) after severe peripheral injury but is maladaptive after SCI. Evidence that hyperfunctional nociceptors make large contributions to behavioral hypersensitivity after SCI suggests that nociceptor-specific ion channels required for nociceptor SA and hypersensitivity offer promising targets for treating chronic pain and hyperreflexia after SCI. PMID:22934060

  9. Friendship Quality and Psychosocial Outcomes among Children with Traumatic Brain Injury

    PubMed Central

    Heverly-Fitt, Sara; Wimsatt, Maureen A.; Menzer, Melissa M.; Rubin, Kenneth H.; Dennis, Maureen; Taylor, Gerry; Stancin, Terry; Gerhardt, Cynthia A.; Vannatta, Kathryn; Bigler, Erin D.; Yeates, Keith Owen

    2014-01-01

    This study examined differences in friendship quality between children with traumatic brain injury (TBI) and orthopedic injury (OI) and behavioral outcomes for children from both groups. Participants were 41 children with TBI and 43 children with OI (M age = 10.4). Data were collected using peer- and teacher-reported measures of participants’ social adjustment and parent-reported measures of children’s post-injury behaviors. Participants and their mutually nominated best friends also completed a measure of the quality of their friendships. Children with TBI reported significantly more support and satisfaction in their friendships than children with OI. Children with TBI and their mutual best friend were more similar in their reports of friendship quality compared to children with OI and their mutual best friends. Additionally, for children with TBI who were rejected by peers, friendship support buffered against maladaptive psychosocial outcomes, and predicted skills related to social competence. Friendship satisfaction was related to higher teacher ratings of social skills for the TBI group only. Positive and supportive friendships play an important role for children with TBI, especially for those not accepted by peers. Such friendships may protect children with TBI who are rejected against maladaptive psychosocial outcomes, and promote skills related to social competence. PMID:24840021

  10. Change in Autism Symptoms and Maladaptive Behaviors in Adolescence and Adulthood: The Role of Positive Family Processes

    ERIC Educational Resources Information Center

    Woodman, Ashley C.; Smith, Leann E.; Greenberg, Jan S.; Mailick, Marsha R.

    2015-01-01

    Little is known about outcomes for individuals with autism spectrum disorders (ASD) into adulthood. Several characteristics of individuals with ASD predict long-term outcomes, and the family environment may also play a role. The present study uses a prospective, longitudinal design to describe and predict trajectories of autism symptoms and…

  11. Neurobiological underpinnings of reward anticipation and outcome evaluation in gambling disorder

    PubMed Central

    Linnet, Jakob

    2014-01-01

    Gambling disorder is characterized by persistent and recurrent maladaptive gambling behavior, which leads to clinically significant impairment or distress. The disorder is associated with dysfunctions in the dopamine system. The dopamine system codes reward anticipation and outcome evaluation. Reward anticipation refers to dopaminergic activation prior to reward, while outcome evaluation refers to dopaminergic activation after reward. This article reviews evidence of dopaminergic dysfunctions in reward anticipation and outcome evaluation in gambling disorder from two vantage points: a model of reward prediction and reward prediction error by Wolfram Schultz et al. and a model of “wanting” and “liking” by Terry E. Robinson and Kent C. Berridge. Both models offer important insights on the study of dopaminergic dysfunctions in addiction, and implications for the study of dopaminergic dysfunctions in gambling disorder are suggested. PMID:24723865

  12. Multidimensional Pain Inventory derived classifications of chronic pain: evidence for maladaptive pain-related coping within the dysfunctional group.

    PubMed

    Rusu, Adina C; Hasenbring, Monika

    2008-01-01

    This study examines maladaptive pain-related fear-avoidance and endurance coping in subgroups of patients with chronic back pain. Hypotheses were derived from the avoidance-endurance model of pain [Hasenbring M. Attentional control of pain and the process of chronification. In: Sandkühler J, Bromm B, Gebhart GF, editors. Progress in pain research, vol. 129. New York: Elsevier; 2000. p. 525-34.], which assumes that endurance coping (cognitive, behavioral tendency to endure severe pain to finish current activities irrespective of pain increases) leads to overuse of muscles, joints, and discs with an increase of pain as long-term consequence. Participants were 120 patients referred for treatment of chronic pain to General Practices. They were classified as 'dysfunctional-DYS' (15.8%), 'interpersonally distressed-ID' (10.8%), and 'adaptive copers-AC' (61.7%) based on the Multidimensional Pain Inventory [Kerns RD, Turk DC, Rudy TE. The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain 1985;23:345-56.] and compared on measures of pain-related fear-avoidance coping (anxiety/depression; help-/hopelessness; catastrophizing; avoidance of social/physical activity) and endurance coping (positive mood; thought suppression; endurance behavior) using the Kiel Pain Inventory [Hasenbring M. The Kiel Pain Inventory-Manual. Three questionnaire scales for assessment of pain-related cognitions, emotions and copying strategies. Bern:Huber; 1994.]. Multivariate analysis of variance indicated that groups differed significantly for pain-related fear-avoidance and endurance coping, even after control for pain intensity and depression. Univariate effects revealed that patients classified as DYS reported more anxiety/depression, help-/hopelessness, and catastrophizing than did those classified as AC. Furthermore, the DYS group showed more thought suppression compared to AC; however, subgroups did not differ significantly with regard to avoidance of social and physical activity

  13. Length polymorphism in the Period 3 gene is associated with sleepiness and maladaptive circadian phase in night-shift workers.

    PubMed

    Drake, Christopher L; Belcher, Ren; Howard, Ryan; Roth, Thomas; Levin, Albert M; Gumenyuk, Valentina

    2015-06-01

    The objective of the current study was to determine if night-shift workers carrying the five-repeat variant of the Period 3 gene show elevated levels of nocturnal sleepiness and earlier circadian phase compared with homozygotes for the four-repeat allele. Twenty-four permanent night-shift workers were randomly selected from a larger study. Participants took part in an observational laboratory protocol including an overnight multiple sleep latency test and half-hourly saliva collection for calculation of dim-light melatonin onset. Period 3(-/5) shift workers had significantly lower multiple sleep latency test during overnight work hours compared with Period 3(4/4) workers (3.52 ± 23.44 min versus 10.39 ± 6.41 min, P = 0.003). We observed no significant difference in sleepiness during early morning hours following acute sleep deprivation. Long-allele carriers indicated significantly higher sleepiness on the Epworth Sleepiness Scale administered at 17:00 hours (12.08 ± 2.55 versus 8.00 ± 1.94, P < 0.001). We observed a significantly earlier melatonin onset in Period 3(-/5) individuals compared with Period 3(4/4) shift workers (20:44 ± 6:37 versus 02:46 ± 4:58, P = 0.021). Regression analysis suggests that Period 3 genotype independently predicts sleepiness even after controlling for variations in circadian phase, but we were unable to link Period 3 to circadian phase when controlling for sleepiness. Period 3(-/5) shift workers showed both subjective and objective sleepiness in the pathological range, while their Period 3(4/4) counterparts showed sleepiness within normal limits. Period 3(-/5) night workers also show a mean circadian phase 6 h earlier (i.e. less adapted) than Period 3(4/4) workers. Because Period 3(-/5) workers have maladaptive circadian phase as well as pathological levels of sleepiness, they may be at greater risk for occupational and automotive accidents. We interpret these findings as a call for future research on the role of Period 3 in

  14. Maladaptive "gambling" by pigeons.

    PubMed

    Zentall, Thomas R

    2011-05-01

    When humans buy a lottery ticket or gamble at a casino they are engaging in an activity that on average leads to a loss of money. Although animals are purported to engage in optimal foraging behavior, similar sub-optimal behavior can be found in pigeons. They show a preference for an alternative that is associated with a low probability of reinforcement (e.g., one that is followed by a red hue on 20% of the trials and then reinforcement or by a green hue on 80% of the trials and then the absence of reinforcement) over an alternative that is associated with a higher probability of reinforcement (e.g., blue or yellow each of which is followed by reinforcement 50% of the time). This effect appears to result from the strong conditioned reinforcement associated with the stimulus that is always followed by reinforcement. Surprisingly, although it is experienced four times as much, the stimulus that is never followed by reinforcement does not appear to result in significant conditioned inhibition (perhaps due to the absence of observing behavior). Similarly, human gamblers tend to overvalue wins and undervalue losses. Thus, this animal model may provide a useful analog to human gambling behavior, one that is free from the influence of human culture, language, social reinforcement, and other experiential biases that may influence human gambling behavior. PMID:21215301

  15. Authentic Assessment for Restorative Outcomes

    ERIC Educational Resources Information Center

    Doerr, Allison

    2008-01-01

    The Developmental Audit[R] is a comprehensive means of assessment and treatment planning that identifies the coping strategies underlying a youth's maladaptive and self-defeating behavior. This is a strength-based assessment that engages youth in conflict in the process of generating solutions rather than focusing on deficits. This process…

  16. Assessing Maladaptive Responses to the Stress of Being At-Risk of HIV Infection among HIV-Negative Gay Men in New York City

    PubMed Central

    Yi, Huso; Shidlo, Ariel; Sandfort, Theo

    2009-01-01

    The aim of this study was to examine the psychometric properties and preliminary validity of a newly developed 16-item measure to assess maladaptive responses to the stress of being at risk for HIV infection among HIV-negative gay men. The measure consisted of three factors: (1) fatalistic beliefs about maintaining an HIV-negative serostatus; (2) reduced perceived severity of HIV infection due to advances in medical treatment of HIV/AIDS; and (3) negative affective states associated with the risk of HIV infection. A total of 285 HIV-negative gay men at a counseling program in New York City participated in the study. Confirmatory factor analyses supported the three-factor model as an acceptable model fit: NNFI = .91, CFI = .92, GFI = .90, RMSEA = .07. The measure and its subscales obtained in this sample achieved adequate internal consistency coefficients. Construct validity was supported by significant positive associations with internalized homophobia, depression, self-justifications for the last unprotected anal intercourse (UAI), and actual UAI with casual sex partners. Understanding the dynamics of maladaptive responses to the epidemic and intense anxieties elicited by HIV risk among HIV-negative gay men living in a place of high seroprevalence provides useful information to guide psychosocial interventions in the population. PMID:20043254

  17. Heart rate variability is enhanced in controls but not maladaptive perfectionists during brief mindfulness meditation following stress-induction: A stratified-randomized trial.

    PubMed

    Azam, Muhammad Abid; Katz, Joel; Fashler, Samantha R; Changoor, Tina; Azargive, Saam; Ritvo, Paul

    2015-10-01

    Heart rate variability (HRV) is a vagal nerve-mediated biomarker of cardiac function used to investigate chronic illness, psychopathology, stress and, more recently, attention-regulation processes such as meditation. This study investigated HRV in relation to maladaptive perfectionism, a stress-related personality factor, and mindfulness meditation, a stress coping practice expected to elevate HRV, and thereby promote relaxation. Maladaptive perfectionists (n=21) and Controls (n=39) were exposed to a lab-based assessment in which HRV was measured during (1) a 5-minute baseline resting phase, (2) a 5-minute cognitive stress-induction phase, and (3) a post-stress phase. In the post-stress phase, participants were randomly assigned to a 10-minute audio-instructed mindfulness meditation condition or a 10-minute rest condition with audio-description of mindfulness meditation. Analyses revealed a significant elevation in HRV during meditation for Controls but not for Perfectionists. These results suggest that mindfulness meditation promotes relaxation following cognitive stress and that the perfectionist personality hinders relaxation possibly because of decreased cardiac vagal tone. The results are discussed in the context of developing psychophysiological models to advance therapeutic interventions for distressed populations. PMID:26116778

  18. Cognitive Mediators of Treatment Outcomes in Pediatric Functional Abdominal Pain

    PubMed Central

    Levy, Rona L.; Langer, Shelby L.; Romano, Joan M.; Labus, Jennifer; Walker, Lynn S.; Murphy, Tasha B.; Van Tilburg, Miranda; Feld, Lauren D.; Christie, Dennis L.; Whitehead, William E.

    2014-01-01

    Objectives Cognitive-behavioral interventions improve outcomes for many pediatric health conditions, but little is known about which mechanisms mediate these outcomes. The goal of this study was to identify whether changes in targeted process variables from baseline to one week post-treatment mediate improvement in outcomes in a randomized controlled trial of a brief cognitive-behavioral intervention for idiopathic childhood abdominal pain. Methods Two-hundred children with persistent functional abdominal pain and their parents were randomly assigned to one of two conditions: a 3-session social learning and cognitive-behavioral treatment (SLCBT) (N=100), or a 3-session educational intervention controlling for time and attention (N=100). Outcomes were assessed at 3, 6 and 12 month follow-ups. The intervention focused on altering parental responses to pain and on increasing adaptive cognitions and coping strategies related to pain in both parents and children. Results Multiple mediation analyses were applied to examine the extent to which the effects of the SLCBT condition on child GI symptom severity and pain as reported by children and their parents were mediated by changes in targeted cognitive process variables and parents’ solicitous responses to their child’s pain symptoms. Reductions in parents’ perceived threat regarding their child’s pain mediated reductions in both parent- and child-reported GI symptom severity and pain. Reductions in children’s catastrophic cognitions mediated reductions in child-reported GI symptom severity but no other outcomes. Reductions in parental solicitousness did not mediate outcomes. Discussion Results suggest that reductions in reports of children’s pain and GI symptoms following a social learning and cognitive-behavioral intervention were mediated at least in part by decreasing maladaptive parent and child cognitions. PMID:24469611

  19. Early maladaptive schema-related impairment and co-occurring current major depressive episode-related enhancement of mental state decoding ability in borderline personality disorder.

    PubMed

    Unoka, Zsolt Szabolcs; Fogd, Dóra; Seres, Imola; Kéri, Szabolcs; Csukly, Gábor

    2015-04-01

    Disturbed interpersonal relationships specific to borderline personality disorder (BPD) suggest biased processing of social information. The goal of this study was to examine alterations in mental state decoding (MSD) and their associations with early maladaptive schemas (EMS) that may lead to the misinterpretation of incoming information. In addition, the authors' aim was to evaluate the effects of a co-occurring current major depressive episode (MDE) on the MSD performance of BPD patients. Seventy-eight BPD patients (34 with MDE) and 76 matched healthy controls (HC) were assessed for Reading the Mind in the Eyes Test (RMET) and the level of EMS. The authors found that impairment in the total RMET performance, as well as specific impairment regarding the recognition of positive and neutral items, was associated with EMS, and enhanced vigilance to negative mental states was characteristic to BPD with MDE. Results suggest that MSD ability is altered in two independent ways in BPD. PMID:24932871

  20. Adaptive and Maladaptive Means of Using Facebook: A Qualitative Pilot Study to Inform Suggestions for Development of a Future Intervention for Depression.

    PubMed

    Tran, Tanya B; Uebelacker, Lisa; Wenze, Susan J; Collins, Caitlin; Broughton, Monica K

    2015-11-01

    Existing literature examining the relation between social networking sites and mental health is primarily based on correlational methods and presents mixed findings. Many researchers neglect to examine the cognitive and behavioral processes used while online. This study's qualitative approach strives to understand how individuals with elevated depressive symptoms may use Facebook following an interpersonal stressor. Participants' narration of their Facebook use was coded. Common adaptive uses included using Facebook to seek social support, actively communicate, distract, recall positive memories, and reappraise negative thoughts. Maladaptive uses included engaging in social comparison, ruminating, and recalling negative memories. Feedback regarding development of a future intervention was also elicited. Suggestions included using Facebook to view positive, interesting, or meaningful information, distract, garner social support, and engage in social activities. Findings indicate that how one engages with Facebook after an interpersonal stressor may affect adjustment and may help to inform the development of a novel, Facebook-based intervention. PMID:26554330

  1. A systematic review of the parenting and outcomes experienced by offspring of mothers with borderline personality pathology: Potential mechanisms and clinical implications.

    PubMed

    Eyden, Julie; Winsper, Catherine; Wolke, Dieter; Broome, Matthew R; MacCallum, Fiona

    2016-07-01

    There is growing interest in whether the parenting strategies and offspring outcomes of mothers with borderline personality disorder (BPD) differ from those of mothers without BPD. We searched PsychINFO, PubMed, EMBASE, Web of Science, Scopus and ASSIA databases for studies examining parenting skills and attitudes among mothers with BPD/BPD symptoms and/or offspring outcomes. PRISMA reporting guidelines were followed. Of 10,067 abstracts screened, 101 full-text articles were retrieved and 33 met pre-determined criteria for qualitative synthesis. Overall, studies suggest that mothers with BPD/BPD symptoms are more likely to engage in maladaptive interactions with their offspring characterised by insensitive, overprotective, and hostile parenting compared to mothers without BPD/BPD symptoms. Adverse offspring outcomes include BPD symptoms, internalising (including depression) and externalising problems, insecure attachment patterns, and emotional dysregulation. Findings suggest that vulnerability from mother to offspring may be partly transmitted via maladaptive parenting and maternal emotional dysfunction. Conclusions were limited by study heterogeneity in methodology and construct definitions, as well as a paucity of clinical comparison groups. Prospective studies of mothers with BPD and their offspring from pregnancy onwards may further elucidate mechanisms of transmission and identify resilience factors across development. Parenting behaviour awareness, improving attachment behaviours and emotional regulation strategies may be important intervention targets. PMID:27261413

  2. Emotional abuse as a predictor of early maladaptive schemas in adolescents: contributions to the development of depressive and social anxiety symptoms.

    PubMed

    Calvete, E

    2014-04-01

    The schema therapy model posits that maltreatment generates early maladaptive schemas (EMSs) that lead to the development of emotional disorders throughout the life span. The model also stipulates that temperament moderates the influence of maltreatment on EMSs. This study examines (a) whether emotional abuse perpetrated by parents and peers, both alone and interactively with temperament, predicts the worsening of EMSs; and (b) whether EMSs in turn predict an increase in depressive and social anxiety symptoms in adolescents. A total of 1,052 adolescents (Mage=13.43; SD=1.29) were assessed at three time points, each of which was separated by 6 months. The subjects completed measures of emotional abuse by parents and peers, neuroticism, extraversion, EMSs, depressive symptoms, and social anxiety. The findings indicate that emotional bullying victimization and neuroticism predict a worsening of all schema domains over time. Contrary to expectations, there was no significant interaction between temperament dimensions and emotional abuse. The results confirmed the mediational hypothesis that changes in EMSs mediated the predictive association between bullying victimization and emotional symptoms. This study provides partial support for the schema therapy model by demonstrating the role of emotional abuse and temperament in the genesis of EMSs. PMID:24252743

  3. Exploring revictimization process among Turkish women: The role of early maladaptive schemas on the link between child abuse and partner violence.

    PubMed

    Atmaca, Sinem; Gençöz, Tülin

    2016-02-01

    The purpose of the current study is to explore the revictimization process between child abuse and neglect (CAN), and intimate partner violence (IPV) based on the schema theory perspective. For this aim, 222 married women recruited in four central cities of Turkey participated in the study. Results indicated that early negative CAN experiences increased the risk of being exposed to later IPV. Specifically, emotional abuse and sexual abuse in the childhood predicted the four subtypes of IPV, which are physical, psychological, and sexual violence, and injury, while physical abuse only associated with physical violence. To explore the mediational role of early maladaptive schemas (EMSs) on this association, first, five schema domains were tested via Parallel Multiple Mediation Model. Results indicated that only Disconnection/Rejection (D/R) schema domains mediated the association between CAN and IPV. Second, to determine the particular mediational roles of each schema, eighteen EMS were tested as mediators, and results showed that Emotional Deprivation Schema and Vulnerability to Harm or Illness Schema mediated the association between CAN and IPV. These findings provided an empirical support for the crucial roles of EMSs on the effect of revictimization process. Clinical implications were discussed. PMID:26826949

  4. Maladaptive Modulations of NLRP3 Inflammasome and Cardioprotective Pathways Are Involved in Diet-Induced Exacerbation of Myocardial Ischemia/Reperfusion Injury in Mice

    PubMed Central

    Penna, Claudia; Nigro, Debora; Chiazza, Fausto; Fracasso, Veronica; Tullio, Francesca; Aragno, Manuela

    2016-01-01

    Excessive fatty acids and sugars intake is known to affect the development of cardiovascular diseases, including myocardial infarction. However, the underlying mechanisms are ill defined. Here we investigated the balance between prosurvival and detrimental pathways within the heart of C57Bl/6 male mice fed a standard diet (SD) or a high-fat high-fructose diet (HFHF) for 12 weeks and exposed to cardiac ex vivo ischemia/reperfusion (IR) injury. Dietary manipulation evokes a maladaptive response in heart mice, as demonstrated by the shift of myosin heavy chain isoform content from α to β, the increased expression of the Nlrp3 inflammasome and markers of oxidative metabolism, and the downregulation of the hypoxia inducible factor- (HIF-)2α and members of the Reperfusion Injury Salvage Kinases (RISK) pathway. When exposed to IR, HFHF mice hearts showed greater infarct size and lactic dehydrogenase release in comparison with SD mice. These effects were associated with an exacerbated overexpression of Nlrp3 inflammasome, resulting in marked caspase-1 activation and a compromised activation of the cardioprotective RISK/HIF-2α pathways. The common mechanisms of damage here reported lead to a better understanding of the cross-talk among prosurvival and detrimental pathways leading to the development of cardiovascular disorders associated with metabolic diseases. PMID:26788246

  5. Connectome Reorganization Associated With Surgical Outcome in Temporal Lobe Epilepsy

    PubMed Central

    Ji, Gong-Jun; Zhang, Zhiqiang; Xu, Qiang; Wei, Wei; Wang, Jue; Wang, Zhengge; Yang, Fang; Sun, Kangjian; Jiao, Qing; Liao, Wei; Lu, Guangming

    2015-01-01

    Abstract To identify the distinct pattern of anatomical network reorganization in surgically refractory mesial temporal lobe epilepsy (MTLE) patients using a longitudinal design. We collected longitudinal diffusion-weighted images of 19 MTLE patients before and after anterior temporal lobectomy. Patients were classified as seizure-free (SF) or nonseizure-free (NSF) at least 1 year after surgery. We constructed whole-brain anatomical networks derived from white matter tractography and evaluated network connectivity measures by graph theoretical analysis. The reorganization trajectories of network measures in SF and NSF patients were investigated by two-way mixed analysis of variance, with factors “group” (SF vs NSF) and “treatment” (presurgery vs postsurgery). Widespread brain structures showed opposite reorganization trajectories in FS and NSF groups (interaction effect). Most of them showed group difference before surgery and then converge after surgery, suggesting that surgery remodeled these structures into a similar status. Conversly, contralateral amygdala-planum-temporale and thalamic-parietal tracts showed higher connectivity strength in NSF than in SF patients after surgery, indicating maladaptive neuroplastic responses to surgery in NSF patients. Our findings suggest that surgical outcomes are associated not only with the preoperative pattern of anatomical connectivity, but also with connectome reconfiguration following surgery. The reorganization of contralateral temporal lobe and corticothalamic tracts may be particularly important for seizure control in MTLE. PMID:26448031

  6. Increased functional connectivity in the default mode network in mild cognitive impairment: a maladaptive compensatory mechanism associated with poor semantic memory performance.

    PubMed

    Gardini, Simona; Venneri, Annalena; Sambataro, Fabio; Cuetos, Fernando; Fasano, Fabrizio; Marchi, Massimo; Crisi, Girolamo; Caffarra, Paolo

    2015-01-01

    Semantic memory decline and changes of default mode network (DMN) connectivity have been reported in mild cognitive impairment (MCI). Only a few studies, however, have investigated the role of changes of activity in the DMN on semantic memory in this clinical condition. The present study aimed to investigate more extensively the relationship between semantic memory impairment and DMN intrinsic connectivity in MCI. Twenty-one MCI patients and 21 healthy elderly controls matched for demographic variables took part in this study. All participants underwent a comprehensive semantic battery including tasks of category fluency, visual naming and naming from definition for objects, actions and famous people, word-association for early and late acquired words and reading. A subgroup of the original sample (16 MCI patients and 20 healthy elderly controls) was also scanned with resting state functional magnetic resonance imaging and DMN connectivity was estimated using a seed-based approach. Compared with healthy elderly, patients showed an extensive semantic memory decline in category fluency, visual naming, naming from definition, words-association, and reading tasks. Patients presented increased DMN connectivity between the medial prefrontal regions and the posterior cingulate and between the posterior cingulate and the parahippocampus and anterior hippocampus. MCI patients also showed a significant negative correlation of medial prefrontal gyrus connectivity with parahippocampus and posterior hippocampus and visual naming performance. Our findings suggest that increasing DMN connectivity may contribute to semantic memory deficits in MCI, specifically in visual naming. Increased DMN connectivity with posterior cingulate and medio-temporal regions seems to represent a maladaptive reorganization of brain functions in MCI, which detrimentally contributes to cognitive impairment in this clinical population. PMID:25547636

  7. The interruption of thyroid and interrenal and the inter-hormonal interference in fish: does it promote physiologic adaptation or maladaptation?

    PubMed

    Peter, Valsa S; Peter, M C Subhash

    2011-12-01

    Endocrines, the chief components of chemical centers which produce hormones in tune with intrinsic and extrinsic clues, create a chemical bridge between the organism and the environment. In fishes also hormones integrate and modulate many physiologic functions and its synthesis, release, biological actions and metabolic clearance are well regulated. Consequently, thyroid hormones (THs) and cortisol, the products of thyroid and interrenal axes, have been identified for their common integrative actions on metabolic and osmotic functions in fish. On the other hand, many anthropogenic chemical substances, popularly known as endocrine disrupting chemicals, have been shown to disrupt the hormone-receptor signaling pathways in a number fish species. These chemicals which are known for their ability to induce endocrine disruption particularly on thyroid and interrenals can cause malfunction or maladaptation of many vital processes which are involved in the development, growth and reproduction in fish. On the contrary, evidence is presented that the endocrine interrupting agents (EIAs) can cause interruption of thyroid and interrenals, resulting in physiologic compensatory mechanisms which can be adaptive, though such hormonal interactions are less recognized in fishes. The EIAs of physical, chemical and biological origins can specifically interrupt and modify the hormonal interactions between THs and cortisol, resulting in specific patterns of inter-hormonal interference. The physiologic analysis of these inter-hormonal interruptions during acclimation and post-acclimation to intrinsic or extrinsic EIAs reveals that combinations of anti-hormonal, pro-hormonal or stati-hormonal interference may help the fish to fine-tune their metabolic and osmotic performances as part of physiologic adaptation. This novel hypothesis on the phenomenon of inter-hormonal interference and its consequent physiologic interference during thyroid and interrenal interruption thus forms the basis of

  8. Measuring Course Learning Outcomes

    ERIC Educational Resources Information Center

    Keshavarz, Mohsen

    2011-01-01

    Accreditation criteria of programs require effective learning outcomes, assessment with documented procedures, tools, results, and actions to close the assessment loop with broad faculty involvement. This article describes a methodology for providing quantitative measurement of a course's learning outcomes. The methodology uses a linkage matrix…

  9. Behavioural Outcome in Children with Congenital Adrenal Hyperplasia: Experience of a Single Centre

    PubMed Central

    Idris, Arini Nuran; Chandran, Viji; Syed Zakaria, Syed Zulkifli; Rasat, Rahmah

    2014-01-01

    The aim of this study was to determine the behavioral outcome in children with CAH and to identify the risk factors that may influence it. Participants (aged 6–18 years) included 29 girls and 20 boys with CAH and unaffected siblings (25 girls and 17 boys). Psychological adjustment was assessed with parent reports on the Child Behavior Checklist (CBCL). Information about disease characteristics was obtained from medical records. Our study reveals that there was higher incidence of parent-reported problem of anxious/depressed and withdrawn/depressed behaviours, somatic complaints, social, thought, and attention problems, and rule-breaking, aggressive, internalizing, and externalizing behaviour among children with CAH compared to controls. The prevalence of internalizing behaviour problems was higher in CAH boys compared with that of controls. Psychosocial adjustment of girls with CAH was found to be similar to unaffected female controls and was within the normal population range. Family income may be associated with behavioral outcome. Glucocorticoid dose may reflect disease severity which may be associated with behavioral outcome. We conclude that internalizing behavioral problem was prevalent among boys with CAH reflecting maladaptive adjustment in coping with chronic illness. This highlighted the importance of psychological and social support for the patients and their families. PMID:24799898

  10. Asthma Outcomes: Pulmonary Physiology

    PubMed Central

    Tepper, Robert S.; Wise, Robert S.; Covar, Ronina; Irvin, Charles G.; Kercsmar, Carolyn M.; Kraft, Monica; Liu, Mark C.; O’Connor, George T.; Peters, Stephen P.; Sorkness, Ronald; Togias, Alkis

    2014-01-01

    Background Outcomes of pulmonary physiology have a central place in asthma clinical research. Objective At the request of National Institutes of Health (NIH) institutes and other federal agencies, an expert group was convened to provide recommendations on the use of pulmonary function measures as asthma outcomes that should be assessed in a standardized fashion in future asthma clinical trials and studies to allow for cross-study comparisons. Methods Our subcommittee conducted a comprehensive search of PubMed to identify studies that focused on the validation of various airway response tests used in asthma clinical research. The subcommittee classified the instruments as core (to be required in future studies), supplemental (to be used according to study aims and in a standardized fashion), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results A list of pulmonary physiology outcomes that applies to both adults and children older than 6 years was created. These outcomes were then categorized into core, supplemental, and emerging. Spirometric outcomes (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], and FEV1/FVC) are proposed as core outcomes for study population characterization, for observational studies, and for prospective clinical trials. Bronchodilator reversibility and pre- and post-bronchodilator FEV1 also are core outcomes for study population characterization and observational studies. Conclusions The subcommittee considers pulmonary physiology outcomes of central importance in asthma and proposes spirometric outcomes as core outcomes for all future NIH-initiated asthma clinical research. PMID:22386510

  11. Why Measure Outcomes?

    PubMed

    Kuhn, John E

    2016-01-01

    The concept of measuring the outcomes of treatment in health care was promoted by Ernest Amory Codman in the early 1900s, but, until recently, his ideas were generally ignored. The forces that have advanced outcome measurement to the forefront of health care include the shift in payers for health care from the patient to large insurance companies or government agencies, the movement toward assessing the care of populations not individuals, and the effort to find value (or cost-effective treatments) amid rising healthcare costs. No ideal method exists to measure outcomes, and the information gathered depends on the reason the outcome information is required. Outcome measures used in research are best able to answer research questions. The methods for assessing physician and hospital performance include process measures, patient-experience measures, structure measures, and measures used to assess the outcomes of treatment. The methods used to assess performance should be validated, be reliable, and reflect a patient's perception of the treatment results. The healthcare industry must measure outcomes to identify which treatments are most effective and provide the most benefit to patients. PMID:27049223

  12. Evaluating Counseling Outcomes.

    ERIC Educational Resources Information Center

    Smyer, Michael A.; Intrieri, Robert C.

