Associations among attachment characteristics,patients’ assessment of therapeutic factors,and treatment outcome following inpatient psychodynamic group psychotherapy

Abstract

Within a multisite study, including 289 inpatients from six different hospitals who underwent interpersonal-psychodynamic group psychotherapy, associations among attachment characteristics, therapeutic factors, and treatment outcome were investigated. Attachment characteristics were assessed with an interview-based measure (Adult Attachment Prototype Rating [AAPR]) as well as an attachment self-report (Bielefeld Questionnaire of Client Expectations [BQCE]). Therapeutic factors were measured retrospectively with the Düsseldorf Therapeutic Factors Questionnaire and treated as an individual- as well as a hospital-specific characteristic. On an individual level, only the group climate factor independently predicted treatment outcome (i.e., Symptom Checklist-90-R Global Severity Index and Inventory of Interpersonal Problems mean). If simultaneously but separately included into a path model, analyses revealed independent significant effects of AAPR-Security and BQCE-Security on group climate. If modeled as a latent variable (common attachment security), a substantially higher proportion of group climate variance could be explained. Further analyses revealed interactions between particular therapeutic factors and attachment characteristics, indicating a particular importance of these therapeutic factors for different attachment categories.     

Attachment characteristics and treatment outcome following inpatient psychotherapy: Results of a multisite study

Abstract

Existential suffering may contribute to treatment-resistant depression. The “VITA” treatment model was designed for such patients with long-standing depression accompanied by existential and/or religious concerns. This naturalistic effectiveness study compared the VITA model (n = 50) with a “treatment as usual” comparison group (TAU; n = 50) of patients with treatment-resistant depression and Cluster C comorbidity. The TAU patients were matched on several characteristics with the VITA patients. The VITA model included existential, dynamic, narrative and affect-focused components. The VITA group had significantly greater improvement on symptom distress and relational problems during treatment and from pre-treatment to 1-year follow-up. Patients in the VITA, at follow-up, were more likely to be employed and less likely be using psychotropic medications.     

Relations between the contamination of beef and cow's milk with radiocesium

The paper presents the results of an experimental investigation designed to study the trend of the contamination by radiocesium of milk and meat of cows: (1) under conditions of a single contamination of the pasture. (2) under conditions of a continuous ingestion corresponding to the case of a constant contamination of the pasture. The knowledge of the evolution in the course of time of the relation between the activities of meat and milk and of its dependence on the nature of the different organs and the age of the animals should make more easy the survey of the contamination of the environment and allow to decide on possible countermeasures to be taken in the case of an accident.     

Assessment of dose to man from releases of 99Tc in fresh water systems

The objective of this paper is to evaluate the dose to man from releases of 99Tc in a fresh water system and to identify the biospheric transfer parameters to which the total dose is the most sensitive. Only internal exposure is taken into account, as the external irradiation leads to a negligible dose contribution. Two release modes were considered: continuous (routine) releases and accidental releases. The concentrations in the biospheric compartments subsequent to routine releases were calculated according to International Atomic Energy Agency procedures. For the accidental releases, a more dynamic approach was adopted, especially for the milk and meat compartments. A routine-release scenario typical for the Mol site has been applied, and the biospheric compartment leading to the highest dose contribution was shown to be the irrigated grain. The biospheric transfer parameters to which the first-year doses were the most sensitive consisted mainly of the mass interception factor for grain and the milk transfer factor. The doses in following years were very dependent on the value of the root zone removal rate. The accidental-release scenario resulted in committed dose equivalent that are strongly influenced by the time of year at which the release occurs.     

Toxicity of 99Tc: can it represent a risk to man?

The movement through the environment and the toxicity to plants of 99Tc have been studied. However, information is scanty on 99Tc toxicity to mammals even though this is the decisive criterion for assessing the consequences of releases of Tc. A critical tissue could be the thyroid because of its preferential accumulation of Tc and the developing organism because of its greater radiosensitivity; moreover, this toxicity might be enhanced under conditions of a low iodine (I) diet. These questions were studied in rats given large amounts of 99Tc in either a normal or an I-deficient diet for several months starting 2 wk before mating. Newborns were continued on these diets after weaning. The parameters determined were: occurrence of pregnancy and litter size, triiodothyronine and thyroxin in serum, uptake of 131I by the thyroid 24 h after injection, histology of the thyroid and concentration of Tc in tissues of the mothers and their decendants. Thyroid damage, as well as the effects on pregnancy, could be observed after amounts of 10 micrograms Tc g-1 food. Iodine deficiency only slightly influences the 99Tc toxicity. The chemical and radiological toxicity of 99Tc to rats is small. Consequently, it seems unlikely that contamination levels in the environment would ever reach levels that could lead to serious non-stochastic effects, even in the developing organism.     

Genotype–phenotype correlation in migraine without aura focusing on the rs1835740 variant on 8q22.1

A large two-stage GWAS by Antilla et al. reported the minor allele of rs1835740 on 8q22.1 to be associated with common types of migraine. The objective of the present study was to determine the clinical correlate of the variant in migraine without aura (MO). Clinical data on 339 successfully genotyped MO patients (patients with attacks of migraine without aura and no attacks of migraine with aura) were obtained by an extensive validated semi-structured telephone interview performed by a physician or a trained senior medical student. Reliable, systematic and extensive data on symptoms, age of onset, attack frequencies and duration, relevant comorbidity, specific provoking factors including different hormonal factors in females, and effect and use of medication, both abortive and prophylactic, were thereby obtained. A comparison of carriers and non-carriers were performed. Comparison of homozygotes with heterozygotes was not performed as the number of homozygotes was too small for statistical purposes. Data from other MO populations in the GWAS by Antilla et al. were not included as phenotype and clinical data were obtained differently. While thousands of patients are needed to detect a genetic variant like rs1835740, 339 are sufficient to detect meaningful clinical differences. 136 of 339 patients were carriers of the variant, 15 were homozygous. Comparison of carriers with non-carriers showed no significant difference in any of the parameters studied. In conclusion, the rs1835740 variant has no significant influence on the clinical expression of MO.     

Echocardiographic and Electrocardiographic Findings of Cardiomyopathy in Duchenne and Becker–Kiener Muscular Dystrophies

We assessed the cardiac findings in Duchenne muscular dystrophy (DMD) and Becker–Kiener muscular dystrophy (BMD) patients in the large outpatient group of our single-center institution. The analysis included the revision of patient records (retrospectively) and current echocardiography, electrocardiogram (ECG), and Holter ECG data (prospectively). Reduced left ventricular fraction shortening (FS) <25% was found in 24% of all patients (50 DMD, 12.1 ± 4.7 years: 20 BMD, 17.1 ± 8.5 years). Median age of onset of FS <25% was 16.8 ± 1.0 in DMD and 30.4 ± 3.4 in BMD; (p <0.05). Holter ECG in DMD demonstrated sinus tachycardia in 26% deprivation of circadian rhythm in 31%, and reduced heart rate variability in 51%. For these reasons, we recommend carrying out echocardiography annually in DMD and BMD >10 years. Because the rate of disturbances in the cardiac autonomic nervous system is high in DMD, we also recommend Holter ECG annually. Further investigation should be conducted to determine if treatment with ß-blockers and ACE inhibitors in combination reduces cardiac autonomic nervous imbalance, thus improving patient outcome in DMD.