Measures Of Social Functioning Research Articles

Exercise, Flourishing, and the Positivity Ratio in Seventh-Day Adventists: A Prospective Study.

Flourishing and mental health in the prediction of health behaviors such as exercise has been understudied. Positive emotions may promote, and negative emotions hinder protective health behaviors; however, the direction of these associations is unclear. The objective here was to investigate possible associations prospectively. Longitudinal cohort study. National. The Biopsychosocial Religion and Health Study of Seventh-day Adventists provided longitudinal data from 2006 to 2007 and 2010 to 2011 (n = 5789). Flourishing was based on 6 measures of social functioning (positive social exchanges, negative social exchanges, religious emotional support given, received, and anticipated, and negative interactions) and 4 measures of psychological functioning (mastery, self-esteem, spiritual meaning, and perceived stress). The positivity ratio was the ratio of positive to negative emotions assessed with the Positive and Negative Affect Schedule. Linear multiple regression and mediation. Flourishing worked indirectly through the positivity ratio to predict a later increase in exercise over the course of 3 to 5 years. Tests of mediation suggest that the association of flourishing with later exercise was indirect through an increased ratio of positive to negative affect. Initial exercise frequency was also associated with later improved flourishing and positivity ratio scores over the same period. The association of mental health and exercise is likely bidirectional. Exercise improves mental health, and those that have better psychosocial functioning have better mood and are more likely to increase exercise behaviors over time. Exercise is likely integral to mental health in mid to late life.

The validity and reliability of the Farsi version of the Body, Eating, and Exercise Comparison Orientation Measure (F-BEECOM) among Iranian male and female students

Body-, eating-, and exercise-related social comparison tendencies are implicated in body dissatisfaction and disordered eating among Western women. To date, no published study examines eating- and exercise-related comparisons in a male or non-Western sample. The current series of studies fills these gaps in the literature by translating and validating the existing measure of these comparisons (the 18-item Body, Eating, and Exercise Comparison Orientation Measure [BEECOM]) in samples of Iranian men and women. In Studies 1 and 2, female (n = 284) and male (n = 302) participants completed the translated Farsi BEECOM. Scores were analyzed by exploratory factor analyses (EFA) revealing two different three factor, 15-item scale structures for men and women. In Studies 3 and 4, participants (female n = 384; male n = 253) completed measures of social comparison and psychological functioning in one session. These data were analyzed using confirmatory factor analyses (CFA) and Pearson correlations. Each CFA yielded adequately fitting models. Results support the use of two different 15-item Farsi BEECOM measures with women and men and highlight unique gender differences in social comparison tendencies. The resulting F-BEECOM demonstrates strong psychometric properties and will be a useful research tool in Iranian women and men.

Randomized controlled trial of social cognition and interaction training compared to befriending group.

BackgroundDeficits in social cognition are common in people with schizophrenia and are associated with impaired functioning. Finding effective interventions to address these deficits is a priority. Social Cognition Interaction Training (SCIT) is a psychosocial intervention that has demonstrated acceptability and feasibility in various health care settings. Larger, well‐designed randomized controlled trials are needed to examine the effectiveness of this intervention.DesignA randomized controlled trial.MethodsOne hundred and twenty adults diagnosed with schizophrenia spectrum disorder were randomized to receive SCIT (n = 61) or Befriending Therapy (BT) (n = 59). Both intervention groups were delivered weekly for 2 hr over 12 weeks. Neurocognitive assessment was completed at baseline. Participants completed assessments of social cognition, social functioning, and meta‐cognition at baseline, post‐intervention, and 3‐month follow‐up.ResultsThere were no clinically significant differences between group outcomes on any measure of social cognition or social functioning. There was a trend for both groups to improve over time but not at a level of statistical significance.ConclusionsSCIT did not show any additional benefits on measures of social cognition compared to Befriending Therapy for people with schizophrenia spectrum disorder. The findings are discussed in terms of potential improvements to the programme.Practitioner points Effective interventions for the social cognitive deficits of schizophrenia spectrum disorders are still being refined.Social Cognition Interaction Training is a promising therapy but requires further modifications to improve its effectiveness.

Profiles of perceived social functioning in adolescent and young adult survivors of childhood cancer.

