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Western societies over the last few decades have seen an increased interest in questions of group belonging and group identities, including ethno‐national groups. According to essentialising or constructivist paradigms, belonging to a national group is commonly conceptualised in the range of objective versus subjective criteria, where objective entails ascription and subjective, self‐identification. This paper suggests disentangling the paired dimensions—objective and other‐classification versus subjective and self‐classification—by analysing the late Habsburg Empire. I argue that the introduction of national registers in the new provincial constitutions and electoral laws of Moravia, Bukovina and Galicia accelerated an objective understanding of nationality and increasingly favoured other‐classification over self‐classification in cases where national belonging had become an administrative category. Yet, to do justice to the individual's subjective feelings, authorities were supposed to investigate objectively a citizen's subjective identification—a procedure that can be termed "objectivisation." Such objectivising procedures thus reconciled an individual's subjective identification with an increasingly objective understanding of nationality by developing guidelines on how classification by others should proceed. [ABSTRACT FROM AUTHOR]

The validity and reliability of diagnoses in psychiatry is a challenging topic in mental health. The current mental health categorization is based primarily on symptoms and clinical course and is not biologically validated. Among multiple ongoing efforts, neurological observations alongside clinical evaluations are considered to be potential solutions to address diagnostic problems. The Bipolar‐Schizophrenia Network on Intermediate Phenotypes (B‐SNIP) has published multiple papers attempting to reclassify psychotic illnesses based on biological rather than symptomatic measures. However, the effort to investigate the relationship between this new categorization approach and other neuroimaging techniques, including resting‐state fMRI data, is still limited. This study focused on investigating the relationship between different psychotic disorders categorization methods and resting‐state fMRI‐based measures called dynamic functional network connectivity (dFNC) using state‐of‐the‐art artificial intelligence (AI) approaches. We applied our method to 613 subjects, including individuals with psychosis and healthy controls, which were classified using both the Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV) and the B‐SNIP biomarker‐based (Biotype) approach. Statistical group differences and cross‐validated classifiers were performed within each framework to assess how different categories. Results highlight interesting differences in occupancy in both DSM‐IV and Biotype categorizations compared to healthy individuals, which are distributed across specific transient connectivity states. Biotypes tended to show less distinctiveness in occupancy level and included fewer cellwise differences. Classification accuracy obtained by DSM‐IV and Biotype categories were both well above chance. Results provided new insights and highlighted the benefits of both DSM‐IV and biology‐based categories while also emphasizing the importance of future work in this direction, including employing further data types. [ABSTRACT FROM AUTHOR]

This paper explores a collaborative generative approach to psychological assessment employed in Puerto Rico, with children, adolescents, and adults. It begins with a critical reflection on how the dominant discourse of mental health, founded in the suppositions and practices of Euro‐American‐centred psychological knowledge, has been disseminated to the globalise south under the claim that its assertions are unaffected by social, ideological, or historical forces. It discusses how its claims of expert scientific knowledge have contributed, through classificatory instruments such as the DSM and the ICD, to the production and re‐production of deficit narratives in our day‐to‐day life. It also examines how these practices have been applied in the use of assessment instruments in Puerto Rico. It then describes, how, through a collaborative approach and narrative theory, the established colonising practices and narratives of traditional forms of psychological assessment can be questioned, deconstructed, and transformed. This approach promotes the co‐creation of dialogic and generative spaces that allow for the emergence of multiple stories and performances that give meaning to a person's identity and relational being. A brief clinical case exposition is used to illustrate how this collaborative, dialogic, and culturally sensitive approach to psychological assessment can help to undermine and disrupt deficit‐based narratives and provide families with new generative possibilities for re‐storying and re‐performing their lives and particularly, the lives of their children. [ABSTRACT FROM AUTHOR]

This commentary discusses the systematic review by Walsh et al. that has found that people with atypical anorexia nervosa have similar symptoms and severity as have people with anorexia nervosa. In this paper, the discussion is broadened to other eating disorders diagnoses and the problem of overlap and crossover between syndromes that impacts adversely on the need for diagnoses to be distinct both at assessment but also over time. It is argued that the derivation of eating disorder diagnostic criteria has also been vulnerable to erroneous assumptions and biased observations. Whether atypical anorexia nervosa becomes a standalone diagnosis or is joined with an expanded anorexia nervosa, future delineations should be based on empirical research including neuroscience. [ABSTRACT FROM AUTHOR]

Since the publication of DSM‐III in 1980, the scientist‐practitioner gap in clinical psychology has expanded, as almost all outcome research in clinical psychology has been on diagnosed mental disorders within a medical model using drug trial methodologies, whereas most practising clinicians undertake functional analyses and case formulations of clinical psychological problems (CPPs) and then apply tailored interventions within an ongoing hypothesis‐testing methodology. But comparatively reliable assessment and generalizable conclusions in psychotherapy outcome research require a comprehensive theory‐derived conception or operational definition of 'CPPs', standardized functional analyses, and a taxonomy of CPPs comparable to DSM's listings of mental disorders. An alternative conception and taxonomy of CPPs have recently been proposed, offering improvements in the reliability and generalizability of case formulation‐based psychotherapy outcome research. It conceives of CPPs as instances of the formation and operation of self‐sustaining problem‐maintaining circles (PMCs) of psychological‐level causal elements—that is, at the level of cognitions, behaviours, emotions, and events or situations (stimuli). The paper describes this new conception of CPPs, a subsequent nascent taxonomy of evidence‐based PMCs which standardizes the underlying mechanisms that maintain CPPs, and ensuing benefits to research (as well as to practice) in clinical psychology. These benefits include being able to encompass all treatment‐worthy CPPs, not just diagnosable mental disorders; to assess theory‐derived intervention strategies, not just arbitrary therapy bundles; and to directly feed back into psychological theories, not just expand an atheoretical list of patented "evidence supported therapies." [ABSTRACT FROM AUTHOR]

Background: There is extremely limited population‐based research on social (pragmatic) communication disorder (SCD). Population‐based samples have the potential to better characterize the SCD phenotype by mitigating confounds and biases that are typical of convenience and clinical samples. Aims: The aims of this preliminary epidemiologic study were to advance our understanding of the SCD phenotype relative to developmental language disorder (DLD), obtain an estimate of prevalence, identify risk factors and lay the groundwork for future population level research of SCD. Methods & Procedures: We analysed existing data from the EpiSLI Database to examine social communication skills in 393 8th grade (13–14 years) children with and without a history of DLD. The primary measure used to evaluate SCD was the Children's Communication Checklist (CCC‐2). Two case definitions of SCD reflecting DSM‐5 criteria were examined. Both definitions involved significant pragmatic impairment, employing a commonly adopted clinical cut‐point of 1.5 SD. In one case, pragmatic deficits could occur along with structural language deficits and, in the other case (established using principal component analysis), pragmatic and social skills were disproportionately lower than structural language abilities. Outcomes & Results: When using the first case definition, SCD was much more common in children with a history of DLD than without DLD and history of language disorder at kindergarten was a significant risk factor for SCD in adolescence. However, it is important to note that SCD could be found in children with no prior deficits in other aspects of language. When the second definition was employed, SCD was equally distributed across children with and without a history of DLD. Male sex was a significant risk factor using this case definition of SCD. The estimated prevalence of SCD ranged from 7% (SE = 1.5%) to 11% (SE = 1.7%), acknowledging that prevalence depends on the cut‐point selected to determine communication disorder. Conclusions & Implications: These findings contribute to our understanding of the association between SCD and DLD by recognizing varying profiles of pragmatic and social communication difficulties, which in turn may help refine our diagnostic categories. Preliminary prevalence estimates of SCD can serve as an initial guidepost for identification and planning for intervention services for this condition. What this paper adds: What is already known on this subject: There is considerable debate about the diagnostic category of SCD and its relation to other neurodevelopmental disorders. What this study adds to existing knowledge: Using data from a US‐based epidemiologic sample of DLD, this study offers new information about the association between SCD and DLD, provides preliminary estimates of SCD prevalence, and identifies risk factors for SCD. Clinical implications of this study: Improved understanding of possible profiles of pragmatic and social communication deficits will help to clarify diagnostic categories and preliminary prevalence estimates may assist with ensuring availability of adequate intervention services. [ABSTRACT FROM AUTHOR]

