Search

BackgroundThe jumping to conclusions bias (JTC) is considered to be an important causal factor in theoretical models for the formation and maintenance of delusions. However, recent meta-analytic findings show a rather equivocal pattern of results regarding associations between JTC and delusions. Thus, the present study aims to investigate in a large sample whether the JTC-bias is more pronounced in patients with psychotic disorders in comparison to controls and whether the JTC bias is associated with a more severe delusional conviction, persecutory delusions, and positive symptoms in general.MethodsPatients with psychotic disorders (n=300) enrolled in a therapy trial and healthy controls (n=51) conducted a variant of the beads task (fish task) as a measure for the JTC-bias at the start of the trial. Further, clinical interviews were used to assess patients' delusional severity and delusional conviction.ResultsThere were no statistically significant differences between patients with psychotic disorders (with 53% displaying the JTC-bias) and controls (41%). Furthermore, there were no statistically significant correlations between JTC measures and persecutory delusions, delusional conviction, and positive symptoms.ConclusionsWe found no differences in JTC between patients with psychotic disorders and healthy controls, which is in part in line with meta-analytic findings using a wide range of JTC task variants. Interestingly, patients with psychotic disorders displayed JTC rates commonly found in the literature, while healthy control subjects showed an unexpectedly high level of JTC. The task variant we used in the present study (fish task) is discussed as a potential reason for our results, as it may induce a more deliberative reasoning style in controls as compared to the traditional beads task. Furthermore, possible implications for the measurement of the JTC-bias, in general, are discussed.Trial RegistrationISRCTN29242879 (isrctn.com), date of registration: April 12

BACKGROUND: The jumping to conclusions bias (JTC) is considered to be an important causal factor in theoretical models for the formation and maintenance of delusions. However, recent meta-analytic findings show a rather equivocal pattern of results regarding associations between JTC and delusions. Thus, the present study aims to investigate in a large sample whether the JTC-bias is more pronounced in patients with psychotic disorders in comparison to controls and whether the JTC bias is associated with a more severe delusional conviction, persecutory delusions, and positive symptoms in general. METHODS: Patients with psychotic disorders (n = 300) enrolled in a therapy trial and healthy controls (n = 51) conducted a variant of the beads task (fish task) as a measure for the JTC-bias at the start of the trial. Further, clinical interviews were used to assess patients' delusional severity and delusional conviction. RESULTS: There were no statistically significant differences between patients with psychotic disorders (with 53% displaying the JTC-bias) and controls (41%). Furthermore, there were no statistically significant correlations between JTC measures and persecutory delusions, delusional conviction, and positive symptoms. CONCLUSIONS: We found no differences in JTC between patients with psychotic disorders and healthy controls, which is in part in line with meta-analytic findings using a wide range of JTC task variants. Interestingly, patients with psychotic disorders displayed JTC rates commonly found in the literature, while healthy control subjects showed an unexpectedly high level of JTC. The task variant we used in the present study (fish task) is discussed as a potential reason for our results, as it may induce a more deliberative reasoning style in controls as compared to the traditional beads task. Furthermore, possible implications for the measurement of the JTC-bias, in general, are discussed. TRIAL REGISTRATION: ISRCTN29242879 ( isrctn.com ), date of re

BACKGROUND: Cognitive models of psychosis postulate an important role of Theory of mind (ToM) in the formation and maintenance of delusions, but research on this plausible conjecture has gathered conflicting findings. In addition, it is still an open question whether problems in emotion recognition (ER) are associated with delusions. We examined the association of problems in ToM and ER with different aspects of delusions in a large sample of patients with psychosis enrolled in a therapy trial. This also enabled us to explore the possible impact of ToM and ER on one part of patients' social life: the quality of their therapeutic relationship. METHODS: Patients with psychotic disorders and delusions and/or hallucinations (n = 185) and healthy controls (n = 48) completed a ToM picture sequencing task and an ER task. Subsequently, patients were enrolled in a randomized-controlled Cognitive Behavior Therapy (CBT) trial (ISRCTN29242879). Patients and therapists rated the quality of the therapeutic relationship during the first five sessions of therapy. RESULTS: In comparison to controls, patients were impaired in both ToM and ER. Patients with deficits in ER experienced more severe delusional distress, whereas ToM problems were not related to delusions. In addition, deficits in ER predicted a less favorable therapeutic relationship and interactional problems viewed by the therapist. Impaired ER also moderated (increased) the negative influence of delusions on the therapeutic relationship and interactional difficulties viewed by the therapist. CONCLUSIONS: Cognitive models on the formation and maintenance of delusions should consider ER as a potential candidate that might be related to the formation and maintenance of delusional distress, whereas problems in ToM might not be directly related to delusions and secondary dimensions of delusions. In addition, problems in ER in patients with psychosis might have an impact on the quality of the therapeutic relationship and pati