    1990-01-01

    Defines the range of interventions considered under the rubric of counseling for the elderly. Uses evaluation of treatments for depression among the elderly to exemplify the current state of outcome-evaluation research. (Author)

  13. SGLT2 Inhibition and cardiovascular events: why did EMPA-REG Outcomes surprise and what were the likely mechanisms?

    PubMed

    Sattar, Naveed; McLaren, James; Kristensen, Søren L; Preiss, David; McMurray, John J

    2016-07-01

    While the modest reduction in the primary composite outcome of myocardial infarction, stroke or cardiovascular death in the EMPA-REG Outcomes trial was welcome, the 30-40% reductions in heart failure hospitalisation (HFH) and cardiovascular and all-cause deaths in patients treated with empagliflozin were highly impressive and unexpected. In this review, we discuss briefly why cardiovascular endpoint trials for new diabetes agents are required and describe the results of the first four such trials to have reported, as a precursor to understanding why the EMPA-REG Outcomes results came as a surprise. Thereafter, we discuss potential mechanisms that could explain the EMPA-REG Outcomes results, concentrating on non-atherothrombotic effects. We suggest that the main driver of benefit may derive from the specific effects of sodium-glucose linked transporter-2 (SGLT2) inhibition on renal sodium and glucose handling, leading to both diuresis and improvements in diabetes-related maladaptive renal arteriolar responses. These haemodynamic and renal effects are likely to be beneficial in patients with clinical or subclinical cardiac dysfunction. The net result of these processes, we argue, is an improvement in cardiac systolic and diastolic function and, thereby, a lower risk of HFH and sudden cardiac death. We also discuss whether other drugs in this class are likely to show similar cardiovascular benefits. Finally, areas for future research are suggested to better understand the relevant mechanisms and to identify other groups who may benefit from SGLT2 inhibitor therapy. PMID:27112340

  14. Does Age of Onset of Risk Behaviors Mediate the Relationship between Child Abuse and Neglect and Outcomes in Middle Adulthood?

    PubMed Central

    Horan, Jacqueline M.; Widom, Cathy Spatz

    2014-01-01

    Child maltreatment has been linked with a number of risk behaviors that are associated with long-lasting maladaptive outcomes across multiple domains of functioning. This study examines whether the ages of onset of four risk behaviors—sexual intercourse, alcohol use, drug use, and criminal behavior—mediate the relationship between child maltreatment and outcomes in middle adulthood among a sample of court-documented victims of child abuse/neglect and matched controls (N = 1,196; 51.7% female; 66.2% White, 32.6% Black). Adult outcomes included employment status, welfare receipt, internalizing symptoms of anxiety and depressive symptoms, substance use problems, and criminal arrests. The results indicated gender differences in these relationships. For females, age of onset of sexual intercourse mediated the relationship between child abuse/neglect and both internalizing symptoms and substance use problems in middle adulthood. For males, age at first criminal arrest mediated the relationship between child abuse/neglect and extensive involvement in the justice system in middle adulthood. Age of onset of alcohol use and drug use did not mediate the relationship between child abuse/neglect and middle adult outcomes. This study expands current knowledge by identifying associations between early initiation of risk behavior in one domain and later, continuing problems in different domains. Thus, early initiation of specific risk behaviors may have more wide-ranging negative consequences than are typically considered during intervention or treatment and strategies may need to target multiple domains of functioning. PMID:25104419

  15. Cardiac surgery outcomes.

    PubMed

    Halpin, Linda S; Barnett, Scott D; Beachy, Jim

    2003-01-01

    Accrediting organizations and payers are demanding valid and reliable data that demonstrate the value of services. Federal agencies, healthcare industry groups, and healthcare watchdog groups are increasing the demand for public access to outcomes data. A new and growing outcomes dynamic is the information requested by prospective patients in an increasingly consumer-oriented business. Patients demand outcomes, and resources are developing to meet these demands. Physicians are increasingly confronted with requests for information about their mortality and morbidity rates, malpractice suits, and disciplinary actions received. For example, in Virginia, prospective patients have access to data provided by the nonprofit group Virginia Health Information. After numerous resolutions by the Virginia Senate since 1999, the prospective Virginia medical consumer now has access to several annual publications: Virginia Hospitals: A Consumer's Guide, 1999 Annual Report and Strategic Plan Update, and the 1999 Industry Report: Virginia Hospitals and Nursing Facilities. Consumers have access to cardiac outcomes data stratified by hospital, gender, and cardiac service line (cardiac surgery, noninvasive cardiology, and invasive cardiology). This is particularly relevant to IHI because Virginia Health Information specifically targets cardiac care. IHI has a sizable investment in cardiovascular outcomes and has found outcomes measurement and research are key to providing quality care. IHI's goal is to move from an outcomes management model to a disease management model. The hope is to incorporate all aspects of the patient's continuum of care, from preoperative and diagnostic services through cardiac interventions to postoperative rehabilitation. Furthermore, every step along the way will be supported with functional status and quality of life assessments. Although these goals are ambitious and expensive, the return on investment is high. PMID:14618772

  16. Transgenic overexpression of caveolin-3 in the heart induces a cardiomyopathic phenotype.

    PubMed

    Aravamudan, Bharathi; Volonte, Daniela; Ramani, Ravi; Gursoy, Erdal; Lisanti, Michael P; London, Barry; Galbiati, Ferruccio

    2003-11-01

    Caveolins are structural protein components of caveolar membrane domains. Caveolin-3, a muscle-specific member of the caveolin family, is expressed in skeletal muscle tissue and in the heart. The multiple roles that caveolin-3 plays in cellular physiology are becoming more apparent. We have shown that lack of caveolin-3 expression in skeletal muscle resembles limb-girdle muscular dystrophy-1C. In contrast, we have demonstrated that overexpression of caveolin-3 in skeletal muscle tissue promotes defects similar to those seen in Duchenne muscular dystrophy (DMD). Thus, a tight regulation of caveolin-3 expression is fundamental for normal muscle functions. Since caveolin-3 is also endogenously expressed in cardiac myocytes, and cardiomyopathies are observed in DMD patients, we looked at the effects of overexpression of caveolin-3 on cardiac structure and function by characterizing caveolin-3 transgenic mice. Our results indicate that overexpression of caveolin-3 causes severe cardiac tissue degeneration, fibrosis and a reduction in cardiac functions. We also show that dystrophin and its associated glycoproteins are down-regulated in caveolin-3 transgenic heart. In addition, we demonstrate that the activity of nitric oxide synthase (NOS) is down-regulated by high levels of caveolin-3 in the heart. Taken together, these results indicate that overexpression of caveolin-3 is sufficient to induce severe cardiomyopathy. In addition, these findings suggest that caveolin-3 transgenic mice may represent a valid mouse model for studying the molecular mechanisms underlying cardiomyopathies associated with Duchenne muscular dystrophy. PMID:12966035

  17. Nanopatterned Human iPSC-based Model of a Dystrophin-Null Cardiomyopathic Phenotype

    PubMed Central

    Macadangdang, Jesse; Guan, Xuan; Smith, Alec S.T.; Lucero, Rachel; Czerniecki, Stefan; Childers, Martin K.; Mack, David L.; Kim, Deok-Ho

    2015-01-01

    Human induced pluripotent stem cell derived cardiomyocytes (hiPSC-CMs) offer unprecedented opportunities to study inherited heart conditions in vitro, but are phenotypically immature, limiting their ability to effectively model adult-onset diseases. Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy (DMD), but the pathogenesis of this disease phenotype is not fully understood. Therefore, we aimed to test whether biomimetic nanotopography could further stratify the disease phenotype of DMD hiPSC-CMs to create more translationally relevant cardiomyocytes for disease modeling applications. We found that anisotropic nanotopography was necessary to distinguish structural differences between normal and DMD hiPSC-CMs, as these differences were masked on conventional flat substrates. DMD hiPSC-CMs exhibited a diminished structural and functional response to the underlying nanotopography compared to normal cardiomyocytes at both the macroscopic and subcellular levels. This blunted response may be due to a lower level of actin cytoskeleton turnover as measured by fluorescence recovery after photobleaching. Taken together these data suggest that DMD hiPSC-CMs are less adaptable to changes in their extracellular environment, and highlight the utility of nanotopographic substrates for effectively stratifying normal and structural cardiac disease phenotypes in vitro. PMID:26366230

  18. Structure of the Val122Ile variant transthyretin - a cardiomyopathic mutant.

    PubMed

    Damas, A M; Ribeiro, S; Lamzin, V S; Palha, J A; Saraiva, M J

    1996-09-01

    The Val122Ile mutant transthyretin (TTR Ile122) is an amyloidogenic protein which has been described as the major protein component of amyloid fibrils isolated from patients with familial amyloidotic cardiomyopathy (FAC), a disease characterized by cardiac failure and amyloid deposits in the heart. The reasons for the deposition of TTR are still unknown and it is conceivable that a conformational alteration, resulting from the mutation, is fundamental for amyloid formation. The three-dimensional structure of TTR Ile122 was determined and refined to a crystallographic R factor of 15.8% at 1.9 A resolution. The r.m.s. deviation from ideality in bond distances is 0.019 A and in angle-bonded distances is 0.027 A. The presence of two crystallographically independent monomers in the asymmetric unit allowed additional means of estimation of atomic coordinate error. The structure of the mutant is essentially identical to that of the wild-type transthyretin (TTR). The largest deviations occur in surface loops and in the region of the substitution. The protein is a tetramer composed of identical subunits; each monomer has two four-stranded beta-sheets which are extended to eight-stranded beta-sheets when two monomers associate through hydrogen bonds forming a dimer, which is the crystallographic asymmetric unit. The replacement of valine for isoleucine introduces very small alterations in relation to the wild-type protein; nevertheless they seem to confirm a tendency for a less stable tetrameric structure. This would support the idea that the tetrameric structure might be disrupted in amyloid fibrils. PMID:15299606

  19. Structural and protein interaction effects of hypertrophic and dilated cardiomyopathic mutations in alpha-tropomyosin

    PubMed Central

    Chang, Audrey N.; Greenfield, Norma J.; Singh, Abhishek; Potter, James D.; Pinto, Jose R.

    2014-01-01

    The potential alterations to structure and associations with thin filament proteins caused by the dilated cardiomyopathy (DCM) associated tropomyosin (Tm) mutants E40K and E54K, and the hypertrophic cardiomyopathy (HCM) associated Tm mutants E62Q and L185R, were investigated. In order to ascertain what the cause of the known functional effects may be, structural and protein-protein interaction studies were conducted utilizing actomyosin ATPase activity measurements and spectroscopy. In actomyosin ATPase measurements, both HCM mutants and the DCM mutant E54K caused increases in Ca2+-induced maximal ATPase activities, while E40K caused a decrease. Investigation of Tm's ability to inhibit actomyosin ATPase in the absence of troponin showed that HCM-associated mutant Tms did not inhibit as well as wildtype, whereas the DCM associated mutant E40K inhibited better. E54K did not inhibit the actomyosin ATPase activity at any concentration of Tm tested. Thermal denaturation studies by circular dichroism and molecular modeling of the mutations in Tm showed that in general, the DCM mutants caused localized destabilization of the Tm dimers, while the HCM mutants resulted in increased stability. These findings demonstrate that the structural alterations in Tm observed here may affect the regulatory function of Tm on actin, thereby directly altering the ATPase rates of myosin. PMID:25520664

  20. Adjudicating outcomes: fundamentals.

    PubMed

    Vannabouathong, Christopher; Saccone, Michel; Sprague, Sheila; Schemitsch, Emil H; Bhandari, Mohit

    2012-07-18

    The adjudication of outcomes has rarely been reported in the orthopaedic literature, although this process is commonly used and reported in clinical trials of other medical disciplines. Adjudication of outcomes provides more reliable and valid outcome assessment, especially when the outcome is subjective as in the case of fracture-healing. The successful implementation of adjudication in a clinical trial is an important and complex process. The process requires a substantial infrastructure of research personnel to oversee data collection at the clinical sites. The development of an adjudication charter specific to the study is a critical aspect of adjudication as it outlines the adjudication committee membership as well as their roles and responsibilities and defines the adjudication process and the decision rules. Web-based adjudication has facilitated the process as it allows rapid, efficient, and timely adjudication. This article provides an overview of the adjudication process, along with details on the common pearls and pitfalls associated with this method of outcomes assessment. PMID:22810452

  1. Psychopathology as an outcome of development.

    PubMed

    Sroufe, L A

    1997-01-01

    When maladaptation is viewed as development rather than as disease, a transformed understanding results and a fundamentally different research agenda emerges. Within a developmental perspective, maladaptation is viewed as evolving through the successive adaptations of persons in their environments. It is not something a person "has" or an ineluctable expression of an endogenous pathogen. It is the complex result of a myriad of risk and protective factors operating over time. Key research questions within this framework center on discovery of factors that place individuals on pathways probabilistically leading to later disturbances and factors and processes which maintain individuals on, or deflect them from, such pathways once enjoined. There is an interest in recognizing patterns of maladaptation which, while not properly considered disorder themselves, commonly are precursors of disorder and also in conditions of risk that lie outside of the individual, as well as any endogenous influences. Likewise, there is a focus on factors and processes that lead individuals away from disorder that has emerged, which goes beyond interest in management of symptoms. Finally, many topics that currently are capturing attention in the field, such as "comorbidity" and "resilience," are seen in new ways from within the perspective of development. PMID:9201444

  2. Simulation: improving patient outcomes.

    PubMed

    Smith, Abi; Siassakos, Dimitrios; Crofts, Joanna; Draycott, Tim

    2013-06-01

    Effective training has been shown to improve perinatal care and outcome, decrease litigation claims and reduce midwifery sick leave. To be effective, training should be incentivised, in a realistic context, and delivered to inter-professional teams similar to those delivering actual care. Teamwork training is a useful addition, but it should be based on the characteristics of effective teamwork as derived from the study of frontline teams. Implementation of simulation and teamwork training is challenging, with constraints on staff time, facilities and finances. Local adoption and adaptation of effective programmes can help keep costs down, and make them locally relevant whilst maintaining effectiveness. Training programmes need to evolve continually in line with new evidence. To do this, it is vital to monitor outcomes and robustly evaluate programmes for their impact on patient care and outcome, not just on participants. PMID:23721770

  3. Longitudinal stability of temperamental exuberance and social-emotional outcomes in early childhood

    PubMed Central

    Degnan, Kathryn A.; Hane, Amie Ashley; Henderson, Heather A.; Moas, Olga Lydia; Reeb-Sutherland, Bethany C.; Fox, Nathan A.

    2014-01-01

    The goals of the current study were to investigate the stability of temperamental exuberance across infancy and toddlerhood and to examine the associations between exuberance and social-emotional outcomes in early childhood. The sample consisted of 291 4-month-olds followed at 9, 24, and 36 months, and again at 5 years of age. Behavioral measures of exuberance were collected at 9, 24, and 36 months. At 36 months, frontal EEG asymmetry was assessed. At 5 years, maternal reports of temperament and behavior problems were collected, as well as observational measures of social behavior during an interaction with an unfamiliar peer in the laboratory. Latent profile analysis revealed a high, stable exuberance profile, which was associated with greater 5-year externalizing behavior and surgency, as well as disruptive behavior and social competence with unfamiliar peers. These associations were particularly true for children who displayed left frontal EEG asymmetry. Multiple factors supported an approach bias for exuberant temperament, but did not differentiate between adaptive and maladaptive social-emotional outcomes at 5 years of age. PMID:21114347

  4. Treating maladaptive grief and posttraumatic stress symptoms in orphaned children in Tanzania: group-based trauma-focused cognitive-behavioral therapy.

    PubMed

    O'Donnell, Karen; Dorsey, Shannon; Gong, Wenfeng; Ostermann, Jan; Whetten, Rachel; Cohen, Judith A; Itemba, Dafrosa; Manongi, Rachel; Whetten, Kathryn

    2014-12-01

    This study was designed to test the feasibility and child clinical outcomes for group-based trauma-focused cognitive behavior therapy (TF-CBT) for orphaned children in Tanzania. There were 64 children with at least mild symptoms of grief and/or traumatic stress and their guardians who participated in this open trial. The TF-CBT for Child Traumatic Grief protocol was adapted for use with a group, resulting in 12 weekly sessions for children and guardians separately with conjoint activities and 3 individual visits with child and guardian. Using a task-sharing approach, the intervention was delivered by lay counselors with no prior mental health experience. Primary child outcomes assessed were symptoms of grief and posttraumatic stress (PTS); secondary outcomes included symptoms of depression and overall behavioral adjustment. All assessments were conducted pretreatment, posttreatment, and 3 and 12 months after the end of treatment. Results showed improved scores on all outcomes posttreatment, sustained at 3 and 12 months. Effect sizes (Cohen's d) for baseline to posttreatment were 1.36 for child reported grief symptoms, 1.87 for child-reported PTS, and 1.15 for guardian report of child PTS. PMID:25418514

  5. Didacticism and Educational Outcomes

    ERIC Educational Resources Information Center

    Johnes, Geraint

    2006-01-01

    This note provides an analysis of the determinants of educational outcomes at age 16, and of subsequent pathways as school pupils transit toward the labour market. There is some evidence that examination results tend to be better where nondidactic teaching methods are used, but there is little evidence to suggest that teaching method has an…

  6. Assessing Instructional Outcomes.

    ERIC Educational Resources Information Center

    Baker, Eva L.; O'Neil, Harold F.

    This paper presents a discussion of outcome assessment that puts into context how measurement has evolved to its present state. Several types of testing and assessment options are considered against a background of validity. Criterion-referenced measurement is discussed extensively in terms of history, field study, identity problems, intellectual…

  7. Experiences and Outcomes

    ERIC Educational Resources Information Center

    Marden, Nicole Y.; Ulman, Leslie G.; Wilson, Fiona S.; Velan, Gary M.

    2013-01-01

    Online formative assessments have become increasingly popular; however, formal evidence supporting their educational benefits is limited. This study investigated the impact of online feedback quizzes on the learning experiences and outcomes of undergraduate students enrolled in an introductory physiology course. Four quiz models were tested, which…

  8. Beyond Academic Outcomes

    ERIC Educational Resources Information Center

    Ladwig, James G.

    2010-01-01

    This chapter attempts to survey contemporary debates and research on outcomes of schooling that have been grouped together under the convenient label "nonacademic". This is not an affirmative labeling. As the nomenclature indicates, it is not a label that groups together things that share like properties. Rather, this is a label of distinction, a…

  9. Student Outcomes Report.

    ERIC Educational Resources Information Center

    Clagett, Craig A.

    Prince George's Community College (PGCC) created a Student Outcomes Report in December 1996 that measures course completion, retention, student achievement, program completion, transfer, and certification. Findings indicated that though the course pass rate was 75%, individual course completion ranged from 44% to 100%. Divisional pass rates ranged…

  10. HRD and Performance Outcomes.

    ERIC Educational Resources Information Center

    1997

    This document contains three papers from a symposium on human resource development (HRD) and performance outcomes. "Going to the Next Level of Growth: Employing Systems Thinking to Make Effective Interventions" (Carol Ann Zulauf, Joseph A. Ilacqua) shows how a systems view enables organizations to find the most effective point for interventions…

  11. HRD & Business Outcomes.

    ERIC Educational Resources Information Center

    1996

    These four papers were presented at a symposium on human resource development (HRD) and business outcomes moderated by Barbara L. Swanson at the 1996 conference of the Academy of Human Resource Development. "Incorporating Continuous Learning into a Cultural Change Process" (Carol Ann Zulauf, Joseph A. Ilacqua), focuses on best practices at…

  12. Outcomes-Based Outrage.

    ERIC Educational Resources Information Center

    Zlatos, Bill

    1993-01-01

    If outcomes-based education is the darling of education reformers, it is the devil to conservative parents, taxpayer groups, and legislators who oppose it. Despite some initial successes in several states, critics charge that the states pushing OBE have no evidence that it works. Costs are another factor. So far, the ultraconservatives are…

  13. Mentoring Phases and Outcomes.

    ERIC Educational Resources Information Center

    Chao, Georgia T.

    1997-01-01

    Data from 178 proteges supported Kram's model of mentoring phases: initiation, cultivation, separation, and redefinition. Data from 82 current and 69 former proteges were compared to those from 93 who were never mentored. Mentees had better career outcomes, organizational socialization, and job satisfaction; those not mentored had slightly higher…

  14. Teleophthalmology: improving patient outcomes?

    PubMed Central

    Sreelatha, Omana Kesary; Ramesh, Sathyamangalam VenkataSubbu

    2016-01-01

    Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP). Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR), glaucoma, age-related macular degeneration (ARMD), and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time. Considering the improved quality of patient care and patient satisfaction reported for these telemedicine services, this review explores how teleophthalmology helps to improve patient outcomes. PMID:26929592

  15. Teleophthalmology: improving patient outcomes?

    PubMed

    Sreelatha, Omana Kesary; Ramesh, Sathyamangalam VenkataSubbu

    2016-01-01

    Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP). Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR), glaucoma, age-related macular degeneration (ARMD), and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients' assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time. Considering the improved quality of patient care and patient satisfaction reported for these telemedicine services, this review explores how teleophthalmology helps to improve patient outcomes. PMID:26929592

  16. Asthma Outcomes: Exacerbations

    PubMed Central

    Fuhlbrigge, Anne; Peden, David; Apter, Andrea J.; Boushey, Homer A.; Camargo, Carlos; Gern, James; Heymann, Peter W.; Martinez, Fernando D.; Mauger, David; Teague, William G.; Blaisdell, Carol

    2013-01-01

    Background The goals of asthma treatment include preventing recurrent exacerbations. Yet there is no consensus about the terminology for describing or defining “exacerbation,” or about how to characterize an episode’s severity. Objective National Institutes of Health (NIH) institutes and other federal agencies convened an expert group to propose how asthma exacerbation should be assessed as a standardized asthma outcome in future asthma clinical research studies. Methods We utilized comprehensive literature reviews and expert opinion to compile a list of asthma exacerbation outcomes, and classified them as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results No dominant definition of “exacerbation” was found. The most widely used definitions included 3 components, all related to treatment, rather than symptoms: (1) systemic use of corticosteroids, (2) asthma-specific emergency department visits or hospitalization, and (3) use of short-acting β-agonists (SABAs) as quick-relief (sometimes referred to as “rescue” or “reliever”) medications. Conclusions The working group participants propose that the definition of “asthma exacerbation” be “a worsening of asthma requiring the use of systemic corticosteroids to prevent a serious outcome.” As core outcomes, they propose inclusion and separate reporting of several essential variables of an exacerbation. Further, they propose the development of a standardized, component-based definition of “exacerbation” with clear thresholds of severity for each component. PMID:22386508

  17. [Transplantation and outcome quality].

    PubMed

    Bechstein, W O; Wullstein, C

    2002-06-01

    Organ transplants are procedures which require intensive personal and material resources. The results of organ transplants have continuously improved during recent decades. International data bases (registries) have documented the continuous evolution of organ transplantation. On the basis of the German Transplant Law guidelines for "Requirements regarding quality control for procedures related to organ procurement and transplantation" have been formulated by the German Medical Chamber. Thus, monitoring of outcome quality will become a requirement for all German transplant centers. In this paper, the guidelines for the different organ transplants (kidney, pancreas, liver, heart, lung) are discussed as well as quality control for living donor transplantation. Studies from the USA and Europe demonstrated volume-outcome relationships in organ transplantation. In addition, in kidney transplantation a centre-effect could be demonstrated which influences outcome more than the immunological match between donor and recipient. The introduction of required quality control may have far reaching consequences for the future structure of organ transplantation in Germany. PMID:12149941

  18. Burns: Treatment and Outcomes

    PubMed Central

    Burd, Andrew

    2010-01-01

    Burns can cause extensive and devastating injuries of the head and neck. Prevention of the initial injury must always be a priority, but once an injury has occurred, then prevention of progression of the damage together with survival of the patient must be the immediate goals. The acute care will have a major influence on the subsequent scarring, reconstructive need, and long-term outcome. In the majority of cases, the reconstruction will involve restoration of form and function to the soft tissues, and the methods used will depend very much on the extent of scarring locally and elsewhere in the body. In nearly all cases, a significant improvement in functional and aesthetic outcomes can be achieved, which, in conjunction with intensive psychosocial rehabilitation, can lead to high-quality patient outcomes. With the prospect of facial transplantation being a clinical reality, the reconstructive spectrum has opened up even further, and, with appropriate reconstruction and support, no patient should be left economically deprived or socially isolated after a burn injury. PMID:22550448

  19. Outcome Based Budgeting: Connecting Budget Development, Allocation and Outcomes.

    ERIC Educational Resources Information Center

    Anderes, Thomas

    This plan for outcome-based budgeting (OBB) is the result of growing demands for increased fiscal accountability, measurable outcomes, strengthened assessment processes, and more meaningful performance indicators as mandated by many State and Federal legislators. OBB focuses on linking funding with outputs and outcomes. Higher education…

  20. Objectives and Outcomes

    SciTech Connect

    Segalman, D.J.