Social interaction and peer relationships are critical for development, especially for adolescents and young adults (AYA). Cancer treatment may disrupt social functioning and impact quality of life. Prior research into AYA social functioning has primarily been qualitative in nature or assessed via broad measures of functioning. Given the multi-dimensional nature of social functioning, and its importance for AYA, a person-centered approach to analyses is needed. AYA survivors of childhood cancer, ages 13 to 23 (n = 192, 51% male) and at least 1 year post-treatment (M = 7.35 ± 4.18 years post), completed measures to assess perceived social functioning, social support, and positive and negative affect. Caregivers also completed a measure of social functioning. Latent profile analysis was used to empirically derive profiles of perceived social functioning using the self-perception profile for adolescents (SPPA). A 3-class solution provided the best fit to the data: 58.9% average, 33.7% high, and 7.5% low functioning. The average group reported mean scores that were similar to normative values available in the SPPA manual. Demographic and medical factors were unrelated to class membership. Social support and positive/negative affect differed significantly by class; caregiver-report of social functioning did not. Overall, the majority of AYA survivors of childhood cancer are doing well socially, with perceived adequate social functioning associated with both high levels of social support as well as greater perceptions of positive affect. Future work is needed to elucidate longitudinal trajectories of social functioning, as well as to identify and intervene with those survivors who are struggling.

Prediction of social behavior in autism spectrum disorders: Explicit versus implicit social cognition.

Difficulties with social communication and interaction are a hallmark feature of autism spectrum disorder. These difficulties may be the result of problems with explicit social cognition (effortful and largely conscious processes) such as learning and recalling social norms or rules. Alternatively, social deficits may stem from problems with implicit social cognition (rapid and largely unconscious processes) such as the efficient integration of social information. The goal of this study was to determine how problems in explicit and implicit social cognition relate to social behavior in 34 youth with autism spectrum disorder. We measured aspects of implicit and explicit social cognition abilities in the laboratory using behavioral, cognitive, and brain (electrophysiological) measures. We then used those measures to predict "real-world" social behavior as reported by parents, clinicians, and independent observers. Results showed that overall better aspects of implicit and explicit social cognition predicted more competent social behavior. In addition, the ability to fluidly integrate social information (implicit social cognition) was more frequently related to competent social behavior that merely knowing what to do in social situations (explicit social cognition). These findings may help with the development of interventions focusing on improving social deficits.

4327 Structural Neural Correlates of Social Functioning in First Episode Psychosis and Malleability in Response to Targeted Cognitive Training

OBJECTIVES/GOALS: Development of interventions that improve social functioning (SF) in first episode psychosis (FEP) is hindered by a poor understanding of the neural mechanisms underlying SF deficits. This research aims to identify neural correlates of social functioning in FEP, and to evaluate whether this substrate is malleable in response to cognitive training. METHODS/STUDY POPULATION: This is a secondary data-analysis of participants in an ongoing randomized clinical trial investigating whether 12 weeks of targeted cognitive training is neuroprotective in FEP, versus treatment as usual. Baseline and post-training assessments include a brain MRI, three measures of SF, and a neurocognitive battery. Healthy controls complete MRI only. Differences in cortical thickness (CTh) and gray matter volume (GMV) in regions of interest between FEP and controls will be determined with ANCOVA. Multiple linear regression will be used to determine the relationship between neural substrate and SF in FEP. Linear mixed models will be used to examine the relationship between change in CTh and GMV and change in SF. Data collection is ongoing for this study. RESULTS/ANTICIPATED RESULTS: In preliminary data including 12 FEP and 9 healthy controls, FEP demonstrated cortical loss in the right superior frontal cortex and the right isthmus-posterior cingulate. Greater cortical thickness in the posterior cingulate cortex was associated with better social functioning across multiple measures when controlling for global cognition. Gray matter volume in the parahippocampal gyrus was also associated with better social functioning. Preliminary results evaluating whether targeted cognitive training is neuroprotective in these regions of interest in a manner that is associated with improved social functioning will also be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: Preliminary results link the posterior cingulate and parahippocampal gyrus to SF in FEP. Further research will investigate the contribution of changes in these brain regions to improved SF. The identification of biological treatment targets for SF may lead to development and optimization of novel interventions to alleviate SF deficits in FEP.

S222. A SYSTEMATIC AND METHODOLOGICAL REVIEW OF RECENT SOCIAL FUNCTIONING MEASURES AND APPROACHES

BackgroundMany people with a psychosis diagnosis have significant impairments in their social functioning. Despite this, long standing lack of consensus exists in the definition of social functioning in psychosis. Efforts to evaluate interventions for social functioning are hampered by measurement difficulties, and comparing interventions is difficult. Popular measures of social functioning vary widely, both conceptually and methodologically, and it is unclear how meaningful they are for service users. With the increasing development and evaluation of social interventions for psychosis and the boom in the development of measures, this paper reviews the recently developed measures of social functioning. It aggregates how often and in which studies measures have been used, the concepts and theories that underlie them, as well as assessing their quality across a number of indicators, with a particular focus on how patient-centred they are.MethodsSystematic review and narrative synthesis.Results21 new measures of social functioning were identified, of low to moderate quality. The content, definitions, theories and domains will be discussed, as well as a discussion of changes in the construct over time. Discussion will include the development of measures for use in first episode psychosis, measures with a focus on negative symptoms and the increasing use of technology in the assessment of social functioning.DiscussionMany measures exist for assessing social functioning in psychosis, of variable quality. Further attention should be directed to psychometric evaluation and ensuring service user involvement in development.