Background Cognitive models of psychosis postulate an important role of Theory of mind (ToM) in the formation and maintenance of delusions, but research on this plausible conjecture has gathered conflicting findings. In addition, it is still an open question whether problems in emotion recognition (ER) are associated with delusions. We examined the association of problems in ToM and ER with different aspects of delusions in a large sample of patients with psychosis enrolled in a therapy trial. This also enabled us to explore the possible impact of ToM and ER on one part of patients' social life: the quality of their therapeutic relationship. Methods Patients with psychotic disorders and delusions and/or hallucinations (n = 185) and healthy controls (n = 48) completed a ToM picture sequencing task and an ER task. Subsequently, patients were enrolled in a randomized-controlled Cognitive Behavior Therapy (CBT) trial (ISRCTN29242879). Patients and therapists rated the quality of the therapeutic relationship during the first five sessions of therapy. Results In comparison to controls, patients were impaired in both ToM and ER. Patients with deficits in ER experienced more severe delusional distress, whereas ToM problems were not related to delusions. In addition, deficits in ER predicted a less favorable therapeutic relationship and interactional problems viewed by the therapist. Impaired ER also moderated (increased) the negative influence of delusions on the therapeutic relationship and interactional difficulties viewed by the therapist. Conclusions Cognitive models on the formation and maintenance of delusions should consider ER as a potential candidate that might be related to the formation and maintenance of delusional distress, whereas problems in ToM might not be directly related to delusions and secondary dimensions of delusions. In addition, problems in ER in patients with psychosis might have an impact on the quality of the therapeutic relationship and patients

BackgroundThe jumping to conclusions bias (JTC) is considered to be an important causal factor in theoretical models for the formation and maintenance of delusions. However, recent meta-analytic findings show a rather equivocal pattern of results regarding associations between JTC and delusions. Thus, the present study aims to investigate in a large sample whether the JTC-bias is more pronounced in patients with psychotic disorders in comparison to controls and whether the JTC bias is associated with a more severe delusional conviction, persecutory delusions, and positive symptoms in general.MethodsPatients with psychotic disorders (n=300) enrolled in a therapy trial and healthy controls (n=51) conducted a variant of the beads task (fish task) as a measure for the JTC-bias at the start of the trial. Further, clinical interviews were used to assess patients' delusional severity and delusional conviction.ResultsThere were no statistically significant differences between patients with psychotic disorders (with 53% displaying the JTC-bias) and controls (41%). Furthermore, there were no statistically significant correlations between JTC measures and persecutory delusions, delusional conviction, and positive symptoms.ConclusionsWe found no differences in JTC between patients with psychotic disorders and healthy controls, which is in part in line with meta-analytic findings using a wide range of JTC task variants. Interestingly, patients with psychotic disorders displayed JTC rates commonly found in the literature, while healthy control subjects showed an unexpectedly high level of JTC. The task variant we used in the present study (fish task) is discussed as a potential reason for our results, as it may induce a more deliberative reasoning style in controls as compared to the traditional beads task. Furthermore, possible implications for the measurement of the JTC-bias, in general, are discussed.Trial RegistrationISRCTN29242879 (isrctn.com), date of registration: April 12

Nitrous oxide (N2O) reducing microorganisms may be key in the mitigation of N2O emissions from managed ecosystems. However, there is still no clear understanding of the physiological and bioenergetic implications of microorganisms possessing either of the two N2O reductase genes (nosZ), clade I and the more recently described clade II type nosZ. It has been suggested that organisms with nosZ clade II have higher growth yields and a lower affinity constant (Ks) for N2O. We compared N2O reducing communities with different nosZI/nosZII ratios selected in chemostat enrichment cultures, inoculated with activated sludge, fed with N2O as a sole electron acceptor and growth limiting factor and acetate as electron donor. From the sequencing of the 16S rRNA gene, FISH and quantitative PCR of nosZ and nir genes, we concluded that betaproteobacterial denitrifying organisms dominated the enrichments with members within the family Rhodocyclaceae being highly abundant. When comparing cultures with different nosZI/nosZII ratios, we did not find support for (i) a more energy conserving N2O respiration pathway in nosZ clade II systems, as reflected in the growth yield per mole of substrate, or (ii) a higher affinity for N2O, defined by μmax/Ks, in organisms with nosZ clade II., BT/Environmental Biotechnology