Background: Previous studies have yielded mixed results on the association between gender and alcohol use disorder (AUD) treatment outcomes. Thus, additional research is needed to determine the effect of gender on AUD treatment outcomes, including quality of life (QoL), particularly among older adults. Aims: In a clinical sample of older adults with DSM‐5 AUD, we examined changes in QoL from the beginning of AUD treatment through 1 year of follow‐ups. We also examined the effect of gender and explored interaction effects with gender on QoL. Methods: We utilized data from the "Elderly Study," a multi‐national, single‐blind, randomized, controlled trial of 693 adults aged 60+ with DSM‐5 AUD. Alcohol use was assessed with the Form‐90, and QoL with the brief version of the World Health Organization QoL measure. Information was collected at treatment initiation and at 4‐, 12‐, 26‐, and 52‐week follow‐ups. Multilevel mixed‐effects logistic and linear regression models were used to examine QoL changes and the effect of gender on changes in QoL. Results: Following treatment, small, but significant improvements were seen over time in overall perceived health (p < 0.05). Improvements that persisted over the 1‐year follow‐up period were seen in the QoL domains of physical health (β: 2.6, 95% CI: 1.4–3.9), psychological health (β: 3.5, 95% CI: 3.3–3.8), social relationships (β: 4.0, 95% CI: 2.5–5.6), and environmental health (β: 1.4, 95% CI: 0.4–2.4). No significant changes were seen over time in overall perceived QoL (p = 0.58). Gender was not associated with changes in any of the QoL outcome measures (all p ≥ 0.05). Conclusions: Among 60+ year‐old adults receiving treatment for DSM‐5 AUD, improvements in QoL were achievable and maintained over time, but were not associated with gender. [ABSTRACT FROM AUTHOR]

Purpose: Although schema therapy has been predominantly applied to treat personality disorders, interest into its application in other clinical disorders is growing. Central to schema therapy are Early Maladaptive Schemas (EMS) and Schema Modes. Since existing EMS and Schema Modes were primarily developed in the context of personality disorders, their relevance for clinical disorders is unclear. Methods: We conducted a systematic review of the presence of EMS and Schema Modes in clinical disorders according to DSM criteria. Per disorder, we evaluated which EMS and Schema Modes were more pronounced in comparison with clinical as well as non‐clinical control groups and which EMS and Schema Modes were most highly endorsed within the disorder. Results: Although evidence concerning EMS was scarce for several disorders, and only few studies on Schema Modes survived inclusion criteria, we identified meaningful relationships and patterns for EMS and Schema Modes in various clinical disorders. Conclusions: The present review highlights the relevance of EMS and Schema Modes for clinical disorders beyond personality disorders. Depending on the theme of the representation, EMS act as vulnerabilities both across diagnoses and for specific disorders. Thus, EMS and resulting Schema Modes are potential, valuable targets for the prevention and treatment of clinical disorders. [ABSTRACT FROM AUTHOR]

Etiological theories on the development of psychopathology often incorporate adverse childhood experiences (ACE) as an important contributing factor. Recent studies suggest personality functioning (PF; i.e., stability of the self and interpersonal relationships) as an important transdiagnostic construct that could be useful in better understanding when persons with ACE do (not) develop psychopathological symptoms. A representative sample of N = 2363 was assessed by questionnaires on ACE, PF (Level of Personality Functioning Scale—Brief Form 2.0), and current symptoms of depression, anxiety, and somatization (Brief Symptom Inventory 18). The interaction between ACE and PF on symptoms was investigated using multiple group models and Bayesian structural equation modeling. ACE were positively associated with psychopathology and PF impairments. The interaction effect between ACE and PF explained incremental variance in current symptoms, ranging from 26% for somatization to 49% for depression with the complete model explaining up to 91% of the latent variance in psychopathology. Our findings indicate a diathesis–stress model with PF as a resource or resilience that may buffer against the development of symptoms in the face of adversity. Treatments of depression and anxiety targeting self and interpersonal functioning therefore may lead to improvements in resilience and relapse prevention. [Correction added on 15 March 2023, after first online publication: Level of Personality Functioning Scale—Brief Form has been replaced to Level of Personality Functioning Scale—Brief Form 2.0 ] [ABSTRACT FROM AUTHOR]

There is considerable controversy around psychiatric diagnosis generally and personality disorders specifically. Since its conception, borderline personality disorder has been controversial because of the stigma associated with the diagnosis and the therapeutic nihilism held by practitioners who encounter people with this high prevalence problem in acute settings. This paper reviews the history of the diagnosis of BPD and summarizes some of the controversy surrounding the categorical nature of diagnosis. Both the DSM 5 and ICD‐11 will be discussed; however, for the purposes of this paper, the DSM 5 will take the primary focus due to greater cultural significance. Recent developments in the treatment of borderline personality disorder suggest that it is a highly treatable condition and that full clinical recovery is possible. This paper formulates an argument that despite problems with psychiatric diagnosis that are unlikely to be resolved soon, a diagnosis should be made with an accompanying formulation to enable people to receive timely and effective treatment to enable personal and clinical recovery. [ABSTRACT FROM AUTHOR]

Objective: There are no generally accepted definitions or markers of treatment nonresponse in eating disorders (EDs). The aim of this paper was to examine how the duration of illness and other potential prognostic markers impacted on nonresponse and drop‐out from treatment across different EDs subtypes. Methods: A total sample of 1199 consecutively treated patients with EDs, according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria, participated in this study. Kaplan–Meier curves were calculated for each ED diagnosis in which the probability of recovery was plotted against the duration of illness. Results: Full remission was more likely for people with binge eating disorder (BED; 47.4%) and anorexia nervosa (AN; 43.9%) compared to bulimia nervosa (BN; 25.2%) and other specified feeding and EDs (OSFED; 23.2%). The cut‐off points for the duration of the illness related with high likelihoods of poor response was 6–8 years among OSFED, 12–14 years among AN and BN and 20–21 years among BED. Other variables predicting nonresponse included dysfunctional personality traits. Conclusions: Nonresponse to treatment is associated with duration of illness which is in turn associated with poor response to previous treatment. However, there was no evidence for staging the illness using specific duration of illness criteria. Nevertheless, the shorter temporal trajectory for OSFED suggests that early interventions may be of importance for this group. Highlights: Almost a half of people with anorexia nervosa (AN) and binge eating disorder (BED) had a good response to treatment, whereas for bulimia nervosa (BN) and other specified feeding and eating disorder (OSFED) only a quarter attained this outcome. Approximately a third of cases dropped out of treatment prematurely (highest for OSFED).The outcome of all EDs, except BED, is associated with duration of illness and number of previous treatment attempts. Optimising the treatment response early in the course of illness (particularly in the group with milder ED symptoms [OSFED]), may prevent the illness from taking a chronic course. However, there are no clear criteria for staging the illness using duration of illness as a marker.Treatments that target traits, such as persistence and harm avoidance, may improve the outcome of AN, and self‐directedness and reward dependence may improve the outcome of BN and BED, respectively. [ABSTRACT FROM AUTHOR]

