The feasibility of psychomotor therapy in acute mental health services for adults with intellectual disability

Background Psychomotor therapy enables people to reflect on the relationship between experiences and feelings by starting from awareness of bodily responses rather than from awareness of emotion. In this study we examine PsyMot (ID), an assessment that directs this psychological therapy.

Method Twelve suitable consecutive admissions were recruited from a specialist intellectual disability (ID) assessment and treatment unit for adults. Video-recordings of PsyMot (ID) allowed assessment of interrater reliability (IRR). Treatment goals indicated by PsyMot (ID) were addressed using psychomotor therapy as part of a comprehensive program of interventions.

Results Psychomotor therapy was both feasible and popular with patients who participated without any adverse effects. Nine patients completed PsyMot (ID). IRR of the treatment goals identified by all 3 raters was good to excellent in 81% cases, but there were discrepancies for individual items.

Conclusions PsyMot (ID) and psychomotor therapy is feasible within this context, and enriched the clinical team's formulation. Further studies of reliability and efficacy should be undertaken.     

Childhood,adolescent and adult age at onset and related clinical correlates in obsessive–compulsive disorder: a report from the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS)

Objective: Many studies suggest that age at onset (AAO) is an important factor for clinically differentiating patients with juvenile and adult onset of obsessive–compulsive disorder (OCD). The present international study aimed to assess the prevalence of different AAO groups and compare related socio-demographic and clinical features in a large sample of OCD patients.

Methods: A total of 431 OCD outpatients, participating in the ICOCS network, were first categorised in groups with childhood (≤12 years), adolescent (13–17 years) and adult-onset (≥18 years), then in pre-adult and adult onset (≥18 years) and their socio-demographic and clinical features compared.

Results: Twenty-one percent (n?=?92) of the sample reported childhood onset, 36% (n?=?155) adolescent onset, and 43% (n?=?184) adult onset. Patients with adult onset showed a significantly higher proportion of females compared with the other subgroups (χ^2?=^?10.9, pχ^2?=^?11.5; p?Conclusions: The present international multicentre study confirms that OCD onset occurs more frequently before adult age, with approximately one out of five patients showing childhood onset. Pre-adult onset was associated with higher rate of CBT, while adult onset was more prevalent in females.     

A new assessment tool for patients with multiple sclerosis from Spanish-speaking countries: validation of the Brief International Cognitive Assessment for MS (BICAMS) in Argentina

Background: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is an international assessment tool for monitoring cognitive function in multiple sclerosis (MS) patients. BICAMS comprises the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test – Second Edition (CVLT II) and the Brief Visuospatial Memory Test – Revised (BVMT-R). Our objective was to validate and assess the reliability of BICAMS as applied in Argentina and to obtain normative data in Spanish for this population. Method: The sample composed of 50 MS patients and 100 healthy controls (HC). In order to test its reliability, BICAMS was re-administered in a subset of 25 patients. Results: The sample’s average age was 43.42 ± 10.17 years old, and average years of schooling were 14.86 ± 2.78. About 74% of the participants were women. The groups did not differ in age, years of schooling, or gender. The MS group performed significantly worse than the HC group across the three neuropsychological tests, yielding the following Cohen’s d values: SDMT: .85; CVLT I: .87; and BVMT-R: .40. The mean raw scores for Argentina normative data were as follows: SDMT: 56.71 ± 10.85; CVLT I: 60.88 ± 10.46; and BVMT-R: 23.44 ± 5.84. Finally, test–retest reliability coefficients for each test were as follows: SDMT: r = .95; CVLT I: r = .87; and BVMT-R: r = .82. Conclusion: This BICAMS version is reliable and useful as a monitoring tool for identifying MS patients with cognitive impairment.     

Virtual reality measures in neuropsychological assessment: a meta-analytic review

Objective: Virtual reality-based assessment is a new paradigm for neuropsychological evaluation, that might provide an ecological assessment, compared to paper-and-pencil or computerized neuropsychological assessment. Previous research has focused on the use of virtual reality in neuropsychological assessment, but no meta-analysis focused on the sensitivity of virtual reality-based measures of cognitive processes in measuring cognitive processes in various populations. Method: We found eighteen studies that compared the cognitive performance between clinical and healthy controls on virtual reality measures. Results: Based on a random effects model, the results indicated a large effect size in favor of healthy controls (g = .95). For executive functions, memory and visuospatial analysis, subgroup analysis revealed moderate to large effect sizes, with superior performance in the case of healthy controls. Participants’ mean age, type of clinical condition, type of exploration within virtual reality environments, and the presence of distractors were significant moderators. Conclusions: Our findings support the sensitivity of virtual reality-based measures in detecting cognitive impairment. They highlight the possibility of using virtual reality measures for neuropsychological assessment in research applications, as well as in clinical practice.     

Editorial: Beware the six honest serving men‐ like the Elephant's child,the questions about implementation just keep coming

This editorial introduces a series of articles that highlight the need for more research to address issues related to the implementation of treatments in routine settings. One of the themes highlighted by these papers is the importance of conceptual frameworks. Conceptual models guide the assessment process and provide the underlying logic model for different treatment programmes, but there is no agreed conceptual framework to guide the development of clinical decisions. A second theme raised by these papers is the importance of understanding the mechanisms underlying the development of mental health problems in young children, and the mediators and moderators of change. The third theme relates to the adoption of new assessment and treatment models. An awareness of issues related to implementation is important in facilitating the uptake of evidence‐informed assessment and treatment models into routine clinical practice.     

Comparison of a direct and an indirect approach for the functional assessment of insistence on sameness in a child with autism spectrum disorder and a typically developing child

Objective: To compare indirect and direct functional assessment of insistence on sameness associated with autism spectrum disorder (ASD) and typical development. Methods: Parents rated the function of insistence on sameness for a 6-year-old boy with ASD (Peter) and a typically developing 4-year-old boy (Nathan) using the Motivation Assessment Scale (MAS). Ratings were compared to the results of a direct assessment. Results: The results of the assessment procedures were mainly consistent for Peter and suggested that his tendency to insist on sameness was maintained by sensory consequences. The finding of an attention function for Nathan in the play-based assessment was consistent with previous functional assessment studies surrounding typically developing children, but in contrast to the MAS. Conclusion: While the play-based assessment may be more suitable for assessing the high rate insistence on sameness observed in individuals with ASD, the MAS may be more suitable for low rate insistence on sameness.