    1998-11-30

    I have recently become involved in the ABET certification process under the new system - ABET 2000. This system relies heavily on concepts of Total Quality Management (TQM). It encourages each institution to define its objectives in terms of its own mission and then create a coherent program based on it. The prescribed steps in setting up the new system at an engineering institution are: o identification of constituencies G definition of mission. It is expected that the department's mission will be consistent with that of the overall institution, but containing some higher resolution language appropriate to that particular discipline of the engineering profession. o statement of objectives consistent with the mission 3G~~\\vED " enumeration of desired, and preferably measurable, outcomes of the process that would ~ `=. verify satisfaction of the objectives. ~~~ 07 !398 o establish performance standards for each outcome. o creation of appropriate feedback loops to assure that the objectives are still consistent with Q$YT1 the mission, that the outcomes remain consistent with the objectives, and that the curriculum and the teaching result in those outcomes. It is my assertion that once the institution verbalizes a mission, enumerated objectives naturally flow from that mission. (We shall try to demonstrate by example.) Further, if the mission uses the word "engineer", one would expect that word also to appear in at least one of the objectives. The objective of producing engineers of any sort must -by decree - involve the presence of the ABET criteria in the outcomes list. In other words, successful satisfaction of the ABET items a-k are a necessary subset of the measure of success in producing engineers. o We shall produce bachelor level engineers whose training in the core topics of chemical (or electrical, or mechanical) engineering is recognized to be among the best in the nation. o We shall provide an opportunity for our students to gain a

  1. Outcomes management in women's health.

    PubMed

    Houston, S; Fleschler, R

    1997-01-01

    Outcomes management uses a quality and research approach to reducing costs in health care. Populations may be targeted for high volumes or their potential for cost savings. Outcomes are identified and measured through data collection and analysis. System and care processes that drive these outcomes are analyzed. Tenets related to outcomes management include questioning practice, administrative and physician involvement; recognizing that change is necessary; accepting uncontrollable factors; and valuing the outcomes management process. Resources necessary for managing outcomes include the use of collaborative practice teams, outcomes assessment, information systems, and educational support services. The women's health population can benefit from an outcomes management effort by improving and standardizing care for mothers and infants across the continuum. There is the opportunity to affect the wellness of this population even before the pregnancy occurs. PMID:9170599

  2. Outcome learning, outcome expectations, and intentionality in Drosophila.

    PubMed

    Heisenberg, Martin

    2015-06-01

    An animal generates behavioral actions because of the effects of these actions in the future. Occasionally, the animal may generate an action in response to a certain event or situation. If the outcome of the action is adaptive, the animal may keep this stimulus-response link in its behavioral repertoire, in case the event or situation occurs again. If a responsive action is innate but the outcome happens to be less adaptive than it had been before, the link may be loosened. This adjustment of outcome expectations involves a particular kind of learning, which will be called "outcome learning." The present article discusses several examples of outcome learning in Drosophila. Learning and memory are intensely studied in flies, but the focus is on classical conditioning. Outcome learning, a particular form of operant learning, is of special significance, because it modulates outcome expectations that are operational components of action selection and intentionality. PMID:25979991

  3. Outcome learning, outcome expectations, and intentionality in Drosophila

    PubMed Central

    2015-01-01

    An animal generates behavioral actions because of the effects of these actions in the future. Occasionally, the animal may generate an action in response to a certain event or situation. If the outcome of the action is adaptive, the animal may keep this stimulus–response link in its behavioral repertoire, in case the event or situation occurs again. If a responsive action is innate but the outcome happens to be less adaptive than it had been before, the link may be loosened. This adjustment of outcome expectations involves a particular kind of learning, which will be called “outcome learning.” The present article discusses several examples of outcome learning in Drosophila. Learning and memory are intensely studied in flies, but the focus is on classical conditioning. Outcome learning, a particular form of operant learning, is of special significance, because it modulates outcome expectations that are operational components of action selection and intentionality. PMID:25979991

  4. Asthma outcomes: Biomarkers

    PubMed Central

    Szefler, Stanley J.; Wenzel, Sally; Brown, Robert; Erzurum, Serpil C.; Fahy, John V.; Hamilton, Robert G.; Hunt, John F.; Kita, Hirohito; Liu, Andrew H.; Panettieri, Reynold A.; Schleimer, Robert P.; Minnicozzi, Michael

    2012-01-01

    Background Measurement of biomarkers has been incorporated within clinical research studies of asthma to characterize the population and associate the disease with environmental and therapeutic effects. Objective National Institutes of Health institutes and federal agencies convened an expert group to propose which biomarkers should be assessed as standardized asthma outcomes in future clinical research studies. Methods We conducted a comprehensive search of the literature to identify studies that developed and/or tested asthma biomarkers. We identified biomarkers relevant to the underlying disease process progression and response to treatment. We classified the biomarkers as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an National Institutes of Health–organized workshop convened in March 2010 and finalized in September 2011. Results Ten measures were identified; only 1, multiallergen screening to define atopy, is recommended as a core asthma outcome. Complete blood counts to measure total eosinophils, fractional exhaled nitric oxide (Feno), sputum eosinophils, urinary leukotrienes, and total and allergen-specific IgE are recommended as supplemental measures. Measurement of sputum polymorphonuclear leukocytes and other analytes, cortisol measures, airway imaging, breath markers, and system-wide studies (eg, genomics, proteomics) are considered as emerging outcome measures. Conclusion The working group participants propose the use of multiallergen screening in all asthma clinical trials to characterize study populations with respect to atopic status. Blood, sputum, and urine specimens should be stored in biobanks, and standard procedures should be developed to harmonize sample collection for clinical trial biorepositories. PMID:22386512

  5. Neuropsychiatric outcomes of stroke.

    PubMed

    Hackett, Maree L; Köhler, Sebastian; O'Brien, John T; Mead, Gillian E

    2014-05-01

    The most common neuropsychiatric outcomes of stroke are depression, anxiety, fatigue, and apathy, which each occur in at least 30% of patients and have substantial overlap of prevalence and symptoms. Emotional lability, personality changes, psychosis, and mania are less common but equally distressing symptoms that are also challenging to manage. The cause of these syndromes is not known, and there is no clear relation to location of brain lesion. There are important gaps in knowledge about how to manage these disorders, even for depression, which is the most studied syndrome. Further research is needed to identify causes and interventions to prevent and treat these disorders. PMID:24685278

  6. Asthma outcome measures.

    PubMed

    Watkins, K D

    1999-08-01

    Annually, asthma accounts for 10.4 million physician visits, 468,000 hospitalizations, 1.8 million emergency room visits, and 10 million missed school days. According to the Centers for Disease Control and Prevention, the number of asthma deaths has increased progressively since 1978 form 1,800 to 5,400 per year. It is an expensive disease, accounting for about 1% of all health expenditure in the United States in 1990. Asthma has a significant impact on the patient and the community at large and the assessment of the clinical, physiologic, humanistic and economic outcomes will be measured. PMID:10563275

  7. Application of Matrix Outcome Mapping to Constructively Align Program Outcomes and Course Outcomes in Higher Education

    ERIC Educational Resources Information Center

    Mazouz, Abdelkader; Crane, Keenan

    2013-01-01

    Establishing a link between Course Learning Outcomes (LOs) and Program Outcomes (POs) while assessing the course contents and delivery are among the most challenging issues in Higher Education. In the present study two forms were generated based on specific Course Learning Outcomes identified in the syllabus at the beginning of the teaching term:…

  8. On the Outcome Project

    PubMed Central

    Manthous, Constantine A.

    2014-01-01

    Background: In 2001, graduate medical education in the United States was renovated to better complement 21st century developments in American medicine, society, and culture. As in 1910, when Abraham Flexner was charged to address a relatively non-standardized system that lacked accountability and threatened credibility of the profession, Dr. David Leach led the Accreditation Council of Graduate Medical Education (ACGME) Outcome Project in a process that has substantially changed medical pedagogy in the United States. Methods: Brief review of the Flexner Report of 1910 and 6 hours of interviews with leaders of the Outcome Project (4 hours with Dr. David Leach and 1-hour interviews with Drs. Paul Batalden and Susan Swing). Results: Medical educational leaders and the ACGME concluded in the late 1990s that medical education was not preparing clinicians sufficiently for lifelong learning in the 21st century. A confluence of medical, social, and historic factors required definitions and a common vocabulary for teaching and evaluating medical competency. After a deliberate consensus-driven process, the ACGME and its leaders produced a system requiring greater accountability of learners and teachers, in six explicitly defined domains of medical “competence.” While imperfect, this construct has started to take hold, creating a common vocabulary for longitudinal learning, from undergraduate to post-graduate (residency) education and in the assessment of performance following graduate training. PMID:24910567

  9. Spirituality factors in the prediction of outcomes of PTSD treatment for U.S. military veterans.

    PubMed

    Currier, Joseph M; Holland, Jason M; Drescher, Kent D

    2015-02-01

    Spirituality is a multifaceted construct that might affect veterans' recovery from posttraumatic stress disorder (PTSD) in adaptive and maladaptive ways. Using a cross-lagged panel design, this study examined longitudinal associations between spirituality and PTSD symptom severity among 532 U.S. veterans in a residential treatment program for combat-related PTSD. Results indicated that spirituality factors at the start of treatment were uniquely predictive of PTSD symptom severity at discharge, when accounting for combat exposure and both synchronous and autoregressive associations between the study variables, βs = .10 to .16. Specifically, veterans who scored higher on adaptive dimensions of spirituality (daily spiritual experiences, forgiveness, spiritual practices, positive religious coping, and organizational religiousness) at intake fared significantly better in this program. In addition, possible spiritual struggles (operationalized as negative religious coping) at baseline were predictive of poorer PTSD outcomes, β = .11. In contrast to these results, PTSD symptomatology at baseline did not predict any of the spirituality variables at posttreatment. In keeping with a spiritually integrative approach to treating combat-related PTSD, these results suggest that understanding the possible spiritual context of veterans' trauma-related concerns might add prognostic value and equip clinicians to alleviate PTSD symptomatology among those veterans who possess spiritual resources or are somehow struggling in this domain. PMID:25624135

  10. Methamphetamines and Pregnancy Outcomes

    PubMed Central

    Wright, Tricia E.; Schuetter, Renee; Tellei, Jacqueline; Sauvage, Lynnae

    2014-01-01

    Introduction Methamphetamine (MA) is one of the most commonly used illicit drugs in pregnancy, yet studies on MA-exposed pregnancy outcomes have been limited because of retrospective measures of drug use, lack of control for confounding factors: other drug use, including tobacco; poverty; poor diet; and lack of prenatal care. This study presents prospective collected data on MA use and birth outcomes, controlling for most confounders. Materials and Methods This is a retrospective cohort study of women obtaining prenatal care from a clinic treating women with substance use disorders, on whom there are prospectively obtained data on MA and other drug use, including tobacco. MA-exposed pregnancies were compared with non-MA exposed pregnancies as well as non-drug exposed pregnancies, using univariate and multivariate analysis to control for confounders. Results One hundred forty-four infants were exposed to MA during pregnancy, 50 had first trimester exposure only, 45 had continuous use until the second trimester, 29 had continuous use until the third trimester, but were negative at delivery and 20 had positive toxicology at delivery. There were 107 non MA-exposed infants and 59 infants with no drug exposure. Mean birth weights were the same for MA-exposed and non-exposed infants (3159 g vs. 3168 g p=0.9), though smaller than those without any drug exposure (3159 vs. 3321 p=0.04), Infants with positive toxicology at birth (meconium or urine) were smaller than infants with first trimester exposure only (2932 g vs. 3300 g p=0.01). Gestation was significantly shorter among the MA-exposed infants compared to non-exposed infants (38.5 vs. 39.1 weeks p=0.045) and those with no drug exposure (38.5 vs. 39.5 p=0.0011), The infants with positive toxicology at birth had a clinically relevant shortening of gestation (37.3 weeks vs. 39.1 p=0.0002). Conclusions MA use during pregnancy is associated with shorter gestational ages and lower birth weight, especially if used continuously

  11. Value, a nursing outcome.

    PubMed

    Pappas, Sharon H

    2013-01-01

    This era of health care reform calls for the ability of hospitals to provide quality patient care while managing costs. Nursing practice is a key determinant of patient care quality and associated costs, or simply put, creating value. The value of nursing has been addressed by multiple qualified authors, yet there is no clear, consistent meaning of the term. Researchers and authors have developed some theoretical foundation for the concept of value, which evolved into important research questions that establish value as an important outcome that is sensitive to nursing practice. The opportunity to attend 2 sessions at the Harvard Business School on health care value has prompted the need for nursing to adapt to common thinking on health care value and establish its meaning for the nursing profession. This report summarizes the nursing literature on value, reflects on the executive education, and proposes direction for nursing leaders in education and practice. PMID:23454991

  12. Asthma Outcomes: Asthma Symptoms

    PubMed Central

    Krishnan, Jerry A.; Lemanske, Robert F.; Canino, Glorisa J.; Elward, Kurtis S.; Kattan, Meyer; Matsui, Elizabeth C.; Mitchell, Herman; Sutherland, E. Rand; Minnicozzi, Michael

    2014-01-01

    Background Respiratory symptoms are commonly used to assess the impact of patient-centered interventions. Objective At the request of National Institutes of Health (NIH) institutes and other federal agencies, an expert group was convened to propose which measurements of asthma symptoms should be used as a standardized measure in future clinical research studies. Methods Asthma symptom instruments were classified as daily diaries (prospectively recording symptoms between research visits) or retrospective questionnaires (completed at research visits). We conducted a systematic search in PubMed and a search for articles that cited key studies describing development of instruments. We classified outcome instruments as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results Four instruments (3 daily diaries, 1 for adults and 2 for children; and 1 retrospective questionnaire for adults) were identified. Minimal clinically important differences have not been established for these instruments, and validation studies were only conducted in a limited number of patient populations. Validity of existing instruments may not be generalizable across racial-ethnic or other subgroups. Conclusions An evaluation of symptoms should be a core asthma outcome measure in clinical research. However, available instruments have limitations that preclude selection of a core instrument. The working group participants propose validation studies in diverse populations, comparisons of diaries versus retrospective questionnaires, and evaluations of symptom assessment alone versus composite scores of asthma control. PMID:22386505

  13. Impulsive choice and pre-exposure to delays: III. Four-month test-retest outcomes in male wistar rats.

    PubMed

    Renda, C Renee; Madden, Gregory J

    2016-05-01

    Delay discounting describes the tendency for organisms to devalue outcomes because they are delayed. Robust, positive correlations exist between excessive delay discounting and many maladaptive behaviors (e.g., substance abuse, obesity). Several studies have demonstrated that delay discounting can be reduced and this may hold promise for improving treatment outcomes. One method of reducing delay discounting provides rats with extended training with delayed reinforcement (i.e., delay-exposure training) and this significantly reduces impulsive choices, relative to rats trained with an equal number of immediate-reinforcement sessions (i.e., immediate-exposure training). To evaluate the stability of this effect, 12 weanling male Wistar rats were randomly assigned to receive either delay-exposure or immediate-exposure training for 120 sessions. Impulsive choice was assessed using an increasing-delay procedure immediately following training and 120 days after completion of the initial assessment. Delay-exposed rats discounted delayed food rewards significantly less than immediate-exposed rats in the initial assessment and the reassessment conducted 120 days later. These results are encouraging as they suggest that the effects of delay-exposure training are robust to the passage of time and intervening experience. PMID:27016155

  14. Beyond Hard Outcomes: "Soft" Outcomes and Engagement as Student Success

    ERIC Educational Resources Information Center

    Zepke, Nick; Leach, Linda

    2010-01-01

    This paper questions current policy discourses that equate student success with hard outcomes like retention, completion and employment. It offers another view, one that uses "soft" outcomes and student engagement literature to widen our understanding of student success. In the paper, we first draw on literature to explore student engagement,…

  15. Learning Outcomes: Skills or Function?

    ERIC Educational Resources Information Center

    Ciancone, Tom; Tout, Dave

    Participants in a teacher workshop compared these two approaches to learning outcomes in adult numeracy: (1) teaching mathematical skills and (2) using and applying mathematics from real life. The first approach was illustrated by an Ontario, Canada, program based on traditional school math, whose outcomes are skill-based and are the following:…

  16. Outcome Evaluation in Supervision Research.

    ERIC Educational Resources Information Center

    Holloway, Elizabeth L.

    1984-01-01

    Presents a framework of different sources of outcome data in supervision, and classifies research according to this framework. Challenges assumptions of previous research in supervision. Emphasizes influences of trainee and client in supervision and counseling contexts, respectively. Supports broader definition and expanded view of outcome in…

  17. Developmental Outcome of Childhood Leukemia.

    ERIC Educational Resources Information Center

    Coniglio, Susan J.; Blackman, James A.

    1995-01-01

    Literature on developmental and psychosocial outcomes of childhood leukemia is reviewed, focusing on preschool-age children. Studies are categorized in terms of outcome measures: intelligence/achievement, neuropsychological, memory/attention, and psychosocial tests. Evidence suggests that preschool children with leukemia are at high risk for…

  18. Measuring Outcomes in Children's Services.

    ERIC Educational Resources Information Center

    Christner, Anne Marshall, Ed.

    Outcomes evaluation can provide program managers and clinical directors in child welfare, juvenile justice, child mental health, and child protective services the necessary tools for program quality assurance and accountability. This guide describes the outcomes evaluation process and provides a summary of articles and reports detailing current…

  19. Improbable Outcomes: Infrequent or Extraordinary?

    ERIC Educational Resources Information Center

    Teigen, Karl Halvor; Juanchich, Marie; Riege, Anine H.

    2013-01-01

    Research on verbal probabilities has shown that "unlikely" or "improbable" events are believed to correspond to numerical probability values between 10% and 30%. However, building on a pragmatic approach of verbal probabilities and a new methodology, the present paper shows that unlikely outcomes are most often associated with outcomes that have a…

  20. IFSP Outcome Statements Made Simple

    ERIC Educational Resources Information Center

    Shelden, M'Lisa L.; Rush, Dathan D.

    2014-01-01

    A critical component for implementing evidence-based early intervention supports and services is the ability to write family-centered, functional, participation-based outcomes. Participation-based outcome statements that are family-focused center on the desires and needs of the parents or other care providers and are based on their interest in…

  1. What Are Good Child Outcomes?

    ERIC Educational Resources Information Center

    Moore, Kristin Anderson; Evans, V. Jeffery; Brooks-Gunn, Jeanne; Roth, Jodie

    This paper considers the question "What are good child outcomes?" from the perspectives of developmental psychology, economics, and sociology. Section 1 of the paper examines good child outcomes as characteristics of stage-salient tasks of development. Section 2 emphasizes the acquisition of "human capital," the development of productive traits…

  2. Genetics of Bariatric Surgery Outcomes.

    PubMed

    Noel, Olivier F; Still, Christopher D; Gerhard, Glenn S

    2016-09-01

    Outcomes after bariatric surgery can vary widely and seem to have a significant genetic component. Only a small number of candidate gene and genome-wide association studies have analyzed bariatric surgery outcomes. The role of bile acids in mediating the beneficial effects of bariatric surgery implicate genes regulated by the farnesoid X receptor transcription factor. PMID:27519134

  3. Outcome Research in Classical Psychodrama.

    ERIC Educational Resources Information Center

    Kellermann, Peter Felix

    1987-01-01

    Examines various aspects of psychodrama outcome research and summarizes in tabular form 23 outcome studies published between 1952 and 1985, interpreting them as a whole. Concludes that psychodrama constitutes a valid alternative to other therapeutic approaches, especially in promoting behavior change in adjustment, antisocial, and related…

  4. Learning Outcomes: A Conceptual Analysis

    ERIC Educational Resources Information Center

    Hussey, Trevor; Smith, Patrick

    2008-01-01

    Learning outcomes have become widely used in higher education, but also misused to the point of being controversial and a bureaucratic burden. This paper distinguishes three kinds of learning outcome found in current literature: (1) those used in individual teaching events; (2) those specified for modules or short courses; and (3) those specified…

  5. MEDICARE HEALTH OUTCOMES SURVEY (HOS)

    EPA Science Inventory

    The Medicare Health Outcomes Survey (HOS) is the first Medicare managed care outcomes measure. CMS, in collaboration with NCQA, launched the Medicare HOS in the 1998 Health Plan Employer Data and Information Set (HEDIS?). The measure includes the most recent advances in summarizi...

  6. [Knowledge production about nursing outcomes].

    PubMed

    Seganfredo, Deborah Hein; Almeida, Miriam de Abreu

    2010-01-01

    This literature review aimed at identifying and analysing the knowledge production regarding nursing outcomes in a worldwide context. A systematized review was carried out using LILACS and MEDLINE databases. The following key words were used: outcomes, nursing and classification. No national production was identified. The main issues raised were: the use of the standardized outcomes classifications to measure changes in the patient's health condition; the use of the Nursing Outcomes Classifications (NOC) as the chosen terminology for nursing practice; the need to rank effectivity of nursing interventions by identifying the nursing-sensitive patient outcomes, as well as to make the nursing practice a profitable one to the institutions. It is important to develop and Brazilian studies addressing the issue. PMID:20339766

  7. Pediatric hydrocephalus outcomes: a review

    PubMed Central

    2012-01-01

    The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets of outcome, including surgical outcome (shunt failure, infection and independence, and complications of endoscopy), clinical outcome (neurological, sensory, cognitive sequels, epilepsy), schooling and social integration. We then provide a brief review of the English-language literature and highlighting selected studies that provide information on the outcome and sequelae of pediatric hydrocephalus, and the impact of predictive variables on outcome. Mortality caused by hydrocephalus and its treatments is between 0 and 3%, depending on the duration of follow-up. Shunt event-free survival (EFS) is about 70% at one year and 40% at ten years. The EFS after endoscopic third ventriculostomy (ETV) appears better but likely benefits from selection bias and long-term figures are not available. Shunt infection affects between 5 and 8% of surgeries, and 15 to 30% of patients according to the duration of follow-up. Shunt independence can be achieved in 3 to 9% of patients, but the definition of this varies. Broad variations in the prevalence of cognitive sequelae, affecting 12 to 50% of children, and difficulties at school, affecting between 20 and 60%, attest of disparities among studies in their clinical evaluation. Epilepsy, affecting 6 to 30% of patients, has a serious impact on outcome. In adulthood, social integration is poor in a substantial number of patients but data are sparse. Few controlled prospective studies exist regarding hydrocephalus outcomes; in their absence, largely retrospective studies must be used to evaluate the long-term consequences of hydrocephalus and its treatments. This review aims to help to establish

  8. Using Chronic Pain Outcomes Data to Improve Outcomes.

    PubMed

    Mehta, Neel; Inturrisi, Charles E; Horn, Susan D; Witkin, Lisa R

    2016-06-01

    Standardization of care that is derived from analysis of outcomes data can lead to improvements in quality and efficiency of care. The outcomes data should be validated, standardized, and integrated into ongoing patient care with minimal burden on the patient and health care team. This article describes the organization and workflow of a chronic pain clinic registry designed to collect and analyze patient data for quality improvement and dissemination. Future efforts in using mobile technology and integrating patient-reported outcome data in the electronic health records have the potential to offer new and improved models of comprehensive pain management. PMID:27208717

  9. Outcomes assessment in the NCCN.

    PubMed

    Weeks, J C

    1997-11-01

    Outcomes assessment has two primary goals: the evaluation of treatments and the evaluation of quality of care. Data on the outcomes associated with specific interventions may provide an empiric basis for guidelines in areas for which no randomized trial data are available. Also, monitoring of patterns of care and outcomes is an essential component of institutional efforts to implement guidelines and to benchmark themselves against regional and national norms. The National Comprehensive Cancer Network (NCCN) has adopted a three-phase approach to its outcomes assessment program. Phase 1, already completed, involved taking a systematic inventory of members' existing institutional data sources. Phase 2, which is currently in progress, entails pooling data from existing outcomes data bases. In particular, tumor registry data from the National Cancer Data Base are being used to examine patterns of care and outcomes in NCCN institutions and to benchmark them against national norms. Phase 3, begun within the past year, involves the creation of a uniform outcomes assessment system for the NCCN. PMID:9430183

  10. Outcomes research in respiratory care.

    PubMed

    Chatburn, R L

    2001-11-01

    Outcomes research seeks to understand the end results of particular health care interventions. End results include effects that people experience and care about, such as change in ability to function. The modern outcomes movement in the United States had its beginnings in the early 1980s, with an official start when Congress created the Agency for Health Care Policy and Research in 1989. Today known as the Agency for Healthcare Research and Quality, this agency supports outcomes research that is designed to answer 4 questions: (1) What works? (2) What doesn't? (3) When in the course of illness does it work or not? and (4) At what cost? Outcomes research provides the data for evidence-based medicine. Both activities work together in a continuous quality improvement cycle under the general heading of disease management. Outcomes research includes such things as epidemiology studies, clinical trials (designed as effectiveness studies), quality of life surveys, and cost analyses. Outcomes research is distinguished from traditional clinical research more by its focus than its methods. For example, outcomes research is population-centered rather than disease-centered, deals more with processes of care than drugs and devices, and relies less on the "hard sciences" such as physics and biochemistry and more on the social sciences such as economics, behavioral sciences, and epidemiology. Appropriate outcomes measures may be classified as (A) clinical, such as physiologic measures and mortality; (B) economic, such as direct and indirect costs of care; or (C) humanistic, such as quality of life and patient satisfaction with care. Respiratory therapists need to be familiar with outcomes research issues in order to be educated consumers of (and to participate in) future studies. PMID:11679143

  11. Do we evaluate outcome appropriately?

    PubMed

    Beristain, X; Gaviria, M; Dujovny, M; Stark, J L; Ausman, J I

    1996-06-01

    We discuss two different ways of measuring outcome in a sample of 20 patients who had intracranial aneurysm surgery. Patients were evaluated at discharge using the Karnofsky Scale and the Glasgow Outcome Scale. Six months after discharge we conducted a neuropsychiatric evaluation including cognitive, behavioral, and mood status assessment. Although 13 of our patients had a "good recovery', 18 had some neuropsychiatric impairment. We did not find statistical relationships between the discharge evaluation and the neuropsychiatric assessment at follow-up. We discuss the need for developing new outcome measures to pick-up neuropsychiatric deficits, beyond the traditional neurologic semiology. PMID:8837062

  12. Social determinants and osteoarthritis outcomes

    PubMed Central

    Luong, My-Linh N; Cleveland, Rebecca J; Nyrop, Kirsten A; Callahan, Leigh F

    2012-01-01

    Osteoarthritis (OA) is one of the most frequently occurring musculoskeletal diseases, posing a significant public health problem due to its impact on pain and disability. Traditional risk factors fail to account for all of the risk observed for OA outcomes. In recent years, our view of disease causation has broadened to include health risks that are created by an individual’s socioeconomic circumstances. Early research into social determinants has focused on social position and explored factors related to the individual such as education, income and occupation. Results from these investigations suggest that low education attainment and nonprofessional occupation are associated with poorer arthritis outcomes. More recently, research has expanded to examine how one’s neighborhood socioeconomic environment may be relevant to OA outcomes. This narrative review proposes a framework to help guide our understanding of how social context may interact with pathophysiological processes and individual-level variables to influence health outcomes in those living with OA. PMID:23243459

  13. Reverse Engineering Adverse Outcome Pathways

    SciTech Connect

    Perkins, Edward; Chipman, J.K.; Edwards, Stephen; Habib, Tanwir; Falciani, Francesco; Taylor, Ronald C.; Van Aggelen, Graham; Vulpe, Chris; Antczak, Philipp; Loguinov, Alexandre

    2011-01-30

    The toxicological effects of many stressors are mediated through unknown, or poorly characterized, mechanisms of action. We describe the application of reverse engineering complex interaction networks from high dimensional omics data (gene, protein, metabolic, signaling) to characterize adverse outcome pathways (AOPs) for chemicals that disrupt the hypothalamus-pituitary-gonadal endocrine axis in fathead minnows. Gene expression changes in fathead minnow ovaries in response to 7 different chemicals, over different times, doses, and in vivo versus in vitro conditions were captured in a large data set of 868 arrays. We examined potential AOPs of the antiandrogen flutamide using two mutual information theory methods, ARACNE and CLR to infer gene regulatory networks and potential adverse outcome pathways. Representative networks from these studies were used to predict a network path from stressor to adverse outcome as a candidate AOP. The relationship of individual chemicals to an adverse outcome can be determined by following perturbations through the network in response to chemical treatment leading to the nodes associated with the adverse outcome. Identification of candidate pathways allows for formation of testable hypotheses about key biologic processes, biomarkers or alternative endpoints, which could be used to monitor an adverse outcome pathway. Finally, we identify the unique challenges facing the application of this approach in ecotoxicology, and attempt to provide a road map for the utilization of these tools. Key Words: mechanism of action, toxicology, microarray, network inference

  14. More than resisting temptation: Beneficial habits mediate the relationship between self-control and positive life outcomes.

    PubMed

    Galla, Brian M; Duckworth, Angela L

    2015-09-01

    Why does self-control predict such a wide array of positive life outcomes? Conventional wisdom holds that self-control is used to effortfully inhibit maladaptive impulses, yet this view conflicts with emerging evidence that self-control is associated with less inhibition in daily life. We propose that one of the reasons individuals with better self-control use less effortful inhibition, yet make better progress on their goals is that they rely on beneficial habits. Across 6 studies (total N = 2,274), we found support for this hypothesis. In Study 1, habits for eating healthy snacks, exercising, and getting consistent sleep mediated the effect of self-control on both increased automaticity and lower reported effortful inhibition in enacting those behaviors. In Studies 2 and 3, study habits mediated the effect of self-control on reduced motivational interference during a work-leisure conflict and on greater ability to study even under difficult circumstances. In Study 4, homework habits mediated the effect of self-control on classroom engagement and homework completion. Study 5 was a prospective longitudinal study of teenage youth who participated in a 5-day meditation retreat. Better self-control before the retreat predicted stronger meditation habits 3 months after the retreat, and habits mediated the effect of self-control on successfully accomplishing meditation practice goals. Finally, in Study 6, study habits mediated the effect of self-control on homework completion and 2 objectively measured long-term academic outcomes: grade point average and first-year college persistence. Collectively, these results suggest that beneficial habits-perhaps more so than effortful inhibition-are an important factor linking self-control with positive life outcomes. PMID:25643222

  15. More than Resisting Temptation: Beneficial Habits Mediate the Relationship between Self-Control and Positive Life Outcomes

    PubMed Central

    Galla, Brian M.; Duckworth, Angela L.