We sought to understand the effect of current treatments for attention deficit hyperactivity disorder (ADHD) on executive functioning deficits, which are often comorbid with ADHD, via a systematic analysis of adult ADHD treatment studies evaluating change in behavioral measures beyond the core symptoms of Diagnostic and Statistical Manual of Mental Disorders ADHD. The standardized mean difference for behavioral measures of executive functioning was determined from controlled trials of adults with ADHD and compared with effects on core ADHD symptoms. Several studies of atomoxetine revealed small to large standardized mean differences. Nonreplicated studies revealed small to medium effects for triple‐bead mixed amphetamine salts, lisdexamfetamine, and forms of cognitive behavioral therapy. Proportional effect versus core ADHD symptoms ranged from 0.78 to 1.16 for atomoxetine, and from 0.65 to 1.44 across all the studies. ADHD treatments have effects on executive functioning behavior beyond core ADHD symptoms in adults. Clinicians can measure and treat this morbidity using available clinical tools. [ABSTRACT FROM AUTHOR]

Background: Endorsement of specific Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM‐IV) alcohol use disorder (AUD) criteria have been shown to change significantly over time in men in their thirties who have persistent or recurrent AUD. However, few studies have documented whether the endorsement of AUD items changes over time in younger individuals or in women. We evaluated changes in the endorsement of AUD criteria in 377 men and women with persistent or recurrent AUD during their twenties. Methods: Information on AUD‐item endorsement over time was available for 223 men and 154 women aged 20‐25 with persistent or recurrent AUD in at least three interviews in the Collaborative Study on the Genetics of Alcoholism. The statistical significance of endorsement changes over time was evaluated using the related‐sample Cochran's Q test for the full sample and for men and women separately. Additional analyses evaluated sex differences in the patterns of change. Results: In the full sample, the predominant pattern was for a significant increase in the rates of endorsement for six of the seven alcohol dependence criteria but not in the four abuse criteria. A similar pattern was seen within men, but women had significant changes in only three of the seven dependence criteria. Conclusions: Endorsement of the seven alcohol dependence criteria among individuals with persistent or recurrent AUD in their twenties generally increased, but few changes were observed in the rates of endorsement of the four abuse criteria. These results are discussed in terms of how they reflect on the nature of AUD and the DSM criteria. [ABSTRACT FROM AUTHOR]

Development of standardized diagnostic instruments has facilitated the systematic characterization of individuals with autism spectrum disorders (ASD) in clinical and research settings. However, overemphasis on scores from specific instruments has significantly detracted from the original purpose of these tools. Rather than provide a definitive "answer," or even a confirmation of diagnosis, standardized diagnostic instruments were designed to aid clinicians in the process of gathering information about social communication, play, and repetitive and sensory behaviors relevant to diagnosis and treatment planning. Importantly, many autism diagnostic instruments are not validated for certain patient populations, including those with severe vision, hearing, motor, and/or cognitive impairments, and they cannot be administered via a translator. In addition, certain circumstances, such as the need to wear personal protective equipment (PPE), or behavioral factors (e.g., selective mutism) may interfere with standardized administration or scoring procedures, rendering scores invalid. Thus, understanding the uses and limitations of specific tools within specific clinical or research populations, as well as similarities or differences between these populations and the instrument validation samples, is paramount. Accordingly, payers and other systems must not mandate the use of specific tools in cases when their use would be inappropriate. To ensure equitable access to appropriate assessment and treatment services, it is imperative that diagnosticians be trained in best practice methods for the assessment of autism, including if, how, and when to appropriately employ standardized diagnostic instruments. [ABSTRACT FROM AUTHOR]

This commentary on Livesley's paper in this special issue on International Classification of Diseases (ICD)‐11's personality disorder (PD) section addresses each of four issues that Livesley claims are impeding progress towards an evidence‐based system for the classification of personality pathology. I focus my commentary on the third issue, but also comment briefly on the others. Regarding, first, the complexity of personality pathology and, second, problematic assumptions about the nature of personality pathology, I contend that Livesley's comments are accurate, but omit that the fundamental impediment is the refusal of the Diagnostic and Statistical Manual of Mental Disorders (DSM) establishment to allow the official classification to reflect the reality of personality pathology that he describes, in contrast to its acceptance in the ICD‐11. In response to Livesley's third claim that a viable alternative to categorical diagnosis is not available, I take issue with various aspects of his assertions and develop arguments that the ICD‐11 PD model provides a useful, although admittedly imperfect, system. Finally, I agree with Livesley that the revision processes for official classifications are conservative and open to non‐scientific influences, but maintain that whereas the Diagnostic and Statistical Manual of Mental Disorders establishment held fast to the status quo, the ICD‐11 PD Working Group made considerable progress towards a valid PD diagnostic system. © 2020 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Conducting routine mild cognitive impairment (MCI) and dementia screening for older adults in the community is important, which not only can improve our understanding of these diseases but also can increase early detection and treatment. Methods: To analyze the reliability and validity of the informant AD8 and explore the cut‐off values for screening MCI and dementia in the community‐dwelling older adults, this study adopted a multi‐stage cluster sampling method to recruit 327 participants aged 60 and over in communities. The informant AD8 and Clinical Dementia Rating (CDR) scales were used to evaluate cognitive function of the subjects, and the receiver operating characteristic curves (ROC) was conducted to test the screening efficacy. Results: Among the 327 participants, 33.0% of them met the criteria of MCI, and 3.4% of them met the criteria of dementia. The area under the receiver operating characteristic curve (AUC) of the informant AD8 for screening dementia was 0.974, with a screening cut‐off of three, sensitivity of 90.9% and specificity of 89.0%. But it has a poor discriminability in MCI screening [AUC = 0.645, 95% confidence interval (CI): 0.578–0.711]. Conclusions: This study suggests that the informant AD8 is an ideal and useful tool for dementia screening in community‐dwelling older adults. However, it is less capable to distinguish older adults with MCI from those with normal cognitive function. [ABSTRACT FROM AUTHOR]

Despite the emphasis on evidence‐based treatment for psychological disorders, to date, there has been limited research examining treatment for nine of the 10 categorical personality disorders in DSM‐5 Section 2. This is perhaps not surprising given the complex heterogeneity and co‐morbidity within personality pathology. The hierarchical taxonomy of psychopathology (HiTOP) was proposed to address limitations within the traditional categorical model of the diagnostic system. Within this system are five spectra: detachment, antagonistic externalizing, disinhibited externalizing, thought disorder and internalizing. These foundational personality traits potentially have direct and specific treatment implications. The purpose of this paper is to highlight potential psychotherapeutic and pharmacological treatment recommendations within the personality spectra. Additionally, we outline the advantages of considering the personality science found within dimensional models of psychopathology in clinical assessment and intervention to aid in treatment planning. © 2019 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The authors present their thoughts on commentary from M.D. Griffiths et al. on their paper outlining the criteria for internet gaming disorder (IGD), arguing against claims the paper does not constitute a consensus and misinterprets IGD criteria. They note that rather than reach a consensus, the study was designed as a guideline for future research on the evaluation of IGD.