Reduction of the greenhouse gas N2O to N2 is a trait among denitrifying and non-denitrifying microorganisms having an N2O reductase, encoded by nosZ. The nosZ phylogeny has two major clades, I and II, and physiological differences among organisms within the clades may affect N2O emissions from ecosystems. To increase our understanding of the ecophysiology of N2O reducers, we determined the thermodynamic growth efficiency of N2O reduction and the selection of N2O reducers under N2O- or acetate-limiting conditions in a continuous culture enriched from a natural community with N2O as electron acceptor and acetate as electron donor. The biomass yields were higher during N2O limitation, irrespective of dilution rate and community composition. The former was corroborated in a continuous culture of Pseudomonas stutzeri and was potentially due to cytotoxic effects of surplus N2O. Denitrifiers were favored over non-denitrifying N2O reducers under all conditions and Proteobacteria harboring clade I nosZ dominated. The abundance of nosZ clade II increased when allowing for lower growth rates, but bacteria with nosZ clade I had a higher affinity for N2O, as defined by μmax/Ks. Thus, the specific growth rate is likely a key factor determining the composition of communities living on N2O respiration under growth-limited conditions., BT/Environmental Biotechnology

Background: The objective of this study is to test the conflicting theories concerning the association of negative self and other schemata and paranoid ideation. Methods: A risk-based approach, including risk stratification, is used to gain insight into the association of the negative self and other schemata that may be shared by individuals or differentiate between individuals at clinical high risk (CHR) for a first-episode psychosis and those with full-blown psychosis. The dataset includes a sample of individuals at CHR (n = 137) and a sample of individuals with persisting positive symptoms (PPS, n = 211). The CHR sample was subdivided according to a prognostic index yielding 4 CHR sub-classes with increasing risk for transition to psychosis. Results: Negative beliefs about the self were associated with paranoid ideation in CHR and a lower risk state. In the highest risk state and full-blown psychosis, there is an association with negative beliefs about others. Conclusion: These findings are in line with theories suggesting a switch from a predominantly activated negative self-schema to a malevolent others-schema in association with paranoid ideation along the risk-continuum. However, due to methodological limitations these results should be replicated by future studies.

Background: The objective of this study is to test the conflicting theories concerning the association of negative self and other schemata and paranoid ideation. Methods: A risk-based approach, including risk stratification, is used to gain insight into the association of the negative self and other schemata that may be shared by individuals or differentiate between individuals at clinical high risk (CHR) for a first-episode psychosis and those with full-blown psychosis. The dataset includes a sample of individuals at CHR (n = 137) and a sample of individuals with persisting positive symptoms (PPS, n = 211). The CHR sample was subdivided according to a prognostic index yielding 4 CHR sub-classes with increasing risk for transition to psychosis. Results: Negative beliefs about the self were associated with paranoid ideation in CHR and a lower risk state. In the highest risk state and full-blown psychosis, there is an association with negative beliefs about others. Conclusion: These findings are in line with theories suggesting a switch from a predominantly activated negative self-schema to a malevolent others-schema in association with paranoid ideation along the risk-continuum. However, due to methodological limitations these results should be replicated by future studies.

Purpose The transdisciplinary practice model is currently being promoted as best practice in early intervention therapy for children with disabilities. However, supporting literature is limited. Thus, the question is asked, “What are service providers' understanding and perception of the transdisciplinary model in early intervention settings for children with disabilities?” Method A systematic review was carried out using the Preferred Reporting Items for Systematic Reviews. An electronic search was conducted via six databases. Eight articles were selected Results Four studies predominantly focused on service providers’ perspectives of the model using semi-structured interviews or surveys. Many studies were of adequate to low quality, and the methods of implementing the transdisciplinary approach varied across organisations. It is therefore difficult to draw valid conclusions based on service provider’s viewpoints of the model. Conclusions This review attempted to determine if the transdisciplinary model is best practice. The inconsistencies in the transdisciplinary teams indicates that overall, the general understanding of the model and its framework amongst organisations is poor. Further research is needed to establish service providers’ understanding of the model and how transdisciplinary teams are functioning since the introduction of the National Disability Insurance Scheme.