    2015-01-01

    Why does self-control predict such a wide array of positive life outcomes? Conventional wisdom holds that self-control is used to effortfully inhibit maladaptive impulses, yet this view conflicts with emerging evidence that self-control is associated with less inhibition in daily life. We propose that one of the reasons individuals with better self-control use less effortful inhibition, yet make better progress on their goals is that they rely on beneficial habits. Across six studies (total N = 2,274), we found support for this hypothesis. In Study 1, habits for eating healthy snacks, exercising, and getting consistent sleep mediated the effect of self-control on both increased automaticity and lower reported effortful inhibition in enacting those behaviors. In Studies 2 and 3, study habits mediated the effect of self-control on reduced motivational interference during a work-leisure conflict and on greater ability to study even under difficult circumstances. In Study 4, homework habits mediated the effect of self-control on classroom engagement and homework completion. Study 5 was a prospective longitudinal study of teenage youth who participated in a five-day meditation retreat. Better self-control before the retreat predicted stronger meditation habits three months after the retreat, and habits mediated the effect of self-control on successfully accomplishing meditation practice goals. Finally, in Study 6, study habits mediated the effect of self-control on homework completion and two objectively measured long-term academic outcomes: grade point average and first-year college persistence. Collectively, these results suggest that beneficial habits--perhaps more so than effortful inhibition--are an important factor linking self-control with positive life outcomes. PMID:25643222

  16. How to Write an Outcome Statement.

    PubMed

    Dickerson, Pamela S

    2015-09-01

    Educators within the health professions are increasingly asked to demonstrate outcomes of educational interventions. Within academia and clinical practice, educators are expected to measure, monitor, and, in many cases, report outcomes of their work. As continuing education transitions to a more deliberate emphasis on outcomes, common questions include how to identify and measure outcomes and how to write an outcome statement. This article will focus on how to write an outcome statement. PMID:26352037

  17. Latent Class Analysis of Gambling Activities in a Sample of Young Swiss Men: Association with Gambling Problems, Substance Use Outcomes, Personality Traits and Coping Strategies.

    PubMed

    Studer, Joseph; Baggio, Stéphanie; Mohler-Kuo, Meichun; Simon, Olivier; Daeppen, Jean-Bernard; Gmel, Gerhard

    2016-06-01

    The study aimed to identify different patterns of gambling activities (PGAs) and to investigate how PGAs differed in gambling problems, substance use outcomes, personality traits and coping strategies. A representative sample of 4989 young Swiss males completed a questionnaire assessing seven distinct gambling activities, gambling problems, substance use outcomes, personality traits and coping strategies. PGAs were identified using latent class analysis (LCA). Differences between PGAs in gambling and substance use outcomes, personality traits and coping strategies were tested. LCA identified six different PGAs. With regard to gambling and substance use outcomes, the three most problematic PGAs were extensive gamblers, followed by private gamblers, and electronic lottery and casino gamblers, respectively. By contrast, the three least detrimental PGAs were rare or non-gamblers, lottery only gamblers and casino gamblers. With regard to personality traits, compared with rare or non-gamblers, private and casino gamblers reported higher levels of sensation seeking. Electronic lottery and casino gamblers, private gamblers and extensive gamblers had higher levels of aggression-hostility. Extensive and casino gamblers reported higher levels of sociability, whereas casino gamblers reported lower levels of anxiety-neuroticism. Extensive gamblers used more maladaptive and less adaptive coping strategies than other groups. Results suggest that gambling is not a homogeneous activity since different types of gamblers exist according to the PGA they are engaged in. Extensive gamblers, electronic and casino gamblers and private gamblers may have the most problematic PGAs. Personality traits and coping skills may predispose individuals to PGAs associated with more or less negative outcomes. PMID:25929440

  18. Personality and adolescent pregnancy outcomes

    PubMed Central

    Harville, Emily W.; Madkour, Aubrey Spriggs; Xie, Yiqiong

    2014-01-01

    Aims To examine the relationship between personality, pregnancy and birth outcomes in adolescents Background Personality has been shown to be a strong predictor of many health outcomes. Adolescents who become pregnant have worse birth outcomes than adults. Design Cross-sectional study using data from the National Longitudinal Study of Adolescent Health (baseline, 1994-1995; follow-up, 2007-2008). Methods The study sample was 6529 girls, 820 of whom reported on pregnancy outcomes for a teenage birth. Personality data was taken from the Mini International Personality Item Pool personality tool, which measures the five-factor personality traits of neuroticism, conscientiousness, intellect/imagination, extraversion and agreeableness. Logistic regression was used to predict teen pregnancy and linear regression was used to predict birth weight and gestational age with adjustment for confounders and stratification by race. Results Agreeableness and intellect/imagination were associated with a reduced likelihood of becoming pregnant as an adolescent, while neuroticism, conscientiousness and extraversion were all associated with an increased likelihood of becoming pregnant. Higher neuroticism was associated with lower birth weight and gestational age among Black girls, but not non-Black. Conscientiousness was associated with lower gestational age among non-Black girls. No relationships were found with extraversion or agreeableness and birth outcomes. Receiving late or no prenatal care was associated with higher intellect/imagination. Conclusions Personality is understudied with respect to pregnancy and birth outcomes compared with other health outcomes. Such research could help professionals and clinicians design and target programs that best fit the characteristics of the population most likely to need them, such as those with high neuroticism. PMID:25040691

  19. The power of outcomes: FOTO Industrial Outcomes Tool -- Initial assessment.

    PubMed

    Hart, D.L.

    2001-01-01

    OBJECTIVE: To demonstrate how outcomes assessment can assist in describing clients receiving rehabilitation in occupational health rehabilitation clinics and to describe the preliminary assessment of internal consistency reliability and construct validity of the FOTO Industrial Outcomes Tool. METHODS: 266 adults referred for acute work rehabilitation (AWR), work conditioning/hardening (WC/WH) or a Functional Capacity Evaluation (FCE) comprised the data set. Clients were treated between July 1998 and January 1999 in 15 clinics from 6 states by 46 clinicians participating in the Focus on Therapeutic Outcomes (FOTO) national rehabilitation database beta test. For AWR and WC/WH, clients completed a health status questionnaire on intake and discharge, and health status was assessed prior to the FCE. Comprehensive demographic data were collected describing the clinics, clinicians, clients and work status collected 2 weeks following discharge. RESULTS: Internal consistency reliability coefficients for the health status scores ranged from 0.57 to 0.89. Construct validity was supported. CONCLUSION: Results demonstrate the power of collecting outcomes from a variety of constructs for clients receiving industrial rehabilitation services. Initial reliability and construct validity findings were adequate and support continuing data analyses. PMID:12441480

  20. Evidence of a Gene × Environment Interaction Between Birth Weight and Genetic Risk in the Prediction of Criminogenic Outcomes Among Adolescent Males.

    PubMed

    Jackson, Dylan B; Beaver, Kevin M

    2016-01-01

    A number of studies have revealed that low birth weight children have a heightened risk of various maladaptive outcomes, including academic challenges and delinquent involvement. However, very little research to date has examined whether the relationship between low birth weight, poor academic performance, and delinquent peer affiliation is moderated by genetic risk. Using data from the National Longitudinal study of Adolescent Health, the present study examines whether male adolescents born at very low birth weights are significantly predisposed to poor academic performance and delinquent peer affiliation. Moreover, we test whether the effect of birth weight on these outcomes is conditioned by level of genetic risk. We find no evidence that very low birth weight males are more likely to affiliate with delinquent peers or perform poorly in school during adolescence. However, upon examining gene-environment interactions, we find that being born at a very low birth weight does significantly increase the odds of poor academic performance and delinquent peer affiliation among males who possess a higher level of genetic risk. Limitations are noted and the implications of the findings are discussed. PMID:25145687

  1. Replantation: current concepts and outcomes.

    PubMed

    Bueno, Reuben A; Battiston, Bruno; Ciclamini, Davide; Titolo, Paolo; Panero, Bernardino; Tos, Pierluigi

    2014-07-01

    Techniques to improve the chance of successful replantation of digits are well established. Indications and contraindications for replantation are generally agreed on, but they continue to evolve as excellent outcomes are achieved at centers with experience and expertise. Form and function can be restored with avulsion injuries and distal amputations, with good results and high patient satisfaction. Increased financial pressure to control the costs of health care and increased accountability for evidence-based outcomes may lead to the regionalization of replantation care and shared decision making in recommending replantation or revision amputation. PMID:24996460

  2. Employment outcomes in Massachusetts Clubhouses.

    PubMed

    McKay, Colleen; Johnsen, Mathew; Stein, Reva

    2005-01-01

    Employment outcomes of individuals participating in 17 Massachusetts Clubhouses certified by the International Center for Clubhouse Development were examined through an annual survey. Major components of employment programs in contemporary clubhouses are identified and individual employment outcomes are described. Within contemporary practice in ICCD clubhouses in this sample, clubhouses provided a three-pronged approach to employment. Between 1998-2001, 1702 individuals worked in 2714 separate job placements, employed in Transitional (TE), Supported (SE), and Independent Employment (IE). Forty percent of members with more than one job (N = 385) participated in at least one TE. Individuals with longer memberships tended to work longer and had higher job earnings. PMID:16075694

  3. Outcomes in Endoscopic Ear Surgery.

    PubMed

    Kiringoda, Ruwan; Kozin, Elliott D; Lee, Daniel J

    2016-10-01

    Endoscopic ear surgery (EES) provides several advantages compared with traditional binocular microscopy, including a wide-field view, improved resolution with high magnification, and visual access to hidden corridors of the middle ear. Although binocular microscopic-assisted surgical techniques remain the gold standard for most otologists, EES is slowly emerging as a viable alternative for performing otologic surgery at several centers in the United States and abroad. In this review, we evaluate the current body of literature regarding EES outcomes, summarize our EES outcomes at the Massachusetts Eye and Ear Infirmary, and compare these results with data for microscopic-assisted otologic surgery. PMID:27565392

  4. Outcomes Following Endoscopic Stapes Surgery.

    PubMed

    Hunter, Jacob B; Rivas, Alejandro

    2016-10-01

    There are limited studies describing the surgical and hearing outcomes following endoscopic stapes surgeries, despite the burgeoning interest and excitement in endoscopic ear surgery. Current studies have demonstrated that endoscopic stapes surgery is safe and has similar audiologic outcomes when compared with microscopic stapes procedures. However, preliminary studies show decreased postoperative pain in endoscopic cases compared with microscopic controls. In regards to possible endoscopic advantages, these few studies demonstrate mixed results when comparing the need to remove the bony medial external auditory canal wall to improve visualization and access to the oval window niche. PMID:27565387

  5. Outcomes of surgery under Medicaid

    PubMed Central

    Klingman, David; Pine, Penelope L.; Simon, James

    1990-01-01

    In this study, health outcomes during the 6-month period following surgery are examined for all Medicaid recipients in Michigan and Georgia who underwent selected surgical procedures between July 1, 1981, and June 30, 1982. Readmissions were somewhat more prevalent in both States for hysterectomy, cholecystectomy, appendectomy, and myringotomy. On almost all measures in both States, levels of post-surgical utilization, expenditure, and complications were higher among females, older patients, Supplemental Security Income enrollees, and those with higher levels of presurgical utilization and longer and more costly surgical stays. The results further demonstrate the utility of claims data in monitoring outcomes of surgery. PMID:10170577

  6. Techniques for objective outcome assessment.

    PubMed

    Hesbach, Amie Lamoreaux

    2007-11-01

    Companion animal rehabilitation, a collaborative practice of physical therapy and veterinary medicine, can only demonstrate the effectiveness of its theories, techniques, interventions, and modalities through evidence-based practice, utilizing standardized, reliable, and valid outcome measures, correlated with objective diagnostic data. This essay examines existing and potential objective outcome measures utilized in companion animal rehabilitation and physical therapy regarding pain, vital signs, body condition and composition, range of motion, muscle strength, inflammation, functional mobility, and gait. Discussion is included of the traditional disablement model and the evolution of the physical therapy diagnosis, prognosis, and plan of care. PMID:18198782

  7. Right hemisphere grey matter structure and language outcomes in chronic left hemisphere stroke.

    PubMed

    Xing, Shihui; Lacey, Elizabeth H; Skipper-Kallal, Laura M; Jiang, Xiong; Harris-Love, Michelle L; Zeng, Jinsheng; Turkeltaub, Peter E

    2016-01-01

    The neural mechanisms underlying recovery of language after left hemisphere stroke remain elusive. Although older evidence suggested that right hemisphere language homologues compensate for damage in left hemisphere language areas, the current prevailing theory suggests that right hemisphere engagement is ineffective or even maladaptive. Using a novel combination of support vector regression-based lesion-symptom mapping and voxel-based morphometry, we aimed to determine whether local grey matter volume in the right hemisphere independently contributes to aphasia outcomes after chronic left hemisphere stroke. Thirty-two left hemisphere stroke survivors with aphasia underwent language assessment with the Western Aphasia Battery-Revised and tests of other cognitive domains. High-resolution T1-weighted images were obtained in aphasia patients and 30 demographically matched healthy controls. Support vector regression-based multivariate lesion-symptom mapping was used to identify critical language areas in the left hemisphere and then to quantify each stroke survivor's lesion burden in these areas. After controlling for these direct effects of the stroke on language, voxel-based morphometry was then used to determine whether local grey matter volumes in the right hemisphere explained additional variance in language outcomes. In brain areas in which grey matter volumes related to language outcomes, we then compared grey matter volumes in patients and healthy controls to assess post-stroke plasticity. Lesion-symptom mapping showed that specific left hemisphere regions related to different language abilities. After controlling for lesion burden in these areas, lesion size, and demographic factors, grey matter volumes in parts of the right temporoparietal cortex positively related to spontaneous speech, naming, and repetition scores. Examining whether domain general cognitive functions might explain these relationships, partial correlations demonstrated that grey matter

  8. Adaptive and maladaptive behavior of idiots savants.

    PubMed

    Duckett, J

    1977-11-01

    A comparison was made of 25 institutionalized idiots savants and a control group of institutionalized retarded persons matched for age, sex, IQ, and length of institutionalization. As a group, idiots savants were found to be somewhat more disturbed and disturbing than their peers, although they did not show extreme emotional disturbance nor reflect a clear behavioral profile. PMID:930969

  9. Early maladaptive schemas in personality disordered individuals.

    PubMed

    Jovev, Martina; Jackson, Henry J

    2004-10-01

    The present study aimed to examine the specificity of schema domains in three personality disorder (PD) groups, namely borderline (BPD), obsessive-compulsive (OCPD), and avoidant PD (AvPD), and to correctly identify the three PD groups on the basis of these schemas. The sample consisted of 48 clinical participants diagnosed with PDs and assigned to 1 of 3 groups on the basis of their Axis II diagnoses (BPD: n = 13; OCPD: n = 13; AvPD: n = 22). High scores on Dependence/Incompetence, Defectiveness/ Shame and Abandonment were found for the BPD group. Such pattern appears to be most consistent with Young's theory of BPD. Consistent with the theory and empirical findings of Beck et al. (1990, 2001), OCPD was associated with elevations on the Unrelenting Standards schema domain, but not on Emotional Inhibition, which was found to be elevated for AvPD. In conclusion, the present study suggests that there are different patterns of schema domains across different PDs and that the Schema Questionnaire (SQ) is potentially useful in differentiating between these PDs. PMID:15519957

  10. Developmental and maladaptive plasticity in neonatal SCI.

    PubMed

    Pape, Karen E

    2012-06-01

    Babies and young children with early spinal cord injury (SCI) have evidence of an improved level of recovery over an extended time period. Enhanced neuroplasticity is well recognized in neonatal animal models. In the young human, developmental apraxia and learned early habitual movements mask expression of residual or recovered motor function. Techniques providing sensorimotor stimulation with threshold electrical stimulation (TES) and EMG triggered stimulation (ETS) act to increase awareness and useful function. Small cohort size and prolonged developmental maturation argue for the use of single subject research designs in this population. PMID:22306423

  11. Infectious Disease Stigmas: Maladaptive in Modern Society.

    PubMed

    Smith, Rachel A; Hughes, David

    2014-04-01

    At multiple times in human history people have asked if there are good stigmas. Is there some useful function stigmas serve in the context of our evolutionary history; is stigma adaptive? This essay discusses stigmas as a group-selection strategy and the human context in which stigmas likely appeared. The next section explores how human patterns have changed in modern society and the consequences for infectious disease (ID) stigmas in the modern age. The concluding section suggests that while social-living species may be particularly apt to create and communicate ID stigmas and enact ID-related stigmatization, such stigma-related processes no longer function to protect human communities. Stigmas do not increase the ability of modern societies to survive infectious diseases, but in fact may be important drivers of problematic disease dynamics and act as catalysts for failures in protecting public health. PMID:25477728

  12. Contingent Faculty and Student Outcomes

    ERIC Educational Resources Information Center

    Jaeger, Audrey J.

    2008-01-01

    While it may provide greater economic efficiency, the increased use of part-time faculty in colleges and universities has been strongly criticized. The criticisms of increased employment of contingent faculty are based on research that supports the idea that faculty-student interaction leads to positive outcomes, including increased cognitive and…

  13. Assessing Education Program Learning Outcomes

    ERIC Educational Resources Information Center

    Bahous, Rima; Nabhani, Mona

    2011-01-01

    Teacher education programs help teachers gain knowledge and skills, develop "new" attitudes, and impact their beliefs about teaching, thereby favorably affecting teaching outcomes. In the absence of national standards and formal studies in Lebanon of existing teacher preparation programs, findings of this study could greatly contribute to needed…

  14. Student Outcomes: Annual Summary Report.

    ERIC Educational Resources Information Center

    Prince George's Community Coll., Largo, MD. Office of Institutional Research.

    Each year a study is conducted at Prince George's Community College (PGCC) to update student outcomes data using quantifiable measures of student achievement. Data for the 1989 study were obtained from the college's student information system, the University of Maryland (UM) system, and surveys of all 825 fiscal year 1988 graduates and 118 of…

  15. Ramadan, Fasting and Educational Outcomes

    ERIC Educational Resources Information Center

    Oosterbeek, Hessel; van der Klaauw, Bas

    2013-01-01

    Using a difference-in-differences framework, we estimate the impact of Ramadan on educational outcomes of Muslim students living in a non-Muslim country. For identification we exploit that the number of Ramadan weeks during the course that we study, varies from year to year, ranging from zero to four. Our main finding is that Ramadan observance…

  16. Family Environments and Children's Outcomes

    ERIC Educational Resources Information Center

    Marjoribanks, Kevin

    2005-01-01

    In the article, theoretical orientations and empirical studies are examined that have investigated relationships between family learning environments and children's school-related outcomes. A family model is proposed that involves associations among family background (human and economic capital, parents aspirations, and cultural contexts),…

  17. Prospects: Student Outcomes. Final Report.

    ERIC Educational Resources Information Center

    Puma, Michael J.; Karweit, Nancy; Price, Cristofer; Ricciuti, Anne; Thompson, William; Vaden-Kiernan, Michael

    This report is one of a series presenting findings from "Prospects: The Congressionally Mandated Study of Educational Growth and Opportunity." This study, conducted in response to the 1988 Hawkins-Stafford Amendments, was a major effort to examine the effects of Chapter 1 on student achievement and other school-related educational outcomes. Data…

  18. Prepregnancy Obesity and Birth Outcomes.

    PubMed

    Averett, Susan L; Fletcher, Erin K

    2016-03-01

    Objective To investigate the association between prepregnancy obesity and birth outcomes using fixed effect models comparing siblings from the same mother. Methods A total of 7496 births to 3990 mothers from the National Longitudinal Survey of Youth 1979 survey are examined. Outcomes include macrosomia, gestational length, incidence of low birthweight, preterm birth, large and small for gestational age (LGA, SGA), c-section, infant doctor visits, mother's and infant's days in hospital post-partum, whether the mother breastfed, and duration of breastfeeding. Association of outcomes with maternal pre-pregnancy obesity was examined using Ordinary Least Squares (OLS) regression to compare across mothers and fixed effects to compare within families. Results In fixed effect models we find no statistically significant association between most outcomes and prepregnancy obesity with the exception of LGA, SGA, low birth weight, and preterm birth. We find that prepregnancy obesity is associated with a with lower risk of low birthweight, SGA, and preterm birth but controlling for prepregnancy obesity, increases in GWG lead to increased risk of LGA. Conclusions Contrary to previous studies, which have found that maternal obesity increases the risk of c-section, macrosomia, and LGA, while decreasing the probability of breastfeeding, our sibling comparison models reveal no such association. In fact, our results suggest a protective effect of obesity in that women who are obese prepregnancy have longer gestation lengths, and are less likely to give birth to a preterm or low birthweight infant. PMID:26515472

  19. SERVICE RESEARCH OUTCOME STUDY (SROS)

    EPA Science Inventory

    The Services Research Outcome Study (SROS) is a follow-up to the 1990 Drug Services Research Survey (DSRS). The SROS provided for a five year post-discharge follow-up of a broadly representative sample of approximately 3,000 drug clients treated during 1989 to 1990. The study asc...

  20. Treatment and Outcomes of Aspergillosis

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  1. Treatment and Outcomes of Histoplasmosis

    MedlinePlus

    ... Outcomes Health Professionals Statistics More Resources en Español Definición Síntomas Las Personas en Riesgo y Prevención Fuentes Diagnóstico y Exámenes Tratamiento y Resultados Profesionales de la Salud Estadísticas C. neoformans Infection Definition Symptoms People at ...

  2. Routine outcome measures in Canada.

    PubMed

    Kisely, Steve; Adair, Carol E; Lin, Elizabeth; Marriott, Brian

    2015-01-01

    Canada is a federal country of 10 provinces and three territories. High level information on mental health conditions and service use has mostly been generated from administrative data collected by provinces and territories. These include four major types - hospital admissions and discharges, physician billings, ambulatory care services, and drug databases. At the national level, the Canadian Institute for Health Information brings together this information to produce indicators of outcome. Although these data provide information on patient and health system characteristics, they do not capture the full spectrum of formal and informal mental healthcare. These include changes in health status, functioning, community integration and quality of life. As a result, some jurisdictions have begun to implement more standardized measures of outcome such as the clinician-rated Health of the Nation Outcome Scales or the inpatient Resident Assessment Instrument - Mental Health. In this paper we provide an overview of mental-health-related data sources in Canada, highlight some of the more progressive practices beginning to emerge, and conclude with some thoughts about how the routine measurement and reporting of mental health outcomes in Canada might be advanced including efforts at engaging both clinicians and decision-makers. PMID:25738745

  3. Linking Outcomes to Organizational Planning.

    ERIC Educational Resources Information Center

    Ligon, Glynn; Jackson, Elaine

    Linking Outcomes to Organizational Planning (LOOP) was initiated during the 1984-85 school year in the Austin (Texas) Independent School District. LOOP was designed to ensure that evaluation, research, and informal findings became part of the instructional planning loop; to provide information to the Superintendent on progress toward priorities…

  4. Neurodevelopmental Outcome in Preterm Infants

    ERIC Educational Resources Information Center

    Bos, Arend F.; Roze, Elise

    2011-01-01

    Aim: To determine the distribution of cognitive and motor scores in preterm children, and to establish the influence of brain lesions and decreasing gestational age thereon. Method: One hundred and six very preterm children (63 males, 43 females; gestational age 24.0-31.6wk; birthweight 480-2275g) were assessed for cognition and motor outcome at 6…

  5. Childhood Maltreatment and Educational Outcomes.

    PubMed

    Romano, Elisa; Babchishin, Lyzon; Marquis, Robyn; Fréchette, Sabrina

    2015-10-01

    Children (0-18 years) with maltreatment histories are vulnerable to experiencing difficulties across multiple domains of functioning, including educational outcomes that encompass not only academic achievement but also mental well-being. The current literature review adopted Slade and Wissow's model to examine (1) the link between childhood maltreatment and academic achievement, (2) the link between childhood maltreatment and mental health outcomes (i.e., emotional and behavioral difficulties), and (3) the bidirectional relationship between childhood academic achievement and mental health. In addition, we reviewed variables that might influence or help explain the link between childhood maltreatment and educational outcomes, drawing on developmental perspectives and Bronfenbrenner's ecological model. Finally, whenever possible, we presented findings specific to maltreated children in out-of-home care to highlight the unique challenges experienced by this population. Results indicated that children with maltreatment histories often experience impairments in both their academic performance (e.g., special education, grade retention, lower grades) and mental well-being (e.g., anxiety, low mood, aggression, social skills deficits, poor interpersonal relationships). These impairments appeared to be particularly pronounced among maltreated children in out-of-home care. Findings, albeit sparse, also indicated that mental health difficulties are negatively associated with children's academic achievement and, similarly, that academic achievement deficits are linked with mental health problems. The link between childhood maltreatment and educational outcomes may be partly explained through the disruption of key developmental processes in children, such as attachment, emotion regulation, and sense of agency. As well, maltreatment characteristics and the functioning of various systems in which children are embedded (e.g., family, school, child welfare) can serve to positively

  6. Family Perception and 6-Month Symptomatic and Functioning Outcomes in Young Adolescents at Clinical High Risk for Psychosis in a General Population in China

    PubMed Central

    Wang, Lu; Shi, JingYu; Chen, FaZhan; Yao, YuHong; Zhan, ChenYu; Yin, XiaoWen; Fang, XiaoYan; Wang, HaoJie; Yuan, JiaBei; Zhao, XuDong

    2015-01-01

    Background and Aims Given the difficulty of treating schizophrenia and other forms of psychosis, researchers have shifted focus to early detection and intervention of individuals at clinical high risk (CHR) for psychosis. Previous studies have shown that elements in family functioning could predict symptom outcome in CHR individuals. However, associations between self reported family functioning and symptom or functioning outcome of CHR individuals was rarely reported. Our study aimed to investigate the characteristics and the role of family functioning in the development of CHR individuals among young adolescents. Methods A sample of 32 CHR individuals was recruited from 2800 university students. The characteristics of family perception were evaluated by both Family Assessment Device (FAD) and Family cohesion and adaptability evaluation Scale II (FACES II). 6 month follow up data was available with 25 of the recruited CHR individuals. Baseline socio-demographic characteristics and family functioning were compared between CHR and control group. We also measured the associations between different dimensions of perceived family functioning and both severity of prodromal symptoms and global functioning at baseline and 6-month follow up. Results CHR individuals showed more maladaptive family functioning compared to control in nearly all of the dimensions of FAD and FACES II except for Affective Involvement. Better Problem Solving and Affective Responsiveness predicted less severe positive and negative symptoms respectively. Family cohesion and adaptability were not only correlated with the baseline severity of general symptoms, but also positively associated with the general and disorganized symptom outcome. Conclusions This study contributed preliminary evidence towards the associations between family perception and symptom outcome of CHR individuals. It also provided evidence for the importance of family interventions on CHR individuals. PMID:26394221

  7. The differing outcomes of hyperthyrotropinaemia.

    PubMed

    Cody, Declan; Kumar, Yadlapalli; Ng, Sze May; Didi, Mohammad; Smith, Colin

    2003-03-01

    Hyperthyrotropinaemia, in which normal levels of T4 occur in association with raised TSH, is picked up on neonatal screening. The outcome of children with persistent hyperthyrotropinaemia is uncertain. The study objective was to evaluate the outcome of children with the persistent form of hyperthyrotropinaemia. We carried out a retrospective analysis on children who attended one institution over the last 20 years with this diagnosis. Eight children were diagnosed with hyperthyrotropinaemia lasting more than 3 months in total. Four had a transient form lasting between 3 and 18 months in total. Three continue to have persistently raised TSH at 5, 9 and 17 years, respectively. One patient became biochemically hypothyroid at 1 year of age requiring treatment with replacement thyroxine. All of our group had normal growth and development. We recommend that thyroid function monitoring should continue in all children with hyperthyrotropinaemia until the thyroid function tests have normalised. PMID:12705361

  8. Pregnancy outcome and uterine fibroids.

    PubMed

    Parazzini, Fabio; Tozzi, Luca; Bianchi, Stefano

    2016-07-01

    Myomas are observed in about 3-12% of pregnant women. Uterine fibroids may affect the outcome of pregnancy. The presence of myomas - in particular of myomas that distort the uterine cavity and larger intramural myomas - has been associated with infertility. In the case of pregnancy, it has been linked to an increased risk of spontaneous abortion, fetal malpresentation, placenta previa, preterm birth, cesarean section, and peripartum hemorrhage. Although fibroids may negatively affect pregnancy outcome, the impact of their treatment, particularly in quantitative terms, is unclear. Hysteroscopic myomectomy is the treatment of choice for submucous fibroids. The comparative efficacy of laparoscopic, laparotomic, or new modalities of treatment of intramural fibroids is not known. Up to date the choice and modalities of treatment of submucous fibroids should not be based on sound evidence but on clinical concerns and the skill of each center. PMID:26723475

  9. Workplace bullying, emotions, and outcomes.

    PubMed

    Glasø, Lars; Notelaers, Guy

    2012-01-01

    This study examines emotional experiences as potential mediators between exposure to workplace bullying and job satisfaction, organizational commitment, and intention to leave the organization, respectively. A total of 5,520 respondents participated in the study. Drawing upon affective events theory (AET), the results show that emotions partly mediate these relationships and, hence, support the notion that emotions play a central part in the relationship between bullying and essential occupational outcomes. PMID:22852437

  10. Thyroid dysfunction and pregnancy outcomes

    PubMed Central

    Nazarpour, Sima; Ramezani Tehrani, Fahimeh; Simbar, Masoumeh; Azizi, Fereidoun

    2015-01-01

    Background: Pregnancy has a huge impact on the thyroid function in both healthy women and those that have thyroid dysfunction. The prevalence of thyroid dysfunction in pregnant women is relatively high. Objective: The objective of this review was to increase awareness and to provide a review on adverse effect of thyroid dysfunction including hyperthyroidism, hypothyroidism and thyroid autoimmune positivity on pregnancy outcomes. Materials and Methods: In this review, Medline, Embase and the Cochrane Library were searched with appropriate keywords for relevant English manuscript. We used a variety of studies, including randomized clinical trials, cohort (prospective and retrospective), case-control and case reports. Those studies on thyroid disorders among non-pregnant women and articles without adequate quality were excluded. Results: Overt hyperthyroidism and hypothyroidism has several adverse effects on pregnancy outcomes. Overt hyperthyroidism was associated with miscarriage, stillbirth, preterm delivery, intrauterine growth retardation, low birth weight, preeclampsia and fetal thyroid dysfunction. Overt hypothyroidism was associated with abortion, anemia, pregnancy-induced hypertension, preeclampsia, placental abruption, postpartum hemorrhage, premature birth, low birth weight, intrauterine fetal death, increased neonatal respiratory distress and infant neuro developmental dysfunction. However the adverse effect of subclinical hypothyroidism, and thyroid antibody positivity on pregnancy outcomes was not clear. While some studies demonstrated higher chance of placental abruption, preterm birth, miscarriage, gestational hypertension, fetal distress, severe preeclampsia and neonatal distress and diabetes in pregnant women with subclinical hypothyroidism or thyroid autoimmunity; the other ones have not reported these adverse effects. Conclusion: While the impacts of overt thyroid dysfunction on feto-maternal morbidities have been clearly identified and its long

  11. Avoiding unfavourable outcomes in liposuction

    PubMed Central

    Khanna, Atul; Filobbos, George

    2013-01-01

    The origin of liposuction can be traced to an adverse event by Dujarrier in 1921 when he used a uterine curette to remove fat from the knees of a ballerina ending in an amputation secondary to damage of the femoral artery. The history of liposuction since then has been one of avoiding complications and optimising outcome. After this adverse event, liposuction was abandoned until the 1960's when Schrudde revived the practice using small stab incisions and sharp curettage with the secondary suction to aspirate the freed tissue. This technique was associated with a high incidence of complications especially seroma and skin necrosis. Illouz then replaced the curette with a blunt cannula connected to vacuum pump thus avoiding the complications of a sharp curette. Despite the presence of various techniques for liposuction, suction assisted liposuction (SAL) is still the standard technique of liposuction. This article aims to discuss literature regarding the various aspects of liposuction (SAL) and to highlight the salient points in the literature and in the senior author's experience in order to avoid unfavourable outcomes in liposuction. A literature review on avoiding complication is in liposuction including some of the seminal papers on liposuction. Liposuction is generally a safe procedure with reproducible outcome. Just like any surgical procedure it should be treated with the utmost care. Illouz published 10 commandments for liposuction in 1989 and we review these commandments to demonstrate how liposuction has evolved. PMID:24501475

  12. Routine outcome measurement in Australia.

    PubMed

    Burgess, Philip; Pirkis, Jane; Coombs, Tim

    2015-08-01

    Australia has been implementing routine outcome measurement in its specialized public sector mental health services for over a decade. It uses a range of clinician-rated and consumer-rated measures that are administered at set times during episodes of inpatient, ambulatory and community residential episodes of care. Routine outcome measurement is now embedded in service delivery, and data are made available in a variety of ways to different audiences. These data are used by policy-makers and planners to inform decisions about system-wide reforms, by service managers to monitor quality and effectiveness, and by clinicians to guide clinical decision-making and to promote dialogue with consumers. Consumers, carers and the general community can use these data to ensure that services are accountable for the care they deliver. This paper describes the status quo in Australia with respect to routine outcome measurement, discusses the factors that led to its successful implementation, and considers the steps that are necessary for its continued development. PMID:25768326

  13. Parental outcome expectations on children's TV viewing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Children's TV viewing has been associated with increased sedentary behavior and poor eating habits. Positive intervention effects have been observed when addressing outcome expectations as a mediator in interventions targeting children's dietary behavior. Little is known about parental outcome expec...