This commentary paper critically discusses the recent debate paper by Petry et al. (2014) that argued there was now an international consensus for assessing Internet Gaming Disorder (IGD). Our collective opinions vary considerably regarding many different aspects of online gaming. However, we contend that the paper by Petry and colleagues does not provide a true and representative international community of researchers in this area. This paper critically discusses and provides commentary on (i) the representativeness of the international group that wrote the ‘ consensus ’ paper, and (ii) each of the IGD criteria. The paper also includes a brief discussion on initiatives that could be taken to move the field towards consensus. It is hoped that this paper will foster debate in the IGD field and lead to improved theory, better methodologically designed studies, and more robust empirical evidence as regards problematic gaming and its psychosocial consequences and impact. [ABSTRACT FROM AUTHOR]

Objective Muscle dysmorphia is a relatively recently identified psychological condition that, since its inception, has been variously conceptualized as an eating disorder and subsequently as a type of body dysmorphic disorder within the somatoform disorders. This review aims to inform and encourage ongoing debate surrounding the diagnostic placement of this disorder. Method We present a review and synthesis of the extant literature with a view to informing future decisions regarding the conceptualization of muscle dysmorphia. Results The validity of muscle dysmorphia as a clinical entity has been empirically demonstrated. While the condition bears little semblance to somatization as currently conceptualized, the research suggests a strong conceptual similarity with anorexia nervosa. However, future research needs to utilize more appropriate measures of male eating disorder pathology. Muscle dysmorphia is also inclusive of obsessive compulsive features that are typical to those seen in eating disorder presentations. Discussion We suggest that muscle dysmorphia be reanalyzed through the lens of an eating disorder spectrum. Recognition of muscle dysmorphia as an eating disorder may offer more clinical utility in recognizing the male experience of eating disorder pathology and also help reduce the number of current male cases falling into the EDNOS category. © 2010 by Wiley Periodicals, Inc. Int J Eat Disord 2010; 43:483-491 [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the processes involved in a guided self‐help (GSH) pre‐treatment intervention (RecoveryMANTRA) for patients with anorexia nervosa (AN), by measuring the levels of patient/mentor Language Style Matching (LSM). RecoveryMANTRA was supported by student mentors or peer mentors (recovered individuals) over six weekly chat‐based sessions. We examined whether LSM during RecoveryMANTRA predicted patients'working alliance with the clinic therapist, motivation, eating disorder (ED) and general psychopathology. A further aim was to examine differences in LSM between student mentors and peer mentors. Method: 87 AN adults received RecoveryMANTRA plus treatment as usual. The LSM algorithm was used to calculate verbal attunement between patient and mentor. Participants were assessed at baseline and at the end of the intervention. Results: Both early (1st session) and late (6th session) LSM predicted higher working alliance with the clinic therapist. Moreover, late LSM predicted lower EDs symptoms at the end of the RecoveryMANTRA intervention. Patient/peer mentor dyads showed higher late verbal attunement than patient/student mentor dyads. Conclusions: These findings suggests that in the early phase of treatment relational aspects can impact on engagement with treatment. Verbal attunement in a GSH for AN is associated with working alliance and better clinical outcome. Highlights: Language Style Matching (LSM) between patients and mentors in both the early and late phase of the RecoveryMANTRA intervention predicted higher working alliance with the clinic therapist.LSM in the last phase (6th session) was associated with lower eating disorders (EDs) symptoms at the end of the RecoveryMANTRA intervention.Patients/peer mentors dyads showed higher late LSM than patients/student mentors dyads. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to scrutinize whether psychopathology symptom networks differ between those with and without lifetime: treatment seeking, treatment and treatment of longer duration. Methods: We created non‐exclusive groups of subjects with versus without lifetime treatment seeking, treatment and treatment of mid‐long‐term duration. We estimated Ising models and carried out network comparison tests (NCTs) to compare (a) overall connectivity and (b) network structure. Furthermore, we examined node strength. We used propensity score matching (PSM) to minimize potential confounding by indication for service use. Results: Based on data from 9,172 participants, there were no statistically significant differences in overall connectivity and network structure in those with versus without lifetime: treatment seeking (p =.75 and p =.82, respectively), treatment (p =.63 and p =.49, respectively) and treatment of mid‐longterm duration (p =.15 and p =.62, respectively). Notably, comparing networks with versus without service use consistently revealed higher node strength in 'obsessions' and 'aggression' and lower node strength in 'elevated mood' in all networks with service use. Conclusions: Findings suggest that after adjusting for potential confounding by indication for service use, there was no indication of an association in overall connectivity or network structure for lifetime treatment seeking, treatment and treatment of longer duration. However, selected structurally important symptoms differed consistently in all three comparisons. Our findings highlight the potential of network analysis methods to examine treatment mechanisms and outcomes. Specifically, more granular network characteristics on the node level may complement and enrich traditional outcomes in clinical research. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the feeling of emptiness in patients with borderline personality disorder (BPD) and patients with eating disorder (ED) and its relationship with suicidal behaviour and childhood traumatic events. Methodology: One hundred three BPD patients and 107 ED patients were assessed with the Feeling of Emptiness Scale (FES) and the Traumatic Experiences Questionnaire (TQ). Suicidal behaviour was assessed with a specific interview for frequency and intensity of suicidal behaviour. Results: Significant differences were found between the different factors of the FES between BPD patients and ED patients. A significant relationship was observed between Factors 1 and 4 of the FES and suicidal behaviour scores in both groups. Traumatic experiences were more strongly related to Factors 1, 2 and 4 in BPD patients. Conclusions: BPD patients and ED patients show similar scores in the global construct of feeling of emptiness. However, results suggest some qualitatively difference between the nature of feeling of emptiness in BPD and in ED. As expected, suicidal behaviour is most frequently in BPD patients, and is significantly associated with Factors 1 and 4 of the FES in both groups. Therefore, feeling of emptiness could be a predictor of suicidal behaviours in patients with emotional and behavioural instability. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to report the presence of categorical and dimensional personality disorders (PD) in adults with longstanding eating disorders (ED) over a period of 17 years and to investigate whether changes in PD predict changes in ED symptoms or vice versa. Methods: In total, 62 of the 80 living patients (78% response rate) with anorexia nervosa (n = 23), bulimia nervosa (n = 25), or other specified feeding or ED (n = 14) at baseline were evaluated during hospital treatment and at 1‐year, 2‐year, 5‐year, and 17‐year follow‐up. PD were assessed using the Structured Clinical Interview for DSM‐IV Axis II disorders, and the eating disorder examination (EDE) interview was used to assess ED. Data were analyzed using multilevel modeling. Results: From baseline to the 17‐year follow‐up, the number of patients with any PD decreased significantly from 74.2% to 24.2%, and the total number of PD diagnoses declined from 80 to 22. Mean EDE score was significantly reduced from 4.2 (SD: 1.1) to 2.0 (SD: 1.6). There was a positive association between ED and PD where the initial level of either disorder was followed by similar levels of the other disorder throughout the entire follow‐up period. High baseline levels of borderline PD predicted less decrease in ED symptoms. No significant within‐person effects were found. Conclusions: Both ED and PD significantly declined over time. As the severity of either disorder seems to be associated with the other, thorough assessment and treatment that incorporates both the ED psychopathology and the personality disturbances are advisable. Public Significance Statement: While personality disorders were highly prevalent in the sample of patients with longstanding eating disorders, both disorders were significantly reduced at the 17‐year follow‐up. The disorders are related in the sense that an initial high level of either disorder is associated with a high level of the other over time. A thorough assessment and attention to both illnesses are advisable in therapy. Clinical Trial Identifier: NCT03968705. [ABSTRACT FROM AUTHOR]