M208. MEASURES OF COGNITION AND SOCIAL FUNCTIONING IN SCHIZOPHRENIA PATIENTS RECEIVING SEP-363856

BackgroundSEP-363856 is a novel trace amine associated receptor-1 (TAAR1)/5-HT1A agonist with no dopamine-D2/5-HT2A antagonist activity. SEP-363856 showed significant antipsychotic efficacy in patients with schizophrenia, and a safety and tolerability profile similar to placebo and consistent with a non-D2 mechanism of action. Here, we examined measures of cognition and social functioning in schizophrenia patients receiving SEP-363856.MethodsPatients aged 18–40 years with an acute exacerbation of schizophrenia were randomized, double-blind (DB), to 4-weeks of flexible-dose treatment with once daily SEP-363856 (N=120; 50 or 75 mg) or placebo (N=125). Patients (N=156) entering a subsequent 26-week open-label (OL) extension study were evaluated utilizing the Cogstate Brief Battery, administered at DB baseline and week 4, and OL baseline and weeks 12 and 26. Standardized z-scores were calculated for the Cogstate composite and subscale tasks (Detection task, Identification task, One Card Learning task, One Back task). The University of California San Diego Performance Based Skills Assessment (UPSA-B) scale was assessed at the same time-points, as were the following psychiatric scales: Positive and Negative Syndrome Scale (PANSS), the Brief Negative Symptom Scale (BNSS), the Montgomery–Åsberg Depression Rating Scale (MADRS), the Clinical Global Impression Scale, severity scale (CGI-S), and the Pittsburgh Sleep Quality Index global score (PSQI-global). Pearson correlation analyses were performed between DB baseline to Week 26 change in Cogstate composite and subscale scores and Week 26 change in the psychiatric scale scores.ResultsSmall improvements, from DB baseline to Week 26, were observed in standardized scores on the Cogstate composite (+0.29), Identification task (+0.19), Detection task (+0.28); One Card learning task (+0.33); and One Back task (+0.33). Improvement from OL baseline at Week 26 was also observed on the mean [SD] UPSA-B total score (+6.2 [11.6]). At DB baseline, there were no correlations between CogState composite score and individual test scores with any of the psychiatric scales. Week 26 improvement in the following Cogstate composite and subscale tasks were correlated with Week 26 improvement in the following psychiatric scale scores: Cogstate composite score (PANSS total, r=-0.26; BNSS total, r=-0.31; CGI-S, r=-0.30; MADRS total, r=-0.23; PSQI-global, r=-0.23); Identification task (PANSS total, r=-0.30; BNSS total, r=-0.30), Detection task (BNSS total, r=-0.30; CGI-S, r=-0.28; PSQI-global, r=-0.23); One Card learning task (MADRS total, r=-0.29); and One Back task (PANSS total, r=-0.26).DiscussionDuring 6-months of open-label extension treatment with SEP-363856, improvement in overall functioning was observed on the UPSA-B scale; and small but consistent improvement in cognition was noted in the Cogstate composite and subscale task scores. Endpoint reduction in the severity of schizophrenia-related symptomatology (eg, on the PANSS, BNSS, MADRS, insomnia) were associated with modest correlations, in the range of 0.2 to 0.3, in cognitive performance as measured by the Cogstate composite and subscale task scores.