  14. Pregnancy outcomes at the Indiana Women's Prison.

    PubMed

    Tanner, Richard

    2010-07-01

    This article presents birth weight outcome data for 200 pregnancies at the Indiana Women's Prison (IWP) over the last 4 years. Overall, 5.5% of the pregnancies at IWP had low birth weight outcomes. The rate was only 2% for women who were incarcerated for more than 4 weeks and got prenatal care. These outcomes were better than the published outcomes for pregnancies in the State of Indiana. PMID:20466701

  15. Increasing hope by addressing clients' outcome expectations.

    PubMed

    Swift, Joshua K; Derthick, Annie O

    2013-09-01

    Addressing clients' outcome expectations is an important clinical process that can lead to a strong therapeutic alliance, more positive treatment outcomes, and decreased rates of premature termination from psychotherapy. Five interventions designed to foster appropriate outcome expectations are discussed, including presenting a convincing treatment rationale, increasing clients' faith in their therapists, expressing faith in clients, providing outcome education, and comparing progress with expectations. Clinical examples and research support are provided for each. PMID:24000836

  16. A longitudinal analysis of nursing home outcomes.

    PubMed Central

    Porell, F; Caro, F G; Silva, A; Monane, M

    1998-01-01

    OBJECTIVE: To investigate resident and facility attributes associated with long-term care health outcomes in nursing homes. DATA SOURCES: Quarterly Management Minutes Questionnaire (MMQ) survey data for Medicaid case-mix reimbursement of nursing homes in Massachusetts from 1991 to 1994, for specification of outcomes and resident attributes. Facility attributes are specified from cost report data. STUDY DESIGN: Multivariate logistic and "state-dependence" regression models are estimated for survival, ADL functional status, incontinence status, and mental status outcomes from longitudinal residence histories of Medicaid residents spanning 3 to 36 months in length. Outcomes are specified to be a function of resident demographic and diagnostic attributes and facility-level operating and nurse staffing attributes. PRINCIPAL FINDINGS: The estimated parameters for resident demographic and diagnostic attributes showed a great deal of construct validity with respect to clinical expectations regarding risk factors for adverse outcomes. Few facility attributes were associated with outcomes generally, and none was significantly associated with all four outcomes. CONCLUSIONS: The absence of uniform associations between facility attributes and the various long-term care health outcomes studied suggests that strong facility performance on one health outcome may coexist with much weaker performance on other outcomes. This has implications for the aggregation of individual facility performance measures on multiple outcomes and the development of overall outcome performance measures. PMID:9776939

  17. Outcome-Reporting Bias in Education Research

    ERIC Educational Resources Information Center

    Pigott, Therese D.; Valentine, Jeffrey C.; Polanin, Joshua R.; Williams, Ryan T.; Canada, Dericka D.

    2013-01-01

    Outcome-reporting bias occurs when primary studies do not include information about all outcomes measured in a study. When studies omit findings on important measures, efforts to synthesize the research using systematic review techniques will be biased and interpretations of individual studies will be incomplete. Outcome-reporting bias has been…

  18. The Evaluation of Outcome in Schizophrenia.

    ERIC Educational Resources Information Center

    Strauss, John S.; Carpenter, William T., Jr.

    Understanding outcome in schizophrenia is important for choosing among the competing concepts of this disorder and for evaluation of treatment methods. Nevertheless, there is much disagreement and confusion about the nature of outcome in schizophrenia. This report describes features of diagnosis and outcome that contribute to this confusion and…

  19. Outcomes from Career Information and Guidance Services.

    ERIC Educational Resources Information Center

    Maguire, Malcolm; Killeen, John

    Outcomes of guidance can be assessed at these three levels: individual, where they are immediate; organizational, where they are intermediate; or societal, where they are ultimate. They may result in learning outcomes, school effectiveness, economic benefits, or social benefits. Various designs of outcome evaluation are described and…

  20. Evaluating more naturalistic outcome measures

    PubMed Central

    Bove, Riley; White, Charles C.; Giovannoni, Gavin; Glanz, Bonnie; Golubchikov, Victor; Hujol, Johnny; Jennings, Charles; Langdon, Dawn; Lee, Michelle; Legedza, Anna; Paskavitz, James; Prasad, Sashank; Richert, John; Robbins, Allison; Roberts, Susan; Weiner, Howard; Ramachandran, Ravi; Botfield, Martyn

    2015-01-01

    Objective: In this cohort of individuals with and without multiple sclerosis (MS), we illustrate some of the novel approaches that smartphones provide to monitor patients with chronic neurologic disorders in their natural setting. Methods: Thirty-eight participant pairs (MS and cohabitant) aged 18–55 years participated in the study. Each participant received an Android HTC Sensation 4G smartphone containing a custom application suite of 19 tests capturing participant performance and patient-reported outcomes (PROs). Over 1 year, participants were prompted daily to complete one assigned test. Results: A total of 22 patients with MS and 17 cohabitants completed the entire study. Among patients with MS, low scores on PROs relating to mental and visual function were associated with dropout (p < 0.05). We illustrate several novel features of a smartphone platform. First, fluctuations in MS outcomes (e.g., fatigue) were assessed against an individual's ambient environment by linking responses to meteorological data. Second, both response accuracy and speed for the Ishihara color vision test were captured, highlighting the benefits of both active and passive data collection. Third, a new trait, a person-specific learning curve in neuropsychological testing, was identified using spline analysis. Finally, averaging repeated measures over the study yielded the most robust correlation matrix of the different outcome measures. Conclusions: We report the feasibility of, and barriers to, deploying a smartphone platform to gather useful passive and active performance data at high frequency in an unstructured manner in the field. A smartphone platform may therefore enable large-scale naturalistic studies of patients with MS or other neurologic diseases. PMID:26516627

  1. Outcomes of Telephone Medical Care

    PubMed Central

    Delichatsios, Helen; Callahan, Mark; Charlson, Mary

    1998-01-01

    OBJECTIVES To document the outcomes of a telephone coverage system and identify patient characteristics that may predict these outcomes. DESIGN Telephone survey. SETTING An academic outpatient medical practice that has a physician telephone coverage service. PATIENTS All patients (483) who called during the 3-week study period to speak to a physician were evaluated, and for the 180 patients with symptoms, attempts were made to survey them by telephone 1 week after their initial telephone call. MEASUREMENTS AND MAIN RESULTS The mean age of the 180 patients was 41 years, 71% were female, and 56% belonged to commercial managed care plans. In the week after the initial telephone call, the following outcomes were reported: 27% of the patients had no further contact with the practice; 9% filled a prescription medication; 19% called the practice again; 48% kept an earlier appointment in the practice; 3% saw an internist elsewhere; 8% saw a specialist; 8% went to an emergency department; 4% were admitted to a hospital. Of the 180 patients who called with symptoms, 160 (89%) were successfully contacted for survey. Eighty-seven percent of these 160 patients rated their satisfaction with the care they received over the telephone as excellent, very good, or good. In multivariate analysis, patients' own health perception identified those most likely to have symptom relief (p = .002), and symptom relief, in turn, was a strong predictor of high patient satisfaction (p = .006). Thirty-three percent of the 160 patients reported that they would have gone to an emergency department if a physician were not available by telephone. CONCLUSIONS In the present study, younger patients, female patients, and patients in commercial managed care plans used the telephone most frequently. Also, the telephone provided a viable alternative to emergency department and walk-in visits. Overall satisfaction with telephone medicine was high, and the strongest predictors of high patient satisfaction

  2. Coeliac disease and pregnancy outcomes

    PubMed Central

    Butler, M M; Kenny, L C; McCarthy, F P

    2011-01-01

    Coeliac disease is a gluten-sensitive enteropathy affecting up to 1% of the population. An accumulating body of evidence supports the association of coeliac disease with adverse pregnancy outcomes, including increased risk of miscarriage and intrauterine growth restriction. Reports differ regarding the extent and severity of these associations, in addition to the exact pathophysiology underlying these associations. Overall, coeliac disease is believed to be a significant condition in pregnancy and reproductive medicine with some advocating the screening of coeliac disease in all pregnant women or some specific high-risk groups.

  3. Best outcomes for Indian children.

    PubMed

    Porter, Loa L; Zink, Patina Park; Gebhardt, Angela R; Ells, Mark; Graef, Michelle I

    2012-01-01

    The Wisconsin Department of Children and Families and the Midwest Child Welfare Implementation Center are collaborating with Wisconsin's tribes and county child welfare agencies to improve outcomes for Indian children by systemically implementing the Wisconsin Indian Child Welfare Act (WICWA). This groundbreaking collaboration will increase practitioners' understanding of the requirements of WICWA and the need for those requirements, enhance communication and coordination between all stakeholders responsible for the welfare of Indian children in Wisconsin; it is designed to effect the systemic integration of the philosophical underpinnings of WICWA. PMID:23444793

  4. Review of key telepsychiatry outcomes

    PubMed Central

    Hubley, Sam; Lynch, Sarah B; Schneck, Christopher; Thomas, Marshall; Shore, Jay

    2016-01-01

    AIM: To conduct a review of the telepsychiatry literature. METHODS: We conducted a systematic search of the literature on telepsychiatry using the search terms, “telepsychiatry”, “telemental health”, “telecare”, “telemedicine”, “e-health”, and “videoconferencing”. To meet criteria for inclusion, studies had to: (1) be published in a peer-reviewed journal after the year 2000; (2) be written in English; (3) use videoconferencing technology for the provision of mental health assessment or treatment services; and (4) use an adequately-powered randomized controlled trial design in the case of treatment outcome studies. Out of 1976 studies identified by searches in PubMed (Medline database), Ovid medline, PsychInfo, Embase, and EBSCO PSYCH, 452 met inclusion criteria. Studies that met all inclusion criteria were organized into one of six categories: (1) satisfaction; (2) reliability; (3) treatment outcomes; (4) implementation outcomes; (5) cost effectiveness; and (6) and legal issues. All disagreements were resolved by reassessing study characteristics and discussion. RESULTS: Overall, patients and providers are generally satisfied with telepsychiatry services. Providers, however, tend to express more concerns about the potentially adverse of effects of telepsychiatry on therapeutic rapport. Patients are less likely to endorse such concerns about impaired rapport with their provider. Although few studies appropriately employ non-inferiority designs, the evidence taken together suggests that telepsychiatry is comparable to face-to-face services in terms of reliability of clinical assessments and treatment outcomes. When non-inferiority designs were appropriately used, telepsychiatry performed as well as, if not better than face-to-face delivery of mental health services. Studies using both rudimentary and more sophisticated methods for evaluating cost-effectiveness indicate that telepsychiatry is not more expensive than face-to-face delivery of

  5. Outcomes for extremely premature infants.

    PubMed

    Glass, Hannah C; Costarino, Andrew T; Stayer, Stephen A; Brett, Claire M; Cladis, Franklyn; Davis, Peter J

    2015-06-01

    Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (<1000 g) remain at high risk for death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address

  6. 20 CFR 411.550 - How are the outcome payments calculated under the outcome payment system?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... outcome payments Outcome payments 1-36 (67% of PCB) Monthly cash benefit not payable due to SGA $657.00...% of PCB) Earnings sufficient to “0” out Federal SSI cash benefits $377.00 $22,620 Note: Outcome payment (outcome payment system) = 67% of PCB Individual payments are rounded to the nearest dollar...

  7. 20 CFR 411.550 - How are the outcome payments calculated under the outcome payment system?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... outcome payments Outcome payments 1-36 (67% of PCB) Monthly cash benefit not payable due to SGA $657.00...% of PCB) Earnings sufficient to “0” out Federal SSI cash benefits $377.00 $22,620 Note: Outcome payment (outcome payment system) = 67% of PCB Individual payments are rounded to the nearest dollar...

  8. 20 CFR 411.550 - How are the outcome payments calculated under the outcome payment system?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... outcome payments Outcome payments 1-36 (67% of PCB) Monthly cash benefit not payable due to SGA $657.00...% of PCB) Earnings sufficient to “0” out Federal SSI cash benefits $377.00 $22,620 Note: Outcome payment (outcome payment system) = 67% of PCB Individual payments are rounded to the nearest dollar...

  9. 20 CFR 411.550 - How are the outcome payments calculated under the outcome payment system?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... outcome payments Outcome payments 1-36 (67% of PCB) Monthly cash benefit not payable due to SGA $657.00...% of PCB) Earnings sufficient to “0” out Federal SSI cash benefits $377.00 $22,620 Note: Outcome payment (outcome payment system) = 67% of PCB Individual payments are rounded to the nearest dollar...

  10. Tradeoffs between Sequences: Weighing Accumulated Outcomes against Outcome-Adjusted Delays

    ERIC Educational Resources Information Center

    Read, Daniel; Scholten, Marc

    2012-01-01

    We extend the recently proposed "tradeoff model" of intertemporal choice (Scholten & Read, 2010) from choices between pairs of single outcomes to pairwise choices involving two-outcome sequences. The core of our proposal is that choices between sequences are made by weighing accumulated outcomes against outcome-adjusted delays. Thus extended, the…

  11. Food Insecurity And Health Outcomes.

    PubMed

    Gundersen, Craig; Ziliak, James P

    2015-11-01

    Almost fifty million people are food insecure in the United States, which makes food insecurity one of the nation's leading health and nutrition issues. We examine recent research evidence of the health consequences of food insecurity for children, nonsenior adults, and seniors in the United States. For context, we first provide an overview of how food insecurity is measured in the country, followed by a presentation of recent trends in the prevalence of food insecurity. Then we present a survey of selected recent research that examined the association between food insecurity and health outcomes. We show that the literature has consistently found food insecurity to be negatively associated with health. For example, after confounding risk factors were controlled for, studies found that food-insecure children are at least twice as likely to report being in fair or poor health and at least 1.4 times more likely to have asthma, compared to food-secure children; and food-insecure seniors have limitations in activities of daily living comparable to those of food-secure seniors fourteen years older. The Supplemental Nutrition Assistance Program (SNAP) substantially reduces the prevalence of food insecurity and thus is critical to reducing negative health outcomes. PMID:26526240

  12. Predicting the outcome of roulette.

    PubMed

    Small, Michael; Tse, Chi Kong

    2012-09-01

    There have been several popular reports of various groups exploiting the deterministic nature of the game of roulette for profit. Moreover, through its history, the inherent determinism in the game of roulette has attracted the attention of many luminaries of chaos theory. In this paper, we provide a short review of that history and then set out to determine to what extent that determinism can really be exploited for profit. To do this, we provide a very simple model for the motion of a roulette wheel and ball and demonstrate that knowledge of initial position, velocity, and acceleration is sufficient to predict the outcome with adequate certainty to achieve a positive expected return. We describe two physically realizable systems to obtain this knowledge both incognito and in situ. The first system relies only on a mechanical count of rotation of the ball and the wheel to measure the relevant parameters. By applying these techniques to a standard casino-grade European roulette wheel, we demonstrate an expected return of at least 18%, well above the -2.7% expected of a random bet. With a more sophisticated, albeit more intrusive, system (mounting a digital camera above the wheel), we demonstrate a range of systematic and statistically significant biases which can be exploited to provide an improved guess of the outcome. Finally, our analysis demonstrates that even a very slight slant in the roulette table leads to a very pronounced bias which could be further exploited to substantially enhance returns. PMID:23020489

  13. Factors affecting outcomes in colonoscopy.

    PubMed

    Selehi, Seema; Leung, Edmund; Wong, Ling

    2008-01-01

    There are many factors that influence successful outcomes in colonoscopy. The aims of this study were to evaluate these factors and determine ways to improve outcomes. All participants (N=229) who underwent planned colonoscopy between July and September 2004 were retrospectively included. Participants included 118 men and 111 women with a mean age of 59 years. Completion rate was 92%. Reasons of failure included poor bowel preparation (2.2%, p< .025), bowel looping (2.2%, p< .025), participant discomfort (1.3%), and obstructing lesion (1.3%). Mean midazolam dose was 3.8 mg. Three participants (1.3%) had midazolam alone, and all had complete colonoscopy. One hundred thirty-three participants (60.7%) had additional meperidine, with a completion rate of 94%. Eighty three participants (37.9%) had additional meperidine and Buscopan, with a completion rate reduced to 89.2%. There was no correlation between sedatives used and completion rate. Completion rate of colonoscopy in our unit was acceptable at 92%. A combination of midazolam and meperidine gave the best completion rates (94%). The two main reasons for incompletion were poor bowel preparation and excessive bowel looping. PMID:18300826

  14. Countrywide analysis of perinatal outcome.

    PubMed

    Stembera, Z; Kravka, A; Mandys, F

    1988-01-01

    The computer laboratory of the Research Institute for the Care of Mother and Child in Prague performs annually a countrywide analysis of perinatal outcome in order to obtain a background for the preparation of the optimal strategy for improving perinatal care in CSR in the future. The total as well as weight specific perinatal mortality rate further sub-divided into early neonatal death rate and late fetal death rate and differentiated according to the birthweight, was correlated with the incidence of different factors influencing the perinatal mortality rate both countrywide and for each of the eight provinces of CSR. This way a correlation was found between some of the mentioned perinatal outcomes and e.g. instrumental equipment of obstetrical departments and neonatal intensive care units, frequency of caesarean sections, or transport of LBW newborns in incubators or "in utero" etc. The results of this analysis have proved that there still remain in some provinces opportunity for further decrease in perinatal mortality due to the incomplete observance of the two intervention strategies "Risk approach" and "New technology" which were introduced in the whole country during the last 10 years. PMID:3221298

  15. Intracranial ependymoma: factors affecting outcome.

    PubMed

    Massimino, Maura; Buttarelli, Francesca R; Antonelli, Manila; Gandola, Lorenza; Modena, Piergiorgio; Giangaspero, Felice

    2009-03-01

    Ependymomas account for 2-9% of all neuroepithelial tumors, amounting to 6-12% of all intracranial tumors in children and up to 30% of those in children younger than 3 years. Recent findings provide evidence that intracranial and spinal ependymomas share similar molecular profiles with the radial glia of their corresponding locations. The management of intracranial ependymoma is still not optimal. The 5-year progression-free survival for children with ependymoma ranges between 30 and 50% with a worse prognosis for patients with residual disease after surgery. The prognostic relevance of most factors are still being debated. Recent studies, in which the current WHO classification criteria were applied, reported the relationship between histological grade and outcome. Biomolecular studies have identified that gain of 1q25 and EGFR overexpression correlate to poor prognosis, whereas low expression of nucleolin correlated with a favorable outcome. Ependymomas have been considered a 'surgical disease', where completeness of excision can be reached in approximately half of the cases. At present the standard treatment is radiation therapy for all patients after gross-total or near-total resection. For high-risk patients, with residual tumor, an interesting, although experimental, approach could be chemotherapy followed by secondary surgery and postoperative conformal irradiation. PMID:19284379

  16. Functional outcomes of face transplantation.

    PubMed

    Fischer, S; Kueckelhaus, M; Pauzenberger, R; Bueno, E M; Pomahac, B

    2015-01-01

    In this study we provide a compilation of functional impairments before and improvements after face transplantation (FT) of five FT recipients of our institution and all FTs reported in current literature. Functional outcome included the ability to smell, breath, eat, speak, grimace and facial sensation. Before FT, all our patients revealed compromised ability to breath, eat, speak, grimace and experience facial sensation. The ability to smell was compromised in two of our five patients. Two patients were dependent on tracheostomy and one on gastrostomy tubes. After FT, all abilities were significantly improved and all patients were independent from artificial air airways and feeding tubes. Including data given in current literature about the other 24 FT recipients in the world, the abilities to smell, eat and feel were enhanced in 100% of cases, while the abilities of breathing, speaking and facial expressions were ameliorated in 93%, 71% and 76% of cases, respectively. All patients that required gastrostomy and 91% of patients depending on tracheostomy were decannulated after FT. Unfortunately, outcomes remain unreported in all other cases and therefore we are unable to comment on improvements. PMID:25359281

  17. Predicting the outcome of roulette

    NASA Astrophysics Data System (ADS)

    Small, Michael; Tse, Chi Kong

    2012-09-01

    There have been several popular reports of various groups exploiting the deterministic nature of the game of roulette for profit. Moreover, through its history, the inherent determinism in the game of roulette has attracted the attention of many luminaries of chaos theory. In this paper, we provide a short review of that history and then set out to determine to what extent that determinism can really be exploited for profit. To do this, we provide a very simple model for the motion of a roulette wheel and ball and demonstrate that knowledge of initial position, velocity, and acceleration is sufficient to predict the outcome with adequate certainty to achieve a positive expected return. We describe two physically realizable systems to obtain this knowledge both incognito and in situ. The first system relies only on a mechanical count of rotation of the ball and the wheel to measure the relevant parameters. By applying these techniques to a standard casino-grade European roulette wheel, we demonstrate an expected return of at least 18%, well above the -2.7% expected of a random bet. With a more sophisticated, albeit more intrusive, system (mounting a digital camera above the wheel), we demonstrate a range of systematic and statistically significant biases which can be exploited to provide an improved guess of the outcome. Finally, our analysis demonstrates that even a very slight slant in the roulette table leads to a very pronounced bias which could be further exploited to substantially enhance returns.

  18. Defining, constructing and assessing learning outcomes.

    PubMed

    Taylor, R M

    2009-08-01

    Learning outcomes define the veterinary curriculum and inform students about what they must be able to demonstrate to succeed. Stakeholder consultation during their development ensures that programme learning outcomes equip graduates to contribute to the veterinary profession. Effective learning outcomes form a hierarchy linking the programme, its courses and tasks. Clear outcomes direct students towards higher quality learning by indicating the achievements intended, but leave scope for emergent learning outcomes. Defined technical competencies fit within this overarching framework, complementing higher order learning. Mapping is used to align learning outcomes horizontally and vertically so students are systematically guided towards entry-level competence and professional independence. Constructively aligned learning and assessment tasks ensure learners spend the focused time required to sequentially develop programme outcomes. Assessment by staff, peers and other stakeholders certifies achievement of intended outcomes. Effective assessment also empowers students to define and achieve their own learning outcomes, so they develop the habits of autonomous life-long learning. Evaluation of the quality and consistency of achieved outcomes informs ongoing programme improvement. If we are going to achieve the objectives of this set of papers, i.e. to improve public health education globally (Rev. sci. tech. Off. int. Epiz. 28 [2] 2009), then it is essential that they be well defined in the learning outcomes statement of all veterinary schools. PMID:20128490

  19. Outcomes evaluation of the athletic elbow.

    PubMed

    Freehill, Michael T; Mannava, Sandeep; Safran, Marc R

    2014-09-01

    The high-level athletic population poses difficulty when evaluating outcomes in orthopedic surgery, given generally good overall health and high function at baseline. Subtle differences in performance following injury or orthopedic surgery are hard to detect in high-performance athletes using standard outcome metrics; however, attaining these subtle improvements after injury or surgery are key to an athletes' livelihood. Outcome measures serve as the cornerstone for critical evaluation of clinical outcomes following orthopedic surgery or injury. In the age of "evidence-based medicine" and "pay-for-performance" accountability for surgical intervention, understanding clinically relevant outcome measures is essential for careful review of the published literature, as well as one's own critical review of surgical performance. The purpose of this manuscript is to evaluate clinical outcome measures in the context of the athletic elbow. An emphasis will be placed on evaluation of the 5 most clinically relevant outcome measures for sports-related elbow outcomes: (1) American Shoulder and Elbow Committee; (2) Mayo Elbow Performance Index; (3) Andrews-Timmerman [and its precursor the (4) Andrews-Carson]; and (5) Kerlan-Jobe Orthopaedic Clinic overhead athlete score. A final outcome measure that will be analyzed is "return to play" statistics, which has been published in various studies of athletes' recovery from elbow surgery, as well as, the outcomes metric known as the "Conway-Jobe scale." Although there is no perfect outcomes score for the athletic elbow, the Kerlan-Jobe Orthopaedic Clinic score is the only outcomes tool developed and validated for outcomes for elbow injuries in the overhead athlete, as compared with the Andrew-Timmerman and Conway-Jobe metrics, which were not validated outcome measures for the elbow in this patient population. Despite the Disabilities of Arm, Shoulder, Hand (DASH) (and DASH-Sport module) being validated in the general population, this

  20. Gallbladder cancer: epidemiology and outcome

    PubMed Central

    Hundal, Rajveer; Shaffer, Eldon A

    2014-01-01

    Gallbladder cancer, though generally considered rare, is the most common malignancy of the biliary tract, accounting for 80%–95% of biliary tract cancers. An early diagnosis is essential as this malignancy progresses silently with a late diagnosis, often proving fatal. Its carcinogenesis follows a progression through a metaplasia–dysplasia–carcinoma sequence. This comprehensive review focuses on and explores the risks, management, and outcomes for primary gallbladder carcinoma. Epidemiological studies have identified striking geographic and ethnic disparities – inordinately high occurrence in American Indians, elevated in Southeast Asia, yet quite low elsewhere in the Americas and the world. Age, female sex, congenital biliary tract anomalies, and a genetic predisposition represent important risk factors that are immutable. Environmental triggers play a critical role in eliciting cancer developing in the gallbladder, best exemplified by cholelithiasis and chronic inflammation from biliary tract and parasitic infections. Mortality rates closely follow incidence; those countries with the highest prevalence of gallstones experience the greatest mortality from gallbladder cancer. Vague symptoms often delay the diagnosis of gallbladder cancer, contributing to its overall progression and poor outcome. Surgery represents the only potential for cure. Some individuals are fortunate to be incidentally found to have gallbladder cancer at the time of cholecystectomy being performed for cholelithiasis. Such an early diagnosis is imperative as a late presentation connotes advanced staging, nodal involvement, and possible recurrence following attempted resection. Overall mean survival is a mere 6 months, while 5-year survival rate is only 5%. The dismal prognosis, in part, relates to the gallbladder lacking a serosal layer adjacent to the liver, enabling hepatic invasion and metastatic progression. Improved imaging modalities are helping to diagnose patients at an earlier

  1. [Early outcomes of Asperger's syndrome].