More recently, the prolonged grief disorder (PGD) has been recognized as a mental health disorder following bereavement, which is distinct from depression and PTSD. However, the number and proposed symptom items vary across the ICD‐11 and the DSM‐5‐TR criteria for PG. The Traumatic Grief Inventory‐Self Report Plus (TGI‐SR+), which is an updated version of the TGI‐SR, is currently the only robust instrument that assesses PG according to the ICD‐11 and DSM‐5‐TR criteria. For research and clinical use among French‐speaking countries, the forward‐backward procedure was applied to translate the TGI‐SR+ into French language. Exploratory factor analysis and parallel analysis converged towards a two‐dimensional structure for the TGI‐SR+, representing adaptation difficulties and traumatic separation distress. However, items mapping onto ICD‐11 and DSM‐5‐TR criteria for PG represented a one‐dimensional structure. Findings based on item response theory method provided strong evidence for discriminative characteristics of the items. The internal reliability was excellent for the TGI‐SR+ (McDonald's ω = 0.97) and ICD‐11 and DSM‐5‐TR criteria for PGD (McDonald's ω = 0.95). We also demonstrated a very high temporal stability for the TGI‐SR+ total score (ICC =.91, p < 0.0001) and ICD‐11 PGD and DSM‐5‐TR PGD (ICC = 0.90, and ICC = 0.88, ps < 0.0001, respectively). The concurrent validity of the instrument was also demonstrated, such that the TGI‐SR+ total score and all combinations were positively and significantly associated with the levels of depression, anxiety and post‐traumatic stress symptoms. However, the effect sizes were moderate. We conclude that for research and clinical use among French bereaved populations, the TGI‐SR+ is a sound tool with very good psychometric properties. [ABSTRACT FROM AUTHOR]

Hoarding disorder is a relatively new diagnosis in the DSM‐5, only just included in the most recent edition. The disorder has piqued the interest of many in the community, in part because of the hit TV show called "Hoarders." Although there is interest, there continues to be relatively few research studies into the causes, treatment, and management of this disorder specifically in adolescences. Yet, in the research that has been published, it often sites the disorder first appearing in adolescents. This paper will discuss the following elements of adolescent hoarding disorder: The potential etiology and risk factors noted in the literature, the DSM‐5 criteria for the diagnosis of hoarding disorder, and the characteristic signs and symptoms found in the adolescent presentation, as well as treatment. Finally, it will also include recommendations for healthcare professionals for early screening and treatment. [ABSTRACT FROM AUTHOR]

The article presents the discussion on addressing health equity starting at home. Topics include diagnostic terms and associated words having potential unintended consequences of harming people and contributing to social injustice; and offering little resistance while simultaneously shielding police from accountability.

Abstract: For almost half a century social scientists have explored the phenomenon of chronic illness. In this paper, I examine how the concept of chronicity participates in present‐day mental health care settings. Using ethnomethodology and material‐semiotic theory within science and technology studies, I investigate how the classification ‘chronically mentally ill’ interacts with the everyday socio‐material shaping of public mental health care in the context of professional institutions. Drawing on ethnographic fieldwork in a psychiatric day hospital and in a community day care centre in Berlin, Germany, I demonstrate how the classification of chronicity acts as a tool of description (of people or their conditions), regulation (of therapy, health care or administration), and connection to infrastructures of care (practised technologies or standards of various kinds). In these ways, I argue, the classification engages in actions of producing treatability, arranging resources, demarcating responsibilities, practicing accountability, and doing presence. Notably, community mental health care has developed into a designated territory of the concept: explicitly arranged for ‘the chronically mentally ill’ as a human kind, we can take everyday life in these institutions as instructive of how chronicity is defined in daily practice. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented that focuses on issues related to personality disorder (PD) classification system, including the multifactorial contextual factors and aetiology of PD, the continued reliance on a strict medical model for psychiatric classification, and viable dimensional alternatives to categorical diagnosis.

Objective: Suicidality is known to be elevated among people with an eating disorder. The aim of the current study was to examine whether any of three specific behavioral facets of eating disorders (i.e., purging, binge eating, restricting) would be the strongest predictors of suicidal ideation, controlling for one another, in longitudinal analyses from admission to discharge. We hypothesized that purging, above and beyond restricting or binge eating, would be the most important predictor of suicidal ideation. Method: In the present study, patients with an eating disorder (N = 936), the majority of whom met criteria for a current DSM‐5 diagnosis of Anorexia Nervosa (n = 560), completed the Eating Pathology Symptoms Inventory (EPSI) and the Beck Depression Inventory II‐Item 9 suicidal ideation index, at admission and again at discharge. The settings were eating disorder treatment facilities offering inpatient, residential, partial hospitalization program (PHP), and intensive outpatient (IOP) levels of care. We pitted EPSI purging, EPSI restriction, and EPSI binge eating against one another in a regression framework predicting discharge suicidal ideation controlling for suicidal ideation at admission. Results: EPSI Purging significantly predicted both presence/absence of suicidal ideation (β =.22, t = 2.48, p =.01; OR = 1.25, 95% CI [1.05, 1.49]) and intensity of suicidal ideation (β =.04, t = 2.31, p =.02) at discharge, whereas neither EPSI Restricting nor EPSI Binge Eating did (p >.30). Discussion: Study results suggest that purging may have particular relevance in estimating suicide risk in patients with an eating disorder. [ABSTRACT FROM AUTHOR]

Learning progressions can reflect students' continuous in‐depth thinking development paths, and their establishment is an iterative process from the construction of hypothetical learning progressions to the verification of that hypotheses. Considering the limitations of the existing verification method of learning progressions based on a rule space model, this study put forward a new validating method based on the hierarchical diagnostic classification model (HDCM) and developed a learning progression with grade 5 students' fraction operations as an example. An expert group first abstracted the attributes and then developed a hypothesized learning progression. Next, the HDCM was used to analyze the test data collected from 817 fifth‐grade students, followed by the revision of the learning progression hypothesis. Results showed that (1) the fractional operations involved five attributes: basic operation (A1), reduction of a fraction (A2), changing fractions to a common denominator (A3), split with mix number (A4), and borrowing (A5); (2) the constructed learning progression featured four levels: Level 1 with A1, Level 2 with both A1 and A2, Level 3 with the first four attributes, and Level 4 with all five attributes. [ABSTRACT FROM AUTHOR]

With TV shows such as Hoarding buried alive, mainstream media depictions of hoarding disorder are presented mostly in the context of adults. Interestingly, however, studies have found that the onset of hoarding disorder often occurs in childhood between the ages of 8 and 10 (Morris et al., 2016). Since hoarding can onset at a young age, early intervention could help decrease the long‐term impairment of the disorder. According to the Diagnostic and statistical manual of mental disorders hoarding disorder is characterized as tending to collect items, difficulty in throwing items away despite the items' value or significance, and possessing an excessive number of items, leading to clutter (5th ed.; DSM–5; American Psychiatric Association, 2013). Despite a typical onset in childhood, most hoarding treatment and research has focused on adults because hoarding behaviors in youth can be challenging to identify due to family accommodation (Morris et al., 2016). In this article, we will review the prevalence of pediatric hoarding and provide a case example to describe clinical considerations for treating pediatric hoarding with exposure with response prevention (ERP). [ABSTRACT FROM AUTHOR]