Purpose The transdisciplinary practice model is currently being promoted as best practice in early intervention therapy for children with disabilities. However, supporting literature is limited. Thus, the question is asked, “What are service providers' understanding and perception of the transdisciplinary model in early intervention settings for children with disabilities?” Method A systematic review was carried out using the Preferred Reporting Items for Systematic Reviews. An electronic search was conducted via six databases. Eight articles were selected Results Four studies predominantly focused on service providers’ perspectives of the model using semi-structured interviews or surveys. Many studies were of adequate to low quality, and the methods of implementing the transdisciplinary approach varied across organisations. It is therefore difficult to draw valid conclusions based on service provider’s viewpoints of the model. Conclusions This review attempted to determine if the transdisciplinary model is best practice. The inconsistencies in the transdisciplinary teams indicates that overall, the general understanding of the model and its framework amongst organisations is poor. Further research is needed to establish service providers’ understanding of the model and how transdisciplinary teams are functioning since the introduction of the National Disability Insurance Scheme.

Freehand mid-Air gestures are a promising input method for interacting with wall displays. However, work on mid-Air gestures for wall-display interaction has mainly explored what is technically possible, which might not result in gestures that users would prefer. This paper presents a guessability study where 20 participants performed gestures for 25 actions on a three-meter wide display. Based on the resulting 1124 gestures, we describe user-defined mid-Air gestures for walldisplay interaction and characterize the types of gesture users prefer for this context. The resulting gestures were largely influenced by surface interaction; they tended to be larger and more physically-based than gestures elicited in previous studies using smaller displays.

Objective: Cognitive models suggest that the self-concept of persons with psychosis can be fundamentally affected. Self-concepts were found to be related to different symptom domains when measured concurrently. Longitudinal investigations to disentangle the possible causal associations are rare. Method: We examined a sample of 160 people with a diagnosis of schizophrenia who took part in a psychotherapy study. All participants had the DSM-IV diagnosis of a schizophrenia and pronounced negative symptoms. Neurocognition, symptoms, and self-concepts were assessed at two time points 12 months apart. Structural equation modeling was used to test whether symptoms influence self-concepts (scar-model) or self-concepts affect symptoms (vulnerability model). Results: Negative symptoms correlated concurrently with self-concepts. Neurocognitive deficits are associated with more negative self-concepts 12 months later. Interpersonal self-concepts were found to be relevant for paranoia. Conclusion: The findings implicate that if deficits in neurocognition are present, fostering a positive self-concept should be an issue in therapy. Negative interpersonal self-concept indicates an increased risk for paranoid delusions in the course of 1 year. New aspects for cognitive models in schizophrenia and clinical implications are discussed.

As large wall displays become increasingly affordable and wide spread we will begin to see them in many aspect of our daily life, from large public displays to the meeting room and home entertainment systems. Thus far most work on how to interact with large displays focus on what is currently technically possible. This means that parameters such as the intuitiveness and learnability of interacting with large wall displays have gone largely unexplored, as most studies have based their assessment of their work based on parameters such as selection speed and accuracy rather than how intuitive it was for users. I aim to help fill this gap by approaching the problem from another angle. I focus on how users would intuitively interact with a large display if they were not bound by technical limitations. I present a study eliciting gestures from users by portraying the effect of command and then asking them to perform gestures to cause that effect and tell me which gesture they prefer. 20 participants suggest gestures for 25 effects resulting in a total of 1124 gestures or an average of 2.25 gestures per participant per effect shown. These gestures were analyzed and combined with data from a questionnaire and a post-study interview with the participants. The results show that participants were not concerned with the specific hand position when performing gestures except in cases where the hand position had a specific meaning; and that participants expected to be able to switch between using their left and right hand when performing gestures. The gestures suggested appear to be largely influenced by touch technology for the effects where corresponding actions are common on touch displays such as smart phones or tablets. The study contributes a user-defined gesture set as well as a taxonomy of the suggested gestures. The results can be used to help guide interface designers by giving them a better understanding of the users behavior and preferences.