    PubMed

    Bobrov, A E; Somova, V M

    2013-01-01

    Mental state of adult patients, who since childhood had features of Asperger's syndrome (AS), was studied. We examined 107 patients (89 men and 18 women). At the moment of inclusion in the study, all the patients met criteria of ICD=10 for AS. This was confirmed by the examination of the patients with the help of ASDASQ and ASDI scales. Based on the results of psychopathological and psychological five variants of AS outcomes in the age of early adulthood were identified as follows: integrated, inhibitory, peculiar, border-line and hypernormative. At the moment of examination, psychosocial compensation was observed in 38% of patients, only 28% of patients were on treatment and 20% had a history of transitory psychotic episodes. The authors conclude that the results of the study suggest the relatively favorable prognosis of AS. The differential clinical evaluation of this group as well as implication of adequate psychosocial and psychotherapeutic methods in their treatment is needed. PMID:24077546

  2. Union Density and Hospital Outcomes.

    PubMed

    Koys, Daniel J; Martin, Wm Marty; LaVan, Helen; Katz, Marsha

    2015-01-01

    The authors address the hospital outcomes of patient satisfaction, healthcare quality, and net income per bed. They define union density as the percentage of a hospital's employees who are in unions, healthcare quality as its 30-day acute myocardial infraction (AMI; heart attack) mortality rate, and patient satisfaction as its overall Hospital Consumer Assessment of Healthcare Providers and Systems score. Using a random sample of 84 union and 84 nonunion hospitals from across the United States, multiple regression analyses show that union density is negatively related to patient satisfaction. Union density is not related to healthcare quality as measured by the AMI mortality rate or to net income per bed. This implies that unions per se are not good or bad for hospitals. The authors suggest that it is better for hospital administrators to take a Balanced Scorecard approach and be concerned about employee satisfaction, patient satisfaction, healthcare quality, and net income. PMID:26652043

  3. Preoperative teaching and hysterectomy outcomes.

    PubMed

    Oetker-Black, Sharon L; Jones, Susan; Estok, Patricia; Ryan, Marian; Gale, Nancy; Parker, Carla

    2003-06-01

    This study used a theoretical model to determine whether an efficacy-enhancing teaching protocol was effective in improving immediate postoperative behaviors and selected short- and long-term health outcomes in women who underwent abdominal hysterectomies. The model used was the self-efficacy theory of Albert Bandura, PhD. One hundred eight patients in a 486-bed teaching hospital in the Midwest who underwent hysterectomies participated. The participation rate was 85%, and the attrition rate was 17% during the six-month study. The major finding was that participants in the efficacy-enhancing teaching group ambulated significantly longer than participants in the usual care group. This is an important finding because the most prevalent postoperative complications after hysterectomy are atelectasis, pneumonia, paralytic ileus, and deep vein thrombosis, and postoperative ambulation has been shown to decrease or prevent all of these complications. This finding could affect the overall health status of women undergoing hysterectomies. PMID:12817743

  4. Creating outcomes with redesign efforts.

    PubMed

    Cole, D A

    1999-09-01

    Integrating principles from a variety of theories, managers have developed a conceptual framework for reengineering processes in an endoscopy unit to improve the value of services provided to customers. A major goal of this redesign was to enhance or maintain quality of care, increase efficiency, and maintain or reduce costs. This was accomplished by analyzing data and outcome measures related to patient, physician, and staff member satisfaction, as well as resource allocation. The departmental results were tangible, positive, and visible almost immediately. With the right team and the right techniques, tools, methodologies, and decision-making processes, redesign projects can and do lead to dramatic improvements in productivity, service, customer and staff member satisfaction, cost control, and innovation. PMID:10514888

  5. Nonpulmonary outcomes of asbestos exposure.

    PubMed

    Bunderson-Schelvan, Melisa; Pfau, Jean C; Crouch, Robert; Holian, Andrij

    2011-01-01

    The adverse pulmonary effects of asbestos are well accepted in scientific circles. However, the extrapulmonary consequences of asbestos exposure are not as clearly defined. In this review the potential for asbestos to produce diseases of the peritoneum, immune, gastrointestinal (GIT), and reproductive systems are explored as evidenced in published, peer-reviewed literature. Several hundred epidemiological, in vivo, and in vitro publications analyzing the extrapulmonary effects of asbestos were used as sources to arrive at the conclusions and to establish areas needing further study. In order to be considered, each study had to monitor extrapulmonary outcomes following exposure to asbestos. The literature supports a strong association between asbestos exposure and peritoneal neoplasms. Correlations between asbestos exposure and immune-related disease are less conclusive; nevertheless, it was concluded from the combined autoimmune studies that there is a possibility for a higher-than-expected risk of systemic autoimmune disease among asbestos-exposed populations. In general, the GIT effects of asbestos exposure appear to be minimal, with the most likely outcome being development of stomach cancer. However, IARC recently concluded the evidence to support asbestos-induced stomach cancer to be "limited." The strongest evidence for reproductive disease due to asbestos is in regard to ovarian cancer. Unfortunately, effects on fertility and the developing fetus are under-studied. The possibility of other asbestos-induced health effects does exist. These include brain-related tumors, blood disorders due to the mutagenic and hemolytic properties of asbestos, and peritoneal fibrosis. It is clear from the literature that the adverse properties of asbestos are not confined to the pulmonary system. PMID:21534087

  6. Nonpulmonary Outcomes of Asbestos Exposure

    PubMed Central

    Bunderson-Schelvan, Melisa; Pfau, Jean C.; Crouch, Robert; Holian, Andrij

    2011-01-01

    The adverse pulmonary effects of asbestos are well accepted in scientific circles. However, the extrapulmonary consequences of asbestos exposure are not as clearly defined. In this review the potential for asbestos to produce diseases of the peritoneum, immune, gastrointestinal (GIT), and reproductive systems are explored as evidenced in published, peer-reviewed literature. Several hundred epidemiological, in vivo, and in vitro publications analyzing the extrapulmonary effects of asbestos were used as sources to arrive at the conclusions and to establish areas needing further study. In order to be considered, each study had to monitor extrapulmonary outcomes following exposure to asbestos. The literature supports a strong association between asbestos exposure and peritoneal neoplasms. Correlations between asbestos exposure and immune-related disease are less conclusive; nevertheless, it was concluded from the combined autoimmune studies that there is a possibility for a higher-than-expected risk of systemic autoimmune disease among asbestos-exposed populations. In general, the GIT effects of asbestos exposure appear to be minimal, with the most likely outcome being development of stomach cancer. However, IARC recently concluded the evidence to support asbestos-induced stomach cancer to be “limited.” The strongest evidence for reproductive disease due to asbestos is in regard to ovarian cancer. Unfortunately, effects on fertility and the developing fetus are under-studied. The possibility of other asbestos-induced health effects does exist. These include brain-related tumors, blood disorders due to the mutagenic and hemolytic properties of asbestos, and peritoneal fibrosis. It is clear from the literature that the adverse properties of asbestos are not confined to the pulmonary system. PMID:21534087

  7. Asthma Outcomes: Quality of Life

    PubMed Central

    Wilson, Sandra R.; Rand, Cynthia S.; Cabana, Michael D.; Foggs, Michael B.; Halterman, Jill S.; Olson, Lynn; Vollmer, William M.; Wright, Rosalind J.; Taggart, Virginia

    2014-01-01

    Background “Asthma-related quality of life” refers to the perceived impact that asthma has on the patient’s quality of life. Objective National Institutes of Health (NIH) institutes and other federal agencies convened an expert group to recommend standardized measures of the impact of asthma on quality of life for use in future asthma clinical research. Methods We reviewed published documentation regarding the development and psychometric evaluation; clinical research use since 2000; and extent to which the content of each existing quality of life instrument provides a unique, reliable, and valid assessment of the intended construct. We classified instruments as core (required in future studies), supplemental (used according to the study’s aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop convened in March 2010 and finalized in September 2011. Results Eleven instruments for adults and 6 for children were identified for review. None qualified as core instruments because they predominantly measured indicators of asthma control (symptoms and/or functional status); failed to provide a distinct, reliable score measuring all key dimensions of the intended construct; and/or lacked adequate psychometric data. Conclusions In the absence of existing instruments that meet the stated criteria, currently available instruments are classified as either supplemental or emerging. Research is strongly recommended to develop and evaluate instruments that provide a distinct, reliable measure of the patient’s perception of the impact of asthma on all of the key dimensions of quality of life, an important outcome that is not captured in other outcome measures. PMID:22386511

  8. Predictors of longitudinal outcome and recovery of pragmatic language and its relation to externalizing behaviour after pediatric traumatic brain injury.

    PubMed

    Ryan, Nicholas P; Catroppa, Cathy; Beare, Richard; Coleman, Lee; Ditchfield, Michael; Crossley, Louise; Beauchamp, Miriam H; Anderson, Vicki A

    2015-03-01

    The purpose of the present investigation was to evaluate the contribution of age-at-insult and brain pathology on longitudinal outcome and recovery of pragmatic language in a sample of children and adolescents with traumatic brain injury (TBI). Children and adolescents with mild to severe TBI (n=112) were categorized according to timing of brain insult: (i) Middle Childhood (5-9 years; n=41); (ii) Late Childhood (10-11 years; n=39); and (iii) Adolescence (12-15 years; n=32) and group-matched for age, gender and socio-economic status (SES) to a typically developing (TD) control group (n=43). Participants underwent magnetic resonance imaging (MRI) including a susceptibility weighted imaging (SWI) sequence 2-8 weeks after injury and were assessed on measures of pragmatic language and behavioural functioning at 6- and 24-months after injury. Children and adolescents with TBI of all severity levels demonstrated impairments in these domains at 6-months injury before returning to age-expected levels at 2-years post-TBI. However, while adolescent TBI was associated with post-acute disruption to skills that preceded recovery to age-expected levels by 2-years post injury, the middle childhood TBI group demonstrated impairments at 6-months post-injury that were maintained at 2-year follow up. Reduced pragmatic communication was associated with frontal, temporal and corpus callosum lesions, as well as more frequent externalizing behaviour at 24-months post injury. Findings show that persisting pragmatic language impairment after pediatric TBI is related to younger age at brain insult, as well as microhemorrhagic pathology in brain regions that contribute to the anatomically distributed social brain network. Relationships between reduced pragmatic communication and more frequent externalizing behavior underscore the need for context-sensitive rehabilitation programs that aim to increase interpersonal effectiveness and reduce risk for maladaptive behavior trajectories into the

  9. Thinking About Clinical Outcomes in Medicaid

    PubMed Central

    Weimar, Dawn; Gray, Jeffrey; Davies, Bud

    2016-01-01

    As Medicaid expands in scope and influence, it is evolving toward being a “purchaser” of quality health care. This commentary discusses measurement and incentivization of clinical outcomes in Medicaid. Advantages and disadvantages of outcome versus process measures are discussed. Distinctions are drawn between the roles of Medicare and Medicaid, including the implications of the growth in Medicaid managed care. Medicaid's influence is particularly notable for obstetric, pediatric, newborn, and long-term care. We provide data on 3 Medicaid outcomes: potentially preventable hospital admissions, readmissions, and complications. The commentary concludes with suggestions for choosing and implementing outcome-oriented value-based purchasing initiatives in Medicaid. PMID:26945295

  10. Outcomes on home haemodialysis: registry challenges

    PubMed Central

    2011-01-01

    Health care policy is encouraging expansion of home haemodialysis, aiming to improve patient outcomes and reduce cost. However, most patient outcome data derive from retrospective observational studies, with all their inherent weaknesses. Conventional thrice weekly home haemodialysis delivers a 22–51% reduction in mortality, but why should that be? Frequent and/or nocturnal haemodialysis reduces mortality by 36–66%, with comparable outcomes to deceased donor kidney transplantation. Approaches which might improve the quality of future observational studies are discussed. Patient-relevant outcomes other than mortality are also discussed. PMID:25949517

  11. Outcomes on home haemodialysis: registry challenges.

    PubMed

    MacGregor, Mark S

    2011-12-01

    Health care policy is encouraging expansion of home haemodialysis, aiming to improve patient outcomes and reduce cost. However, most patient outcome data derive from retrospective observational studies, with all their inherent weaknesses. Conventional thrice weekly home haemodialysis delivers a 22-51% reduction in mortality, but why should that be? Frequent and/or nocturnal haemodialysis reduces mortality by 36-66%, with comparable outcomes to deceased donor kidney transplantation. Approaches which might improve the quality of future observational studies are discussed. Patient-relevant outcomes other than mortality are also discussed. PMID:25949517

  12. Outcome instruments for prosthetics: clinical applications.

    PubMed

    Heinemann, Allen W; Connelly, Lauri; Ehrlich-Jones, Linda; Fatone, Stefania

    2014-02-01

    Outcome measurement is crucial to assuring high-quality patient services and improving the quality of services provided by prosthetists. This article summarizes recent evidence on the measurement properties of outcome measures, and updates previously published summaries of outcome instruments. The review focuses on measures of mobility, functional status, quality of life, and patient satisfaction, and includes both performance-based and patient-reported outcomes. Amputation-specific and general measures that are suitable for patients served by prosthetists are discussed. It is encouraging that responsiveness of measures is often reported, as this information is needed to improve clinical utility. PMID:24287247

  13. Breastfeeding Outcome Comparison by Parity

    PubMed Central

    Schaefer, Eric W.; Beiler, Jessica S.; Rose, Chelsea M.; Paul, Ian M.

    2015-01-01

    Abstract Objective: Anecdotally, breastfeeding experiences differ between those who have previously nursed an infant and those who are primiparous. This analysis contrasted breastfeeding outcomes between primiparous women and those with previous experience spanning from maternity stay through 6 months postpartum. Study Design: A secondary analysis was conducted of data collected in a randomized, controlled trial with mothers and “well” newborns ≥34 weeks of gestation comparing two post–hospital discharge care models. Mothers completed an in-person interview during the postpartum stay and phone surveys at 2 weeks, 2 months, and 6 months where questionnaires related to breastfeeding were completed. All participants intended to breastfeed. Chi-squared and Wilcoxon rank sum tests were used to test for differences between parity groups. Breastfeeding duration by parity group was compared using a Kaplan–Meier plot and a logrank test. A Cox proportional hazards model was used to evaluate the relationship between breastfeeding duration and parity after adjusting for covariates. Results: Among 1,099 mothers available for analysis, 542 (49%) were primiparous. Multiparous mothers had a longer intended breastfeeding duration (median, 9 vs. 6 months; p<0.001). Following delivery, primiparous mothers had a longer median time to first breastfeeding attempt (119 vs. 96 minutes; p<0.001) and were more likely to have eight or fewer feeding attempts in the first 24 hours (33% vs. 44%; p<0.001)). More primiparous women reported early breastfeeding problems (35% vs. 20%; p<0.001) and mixed feeding at hospital discharge (39% vs. 23%; p<0.001) despite reporting less breastfeeding-associated pain during the first week (p=0.04). Multiparous women were more likely to breastfeed through 6 months (p<0.001). In a multivariable Cox model for breastfeeding duration, an interaction existed between intended breastfeeding duration and parity (p=0.006); among those intending to breastfeed

  14. [Patient evaluation and outcome measures].

    PubMed

    Nieto Pol, Enrique

    2014-01-01

    Both the initial evaluation and follow-up of patients with osteoarthritis require systematic evaluation of the indicators that provide information on the degree of involvement of the disease and allow its quantification. Reliable measures of disease progression help decision-making by clinicians and provide valid information on treatment response and the effectiveness of the distinct therapeutic interventions. The instruments recommended in research, as outcome measures in osteoarthritis, are pain evaluation, assessment of physical function, and self-reported global evaluation. In studies lasting more than 1 year, structural changes are evaluated through simple X-ray. Self-reported quality of life assessment and physician global assessment are also recommended as options. These indicators should be incorporated into routine clinical practice for adequate evaluation and correct follow-up of patients with osteoarthritis. The recommended pain evaluation method for use in clinical practice is the visual analog scale (VAS). The best instrument to evaluate physical function in patients with hip or knee osteoarthritis is the WOMAC scale (Western Ontario and McMaster Universities Osteoarthritis Index). For patient-reported global assessment in routine practice, the recommended scales are VAS or the SF-12 (12-item short-form health survey). PMID:24467959

  15. Social networks and environmental outcomes

    PubMed Central

    Kalberg, Kolter; Leung, PingSun

    2016-01-01

    Social networks can profoundly affect human behavior, which is the primary force driving environmental change. However, empirical evidence linking microlevel social interactions to large-scale environmental outcomes has remained scarce. Here, we leverage comprehensive data on information-sharing networks among large-scale commercial tuna fishers to examine how social networks relate to shark bycatch, a global environmental issue. We demonstrate that the tendency for fishers to primarily share information within their ethnic group creates segregated networks that are strongly correlated with shark bycatch. However, some fishers share information across ethnic lines, and examinations of their bycatch rates show that network contacts are more strongly related to fishing behaviors than ethnicity. Our findings indicate that social networks are tied to actions that can directly impact marine ecosystems, and that biases toward within-group ties may impede the diffusion of sustainable behaviors. Importantly, our analysis suggests that enhanced communication channels across segregated fisher groups could have prevented the incidental catch of over 46,000 sharks between 2008 and 2012 in a single commercial fishery. PMID:27217551

  16. OUTCOME OF TRANSPLANTATION FOR MYELOFIBROSIS

    PubMed Central

    Ballen, Karen K.; Shrestha, Smriti; Sobocinski, Kathleen A; Zhang, Mei-Jie; Bashey, Asad; Bolwell, Brian J.; Cervantes, Francisco; Devine, Steven M.; Gale, Robert Peter; Gupta, Vikas; Hahn, Theresa E.; Hogan, William J.; Kröger, Nicolaus; Litzow, Mark R.; Marks, David I.; Maziarz, Richard T.; McCarthy, Philip L.; Schiller, Gary; Schouten, Harry C.; Roy, Vivek; Wiernik, Peter H.; Horowitz, Mary M.; Giralt, Sergio A.; Arora, Mukta

    2010-01-01

    Myelofibrosis is a myeloproliferative disorder incurable with conventional strategies. Several small series have reported long-term disease free survival after allogeneic hematopoietic cell transplantation. In this study, we analyze the outcomes of 289 patients receiving allogeneic transplantation for primary myelofibrosis between 1989 and 2002, from the database of the Center for International Bone Marrow Transplant Research (CIBMTR). The median age was 47 years (range 18-73 years). Donors were HLA identical siblings in 162 patients, unrelated individuals in 101 patients, and HLA non-identical family members in 26 patients. Patients were treated with a variety of conditioning regimens and graft versus host disease prophylaxis regimens. Splenectomy was performed in 65 patients prior to transplantation. The 100-day transplant related mortality was 18% for HLA identical sibling transplants, 35% for unrelated transplants, and 19% for transplants from alternative related donors. Corresponding 5 year overall survival rates were 37%, 30%, and 40% respectively. Disease-free survival rates were 33%, 27% and 22% respectively. Disease-free survival for patients receiving reduced intensity transplants was comparable, 39% for HLA identical sibling donors and 17% for unrelated donors at three years. In this large retrospective series, allogeneic transplantation for myelofibrosis resulted in long-term relapse-free survival in about one-third of patients. PMID:19879949

  17. ▼ Empagliflozin, diabetes and outcomes.

    PubMed

    2016-07-01

    The prevalence of type 2 diabetes is rising, and in 2015 more than 5% of adults in the UK were affected by this condition.(1,2) Management of type 2 diabetes includes encouraging lifestyle changes (increased exercise, modification of diet and smoking cessation) alongside the provision of medication to minimise long-term complications and manage blood sugar control while avoiding unwanted effects of drug treatment.(3) Of particular importance, people with type 2 diabetes are at increased risk of cardiovascular disease, and therefore the aims of treatment also include modification of associated risk factors.(2-5)▼ Empagliflozin (Jardiance-Boehringer Ingelheim) is the third sodium-glucose co-transporter-2 (SGLT2) inhibitor licensed for use in the UK. It was launched in August 2014, and acts in a similar way to the other SGLT2 inhibitors, ▼ dapagliflozin and ▼ canagliflozin, by inhibiting renal glucose resorption and promoting glycosuria.(6) It is indicated for the treatment of type 2 diabetes in adults to improve glycaemic control, as monotherapy when metformin cannot be used, and in combination with other glucose-lowering drugs including insulin. Here we review the evidence for empagliflozin and discuss the results of a recent study that assessed cardiovascular outcomes. PMID:27417322

  18. Social networks and environmental outcomes.

    PubMed

    Barnes, Michele L; Lynham, John; Kalberg, Kolter; Leung, PingSun

    2016-06-01

    Social networks can profoundly affect human behavior, which is the primary force driving environmental change. However, empirical evidence linking microlevel social interactions to large-scale environmental outcomes has remained scarce. Here, we leverage comprehensive data on information-sharing networks among large-scale commercial tuna fishers to examine how social networks relate to shark bycatch, a global environmental issue. We demonstrate that the tendency for fishers to primarily share information within their ethnic group creates segregated networks that are strongly correlated with shark bycatch. However, some fishers share information across ethnic lines, and examinations of their bycatch rates show that network contacts are more strongly related to fishing behaviors than ethnicity. Our findings indicate that social networks are tied to actions that can directly impact marine ecosystems, and that biases toward within-group ties may impede the diffusion of sustainable behaviors. Importantly, our analysis suggests that enhanced communication channels across segregated fisher groups could have prevented the incidental catch of over 46,000 sharks between 2008 and 2012 in a single commercial fishery. PMID:27217551

  19. Surgical Outcome of Spinal Neurilemmoma

    PubMed Central

    Yeh, Kuang-Ting; Lee, Ru-Ping; Yu, Tzai-Chiu; Chen, Ing-Ho; Peng, Cheng-Huan; Liu, Kuan-Lin; Wang, Jen-Hung; Wu, Wen-Tien

    2015-01-01

    Abstract Neurilemmoma commonly occurs from the fourth to sixth decades of life with an incidence of 3 to 10 per 100,000 people, and is rare in adolescence. This case report describes the clinical and radiographic features of 2 rare cases with intraspinal neurilemmoma of the cervical and thoracic spine. A 29-year-old man who experienced middle back pain with prominent right lower limb weakness, and an 11-year-old boy who suffered from sudden onset neck pain with left arm weakness and hand clawing for 2 weeks before admission to our department were included in this case report. Magnetic resonance imaging of both patients revealed an intraspinal mass causing spinal cord compression at the cervical and thoracic spine. The patients subsequently received urgent posterior spinal cord decompression and tumor resection surgery. The histopathology reports revealed neurilemmoma. The 2 patients recovered and resumed their normal lives within 1 year. Intraspinal neurilemmoma is rare but should be considered in the differential diagnosis of spinal cord compression. Advances in imaging techniques and surgical procedures have yielded substantially enhanced clinical outcomes in intraspinal neoplasm cases. Delicate preoperative study and surgical skill with rehabilitation and postoperative observation are critical. PMID:25654395

  20. Allograft Pancreatectomy: Indications and Outcomes.

    PubMed

    Nagai, S; Powelson, J A; Taber, T E; Goble, M L; Mangus, R S; Fridell, J A

    2015-09-01

    This study evaluated the indications, surgical techniques, and outcomes of allograft pancreatectomy based on a single center experience. Between 2003 and 2013, 47 patients developed pancreas allograft failure, excluding mortality with a functioning pancreas allograft. Early graft loss (within 14 days) occurred in 16, and late graft loss in 31. All patients with early graft loss eventually required allograft pancreatectomy. Nineteen of 31 patients (61%) with late graft loss underwent allograft pancreatectomy. The main indication for early allograft pancreatectomy included vascular thrombosis with or without severe pancreatitis, whereas one recipient required urgent allograft pancreatectomy for gastrointestinal hemorrhage secondary to an arterioenteric fistula. In cases of late allograft pancreatectomy, graft failure with clinical symptoms such as abdominal discomfort, pain, and nausea were the main indications (13/19 [68%]), simultaneous retransplantation without clinical symptoms in 3 (16%), and vascular catastrophes including pseudoaneurysm and enteric arterial fistula in 3 (16%). Postoperative morbidity included one case each of pulmonary embolism leading to mortality, formation of pseudoaneurysm requiring placement of covered stent, and postoperative bleeding requiring relaparotomy eventually leading to femoro-femoral bypass surgery 2 years after allograftectomy. Allograft pancreatectomy can be performed safely, does not preclude subsequent retransplantation, and may be lifesaving in certain instances. PMID:25912792

  1. Dietary patterns and health outcomes.

    PubMed

    Kant, Ashima K

    2004-04-01

    A systematic review of the literature on dietary patterns (multiple dietary components operationalized as a single exposure) in relation to nutrient adequacy, lifestyle and demographic variables, and health outcome was conducted. Most of the published reports on the subject have used one of two methods to determine dietary patterns: (a) diet indexes or scores that assess compliance with prevailing dietary guidance as dietary patterns, and (b) data-driven methods that use factor or cluster analysis to derive dietary patterns. Irrespective of the approach used, patterns characterized by fruit/vegetable/whole grain/fish/poultry consumption generally have been reported to relate to micronutrient intake, and to selected biomarkers of dietary exposure and disease risk in the expected direction. Age, income, and education have been reported to be among positive predictors of the so-called more healthful dietary patterns. An inverse association of healthful dietary patterns with all-cause mortality and cardiovascular disease risk was reported in most studies. However, the magnitude of risk reduction was modest and was attenuated after control for confounders. Few published studies showed an association between risk of most incident cancers and dietary patterns. Both of the currently used approaches for extracting dietary patterns have limitations, are subject to dietary measurement errors, and have not generated new diet and disease hypotheses. PMID:15054348

  2. [Fatal outcome of Ecstasy overdose].

    PubMed

    Sticht, Guido; Pluisch, Frank; Bierhoff, Erhard; Käferstein, Herbert

    2003-01-01

    Consumption of amphetamine derivatives has considerably increased in Germany since the early nineties. Again and again intoxications with lethal outcome have also been reported, especially after physical activities such as intensive dancing. The authors present a case of an obviously suicidal intoxication of a 21-year-old man who was found dead with marked cuts on the right forearm. Toxicological tests showed in particular 3, 4-methylene-dioxymethamphetamine (MDMA). The results of the hair analysis revealed chronic consumption, but no cellular liver damage could be demonstrated. When examining the body fluids and organs, the highest concentrations by far were measured in the lungs (36.6 mg/kg), the liver (29.7 mg/kg) and the brain (29.1 mg/kg). The concentration in heart blood amounted to 10.8 mg/kg and was thus markedly higher than in peripheral blood (7.2 mg/kg). In the muscles concentrations ranged between 14.3 mg/kg and 20.2 mg/kg. On the basis of these concentrations and the available pharmacokinetic data the amount of MDMA probably consumed is assessed. It is demonstrated that for this assessment the concentrations in the muscular system are of special importance, as redistribution of highly lipophilic substances from the surrounding tissue is possible also in peripheral blood. PMID:12722556

  3. Foetal Gender and Obstetric Outcome

    PubMed Central

    Schildberger, B.; Leitner, H.