Over the past decades, a number of complementary treatments for schizophrenia have emerged. One of these is metacognitive training (MCT), which combines the principles of cognitive‐behavioral therapies, cognitive remediation, and psychoeducation into a hybrid approach placing emphasis on increasing metacognitive awareness. The aim of our study was to investigate the efficacy of MCT on symptom severity, and neurocognitive and social cognitive functioning in schizophrenia; also, attention was paid to the assessment of subjective acceptability. Forty‐six patients diagnosed with schizophrenia were included in our single‐blind randomized controlled trial, who were assigned to the intervention or control group. The intervention group was provided standard MCT, while the control group received treatment as usual. We assessed symptom severity and cognitive functions before and after the training, as well as after a 6‐month follow‐up period. Compared to the control group, the intervention group showed improvement in overall symptom severity, and positive and disorganized symptoms. Training participans showed further improvement at the follow‐up assessment. Regarding neurocognitive functions, improvement in visuospatial functions was observed between pre‐ and post‐intervention assessments compared to the control group. Patients showed excellent adherence, and evaluated the training as useful and interesting. In line with the results of previous studies, our results demonstrate the efficacy of MCT on symptom severity in schizophrenia. Improvements in cognitive functions that are closely related to the onset and prevalence of symptoms of schizophrenia were also found. [ABSTRACT FROM AUTHOR]

Background and Aims: Previous twin research suggests relationship status can moderate underlying genetic liability towards alcohol misuse. This paper examined: (1) whether genome‐wide polygenic scores (GPS) for alcohol consumption are associated with alcohol misuse; (2) whether these GPS are moderated by romantic relationships (gene–environment interaction; G × E) and (3) whether G × E results are consistent across sex. Design: Linear mixed‐effects models were used to test associations between genome‐wide polygenic scores, relationship status and alcohol use/misuse. Setting: Finnish twins born between 1983 and 1987 identified through Finland's central population registry. Participants: An intensively studied subset of Finnish Twin Study (FinnTwin12) during the young adult phase (aged 20–26 years). The analytical sample includes those with complete interview and genetic data (n = 1201). Measurements Key measurements included involvement in a romantic partnership, drinking frequency, intoxication frequency and DSM‐IV alcohol dependence (AD) symptoms. Genome‐wide polygenic scores (GPS) were created from available summary statistics from a large genome‐wide association study (GWAS) of drinks per week. Results: GPS predicted drinking frequency [b = 0.109; 95% confidence interval (CI) = 0.050, 0.168], intoxication frequency (b = 0.111; 95% CI = 0.054, 0.168) and AD symptoms (b = 0.123; 95% CI = 0.064, 0.182). Having a romantic relationship negatively influenced the association between GPS and drinking frequency (b = −0.105; 95% CI = −0.211, −0.001), intoxication frequency (b = −0.118; 95% CI = −0.220, −0.016) and AD symptoms (b = −0.119; 95% CI = −0.229, −0.009). There was a three‐way interaction between sex, relationship status and GPS for intoxication frequency (b = 0.223; 95% CI = 0.013, 0.433), such that the reduced association between GPS and intoxication frequency for those in a relationship was only apparent in males. We found no evidence of three‐way interactions for drinking frequency or AD symptoms. Conclusions: Being in a romantic relationship reduced the association between genetic predisposition and drinking, high‐risk drinking and alcohol problems. However, for high‐risk drinking the protective effect was limited to males, mapping onto earlier findings suggesting that males benefit more from romantic partnerships. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption and problems are increasing among older adults, who are at elevated risk for alcohol‐related accidents and medical problems. This paper describes a pilot follow‐up of older adults with a history of alcohol dependence that was designed to determine the feasibility of conducting a more extensive investigation. Methods: The sample consisted of previously assessed subjects in the Collaborative Studies on the Genetics of Alcoholism who: (i) were age 50+; (ii) had lifetime DSM‐IV AD; and (iii) had DNA available. Individuals were located through family contacts, Internet searches, and death registries. A brief telephone interview assessed demographics, health, and alcohol involvement. Results: Of the total sample (N = 2,174), 36% were contacted, 24% were deceased, and 40% were not yet located. Most (89%) contacted subjects were interviewed, and 99% of them agreed to future evaluation. Thirty percent of interviewed subjects reported abstinence for 10+ years, 56% reported drinking within the past year, and 14% last drank between >1 and 10 years ago. There were no age‐related past‐year differences in weekly consumption (overall sample mean: 16 drinks), number of drinking weeks (30.8), maximum number of drinks in 24 hours (8.1), or prevalence of weekly risky drinking (19%). Among those who drank within the past 5 years, the 3 most common alcohol‐related problems were spending excessive time drinking or recovering (49%), drinking more/longer than intended (35%), and driving while intoxicated (35%); and about a third (32%) received some form of treatment. Conclusions: Over a 1‐year period, we located 60% of individuals last seen an average of 23 years ago. The majority of contacted individuals were interviewed and willing to be evaluated again. Although the proportion of individuals currently drinking diminished with age, subjects exhibited troublesome levels of alcohol consumption and problems. Our findings suggest the importance and feasibility of a more comprehensive follow‐up. [ABSTRACT FROM AUTHOR]

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Several studies have shown the efficacy of group treatments for patients with eating disorders (EDs) who have negative attitudes towards their bodies, also using the group climate as an indicator of process. Within this field of study, perfectionism has been examined as a factor that maintains eating disorders. This study proposes to comprehend what kind of treatment favours a better group climate, by providing a within‐person comparison between two short group treatments of ED patients, where one was not focused on a specific topic and the other was structured around the topic of clinical perfectionism. Two groups of young adult patients with eating disorders were monitored for three months. Group climate was measured both with the Group Climate Questionnaire, which was administered at the end of each session, and through the clinical accounts written by an observer. The findings revealed that the perfectionism group, in comparison with the control group, presented a significantly higher level of engagement and avoidance, along with a lower level of conflict. In particular, the engagement of the perfectionism group increased in accordance with the therapeutic process, whilst in the control group, it remained relatively constant. The conflict decreased in both groups whilst avoidance increased alongside the sessions of the perfectionism group and decreased in the control group. The group on perfectionism, despite its enhanced high levels of avoidance, was effective in promoting a positive group climate. The clinical implications of structured group treatment for eating disorders, which manage the theme of mind‐body splitting, will be discussed. [ABSTRACT FROM AUTHOR]

Background: Surveys of changes in drinking during the COVID‐19 pandemic have primarily relied on retrospective self‐report. Further, most such surveys have not included detailed measures of alcohol use patterns, such as beverage‐specific consumption, nor measures of alcohol use disorder (AUD) symptoms that would allow a comprehensive understanding of changes in alcohol use. Methods: Data from 1819 completed interviews from the N14C follow‐up survey to the 2019 to 2020 National Alcohol Survey (N14) were conducted between January 30 and March 28, 2021. Questions on alcohol use from the Graduated Frequency series, beverage‐specific quantity and frequency, and DSM‐5 AUD items were asked in both surveys and used to estimate changes from pre‐pandemic drinking to drinking during the pandemic. Analyses focus on changes in these measures over time and comparisons between key subgroups defined by gender, race/ethnicity, and age. Results: Key findings include particularly large increases in drinking and AUD for African Americans and women, reduced drinking and heavy drinking prevalence among men and White respondents, and a concentration of increased drinking and AUD among respondents aged 35 to 49. Increases in alcohol use were found to be driven particularly by increases in drinking frequency and the consumption of spirits. Conclusions: Results confirm prior findings of overall increases and subgroup‐specific changes, and importantly, provide detailed information on the patterns of change across major socio‐demographic subgroups. Substantial increases in the prevalence of DSM‐5 moderate to severe AUDs are a novel finding that is of particular concern. [ABSTRACT FROM AUTHOR]