As large wall displays become increasingly affordable and wide spread we will begin to see them in many aspect of our daily life, from large public displays to the meeting room and home entertainment systems. Thus far most work on how to interact with large displays focus on what is currently technically possible. This means that parameters such as the intuitiveness and learnability of interacting with large wall displays have gone largely unexplored, as most studies have based their assessment of their work based on parameters such as selection speed and accuracy rather than how intuitive it was for users. I aim to help fill this gap by approaching the problem from another angle. I focus on how users would intuitively interact with a large display if they were not bound by technical limitations. I present a study eliciting gestures from users by portraying the effect of command and then asking them to perform gestures to cause that effect and tell me which gesture they prefer. 20 participants suggest gestures for 25 effects resulting in a total of 1124 gestures or an average of 2.25 gestures per participant per effect shown. These gestures were analyzed and combined with data from a questionnaire and a post-study interview with the participants. The results show that participants were not concerned with the specific hand position when performing gestures except in cases where the hand position had a specific meaning; and that participants expected to be able to switch between using their left and right hand when performing gestures. The gestures suggested appear to be largely influenced by touch technology for the effects where corresponding actions are common on touch displays such as smart phones or tablets. The study contributes a user-defined gesture set as well as a taxonomy of the suggested gestures. The results can be used to help guide interface designers by giving them a better understanding of the users behavior and preferences.

Zusammenfassung Anliegen: Analyse der direkten Krankheitskosten bei persistierender Positivsymptomatik psychotischer Erkrankungen. Methode: Analyse von 3-Monats-Kosten bei 330 Patienten auf Grundlage von Befragungsdaten. Ergebnisse: Die durchschnittlichen direkten Kosten betrugen 7065Euro (63% psychiatrisch stationar, 17% Wohnbetreuung, 8% komplementare Angebote) und waren mit der negativen Subskala der PANSS (+2484Euro/Punkt, p<0,001) und dem Erfahren von weniger als einem Sozialkontakt pro Woche (-2272Euro, p=0,003) assoziiert. Schlussfolgerungen: Persistierende Positivsymptomatik ist mit hohen direkten Kosten verbunden. Abstract Objective: To analyze direct costs and cost determinants in psychotic patients with persistent positive symptoms (PPS). Methods: A total of 330 patients with PPS were recruited via 6 university clinics and interviewed about service utilization in the previous 3 months. After monetary valuation, costs were analyzed via generalized linear mixed models with gamma distribution and log-link function to identify determinants of direct costs. Results: The mean costs were 7,065Euro and resulted predominantly from psychiatric hospital care (63%), assisted living (17%) and complementary services (8%). We found statistically significant associations between direct costs and an increasing score of the negative subscale of the Positive and Negative Syndrome Scale (+2,484Euro per point, p<0.001) and experiencing less than one social contact per week (-2,272Euro, p=0.003). Conclusion: PPS incurred substantial direct costs which primarily resulted from hospital treatment, and were strongly associated with symptom severity.

Theoretical models postulate an important role of attributional style (AS) in the formation and maintenance of persecutory delusions and other positive symptoms of schizophrenia. However, current research has gathered conflicting findings. In a cross-sectional design, patients with persistent positive symptoms of schizophrenia (n = 258) and healthy controls (n = 51) completed a revised version of the Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R) and assessments of psychopathology. In comparison to controls, neither patients with schizophrenia in general nor patients with persecutory delusions (n = 142) in particular presented an externalizing and personalizing AS. Rather, both groups showed a self-blaming AS and attributed negative events more toward themselves. Persecutory delusions were independently predicted by a personalizing bias for negative events (beta = 0.197, P = .001) and by depression (beta = 0.152, P = .013), but only 5% of the variance in persecutory delusions could be explained. Cluster analysis of IPSAQ-R scores identified a personalizing (n = 70) and a self-blaming subgroup (n = 188), with the former showing slightly more pronounced persecutory delusions (P = .021). Results indicate that patients with schizophrenia and patients with persecutory delusions both mostly blamed themselves for negative events. Nevertheless, still a subgroup of patients could be identified who presented a more pronounced personalizing bias and more severe persecutory delusions. Thus, AS in patients with schizophrenia might be less stable but more determined by individual and situational characteristics that need further elucidation.