    2016-01-01

    Introduction: Data on specific characteristics based on the gender of the unborn baby and their significance for obstetrics are limited. The aim of this study is to analyse selected parameters of obstetric relevance in the phases pregnancy, birth and postpartum period in dependence on the gender of the foetus. Materials and Methods: The selected study method comprised a retrospective data acquisition and evaluation from the Austrian birth register of the Department of Clinical Epidemiology of Tyrolean State Hospitals. For the analysis all inpatient singleton deliveries in Austria during the period from 2008 to 2013 were taken into account (live and stillbirths n = 444 685). The gender of the baby was correlated with previously defined, obstetrically relevant parameters. Results: In proportions, significantly more premature births and sub partu medical interventions (vaginal and abdominal surgical deliveries. episiotomies) were observed for male foetuses (p < 0.001). The neonatal outcome (5-min Apgar score, umbilical pH value less than 7.1, transfer to a neonatal special unit) is significantly poorer for boys (p < 0.001). Discussion: In view of the vulnerability of male foetuses and infants, further research is needed in order to be able to react appropriately to the differing gender-specific requirements in obstetrics. PMID:27065487

  4. AMEE Guide No. 14. Outcome-Based Education: Part 3--Assessment in Outcome-Based Education.

    ERIC Educational Resources Information Center

    Ben-David, Miriam Friedman

    1999-01-01

    Discusses the role of performance assessment in outcome-based education. Compares the relationship and interplay between the two related paradigms and presents guidelines of assessment programs in outcome-based education. (Author/CCM)

  5. Expectations predict chronic pain treatment outcomes.

    PubMed

    Cormier, Stéphanie; Lavigne, Geneviève L; Choinière, Manon; Rainville, Pierre

    2016-02-01

    Accumulating evidence suggests an association between patient pretreatment expectations and numerous health outcomes. However, it remains unclear if and how expectations relate to outcomes after treatments in multidisciplinary pain programs. The present study aims at investigating the predictive association between expectations and clinical outcomes in a large database of chronic pain patients. In this observational cohort study, participants were 2272 patients treated in one of 3 university-affiliated multidisciplinary pain treatment centers. All patients received personalized care, including medical, psychological, and/or physical interventions. Patient expectations regarding pain relief and improvements in quality of life and functioning were measured before the first visit to the pain centers and served as predictor variables. Changes in pain intensity, depressive symptoms, pain interference, and tendency to catastrophize, as well as satisfaction with pain treatment and global impressions of change at 6-month follow-up, were considered as treatment outcomes. Structural equation modeling analyses showed significant positive relationships between expectations and most clinical outcomes, and this association was largely mediated by patients' global impressions of change. Similar patterns of relationships between variables were also observed in various subgroups of patients based on sex, age, pain duration, and pain classification. Such results emphasize the relevance of patient expectations as a determinant of outcomes in multimodal pain treatment programs. Furthermore, the results suggest that superior clinical outcomes are observed in individuals who expect high positive outcomes as a result of treatment. PMID:26447703

  6. Principal Leadership for Outstanding Educational Outcomes

    ERIC Educational Resources Information Center

    Dinham, Stephen

    2005-01-01

    Purpose: Aims to explore the role of Principals in producing outstanding education outcomes in Years 7 to 10 in New South Wales (Australia) government schools. Design/methodology/approach: Sites where "outstanding" educational outcomes were believed to be occurring were selected using a variety of data including performance in standardised tests,…

  7. The Influence of Outcome Desirability on Optimism

    ERIC Educational Resources Information Center

    Krizan, Zlatan; Windschitl, Paul D.

    2007-01-01

    People are often presumed to be vulnerable to a desirability bias, namely, a tendency to be overoptimistic about a future outcome as a result of their preferences or desires for that outcome. In this article, this form of wishful thinking is distinguished from the more general concepts of motivated reasoning and overoptimism, and the evidence for…

  8. Outcome-Based Education. Final Report.

    ERIC Educational Resources Information Center

    Kearney, James M.

    This paper presents a summary of research on outcome-based education (OBE). The first section provides an overview of the evolution and history of OBE in the United States. Other outcome-based models are described in the second section. The third section reviews research on OBE and related concepts, including mastery learning, cooperative…

  9. Strategic approaches to adverse outcome pathway development

    EPA Science Inventory

    Adverse outcome pathways (AOPs) are conceptual frameworks for organizing biological and toxicological knowledge in a manner that supports extrapolation of data pertaining to the initiation or early progression of toxicity to an apical adverse outcome that occurs at a level of org...

  10. Treatment Outcomes and Efficacy in the Schools.

    ERIC Educational Resources Information Center

    Logemann, Jeri A.

    1998-01-01

    Introduces six articles which address treatment outcomes and efficacy in audiology and speech-language pathology in the schools. Stresses the importance of practitioners participating in studies of treatment outcomes and efficacy to demonstrate that their evaluations and treatments make a significant difference to individuals served. (DB)

  11. Designing Radiology Outcomes Studies-Essential Principles.

    PubMed

    Kang, Stella K; Mushlin, Alvin I

    2016-07-01

    Health outcomes research is essential to align radiology with current standards of high-value patient care, through the assessment of end results of diagnostic tests, interventions, or policy on patient health. To bridge studies of diagnostic test accuracy and health outcomes research, key considerations include: (1) how to determine when a diagnostic test merits evaluation of impact on outcomes, (2) when study of intermediate/surrogate outcomes can be useful, (3) how to consider the possible harms as well as potential benefits of a test, and (4) how to integrate evidence of an imaging test's efficacy/effectiveness with clinical data to assess outcomes. Due to challenges in conducting studies of long-term outcomes consequent to imaging use, intermediate health outcomes may capture a test's impact on successful diagnosis and therapy, and can provide readily measurable, incremental insights into the role of imaging in health-care delivery and efficiency. In an era marked by recognition of quality and value of care, outcomes research will provide essential evidence to inform radiologists' guidance of imaging use toward improved patient care, creation of clinical guidelines, and policy decisions. PMID:27066756

  12. DRINKING WATER ARSENIC AND PERINATAL OUTCOMES

    EPA Science Inventory

    Drinking Water Arsenic and Perinatal Outcomes
    DT Lobdell, Z Ning, RK Kwok, JL Mumford, ZY Liu, P Mendola

    Many studies have documented an association between drinking water arsenic (DWA) and cancer, vascular diseases, and dermatological outcomes, but few have investigate...

  13. Outcomes of Children Adopted from Eastern Europe

    ERIC Educational Resources Information Center

    Miller, Laurie; Chan, Wilma; Tirella, Linda; Perrin, Ellen

    2009-01-01

    Behavioral problems are frequent among post-institutionalized Eastern European adoptees. However, risk factors related to outcomes have not been fully delineated. We evaluated 50 Eastern European adoptees, age 8-10 years, with their adoptive families for more than five years. Cognitive and behavioral outcomes and parenting stress were evaluated in…

  14. Challenges in Measuring Outcomes Following Digital Replantation

    PubMed Central

    Sebastin, Sandeep J.; Chung, Kevin C.

    2013-01-01

    In the early period of replantation surgery, the emphasis was on digit survival. Subsequently, with better microsurgical techniques and instrumentation, the focus has shifted to function and in recent years to consideration of cost-effectiveness. Despite over 40 years of effort in refining digital replantation surgery, a rigorous evaluation of the outcomes of digital replantation has not been performed. This is because of the many confounding variables that influence outcome comparisons. These variables include the mechanism of injury (guillotine, crush, avulsion), the injury itself (total, near total, subtotal, partial amputation), and the surgical procedure (replantation, revascularization). In addition, the traditional outcome measures (two-point discrimination, range of motion, grip strength, or the ability to return to work) are reported inconsistently and vary widely among publications. All these factors make meaningful comparison of outcomes difficult. The recent emphasis on outcome research and cost-effectiveness necessitates a rethinking in the way we report outcomes of digital replantation. In this article, the authors summarize the challenges in assessing outcomes of digital replantation and explain the need to measure outcomes using rigorous clinical research designs that incorporate cost-effectiveness studies in the research protocol. PMID:24872766

  15. Improving Outcomes for Workers with Mental Retardation

    ERIC Educational Resources Information Center

    Fornes, Sandra; Rocco, Tonette S.; Rosenberg, Howard

    2008-01-01

    This research presents an analysis of factors predicting job retention, job satisfaction, and job performance of workers with mental retardation. The findings highlight self-determination as a critical skill in predicting the three important employee outcomes. The study examined a hypothesized job retention model and the outcome of the three…

  16. Measuring Inclusive Education Outcomes in Alberta, Canada

    ERIC Educational Resources Information Center

    Loreman, Tim

    2014-01-01

    This study details the results of a review of the academic and public sector literature on measuring inclusive education in large systems. It highlights some outcomes drawn from the international literature on inclusion that might be indicative of the presence and quality of inclusive education in an effort to develop a set of outcomes for…

  17. Model Learner Outcomes for Science Education.

    ERIC Educational Resources Information Center

    Clark, Richard C.; Hessler, Edward

    This document provides curriculum planners with models of learner outcomes that can be incorporated into a science curriculum and science essential learner outcomes. The first chapter includes a list of educational system values and learner values, philosophy of education, the mission for public education, and learner goals that describe the…

  18. Friction and the Intuition-Outcome Disparity

    ERIC Educational Resources Information Center

    Kalajian, Peter; Makarova, Maria

    2014-01-01

    Humans have evolved to follow their intuition, but as any high school physics teacher knows, relying on intuition often leads students to predict outcomes that are at odds with evidence. Over the years, we have attempted to make this intuition-outcome disparity a central theme running throughout our physics classes, with limited success. Part of…

  19. Outcomes Evaluation: A Model for the Future.

    ERIC Educational Resources Information Center

    Blasi, John F.; Davis, Barbara S.

    1986-01-01

    Examines issues and problems related to the measurement of community college outcomes in relation to mission and goals. Presents a model for outcomes evaluation at the community college which derives from the mission statement and provides evaluative comment and comparison with institutional and national norms. (DMM)

  20. Determinants of outcome in smoking cessation.

    PubMed Central

    Lennox, A S

    1992-01-01

    A large amount of research has been conducted into the factors which influence outcome in attempts to stop smoking. This article reviews the literature in two main areas: first, the effects of patient characteristics on outcome, and secondly, the effectiveness of various primary care interventions. The practical implications of this research for primary care interventions to help people stop smoking are explored. PMID:1419248

  1. Trust, Behavior, and High School Outcomes

    ERIC Educational Resources Information Center

    Romero, Lisa S.

    2015-01-01

    Purpose: The purpose of this paper is to contribute to the literature on student trust and to examine the relationship between student trust, behavior, and academic outcomes in high school. It asks, first, does trust have a positive effect on high school outcomes? Second, does trust influence student behavior, exerting an indirect effect on…

  2. Financial Literacy, Financial Education, and Economic Outcomes

    ERIC Educational Resources Information Center

    Hastings, Justine S.; Madrian, Brigitte C.; Skimmyhorn, William L.

    2013-01-01

    In this article, we review the literature on financial literacy, financial education, and consumer financial outcomes. We consider how financial literacy is measured in the current literature and examine how well the existing literature addresses whether financial education improves financial literacy or personal financial outcomes. We discuss the…

  3. Does Cooperative Learning Improve Student Learning Outcomes?

    ERIC Educational Resources Information Center

    Yamarik, Steven

    2007-01-01

    What is the effect of small-group learning on student learning outcomes in economic instruction? In spring 2002 and fall 2004, the author applied cooperative learning to one section of intermediate macroeconomics and taught another section using a traditional lecture format. He identified and then tracked measures of student learning outcomes.…

  4. Outcomes Assessment in Dental Hygiene Programs.

    ERIC Educational Resources Information Center

    Grimes, Ellen B.

    1999-01-01

    A survey of 22 dental-hygiene-program directors found that programs routinely and effectively assess student outcomes and use the information for program improvements and to demonstrate accountability. Both policy and faculty/administrative support were deemed important to implementation. Time constraints were a major barrier. Outcomes-assessment…

  5. Child Health and Young Adult Outcomes

    ERIC Educational Resources Information Center

    Currie, Janet; Stabile, Mark; Manivong, Phongsack; Roos, Leslie L.

    2010-01-01

    Research has shown a strong connection between birth weight and future outcomes. We ask how health problems after birth affect outcomes using data from public health insurance records for 50,000 children born between 1979 and 1987 in the Canadian province of Manitoba. We compare children to siblings born an average of three years apart. We find…

  6. Outcome Assessment in Aphasia: A Survey

    ERIC Educational Resources Information Center

    Simmons-Mackie, Nina; Threats, Travis T.; Kagan, Aura

    2005-01-01

    There has been a marked increase in attention to the measurement of ''outcomes'' after speech-language intervention for adult aphasia. Consumers, speech-language pathologists (SLPs), and funding sources desire evidence of therapy outcomes that improve communication and enhance the quality of life for people with aphasia. While many assessment…

  7. Student Outcomes 2009: Data Dictionary. Support Document

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2009

    2009-01-01

    This document was produced as an added resource for the report "Outcomes from the Productivity Places Program, 2009." The study reported the outcomes for students who completed their vocational education and training (VET) under the Productivity Places Program (PPP) during 2008. This document presents an alphabetical arrangement of the data used…

  8. Educational Outcomes and Indicators for Grade 8.

    ERIC Educational Resources Information Center

    Ysseldyke, James E.; And Others

    This document presents a conceptual model of educational domains and outcomes for learners in Grade 8 (or approximately 13 years of age) and possible indicators for each outcome for all students, including students with disabilities or developmental delays. In the model, educational resources (inputs and contexts) influence learning opportunity…

  9. Educational Outcomes and Indicators for Grade 4.

    ERIC Educational Resources Information Center

    Ysseldyke, James E.; And Others

    This document presents a model of educational outcomes for learners in grade 4 and the indicators of these outcomes for all students. This includes students identified as having disabilities or developmental delays. The document begins with a presentation of the conceptual model, with Educational Resources (Inputs and Contexts) influencing…

  10. Separable Attentional Predictors of Language Outcome

    ERIC Educational Resources Information Center

    Salley, Brenda; Panneton, Robin K.; Colombo, John

    2013-01-01

    The aim of this study was to examine the combined influences of infants' attention and use of social cues in the prediction of their language outcomes. This longitudinal study measured infants' visual attention on a distractibility task (11 months), joint attention (14 months), and language outcomes (word-object association, 14 months;…

  11. Requiring Writing, Ensuring Distance-Learning Outcomes.

    ERIC Educational Resources Information Center

    Mulligan, Roark; Geary, Susan

    1999-01-01

    Discussion of the quality of distance learning programs focuses on a study of Christopher Newport University (CPU ONLINE) that showed learning outcomes in online courses were as good as outcomes in traditional courses. Describes online writing requirements that helped students develop critical thinking skills. (Author/LRW)

  12. Adolescent Survivors of Sexual Abuse: Developmental Outcomes

    ERIC Educational Resources Information Center

    Banyard, Victoria L.; Williams, Linda M.

    2007-01-01

    Using an ecological model as a guiding framework, this article reviews key factors which put adolescent survivors of sexual abuse at risk for negative outcomes, as well as resources which might enhance positive outcomes and recovery. Throughout the article, quotes from women who experienced sexual abuse during their youth highlight opportunities…

  13. Psychosexual Outcome of Gender-Dysphoric Children

    ERIC Educational Resources Information Center

    Wallien, Madeleine S.; Cohen-Kettenis, Peggy T.

    2008-01-01

    The psychosexual outcome of 77 children with gender dysphoria is investigated. Results reveal that after puberty, most gender-dysphoric children will not remain as such. The outcome of gender-dysphoric children in terms of sexual orientation is also studied.

  14. Relationship between Learning Outcomes and Online Accesses

    ERIC Educational Resources Information Center

    Suanpang, Pannee; Petocz, Peter; Reid, Anna

    2004-01-01

    This paper reports on a study carried out in Thailand investigating the relationship between students' use of an e-learning system and their learning outcomes in a course on Business Statistics. The results show a clear relationship between accesses to the e-learning system, as measured by number of "hits", and outcomes, as measured by final…

  15. Young men’s intimate partner violence and relationship functioning: Long-term outcomes associated with suicide attempt and aggression in adolescence

    PubMed Central

    Kerr, David C. R.; Capaldi, Deborah M.

    2010-01-01

    Background Longitudinal research supports that suicidal thoughts and behaviors in adolescence predict maladjustment in young adulthood. Prior research supports links between suicide attempt and aggression, perhaps because of a propensity for impulsive behavior in states of high negative affect that underlies both problems. Such vulnerability may increase risk for intimate partner violence and generally poor young adulthood relational adjustment. Method 153 men participated in annual assessments from ages 10 to 32 years and with a romantic partner at three assessments from ages 18 to 25 years. Multimethod/multi-informant constructs were formed for parent/family risk factors, adolescent psychopathology (e.g., suicide attempt history; mother-, father-, teacher-, and self-reported physical aggression), and young adulthood relational distress (jealousy and low relationship satisfaction) and maladaptive relationship behavior (observed, self-, and partner-reported physical and psychological aggression toward a partner, partner-reported injury, official domestic violence arrest records, and relationship instability). Results Across informants, adolescent aggression was correlated with suicide attempt history. With few exceptions, aggression and a suicide attempt in adolescence each predicted negative romantic relationship outcomes after controlling for measured confounds. Adolescent aggression predicted young adulthood aggression toward a partner, in part, via relationship dissatisfaction. Conclusions Boys’ aggression and suicide attempt history in adolescence each predict poor relationship outcomes, including partner violence, in young adulthood. Findings are consistent with the theory of a trait-like vulnerability, such as impulsive aggression, that undermines adaptation across multiple domains in adolescence and young adulthood. Prevention and intervention approaches can target common causes of diverse public health problems. PMID:20540815

  16. Family Outcomes of Early Intervention: Families' Perceptions of Need, Services, and Outcomes

    ERIC Educational Resources Information Center

    Epley, Pamela H.; Summers, Jean Ann; Turnbull, Ann P.

    2011-01-01

    Relationships between parent ratings of Part C/early intervention (EI) services and family outcomes for families of young children with disabilities were examined--specifically, the early childhood outcomes (ECO)-recommended family outcomes and family quality of life (FQOL). Measures included the Early Childhood Services Survey, the ECO Center…

  17. Maternal Dietary Patterns and Pregnancy Outcome

    PubMed Central

    Chen, Xuyang; Zhao, Diqi; Mao, Xun; Xia, Yinyin; Baker, Philip N.; Zhang, Hua

    2016-01-01

    Maternal nutritional status during pregnancy will affect the outcomes for the mother and the baby. Many analyses of the relationship between diet and outcome are often based on a single or a few food items or nutrients. However, foods are not consumed in isolation and dietary patterns can be used to assess the whole diet consumed. The use of dietary pattern analysis to understand nutritional intake and pregnancy outcome is becoming more and more popular. Many published studies have showed the association between maternal dietary patterns and pregnancy outcome. This review examined articles about the relationship between maternal dietary patterns and pregnancy outcome. As a modifiable factor, dietary patterns may be more applicable to clinical and pregnant health interventions. PMID:27338455

  18. Hindsight bias, outcome knowledge and adaptive learning.

    PubMed

    Henriksen, K; Kaplan, H

    2003-12-01

    The ubiquitous nature of hindsight bias is a cause for concern for those engaged in investigations and retrospective analysis of medical error. Hindsight does not equal foresight. Investigations that are anchored to outcome knowledge run the risk of not capturing the complexities and uncertainties facing sharp end personnel and why their actions made sense at the time. Important lessons go unlearned if the exercise is simply to back track someone else's decision landmarks. Outcome knowledge can also bias our thinking on the quality of the processes that led to the outcome. This paper examines the influence of outcome knowledge in relation to reconstructive memory and legal testimony, ways for reducing the impact of outcome knowledge, and an adaptive learning framework that places hindsight bias in a broader context of rapid updating of knowledge. PMID:14645895

  19. Computing Stable Outcomes in Hedonic Games

    NASA Astrophysics Data System (ADS)

    Gairing, Martin; Savani, Rahul

    We study the computational complexity of finding stable outcomes in symmetric additively-separable hedonic games. These coalition formation games are specified by an undirected edge-weighted graph: nodes are players, an outcome of the game is a partition of the nodes into coalitions, and the utility of a node is the sum of incident edge weights in the same coalition. We consider several natural stability requirements defined in the economics literature. For all of them the existence of a stable outcome is guaranteed by a potential function argument, so local improvements will converge to a stable outcome and all these problems are in PLS. The different stability requirements correspond to different local search neighbourhoods. For different neighbourhood structures, our findings comprise positive results in the form of polynomial-time algorithms for finding stable outcomes, and negative (PLS-completeness) results.

  20. Outcomes after Arthroscopic Bankart Repair

    PubMed Central

    Marshall, Tyler James; Vega, Jose F.; Siqueira, Marcelo BP; Gelber, Jonathan David; Cagle, Robert; Saluan, Paul M.

    2016-01-01

    Objectives: The shoulder is the most common joint dislocation effecting roughly 2% of the general population. Males are effected to a higher degree that females at a ratio of 3:1.1-2 The young, athletic population make up the largest portion of shoulder instability, and treated nonoperatively have a recurrent dislocation rate approaching 50%.3-5 Owens et. al recently published a cohort looking at 45 college athletes with an in season shoulder instability event. 73% of athletes returned to play in season. Only 36% of athletes completed the season without re-injury and 64% of athletes had a recurrent instability event.6 It is unknown how the outcomes of those who go on to have a recurrent dislocation in season are effected versus those who have a stabilization procedure after a first time dislocation. The objective of the current study is to report the postoperative outcomes of first time dislocators versus patients with recurrent dislocations prior to surgery. Methods: CPT codes were used to identify patients who had arthroscopic Bankart repair between 2003-2013. 439 patients aged 16-30 years were identified across 8 fellowship trained surgical practices. The first phase of the study was a retrospective chart review to obtain patient demographics, number of reported preoperative dislocations, review imaging, and number of anchors placed. Patients were identified as first time dislocators or as recurrent dislocators when they had more than one dislocation prior to surgical intervention. The second phase consisted of a survey to obtain a simple shoulder test score, whether they returned to sport, postoperative instability events and further surgery on the shoulder. Postoperative instability was defined as a subluxation or dislocation reported by the patient survey in the postoperative period. Of the 439 patients identified, 296 were excluded for revision surgery, open repair, posterior instability, multidirectional instability, HAGL lesion, labral tears involving the

  1. Measurement outcomes from hip simulators.

    PubMed

    de Villiers, Danielle; Shelton, Julia C

    2016-05-01

    Simulation of wear in total hip replacements has been recognised as an important factor in determining the likelihood of clinical success. However, accurate measurement of wear can be problematic with factors such as number and morphology of wear particles produced as well as ion release proving more important in the biological response to hip replacements than wear volume or wear rate alone. In this study, hard-on-hard (CoCr alloy, AgCrN coating) and hard-on-soft (CoCr alloy and CrN coating on vitamin E blended highly cross-linked polyethylene) bearing combinations were tested in an orbital hip simulator under standard and some adverse conditions. Gravimetric wear rates were determined for all bearings, with cobalt and where applicable, silver release determined throughout testing. Isolation of wear particles from the lubricating fluid was used to determine the influence of different bearing combinations and wear conditions on particle morphology. It was found that cobalt and silver could be measured in the lubricating fluid even when volumetric wear was not detectable. In hard-on-hard bearings, Pearson's correlation of 0.98 was established between metal release into the lubricating fluid and wear volume. In hard-on-soft bearings, coating the head did not influence the polyethylene wear rates measured under standard conditions but did influence the cobalt release; the diameter influenced both polyethylene wear and cobalt release, and the introduction of adverse testing generated smaller polyethylene particles. While hip simulators can be useful to assess the wear performance of a new material or design, measurement of other outcomes may yield greater insight into the clinical behaviour of the bearings in vivo. PMID:26888886

  2. The Multifund and outcome research.

    PubMed

    D'Souza, M F

    1995-01-01

    The UK health reforms, among other things, have allowed some family practitioners ('fundholders') to control part of the budget used to purchase secondary care for the patients registered with their practices. Some feared that this change in organization might threaten the equity of the National Health Service (NHS) by giving advantages to the patients of fundholding general practitioners (GPs). This has led to the formation of the first large GP 'Multifund' in the UK. Whilst the first small fundholding co-operatives were conceived simply as a way of improving the business efficiency of ordinary fundholding, the much larger Kingston and Richmond (K&R) Multifund is a professional co-operative of fundholding family practitioners who share a common management allowance, which controls pounds 32.6 million per annum, about 20% of the public funds devoted to health care in its locality, and has a broader agenda. It sets out to end any two-tier system discriminating between the patients of fundholding and other practitioners within a locality by making it possible for all GPs to become fundholders within an open, democratic doctors' co-operative. Its declared aims are to maintain equity and clinical integrity, to plan health care and to undertake scientific evaluation. Its overall goal is to preserve and improve upon the economic and ethical success of the British NHS. A brief evaluation is included which suggests that Multifund members believe their organization is currently meeting most of these aims. The essay argues for GP-led Multifund systems centred on outcome evidence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7558544

  3. Women, work and pregnancy outcome.

    PubMed

    Huffman, S

    1988-01-01

    In developing countries, 1/3 of infants are born weighing less than 2500 grams. A study conducted in Ethiopia among women consuming about 1600 kcal/day, those who were very physically active during pregnancy bore smaller babies, and gained less weight during pregnancy, than those who were not so active. Average birth weight was 3068 grams for the 1st group, 3270 grams for the less active. The active group of women gained an average of 6.5 kilograms, and the less active 9.2 kilograms. Women who did not engage in heavy work during pregnancy, although they were undernourished, apparently did not bear growth-retarded babies. Indirect evidence for the effect of physical activity on pregnancy outcome comes from studies conducted in Taiwan, and the Gambia. These studies, and others from Malawi, Burkina Faso, and Kenya have shown that women's energy expenditures vary greatly with the agricultural season. Daily housekeeping tasks, however, also consume a lot of women's energy. Technologies that allow women to reduce energy expenditure can have beneficial effects, if they do not simultaneously reduce their incomes. For instance, programs improving water or fuel availability, or reducing fuel needs, reduce women's energy expenditures. Food processing mills can help too if women have access to them, and are thus not in danger of being displaced from their jobs and losing necessary income. Examples of technology improving women's tasks are pedal drying machines for nice in Bangladesh, using a greater and pressing machine to prepare gari in Ghana; but growing thicker rice stalks in Indonesia displaced women workers and reduced income. PMID:12342139

  4. Clinical Outcome of Hypertensive Uveitis

    PubMed Central

    Lewkowicz, Deborah; Willermain, François; Relvas, Lia Judice; Makhoul, Dorine; Janssens, Sarah; Janssens, Xavier; Caspers, Laure

    2015-01-01

    Purpose. To review the clinical outcome of patients with hypertensive uveitis. Methods. Retrospective review of uveitis patients with elevated intraocular pressure (IOP) > 25 mmHg and >1-year follow-up. Data are uveitis type, etiology, viral (VU) and nonviral uveitis (NVU), IOP, and medical and/or surgical treatment. Results. In 61 patients, IOP values are first 32.9 mmHg (SD: 9.0), highest 36.6 mmHg (SD: 9.9), 3 months after the first episode 19.54 mmHg (SD: 9.16), and end of follow-up 15.5 mmHg (SD: 6.24). Patients with VU (n = 25) were older (50.6 y/35.7 y, p = 0.014) and had more unilateral disease (100%/72.22%  p = 0.004) than those with NVU (n = 36). Thirty patients (49.2%) had an elevated IOP before topical corticosteroid treatment. Patients with viral uveitis might have higher first elevated IOP (36.0/27.5 mmHg, p = 0,008) and maximal IOP (40.28/34.06 mmHg, p = 0.0148) but this was not significant when limited to the measurements before the use of topical corticosteroids (p = 0.260 and 0.160). Glaucoma occurred in 15 patients (24.59%) and was suspected in 11 (18.03%) without difference in viral and nonviral groups (p = 0.774). Conclusion. Patients with VU were older and had more unilateral hypertensive uveitis. Glaucoma frequently complicates hypertensive uveitis. Half of the patients had an elevated IOP before topical corticosteroid treatment. PMID:26504598

  5. Clinical outcome of daily dialysis.

    PubMed

    Vos, P F; Zilch, O; Kooistra, M P

    2001-01-01

    Dialysis patients are prone to malnutrition, which may be counteracted by daily home hemodialysis (DHHD, 6 times a week) due to improved clinical outcome and quality of life. Eleven patients were treated with DHHD during 18 months, after a run-in period with three dialysis sessions a week. The total weekly dialysis dose was kept constant during the first 6 months of DHHD, whereupon it was allowed to increase. KT/V was 3.1 +/- 0.5 at baseline, 3.2 +/- 0.5 after 6 months and 4.0 +/- 0.8 at 18 months. Blood pressure decreased from 142 +/- 19/83 +/- 8 to 130 +/- 25/79 +/- 9 mmHg with a more than 50% reduction in antihypertensive medication. Potassium did not change, but potassium binding resins could be stopped almost completely. Bicarbonate increased from 20.6 +/- 3.3 to 23.1 +/- 2.6 mEq/L after 18 months. Patients with a protein intake of less than 1.0 g/kg/d showed a greater increase in body weight (62.3 +/- 6.0 to 65.5 +/- 3.7, P: < 0.05) and normalized protein catabolic rate (nPCR) (0.87 +/- 0.08 to 1.25 +/- 0.36, ns) than patients with acceptable protein intake (>/=1.0 g/kg/d). Phosphate decreased, though not significantly, especially in the latter group. Erythropoietin dose could be reduced from 6400 +/- 5400 U/L at baseline to 5100 +/- 4000 U/L at 18 months. Quality of life improved significantly, especially with to respect to physical condition and mental health. The DHHD markedly improves hemodynamic control and quality of life. Overall nutritional parameters did not change, except cholesterol. Patients with a low protein intake, however, showed a significant increase in body weight, and a greater rise in nPCR. PMID:11158871