The inclusion of “Internet gaming disorder (IGD)” in the fifth edition of Diagnostic and statistical manual of mental disorders (DSM‐5) creates a possible line of research. Despite the fact that adolescents are vulnerable to IGD, studies had reported wide array of prevalence estimates in this population. The aim of this paper is to review the published studies on prevalence of IGD among adolescents. Relevant studies prior to March 2017 were identified through databases. A total of 16 studies met the inclusion criteria. The pooled prevalence of IGD among adolescents was 4.6% (95% CI = 3.4%–6.0%). Male adolescents generally reported higher prevalence rate (6.8%, 95% CI = 4.3%–9.7%) than female adolescents (1.3%, 95% CI = 0.6%–2.2%). Subgroup analyses revealed that prevalence estimates were highest when studies were conducted in: (i) 1990s; (ii) use DSM criteria for pathological gambling; (iii) examine gaming disorder; (iv) Asia; and (v) small samples (<1,000). This study confirms the alarming prevalence of IGD among adolescents, especially among males. Given the methodological deficits in past decades (such as reliance on DSM criteria for “pathological gambling,” inclusion of the word “Internet,” and small sample sizes), it is critical for researchers to apply a common methodology for assess this disorder. [ABSTRACT FROM AUTHOR]

Abstract: Despite its demonstrated empirical superiority over the DSM‐5 Section 2 categorical model of personality disorders for organizing the features of personality pathology, limitations remain with regard to the translation of the DSM‐5 Section 3 alternative model of personality disorders (AMPD) to clinical practice. The goal of this paper is to outline a general and preliminary framework for approaching treatment from the perspective of the AMPD. Specific techniques are discussed for the assessment and treatment of both Criterion A personality dysfunction and Criterion B maladaptive traits. A concise and step‐by‐step model is presented for clinical decision making with the AMPD, in the hopes of offering clinicians a framework for treating personality pathology and promoting further research on the clinical utility of the AMPD. Copyright © 2018 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Despite its potential to produce serious adverse outcomes, DSM‐5 alcohol withdrawal syndrome (AWS) has not been widely studied in the general population. Methods: We used cross‐sectional data from 36,309 U.S. adults from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions‐III to examine the past‐year prevalence of AWS and its correlates. We focused on an important clinical population–past‐year drinkers with unhealthy alcohol use–i.e., those with a positive score on the Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C) questionnaire. We also examined the association of AWS with sociodemographic measures, psychiatric disorders, alcohol‐related measures, and healthcare utilization. Results: Approximately one‐third (n = 12,634) of respondents reported unhealthy alcohol use (AUDIT‐C+). Of these, 14.3% met criteria for a DSM‐5 AWS diagnosis. The mean (SE) number of withdrawal symptoms among individuals with AWS was 2.83 (1.88), with the most common being nausea/vomiting and insomnia (19.8% and 11.6%, respectively). Among AUDIT‐C+ respondents, the odds of AWS were significantly higher among males (adjusted odds ratio [aOR] = 1.17 [95% CI, 1.02–1.33]), unmarried participants (aOR = 1.55 [95% CI, 1.25–1.92]), and those at the lowest (vs. highest) income levels (aOR = 1.62 [95% CI, 1.37–1.92]). Among AUDIT‐C+ respondents, AWS was also associated with psychiatric disorders (with aORs that ranged from 2.08 [95% CI, 1.79–2.41]) for major depressive disorder to 3.14 (95% CI, 1.79–2.41) for borderline personality disorder. AUDIT‐C+ respondents with AWS also had higher odds of past‐year alcohol use disorder (aOR = 11.2 [95% CI, 9.66–13.07]), other alcohol‐related features (e.g., binge drinking), and healthcare utilization. Conclusions: Among individuals with unhealthy alcohol use, AWS is prevalent, highly comorbid, and disabling. Given the risk of AWS among unhealthy drinkers, a comparatively large segment of the general population, clinicians should seek to identify individuals with AWS and intervene with them to prevent serious adverse outcomes. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is underdiagnosed and undertreated in medical settings, in part due to a lack of AUD assessment instruments that are reliable and practical for use in routine care. This study evaluates the test‐retest reliability of a patient‐report Alcohol Symptom Checklist questionnaire when it is used in routine care, including primary care and mental health specialty settings. Methods: We performed a pragmatic test‐retest reliability study using electronic health record (EHR) data from Kaiser Permanente Washington, an integrated health system in Washington state. The sample included 454 patients who reported high‐risk drinking on a behavioral health screen and completed two Alcohol Symptom Checklists 1 to 21 days apart. Subgroups of these patients who completed both checklists in primary care (n = 271) or mental health settings (n = 79) were also examined. The primary measure was an Alcohol Symptom Checklist on which patients self‐reported whether they experienced each of the 11 AUD criteria within the past year, as defined by the Diagnostic and Statistical Manual of Mental Disorders‐5th edition (DSM‐5). Results: Alcohol Symptom Checklists completed in routine care and documented in EHRs had excellent test‐retest reliability for measuring AUD criterion counts (ICC = 0.79, 95% CI: 0.76 to 0.82). Test‐retest reliability estimates were also high and not significantly different for the subsamples of patients who completed both checklists in primary care (ICC = 0.82, 95% CI: 0.77 to 0.85) or mental health settings (ICC = 0.74, 95% CI: 0.62 to 0.83). Test‐retest reliability was not moderated by having a past two‐year AUD diagnosis, nor by the age or sex of the patient completing it. Conclusions: Alcohol Symptom Checklists can reliably and pragmatically assess AUD criteria in routine care among patients who screen positive for high‐risk drinking. The Alcohol Symptom Checklist may be a valuable tool in supporting AUD‐related care and monitoring AUD criteria longitudinally in routine primary care and mental health settings. [ABSTRACT FROM AUTHOR]

Literature provides a moderate level of evidence for the beneficial effects of incisional negative pressure wound therapy (iNPWT) on scar quality. The purpose of this study was to establish if iNPWT results in improved scar outcomes in comparison to the standard of care. Therefore, a within‐patient randomised controlled, open‐label trial was conducted in transgender men undergoing gender‐affirming mastectomies. A unilateral side was randomised to receive iNPWT (PICO™, Smith&Nephew) without suction drains and contrastingly the standard dressing (Steri‐Strips™) with suction drain. Scar quality and questionnaires were bilaterally measured by means of objective assessments and patient‐reported outcome measures (PROM) at 1, 3 and 12 months. Objective scar outcomes were scar pliability (Cutometer®), colouration (DSM‐II) and scar width (3‐D imaging). PROM outcomes were related to scars (POSAS and SCAR‐Q) and body satisfaction (BODY‐Q). From 85 included patients, 80 were included for analyses. No significant difference between treatments was seen in the quantitative outcomes of scar pliability, colour, and width. For qualitative scar outcomes, several significant findings for iNPWT were found for several subscales of the POSAS, SCAR‐Q, and BODY‐Q. These effects could not be substantiated with linear mixed‐model regression, signifying no statically more favourable outcome for either treatment option. In conclusion, this study demonstrated that some PROM outcomes were more favourable for the iNPWT compared to standard treatment. In contrast, the quantitative outcomes showed no beneficial effects of iNPWT on scar outcomes. This suggests that iNPWT is of little benefit as a scar‐improving therapy. [ABSTRACT FROM AUTHOR]