Zusammenfassung Anliegen: Analyse der direkten Krankheitskosten bei persistierender Positivsymptomatik psychotischer Erkrankungen. Methode: Analyse von 3-Monats-Kosten bei 330 Patienten auf Grundlage von Befragungsdaten. Ergebnisse: Die durchschnittlichen direkten Kosten betrugen 7065Euro (63% psychiatrisch stationar, 17% Wohnbetreuung, 8% komplementare Angebote) und waren mit der negativen Subskala der PANSS (+2484Euro/Punkt, p<0,001) und dem Erfahren von weniger als einem Sozialkontakt pro Woche (-2272Euro, p=0,003) assoziiert. Schlussfolgerungen: Persistierende Positivsymptomatik ist mit hohen direkten Kosten verbunden. Abstract Objective: To analyze direct costs and cost determinants in psychotic patients with persistent positive symptoms (PPS). Methods: A total of 330 patients with PPS were recruited via 6 university clinics and interviewed about service utilization in the previous 3 months. After monetary valuation, costs were analyzed via generalized linear mixed models with gamma distribution and log-link function to identify determinants of direct costs. Results: The mean costs were 7,065Euro and resulted predominantly from psychiatric hospital care (63%), assisted living (17%) and complementary services (8%). We found statistically significant associations between direct costs and an increasing score of the negative subscale of the Positive and Negative Syndrome Scale (+2,484Euro per point, p<0.001) and experiencing less than one social contact per week (-2,272Euro, p=0.003). Conclusion: PPS incurred substantial direct costs which primarily resulted from hospital treatment, and were strongly associated with symptom severity.

Theoretical models postulate an important role of attributional style (AS) in the formation and maintenance of persecutory delusions and other positive symptoms of schizophrenia. However, current research has gathered conflicting findings. In a cross-sectional design, patients with persistent positive symptoms of schizophrenia (n = 258) and healthy controls (n = 51) completed a revised version of the Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R) and assessments of psychopathology. In comparison to controls, neither patients with schizophrenia in general nor patients with persecutory delusions (n = 142) in particular presented an externalizing and personalizing AS. Rather, both groups showed a self-blaming AS and attributed negative events more toward themselves. Persecutory delusions were independently predicted by a personalizing bias for negative events (beta = 0.197, P = .001) and by depression (beta = 0.152, P = .013), but only 5% of the variance in persecutory delusions could be explained. Cluster analysis of IPSAQ-R scores identified a personalizing (n = 70) and a self-blaming subgroup (n = 188), with the former showing slightly more pronounced persecutory delusions (P = .021). Results indicate that patients with schizophrenia and patients with persecutory delusions both mostly blamed themselves for negative events. Nevertheless, still a subgroup of patients could be identified who presented a more pronounced personalizing bias and more severe persecutory delusions. Thus, AS in patients with schizophrenia might be less stable but more determined by individual and situational characteristics that need further elucidation.

Despite the promising findings in relation to the efficacy of cognitive behavioral therapy for psychosis (CBTp), little attention has been paid to the therapy skills necessary to deliver CBTp.and to the influence of such skills on processes underlying therapeutic change. Our study investigated the associations between general and technical therapy skills and patient experiences of change processes in CBTp. The study sample consisted of 79 patients with psychotic disorders who had undergone CBTp. We randomly selected one tape-recorded therapy session from each of the cases. General and technical therapy skills were assessed by the Cognitive Therapy Scale for Psychosis. The Bern Post Session Report for Patients was applied to measure patient experiences of general change processes in the sense of Grawe's psychological therapy. General skills, such as feedback and understanding, explained 23% of the variance of patients' self-esteem experience, but up to 10% of the variance of mastery, clarification, and contentment experiences. The technical skill of guided discovery consistently showed negative associations with patients' alliance, contentment, and control experiences. The study points to the importance of general therapy skills for patient experiences of change processes in CBTp. Some technical skills, however, could detrimentally affect the therapeutic relationship. (c) 2013 Elsevier Ireland Ltd. All rights reserved.

In clinical trials, longitudinal data are often analyzed using T-tests, anovas or ancovas instead of the more powerful linear mixed models. The purpose of this paper is to demonstrate how the more sophisticated linear mixed models according to the approach of Singer and Willett, which allows special insight into the behaviour of the data, can be used in clinical trials. Individual trajectories of PANNS-MNS Scores from a controlled clinical trial were used to demonstrate all the steps needed for an analysis of longitudinal data. The model is built step by step, model assumptions are checked, time-variant and time-invariant factors are included and the results are interpreted. The unique needs of a clinical trial, such as the calculation of effect sizes or of an appropriate sample size, are taken into account. Finally, a flow chart is presented that would serve as an instruction tool for the analysis of longitudinal data in clinical trials.