  6. Outcome Prediction in Clinical Treatment Processes.

    PubMed

    Huang, Zhengxing; Dong, Wei; Ji, Lei; Duan, Huilong

    2016-01-01

    Clinical outcome prediction, as strong implications for health service delivery of clinical treatment processes (CTPs), is important for both patients and healthcare providers. Prior studies typically use a priori knowledge, such as demographics or patient physical factors, to estimate clinical outcomes at early stages of CTPs (e.g., admission). They lack the ability to deal with temporal evolution of CTPs. In addition, most of the existing studies employ data mining or machine learning methods to generate a prediction model for a specific type of clinical outcome, however, a mathematical model that predicts multiple clinical outcomes simultaneously, has not yet been established. In this study, a hybrid approach is proposed to provide a continuous predictive monitoring service on multiple clinical outcomes. More specifically, a probabilistic topic model is applied to discover underlying treatment patterns of CTPs from electronic medical records. Then, the learned treatment patterns, as low-dimensional features of CTPs, are exploited for clinical outcome prediction across various stages of CTPs based on multi-label classification. The proposal is evaluated to predict three typical classes of clinical outcomes, i.e., length of stay, readmission time, and the type of discharge, using 3492 pieces of patients' medical records of the unstable angina CTP, extracted from a Chinese hospital. The stable model was characterized by 84.9% accuracy and 6.4% hamming-loss with 3 latent treatment patterns discovered from data, which outperforms the benchmark multi-label classification algorithms for clinical outcome prediction. Our study indicates the proposed approach can potentially improve the quality of clinical outcome prediction, and assist physicians to understand the patient conditions, treatment inventions, and clinical outcomes in an integrated view. PMID:26573645

  7. Functional outcomes assessment in shoulder surgery

    PubMed Central

    Wylie, James D; Beckmann, James T; Granger, Erin; Tashjian, Robert Z

    2014-01-01

    The effective evaluation and management of orthopaedic conditions including shoulder disorders relies upon understanding the level of disability created by the disease process. Validated outcome measures are critical to the evaluation process. Traditionally, outcome measures have been physician derived objective evaluations including range of motion and radiologic evaluations. However, these measures can marginalize a patient’s perception of their disability or outcome. As a result of these limitations, patient self-reported outcomes measures have become popular over the last quarter century and are currently primary tools to evaluate outcomes of treatment. Patient reported outcomes measures can be general health related quality of life measures, health utility measures, region specific health related quality of life measures or condition specific measures. Several patients self-reported outcomes measures have been developed and validated for evaluating patients with shoulder disorders. Computer adaptive testing will likely play an important role in the arsenal of measures used to evaluate shoulder patients in the future. The purpose of this article is to review the general health related quality-of-life measures as well as the joint-specific and condition specific measures utilized in evaluating patients with shoulder conditions. Advances in computer adaptive testing as it relates to assessing dysfunction in shoulder conditions will also be reviewed. PMID:25405091

  8. Outcome mapping for health system integration

    PubMed Central

    Tsasis, Peter; Evans, Jenna M; Forrest, David; Jones, Richard Keith

    2013-01-01

    Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. PMID:23526058

  9. Outcome mapping for health system integration.

    PubMed

    Tsasis, Peter; Evans, Jenna M; Forrest, David; Jones, Richard Keith

    2013-01-01

    Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. PMID:23526058

  10. Advanced paternal age and reproductive outcome.

    PubMed

    Wiener-Megnazi, Zofnat; Auslender, Ron; Dirnfeld, Martha

    2012-01-01

    Women have been increasingly delaying the start of motherhood in recent decades. The same trend is seen also for men. The influence of maternal age on fertility, chromosomal anomalies, pregnancy complications, and impaired perinatal and post-natal outcome of offspring, has been thoroughly investigated, and these aspects are clinically applied during fertility and pregestational counseling. Male aging and reproductive outcome has gained relatively less attention. The purpose of this review is to evaluate updated and relevant literature on the effect of paternal age on reproductive outcome. PMID:22157982

  11. Advanced paternal age and reproductive outcome

    PubMed Central

    Wiener-Megnazi, Zofnat; Auslender, Ron; Dirnfeld, Martha

    2012-01-01

    Women have been increasingly delaying the start of motherhood in recent decades. The same trend is seen also for men. The influence of maternal age on fertility, chromosomal anomalies, pregnancy complications, and impaired perinatal and post-natal outcome of offspring, has been thoroughly investigated, and these aspects are clinically applied during fertility and pregestational counseling. Male aging and reproductive outcome has gained relatively less attention. The purpose of this review is to evaluate updated and relevant literature on the effect of paternal age on reproductive outcome. PMID:22157982

  12. Outcome analysis of shunt surgery in hydrocephalus

    PubMed Central

    Ahmed, Ashraf; Sandlas, Gursev; Kothari, Paras; Sarda, Dinesh; Gupta, Abhaya; Karkera, Parag; Joshi, Prashant

    2009-01-01

    Aim: To study the clinical outcome of shunt surgeries in children suffering from hydrocephalus. Methods: A prospective study of 50 children with hydrocephalus who underwent a ventriculo-peritoneal shunt insertion over a period of two years. These patients were then followed up for shunt related complications, shunt revisions and outcome. Results: Twenty six of the 50 patients (52%) suffered from complications. The most common complications were shunt blockage (n=7) and shunt infection (n=6). These complications necessitated repeated shunt revisions. Conclusions: Infective complications of hydrocephalus are more likely to leave behind an adverse neurological outcome in the form of delayed milestones and mental retardation. PMID:20376249

  13. Applicability of large databases in outcomes research.

    PubMed

    Malay, Sunitha; Shauver, Melissa J; Chung, Kevin C

    2012-07-01

    Outcomes research serves as a mechanism to assess the quality of care, cost effectiveness of treatment, and other aspects of health care. The use of administrative databases in outcomes research is increasing in all medical specialties, including hand surgery. However, the real value of databases can be maximized with a thorough understanding of their contents, advantages, and limitations. We performed a literature review pertaining to databases in medical, surgical, and epidemiologic research, with special emphasis on orthopedic and hand surgery. This article provides an overview of the available database resources for outcomes research, their potential value to hand surgeons, and suggestions to improve their effective use. PMID:22522104

  14. Delta Alerts: Changing Outcomes in Geriatric Trauma.

    PubMed

    Wiles, Lynn L; Day, Mark D; Harris, LeAnna

    2016-01-01

    Geriatric trauma patients (GTPs) suffering minor injuries have suboptimal outcomes compared with younger populations. Patients 65 years or older account for 10% of all traumas but 28% of all trauma deaths. This trauma center established a third tier trauma alert specifically targeting GTPs at risk for poor outcomes. A Delta Alert is activated when GTPs suffer injuries that fall outside traditional trauma alert guidelines. Early identification and treatment of injuries and expedited referral to specialty groups have improved our GTPs' outcomes including decreased mortality and length of stay and increased percentage of GTPs who are discharged home. PMID:27414140

  15. Pregnancy complications and neuropsychological outcomes: A review.

    PubMed

    Gerner, Gwendolyn; Baron, Ida Sue

    2015-01-01

    Pregnancy complications elevate risk of associated adverse medical, socioenvironmental, and behavioral outcomes in children. These are likely to have a substantial impact on neuropsychological functioning and mental health across the child's lifespan. Thus, an understanding of the complex relationships between pregnancy complications and neuropsychological outcomes is critical for both practitioners and researchers. This review summarizes prevalent pregnancy complications and the associated psychological and neuropsychological findings, highlighting methodological challenges that have restricted investigations of these outcomes and identifying opportune areas for future study. PMID:24801883

  16. FINANCIAL LITERACY, FINANCIAL EDUCATION AND ECONOMIC OUTCOMES

    PubMed Central

    Hastings, Justine S.; Madrian, Brigitte C.; Skimmyhorn, William L.

    2013-01-01

    In this article we review the literature on financial literacy, financial education, and consumer financial outcomes. We consider how financial literacy is measured in the current literature, and examine how well the existing literature addresses whether financial education improves financial literacy or personal financial outcomes. We discuss the extent to which a competitive market provides incentives for firms to educate consumers or offer products that facilitate informed choice. We review the literature on alternative policies to improve financial outcomes, and compare the evidence to evidence on the efficacy and cost of financial education. Finally, we discuss directions for future research. PMID:23991248

  17. Outcome-Based Education: Another Educational Bandwagon?

    ERIC Educational Resources Information Center

    Towers, James M.

    1992-01-01

    Traces the roots of outcome-based education in mastery learning. Considers such obstacles as lack of reform preconditions, poor understanding of program features, teacher resistance, teacher domestication, staff mobility, and routinization. (SK)

  18. Synergistic Man: Outcome Model for Counselors

    ERIC Educational Resources Information Center

    Rousseve, Ronald J.

    1973-01-01

    Drawing on the insights of Ruth Benedict and Abraham Maslow in their search for an ethical gauge by which to rate personal-social health, this article proposes synergistic man'' as the desired outcome model for counselors. (Author)

  19. Adverse Outcome Pathways: From Definition to Application

    EPA Science Inventory

    A challenge for both human health and ecological toxicologists is the transparent application of mechanistic (e.g., molecular, biochemical, histological) data to risk assessments. The adverse outcome pathway (AOP) is a conceptual framework designed to meet this need. Specifical...

  20. Impact of Doulas on Healthy Birth Outcomes

    PubMed Central

    Gruber, Kenneth J.; Cupito, Susan H.; Dobson, Christina F.

    2013-01-01

    Birth outcomes of two groups of socially disadvantaged mothers at risk for adverse birth outcomes, one receiving prebirth assistance from a certified doula and the other representing a sample of birthing mothers who elected to not work with a doula, were compared. All of the mothers were participants in a prenatal health and childbirth education program. Expectant mothers matched with a doula had better birth outcomes. Doula-assisted mothers were four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding. Communication with and encouragement from a doula throughout the pregnancy may have increased the mother’s self-efficacy regarding her ability to impact her own pregnancy outcomes. PMID:24381478

  1. RACIAL RESIDENTIAL SEGREGATION AND ADVERSE BIRTH OUTCOMES

    EPA Science Inventory

    INTRODUCTION. The disparity between black and white women's adverse birth outcomes has been subject to much investigation, yet the factors underlying its persistence remain elusive, which has encouraged research on neighborhood-level influences, including racial residential segr...

  2. [Notes on equity in health outcomes].

    PubMed

    Fresneda-Bautista, Oscar

    2008-12-01

    The article locates analysing health outcomes within a set of elements covering evaluating equity in health and suggests some orientations for such analysis. The model of analysis for examining equity in health which has been adopted by the has been taken as a point of reference. The text approaches the following questions: What is the role played by evaluating health outcomes within the context of equity in health? How can inequities in health outcomes be evaluated? What should be evaluated regarding health outcomes? The final part deals with how the topic of equity in health does not become exhausted in examining unjust inequalities between individuals or groups. PMID:19377730

  3. Negotiating outcomes with patients and families.

    PubMed

    Zander, K S

    1996-09-01

    Negotiating outcomes is a complex skill that is crucial to attaining quality care, particularly in an environment characterized by an accelerated speed of care and regimented options for care. In this environment, patients and their families need a realistic view of achievable outcomes. Caregivers must be able to reformulate and renegotiate outcomes quickly with patients and their families. Caregivers act as a catalyst in the outcome-achievement process and, to be successful, seek new and creative strategies to accomplish this. Being a catalyst also involves determining the patients' personal feelings about their illnesses and the proposed interventions, assisting patients in planning how to translate their new knowledge into behaviors, and to build in feedback mechanisms. PMID:8920372

  4. Developments in pharmacists' disciplinary processes and outcomes.

    PubMed

    Hattingh, Laetitia; Smith, Nerida; Searle, Judy; Forrester, Kim

    2008-08-01

    Pharmacy disciplinary processes and outcomes protect consumers by deterring pharmacists from unacceptable practices and maintaining the reputation and standing of the pharmacy profession. It is important that pharmacists are informed of disciplinary processes and outcomes in order to predict what is regarded as unacceptable behaviour and the potential consequences thereof. Disciplinary procedures and outcomes also play an important role in maintaining public trust in the pharmacy profession and it is therefore important that the public has confidence in the disciplinary structure. The outcomes of pharmacy disciplinary cases that reflect the patient care role of pharmacists are particularly important in helping to determine pharmacists' changed professional responsibility and potential legal liability in the provision of these patient care services. PMID:18807799

  5. Co-Curricular Outcomes Assessment and Accreditation

    ERIC Educational Resources Information Center

    Busby, Katie

    2015-01-01

    This chapter describes how assessment of co-curricular student learning outcomes can be used as part of the institutional accreditation process and the opportunities institutional researchers and student affairs educators have to collaborate in those efforts.

  6. Classifying outcomes of care for injured patients

    PubMed Central

    Bell, Nathaniel; Sobolev, Boris; Townson, Andrea; Evans, David C.; Anton, Hugh; Simons, Richard K.

    2014-01-01

    Summary Many trauma survivors face challenges of impaired functioning, limited activities and reduced participation. Recovery from injury after acute care, therefore, becomes an important public health issue. This commentary discusses a framework for evaluating outcomes of acute care. PMID:25421077

  7. The interaction of criminal procedure and outcome.

    PubMed

    Laxminarayan, Malini; Pemberton, Antony

    2014-01-01

    Procedural quality is an important aspect of crime victims' experiences in criminal proceedings and consists of different dimensions. Two of these dimensions are procedural justice (voice) and interpersonal justice (respectful treatment). Social psychological research has suggested that both voice and respectful treatment are moderated by the impact of outcomes of justice procedures on individuals' reactions. To add to this research, we extend this assertion to the criminal justice context, examining the interaction between the assessment of procedural quality and outcome favorability with victim's trust in the legal system and self-esteem. Hierarchical regression analyses reveal that voice, respectful treatment and outcome favorability are predictive of trust in the legal system and self-esteem. Further investigation reveals that being treated with respect is only related to trust in the legal system when outcome favorability is high. PMID:24656217

  8. Ethnic differences in assisted reproductive technologies outcomes.

    PubMed

    Spitzer, Trimble; Fujimoto, Victor Y

    2013-09-01

    Disparities in assisted reproductive technologies (ARTs) outcomes have been identified among ethnic minorities when compared with their Caucasian counterparts. Minority ethnicity has been shown to be an independent predictor of lower clinical pregnancy and live birth rates in many studies. In this article, we seek to summarize the most recent literature on ethnic difference reported within ART outcomes. We will discuss potential reasons behind these disparities and further explore independent predictors and associations between ethnicity and ART success. PMID:23934696

  9. Outcomes of endoscopic transsphenoidal pituitary surgery.

    PubMed

    Dallapiazza, Robert F; Jane, John A

    2015-03-01

    Since the 1990s, endoscopic transsphenoidal surgery for pituitary adenomas has increased in popularity. Outcomes of endoscopic surgery for clinically secretory adenomas are favorable, and results for nonfunctional tumors reveal high rates of complete resection, improvements in vision, and low rates of complications. This article discusses some of the recent studies reporting outcomes from endoscopic series for Cushing disease, acromegaly, prolactin-secreting tumors, and nonfunctioning macroadenomas. PMID:25732647

  10. Collateral Adverse Outcomes After Lumbar Spine Surgery.

    PubMed

    Daniels, Alan H; Gundle, Kenneth; Hart, Robert A

    2016-01-01

    Collateral adverse outcomes are the expected or unavoidable results of a procedure that is performed in a standard manner and typically experienced by the patient. Collateral adverse outcomes do not result from errors, nor are they rare. Collateral adverse outcomes occur as the direct result of a surgical procedure and must be accepted as a trade-off to attain the intended benefits of the surgical procedure. As such, collateral adverse outcomes do not fit into the traditional definition of a complication or adverse event. Examples of collateral adverse outcomes after lumbar spine arthrodesis include lumbar stiffness, postoperative psychological stress, postoperative pain, peri-incisional numbness, paraspinal muscle denervation, and adjacent-level degeneration. Ideally, a comparison of interventions for the treatment of a clinical condition should include information on both the negative consequences (expected and unexpected) and potential benefits of the treatment options. The objective evaluation and reporting of collateral adverse outcomes will provide surgeons with a more complete picture of invasive interventions and, thus, the improved ability to assess alternative treatment options. PMID:27049197

  11. The complement system and adverse pregnancy outcomes.

    PubMed

    Regal, Jean F; Gilbert, Jeffrey S; Burwick, Richard M

    2015-09-01

    Adverse pregnancy outcomes significantly contribute to morbidity and mortality for mother and child, with lifelong health consequences for both. The innate and adaptive immune system must be regulated to insure survival of the fetal allograft, and the complement system is no exception. An intact complement system optimizes placental development and function and is essential to maintain host defense and fetal survival. Complement regulation is apparent at the placental interface from early pregnancy with some degree of complement activation occurring normally throughout gestation. However, a number of pregnancy complications including early pregnancy loss, fetal growth restriction, hypertensive disorders of pregnancy and preterm birth are associated with excessive or misdirected complement activation, and are more frequent in women with inherited or acquired complement system disorders or complement gene mutations. Clinical studies employing complement biomarkers in plasma and urine implicate dysregulated complement activation in components of each of the adverse pregnancy outcomes. In addition, mechanistic studies in rat and mouse models of adverse pregnancy outcomes address the complement pathways or activation products of importance and allow critical analysis of the pathophysiology. Targeted complement therapeutics are already in use to control adverse pregnancy outcomes in select situations. A clearer understanding of the role of the complement system in both normal pregnancy and complicated or failed pregnancy will allow a rational approach to future therapeutic strategies for manipulating complement with the goal of mitigating adverse pregnancy outcomes, preserving host defense, and improving long term outcomes for both mother and child. PMID:25802092

  12. Characterising reward outcome signals in sensory cortex☆

    PubMed Central

    FitzGerald, Thomas H.B.; Friston, Karl J.; Dolan, Raymond J.

    2013-01-01

    Reward outcome signalling in the sensory cortex is held as important for linking stimuli to their consequences and for modulating perceptual learning in response to incentives. Evidence for reward outcome signalling has been found in sensory regions including the visual, auditory and somatosensory cortices across a range of different paradigms, but it is unknown whether the population of neurons signalling rewarding outcomes are the same as those processing predictive stimuli. We addressed this question using a multivariate analysis of high-resolution functional magnetic resonance imaging (fMRI), in a task where subjects were engaged in instrumental learning with visual predictive cues and auditory signalled reward feedback. We found evidence that outcome signals in sensory regions localise to the same areas involved in stimulus processing. These outcome signals are non-specific and we show that the neuronal populations involved in stimulus representation are not their exclusive target, in keeping with theoretical models of value learning. Thus, our results reveal one likely mechanism through which rewarding outcomes are linked to predictive sensory stimuli, a link that may be key for both reward and perceptual learning. PMID:23811411

  13. A relational framework for understanding bullying: Developmental antecedents and outcomes.

    PubMed

    Rodkin, Philip C; Espelage, Dorothy L; Hanish, Laura D

    2015-01-01

    This article reviews current research on the relational processes involved in peer bullying, considering developmental antecedents and long-term consequences. The following themes are highlighted: (a) aggression can be both adaptive and maladaptive, and this distinction has implications for bullies' functioning within peer social ecologies; (b) developmental antecedents and long-term consequences of bullying have not been well-distinguished from the extant research on aggressive behavior; (c) bullying is aggression that operates within relationships of power and abuse. Power asymmetry and repetition elements of traditional bullying definitions have been hard to operationalize, but without these specifications and more dyadic measurement approaches there may be little rationale for a distinct literature on bullying--separate from aggression. Applications of a relational approach to bullying are provided using gender as an example. Implications for future research are drawn from the study of relationships and interpersonal theories of developmental psychopathology. PMID:25961312

  14. ISTIMES project: status and outcomes

    NASA Astrophysics Data System (ADS)

    Cuomo, V.; Proto, M.; Soldovieri, F.

    2012-04-01

    Thermography; Ground Penetrating Radar; low-frequency Geophysical Techniques; ground based SAR and optical cameras for the assessment of the dynamical behaviour of the infrastructure. A great effort has been devoted to "transfer" these novel and state-of art technologies from the laboratory experience to actual on field applications by adapting/improving them and developing prototypes for the specific application domain of the monitoring of transport and critical infrastructures. Sensor synergy, data cross correlation and novel concepts of information fusion have permitted to carry out a multi-method, multi-resolution and multi-scale electromagnetic detection and monitoring of the infrastructure, including surface and subsurface aspects. The project has allowed to develop an ICT architecture based on web sensors and serviceoriented- technologies that comply with specific end-user requirements, including interoperability, economical convenience, exportability, efficiency and reliability. The efforts have focussed mainly to the creation of web based interfaces able to control "not standard" sensors, as the ones proposed in the project, and to the standardization necessary to have a full interoperability and modularity of the monitoring system. In addition, the system is able to provide a more easily accessible and transparent scheme for use by different end-users and to integrate the monitoring results and images with other kind of information such as GIS layer and historical datasets relating to the site. The ISTIMES system has been evaluated at two test sites and two test beds. At the two test sites of Montagnole rock-fall station (Chambery, France) and Hydrogeosite Laboratory (Potenza, Italy), the attention was posed to a thorough analysis of the performances of the in situ sensing techniques, by investigating, with good outcomes, also the possibility to correlate and have a synergy from the different sensors. In particular, it is worth noting that the experiment realized at

  15. Long-term Outcomes after Severe Shock

    PubMed Central

    Pratt, Cristina M.; Hirshberg, Eliotte L.; Jones, Jason P.; Kuttler, Kathryn G.; Lanspa, Michael J.; Wilson, Emily L.; Hopkins, Ramona O.; Brown, Samuel M.

    2014-01-01

    Background Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Methods Seventy-six patients who were alive 90 days after severe shock (received ≥1 mcg/kg/min of norepinephrine equivalent) were eligible for the study. We measured three-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. Results The mean long-term survival was 5.1 years: 82% (62/76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of five years after hospital admission. The patients’ Physical Functioning scores were below US population norms (p<0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full time. Conclusions Early survivors of severe shock had a high three-year survival rate. Patients’ long term physical and psychological outcomes were similar to those reported for cohorts of less severely ill ICU survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long

  16. Cue-elicited food seeking is eliminated with aversive outcomes following outcome devaluation.

    PubMed

    Eder, Andreas B; Dignath, David

    2016-01-01

    In outcome-selective Pavlovian-to-instrumental transfer (PIT), stimuli that are predictive of specific outcomes prime instrumental responses that are associated with these outcomes. Previous human studies yielded mixed evidence in respect to whether the PIT effect is affected by a posttraining devaluation of an outcome, with the PIT effect being preserved after a devaluation of a primary reinforcer (food, drugs) but not following the devaluation of a secondary reinforcer (money). The present research examined whether outcome-selective transfer is eliminated when the devaluation of a primary (liquid) reinforcer is strong and aversive. Experiment 1 confirmed these expectations following a devaluation with bad tasting Tween 20. However, outcome-selective transfer was still observed when the earned (devalued) outcome was not consumed immediately after each test (Experiment 2). These results suggest that the capacity of a Pavlovian cue to motivate a specific response is affected by the incentive value of the shared outcome only when the devaluation yields an aversive outcome that is consumed immediately. PMID:26089111

  17. Fundamentals of Clinical Outcomes Assessment for Spinal Disorders: Clinical Outcome Instruments and Applications.

    PubMed

    Vavken, Patrick; Ganal-Antonio, Anne Kathleen B; Quidde, Julia; Shen, Francis H; Chapman, Jens R; Samartzis, Dino

    2015-08-01

    Study Design A broad narrative review. Objectives Outcome assessment in spinal disorders is imperative to help monitor the safety and efficacy of the treatment in an effort to change the clinical practice and improve patient outcomes. The following article, part two of a two-part series, discusses the various outcome tools and instruments utilized to address spinal disorders and their management. Methods A thorough review of the peer-reviewed literature was performed, irrespective of language, addressing outcome research, instruments and tools, and applications. Results Numerous articles addressing the development and implementation of health-related quality-of-life, neck and low back pain, overall pain, spinal deformity, and other condition-specific outcome instruments have been reported. Their applications in the context of the clinical trial studies, the economic analyses, and overall evidence-based orthopedics have been noted. Additional issues regarding the problems and potential sources of bias utilizing outcomes scales and the concept of minimally clinically important difference were discussed. Conclusion Continuing research needs to assess the outcome instruments and tools used in the clinical outcome assessment for spinal disorders. Understanding the fundamental principles in spinal outcome assessment may also advance the field of "personalized spine care." PMID:26225283

  18. Comparison of normal and abnormal cardiotocography with pregnancy outcomes and early neonatal outcomes.

    PubMed

    Sultana, Jobaida; Chowdhury, T A; Begum, Kohinoor; Khan, Manir Hossain

    2009-01-01

    Cardiotocography (CTG) is the most commonly used test for antepartum and intrapartum foetal surveillance in the majority hospitals of developed countries. The purpose of this study was to compare the pregnancy outcome and early neonatal outcome among the normal and abnormal CTG groups. In this prospective study, fifty consecutive normal and fifty consecutive abnormal CTG were collected within one hour before delivery from patients who have singleton pregnancy with gestational age >or=32 weeks and having obstetric or medical indication for CTG. In this study, the measure of pregnancy outcomes were mode of delivery, indications of caesarean section, percentage requiring caesarean section for foetal distress, oligohydramnios, meconium stained liquor, small placenta and cord around the neck. Early neonatal outcomes included apgar score, birth weight, admission into neonatal intensive care unit (NICU), duration of stay in NICU and perinatal mortality. There were significant differences between the two groups regarding pregnancy outcomes and early neonatal outcomes. So, CTG is an important test to assess the foetal condition in both antepartum and intrapartum period. The sensitivity of CTG was 87%, specificity was 66%, positive predictive value was 54% and negative predictive value was 92% in the prediction of abnormal outcomes. So, normal CTG is more predictive of normal outcomes than abnormal CTG regarding abnormal outcomes. PMID:19377417

  19. Early Adolescent Affect Predicts Later Life Outcomes

    PubMed Central

    Kansky, Jessica; Allen, Joseph P.; Diener, Ed

    2016-01-01

    Background Subjective well-being as a predictor for later behavior and health has highlighted its relationship to health, work performance, and social relationships. However, the majority of such studies neglect the developmental nature of well-being in contributing to important changes across the transition to adulthood. Methods To examine the potential role of subjective well-being as a long-term predictor of critical life outcomes, we examined indicators of positive and negative affect at age 14 as a predictor of relationship, adjustment, self worth, and career outcomes a decade later at ages 23 to 25, controlling for family income and gender. We utilized multi-informant methods including reports from the target participant, close friends, and romantic partners in a demographically diverse community sample of 184 participants. Results Early adolescent positive affect predicted less relationship problems (less self-reported and partner-reported conflict, greater friendship attachment as rated by close peers), healthy adjustment to adulthood (lower levels of depression, anxiety, and loneliness). It also predicted positive work functioning (higher levels of career satisfaction and job competence) and increased self-worth. Negative affect did not significantly predict any of these important life outcomes. In addition to predicting desirable mean levels of later outcomes, early positive affect predicted beneficial changes across time in many outcomes. Conclusions The findings extend early research on the beneficial outcomes of subjective well-being by having an earlier assessment of well-being, including informant reports in measuring a large variety of outcome variables, and by extending the findings to a lower socioeconomic group of a diverse and younger sample. The results highlight the importance of considering positive affect as an important component of subjective well-being distinct from negative affect. PMID:27075545

  20. Science Outcomes Assessment Plan (SOAP): Design phase

    NASA Astrophysics Data System (ADS)

    Webster, Zodiac T.; Gurkas, P.; Shaw, K.

    2009-01-01

    Columbus State University is under pressure to reduce the number of "unproductive grades” in its introductory science classes, to increase the number of STEM majors, and to assess the level of attainment of science outcomes in its general education courses for accreditation documentation. The authors designed a study to examine affective, cognitive, social, and classroom factors as predictors of success in science while also attempting to document the link between introductory "gateway to science major” course outcomes and the general education program. One of the factors probed is the match between students’ understanding of important learning outcomes of the course and the instructor's stated priorities. A very real risk in content focused courses (e.g., astronomy) is the mismatch between the university's stated outcomes for a general education science course (e.g., critical thinking) and the instructor's content related outcomes. This mismatch may become a barrier for students taking `required’ courses as they may not comprehend the rationale for the requirement, fail to engage in the course, and consequently receive a failing grade. Another possible factor affecting student success in science is the student reasoning level. Students who are concrete thinkers may not be as successful in introductory science classes that require advanced logical thinking about unfamiliar concepts. The authors hope to use the results of this study to help inform university practices such as placement into introductory science courses and for future faculty development.