The aim was to (i) compare the rates of perceived stress, post‐traumatic stress symptoms (PTSS) and other potential correlates (i.e., resilience, social support, coping strategies, and loneliness) in the general population between the two COVID‐19 lockdowns in Greece and (ii) explore risk and protective factors of PTSS. Online data were collected amid the first (timepoint 1‐T1) and second lockdown (timepoint 2‐T2) by 1009 and 352 participants, respectively. The PTSD Checklist for DSM‐5 and the Perceived Stress Scale measured levels of PTSS and perceived stress. The Brief Resilience Scale, the COPE, the revised UCLA Loneliness Scale, and the ENRICHD Social Support Instrument measured resilience, coping strategies, loneliness, and social support, respectively. Higher levels of PTSS and perceived stress were reported during T2, compared to T1. Clinically significant levels of PTSS were presented by 26.1% and 35.5% of the participants during T1 and T2, respectively. Higher levels of loneliness and use of maladaptive coping strategies and lower levels of social support, resilience and use of adaptive coping strategies were also found. During both lockdowns, PTSS were predicted by perceived stress, loneliness, reduced resilience and the coping strategies of denial and self‐blame. PTSS were associated with younger age, female gender, being single, not having children, and the evaluation of the pandemic as a crisis. The findings highlight the significant public mental health concerns during the COVID‐19 lockdowns. Understanding the risk and protective factors against PTSS and focusing on vulnerable populations should be prioritized by the governments worldwide in the development of evidence‐based interventions. [ABSTRACT FROM AUTHOR]

This paper offers some reflections on Griffith Edwards' continuing legacy with particular reference to his and Milton Gross's formulation of alcohol dependence as a 'provisional' clinical syndrome. The ideas and language from this seminal paper have heavily influenced international diagnostic classification systems. However, it is observed that there has also been significant (and increasing) divergence-in particular around the original proposal that dependence and negative alcohol-related consequences are independent, if inevitably inter-related dimensions. This is most apparent in the conflation of alcohol-related problems and dependence phenomena implicit in DSM-V. It is also argued that the alcohol dependence syndrome (ADS) has substantial continuing influence and relevance to current clinical practice. The hypothesis that degree of alcohol dependence is a useful indicator of the possibility of a return to controlled drinking continues to receive support, and underpins the widespread implementation of brief interventions for 'early stage' problem drinkers. It is suggested that the kind of careful clinical observations that underpinned the original concept of alcohol dependence have continuing relevance to the formulation of improved understanding, measurement instruments, diagnostic systems and clinical responses. [ABSTRACT FROM AUTHOR]

In this article, we take forward recent initiatives to assess regulation based on contemporary computer technologies such as big data and artificial intelligence. In order to characterize current phenomena of regulation in the digital age, we build on Karen Yeung's concept of "algorithmic regulation," extending it by building bridges to the fields of quantification, classification, and evaluation research, as well as to science and technology studies. This allows us to develop a more fine‐grained conceptual framework that analyzes the three components of algorithmic regulation as representation, direction, and intervention and proposes subdimensions for each. Based on a case study of the algorithmic regulation of Uber drivers, we show the usefulness of the framework for assessing regulation in the digital age and as a starting point for critique and alternative models of algorithmic regulation. [ABSTRACT FROM AUTHOR]

Background and Aims: The Brief Scale for Anxiety (BSA) and the State–Trait Anxiety Inventory Form Y‐2 (STAI‐Y‐2) are self‐report scales used to gauge anxiety symptoms in clinical settings. Co‐occuring anxiety is common in alcohol use disorder (AUD); however, no studies have assessed the validity of the BSA and STAI‐Y‐2 compared with a clinical diagnostic tool of anxiety in alcohol treatment programs. We aimed to examine the validity of the BSA and STAI‐Y‐2 to predict a clinical diagnosis of an anxiety disorder (via the Structured Clinical Interview for DSM [SCID]) in AUD patients. Design Participants were administered the BSA (n = 1005) on day 2 and the STAI‐Y‐2 (n = 483) between days 2 and 10 of the detoxification program. SCID‐based clinical diagnoses of AUD and anxiety were made approximately on day 10. Setting and participants: Individuals seeking treatment for AUD admitted to an inpatient unit at the National Institutes of Health (NIH) Clinical Center in Bethesda, MD, USA (n = 1010). Measurements Inclusion criteria included a current diagnosis of alcohol dependence (AD) according to DSM‐IV‐TR or moderate to severe AUD according to DSM‐5‐RV, as well as available baseline BSA and/or STAI Y‐2 data. Empirical receiver operating characteristic (ROC) curves were generated using estimates of sensitivity, 1‐specificity and positive and negative predictive values for each cut‐point to determine the accuracy of scale outcomes in relation to SCID diagnoses. Findings The BSA demonstrated low accuracy relative to a clinical diagnosis of anxiety with an area under the curve (AUC) of 0.67 at the optimal cut‐point of ≥ 10. The STAI‐Y‐2 had moderate accuracy relative to a clinical diagnosis of anxiety with an AUC of 0.70 at the optimal cut‐point of ≥ 51. The accuracy of the STAI‐Y‐2 increased (AUC = 0.74) when excluding post‐traumatic stress disorder and obsessive–compulsive disorder from anxiety disorder classification. Conclusions: Use of the Brief Scale for Anxiety (BSA) and/or State–Trait Anxiety Inventory Form Y‐2 (STAI‐Y‐2) does not appear to be a reliable substitute for clinical diagnoses of anxiety disorder among inpatients with alcohol use disorder. The BSA and STAI‐Y‐2 could serve as a screening tool to reject the presence of anxiety disorders rather than for detecting an anxiety disorder. [ABSTRACT FROM AUTHOR]

Background: Data from 2 generations of participants in the San Diego Prospective Study (SDPS) were used to compare cross‐sectional and prospective relationships of 5 measures of the low level of response (low LR) to alcohol to 2 key alcohol‐related outcomes. Methods: The analyses used data from 373 SDPS male probands and 158 male and female offspring of these individuals to evaluate relationships of 5 LR measures to the prior 5‐year maximum drinks per occasion and the number of 11 DSM‐IV alcohol use disorder (AUD) criteria experienced. Probands' LR measures included responses to alcohol challenges administered 15 years previously, and ratings for both generations included measures of the number of standard drinks during four periods: the first five times of drinking (SRE‐5), the prior three drinking months (SRE‐3), the period of heaviest drinking (SRE‐H), and a total average across all time frames (SRE‐T). Analyses included zero‐order correlations, correlations using covariates, and hierarchical multiple regression analyses. Results: All 5 LR measures were correlated with aspects of maximum drinks and the number of AUD criteria, but the most robust results were seen for SRE‐3 and maximum drinks. Correlations were less consistent for SRE‐5, a measure more closely related to outcomes in the offspring. Hierarchical regression analyses supported most of these conclusions and showed that alcohol challenge–based LRs added significant information regarding maximum drinks even when evaluated with SRE values. The close correlation between SRE‐H and SRE‐T argues against the need for studies to include both measures. The patterns of results were similar irrespective of whether covariates were included. Conclusions: There were significant correlations of maximum drinks and the number of AUD criteria with findings from prior alcohol challenges and all SRE scores. Challenges and SRE reports are related but not identical LR measures. All SRE scores, including SRE‐5, offered useful information regarding subsequent drinking behavior. The low level of response (low LR) to alcohol predicts future heavier drinking and alcohol problems and can be measured using alcohol challenges or by four scores from the SRE questionnaire regarding the number of drinks required for up to four alcohol effects. These analyses compare how the five LR measures predict future maximum drinks and alcohol problems across generations of participants in a 40‐year study. All measures correlated significantly with each other, but each added unique information about future adverse alcohol outcomes. [ABSTRACT FROM AUTHOR]

Aims For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces nonsubstance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition. Methods We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5. Results We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted. Conclusions Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder. [ABSTRACT FROM AUTHOR]