Despite the promising findings in relation to the efficacy of cognitive behavioral therapy for psychosis (CBTp), little attention has been paid to the therapy skills necessary to deliver CBTp.and to the influence of such skills on processes underlying therapeutic change. Our study investigated the associations between general and technical therapy skills and patient experiences of change processes in CBTp. The study sample consisted of 79 patients with psychotic disorders who had undergone CBTp. We randomly selected one tape-recorded therapy session from each of the cases. General and technical therapy skills were assessed by the Cognitive Therapy Scale for Psychosis. The Bern Post Session Report for Patients was applied to measure patient experiences of general change processes in the sense of Grawe's psychological therapy. General skills, such as feedback and understanding, explained 23% of the variance of patients' self-esteem experience, but up to 10% of the variance of mastery, clarification, and contentment experiences. The technical skill of guided discovery consistently showed negative associations with patients' alliance, contentment, and control experiences. The study points to the importance of general therapy skills for patient experiences of change processes in CBTp. Some technical skills, however, could detrimentally affect the therapeutic relationship. (c) 2013 Elsevier Ireland Ltd. All rights reserved.

The study examines the adequacy of the measurement of the cross-section of expected stock returns on the London Stock Exchange of the recent three-factor model introduced by Chen, Novy-Marx and Zhang against that of the Fama and French three-factor model. The former model use factors in addition to the market factor based on profitability and investment while the latter model use factors based on size and book-to-market equity. The models are tested together with the CAPM on a number of anomalies based trading strategies. It is found that the three-factor models consistently outperforms the CAPM and that the model by Chen, Novy-Marx and Zhang in general is not able to outperform the Fama and French three-factor model during the time period tested on the London Stock Exchange.

Background: It has been demonstrated that cognitive behavioural therapy (CBT) has a moderate effect on symptom reduction and on general well being of patients suffering from psychosis. However, questions regarding the specific efficacy of CBT, the treatment safety, the cost-effectiveness, and the moderators and mediators of treatment effects are still a major issue. The major objective of this trial is to investigate whether CBT is specifically efficacious in reducing positive symptoms when compared with non-specific supportive therapy (ST) which does not implement CBT-techniques but provides comparable therapeutic attention. Methods: The POSITIVE study is a multicenter, prospective, single-blind, parallel group, randomised clinical trial, comparing CBT and ST with respect to the efficacy in reducing positive symptoms in psychotic disorders. CBT as well as ST consist of 20 sessions altogether, 165 participants receiving CBT and 165 participants receiving ST. Major methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, analysis by intention to treat, data management using remote data entry, measures of quality assurance (e.g. on-site monitoring with source data verification, regular query process), advanced statistical analysis, manualized treatment, checks of adherence and competence of therapists. Research relating the psychotherapy process with outcome, neurobiological research addressing basic questions of delusion formation using fMRI and neuropsychological assessment and treatment research investigating adaptations of CBT for adolescents is combined in this network. Problems of transfer into routine clinical care will be identified and addressed by a project focusing on cost efficiency. Discussion: This clinical trial is part of efforts to intensify psychotherapy research in the field of psychosis in Germany, to contribute to the international discussion on psy

The study examines the adequacy of the measurement of the cross-section of expected stock returns on the London Stock Exchange of the recent three-factor model introduced by Chen, Novy-Marx and Zhang against that of the Fama and French three-factor model. The former model use factors in addition to the market factor based on profitability and investment while the latter model use factors based on size and book-to-market equity. The models are tested together with the CAPM on a number of anomalies based trading strategies. It is found that the three-factor models consistently outperforms the CAPM and that the model by Chen, Novy-Marx and Zhang in general is not able to outperform the Fama and French three-factor model during the time period tested on the London Stock Exchange.

Background: It has been demonstrated that cognitive behavioural therapy (CBT) has a moderate effect on symptom reduction and on general well being of patients suffering from psychosis. However, questions regarding the specific efficacy of CBT, the treatment safety, the cost-effectiveness, and the moderators and mediators of treatment effects are still a major issue. The major objective of this trial is to investigate whether CBT is specifically efficacious in reducing positive symptoms when compared with non-specific supportive therapy (ST) which does not implement CBT-techniques but provides comparable therapeutic attention. Methods/Design: The POSITIVE study is a multicenter, prospective, single-blind, parallel group, randomised clinical trial, comparing CBT and ST with respect to the efficacy in reducing positive symptoms in psychotic disorders. CBT as well as ST consist of 20 sessions altogether, 165 participants receiving CBT and 165 participants receiving ST. Major methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, analysis by intention to treat, data management using remote data entry, measures of quality assurance (e.g. on-site monitoring with source data verification, regular query process), advanced statistical analysis, manualized treatment, checks of adherence and competence of therapists. Research relating the psychotherapy process with outcome, neurobiological research addressing basic questions of delusion formation using fMRI and neuropsychological assessment and treatment research investigating adaptations of CBT for adolescents is combined in this network. Problems of transfer into routine clinical care will be identified and addressed by a project focusing on cost efficiency. Discussion: This clinical trial is part of efforts to intensify psychotherapy research in the field of psychosis in Germany, to contribute to the international discussion

The present study adds to the sparse published Swedish literature on the performance of the Fama and French Three-Factor model on the Swedish stock market. The ability of the model to measure the cost of equity is compared with that of the CAPM. The tests are conducted in time periods with and without financial turmoil. The Fama and French Three-Factor Model is found to provide improved explanatory power over the CAPM in both stable and unstable market conditions. Another finding is that the performance of the Fama and French Three- Factor model does not perform well during a period of financial turmoil on the Swedish market.

BACKGROUND: It has been demonstrated that cognitive behavioural therapy (CBT) has a moderate effect on symptom reduction and on general well being of patients suffering from psychosis. However, questions regarding the specific efficacy of CBT, the treatment safety, the cost-effectiveness, and the moderators and mediators of treatment effects are still a major issue. The major objective of this trial is to investigate whether CBT is specifically efficacious in reducing positive symptoms when compared with non-specific supportive therapy (ST) which does not implement CBT-techniques but provides comparable therapeutic attention. METHODS/DESIGN: The POSITIVE study is a multicenter, prospective, single-blind, parallel group, randomised clinical trial, comparing CBT and ST with respect to the efficacy in reducing positive symptoms in psychotic disorders. CBT as well as ST consist of 20 sessions altogether, 165 participants receiving CBT and 165 participants receiving ST. Major methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, analysis by intention to treat, data management using remote data entry, measures of quality assurance (e.g. on-site monitoring with source data verification, regular query process), advanced statistical analysis, manualized treatment, checks of adherence and competence of therapists. Research relating the psychotherapy process with outcome, neurobiological research addressing basic questions of delusion formation using fMRI and neuropsychological assessment and treatment research investigating adaptations of CBT for adolescents is combined in this network. Problems of transfer into routine clinical care will be identified and addressed by a project focusing on cost efficiency. DISCUSSION: This clinical trial is part of efforts to intensify psychotherapy research in the field of psychosis in Germany, to contribute to the international discussion

Background: It has been demonstrated that cognitive behavioural therapy (CBT) has a moderate effect on symptom reduction and on general well being of patients suffering from psychosis. However, questions regarding the specific efficacy of CBT, the treatment safety, the cost-effectiveness, and the moderators and mediators of treatment effects are still a major issue. The major objective of this trial is to investigate whether CBT is specifically efficacious in reducing positive symptoms when compared with non-specific supportive therapy (ST) which does not implement CBT-techniques but provides comparable therapeutic attention. Methods/Design: The POSITIVE study is a multicenter, prospective, single-blind, parallel group, randomised clinical trial, comparing CBT and ST with respect to the efficacy in reducing positive symptoms in psychotic disorders. CBT as well as ST consist of 20 sessions altogether, 165 participants receiving CBT and 165 participants receiving ST. Major methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, analysis by intention to treat, data management using remote data entry, measures of quality assurance (e.g. on-site monitoring with source data verification, regular query process), advanced statistical analysis, manualized treatment, checks of adherence and competence of therapists. Research relating the psychotherapy process with outcome, neurobiological research addressing basic questions of delusion formation using fMRI and neuropsychological assessment and treatment research investigating adaptations of CBT for adolescents is combined in this network. Problems of transfer into routine clinical care will be identified and addressed by a project focusing on cost efficiency. Discussion: This clinical trial is part of efforts to intensify psychotherapy research in the field of psychosis in Germany, to contribute to the international discussion

The present study adds to the sparse published Swedish literature on the performance of the Fama and French Three-Factor model on the Swedish stock market. The ability of the model to measure the cost of equity is compared with that of the CAPM. The tests are conducted in time periods with and without financial turmoil. The Fama and French Three-Factor Model is found to provide improved explanatory power over the CAPM in both stable and unstable market conditions. Another finding is that the performance of the Fama and French Three- Factor model does not perform well during a period of financial turmoil on the Swedish market.

Fitzmaurice, E., Richmond, J. E. & Wittorf, M. (2017). An Investigation of Service Providers’ understanding, perspectives and implementations of the Transdisciplinary model in Early Intervention settings for Children with Disabilities. Internet Journal of Allied Health Sciences and Practice, 15(2), 5. Available here