M227. AN EXPLORATORY STUDY OF AUTOMATED LINGUISTIC ANALYSIS OF SOCIAL NARRATIVES IN SCHIZOPHRENIA

BackgroundSchizophrenia has been suggested to be a disorder of social communication, which depends on the way language is used to convey thoughts, beliefs, feelings, and intentions. Everyday language can also reveal personality, emotions, and social skills of the speaker. Extensive past research affirms the central importance of language and thought disorder as diagnostic features of schizophrenia, mostly focused on the neurocognitive aspects of language output collected during clinical interviews, and not on the social nature of language. In this study, we examined narratives written in response to viewing social scenes by individuals with schizophrenia (SZ) and matched controls (CO) using an automated computational linguistics and statistical-based text analysis tool that computes socially-relevant variables.Methods23 individuals with schizophrenia (SZ) and 23 demographically matched controls (CO) were shown paintings of social situations, and were asked to write reflections describing what they thought and felt about these scenes. Two pictures were presented consecutively. There was no time limit. Resulting narratives were analyzed with the Linguistic Inquiry and Word Count program (LIWC; Pennebaker et al, 2015). LIWC computes basic linguistic variables such as the % of self-referring and non-self-referring pronouns, social and emotion words, and cognitive items. LIWC also generates 4 complex variables: formal and logical thinking patterns (“analytic”); social status or confidence (“clout”); authenticity, and emotional tone. Clinical symptoms in SZ were assessed using the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS). For all participants, the UCLA Loneliness Scale, the National Adult Reading Test (NART), and the Edinburgh Handedness Inventory (EHI) were administered.ResultsThe two groups did not differ in NART or EHI. There was no group difference in the number of words produced. SZ produced greater number of pronouns than CO but this effect was driven by a higher % of self-referring pronouns in SZ than CO, with no group difference in non self-referring pronouns. For complex variables, CO scored significantly higher in authenticity than SZ but no group differences were observed in clout, analytics, or emotional tone. Loneliness was higher in SZ compared with CO. There were no other significant group differences. In SZ, pronoun use was correlated with positive symptoms (especially with ratings of hallucinations, bizarre behavior, delusions of mind-reading and thought broadcasting) and inversely correlated with negative symptoms (avolition, apathy and motor retardation). Social words were inversely correlated with SAPS Thought Disorder. Clout was inversely correlated with SANS Alogia and SAPS Thought Disorder. Authenticity was correlated with SANS Anhedonia and Asociality. In CO, loneliness was correlated with the % negative emotion words and NART was correlated with total number of emotion words.DiscussionWe used an automated linguistic analysis tool to extract information relevant to social communication from written narratives. We found group differences in the use of pronouns and authenticity. We also observed associations of clinical symptoms with certain social aspects of language use in schizophrenia. One advantage of automated text analysis tools is the minimization of implicit biases inherent in ratings of interviews. Limitations of this study include lack of direct social functioning measures and the sample size. Future work will incorporate linguistic text analysis within a social paradigm to directly examine the role of language use in social functioning.

Impact of Sensory Processing on School Performance Outcomes in High Functioning Individuals with Autism Spectrum Disorder.

Difficulty processing sensory information may impede progress in school for students with autism spectrum disorder (ASD). We explore the relationship between sensory processing and school performance in 26 high-functioning youths with ASD and 26 controls (age 8-14) using measures of sensory, social, cognitive, and academic functioning. In the ASD group, bivariate Pearson correlations indicated a significant positive relationship between intelligence quotient (IQ) and the School Competence Scale (SCS) of the Child Behavior Checklist (CBCL), and a significant negative relationship between Dunn's Sensory Processing Framework and SCS scores. Final hierarchical multiple linear regression model accounting for SCS scores in ASD included IQ, ADHD symptoms, and sensory features. An interaction between increased sensory sensitivity with reduced sensory avoidance behaviors explained the greatest amount of variance in SCS, meaning school performance is lowest for children with greater hypersensitivity and fewer avoidance behaviors. Results indicate a strong impact of sensory processing on school performance in ASD.

Examination of Correlates to Health-Related Quality of Life in Individuals with Fragile X Syndrome.

Health-related quality of life (HRQoL) is a multidimensional concept involving physical, psychological, social, and cognitive aspects of life. Individuals with Fragile X syndrome (FXS) experience a life-long disorder that impacts the HRQoL of the affected individual and their family. Thus, HRQoL may be an important outcome measure following intervention. However, it is yet not known whether HRQoL concerns relate to observed impairments in FXS. In the present study, we examined the nature and degree of association between HRQoL and established measures of functioning in FXS using the Parent Report for Children version of the PedsQL 4.0 Generic Core Scales and Cognitive Functioning Scale. We observed significant relationships between HRQoL a nd measures of adaptive behavior, maladaptive behaviors, and social functioning. The present study has implications for treatment outcomes for clinical trials in FXS.

Behavioral Treatment for the Social-Emotional Difficulties of Preadolescent and Adolescent Girls with ADHD

ABSTRACT Girls with attention-deficit/hyperactivity disorder (ADHD) are at high risk for peer difficulties that often persist into adolescence and adulthood and portend risk for additional difficulties, such as depression, anxiety, and borderline personality disorder. However, very little research has examined interventions that address the widespread peer difficulties of girls with ADHD. This paper describes two open trials of behavior therapy aimed at addressing their social-emotional difficulties. The first trial includes 33 preadolescent girls (ages 7–11) with ADHD enrolled in an eight-week treatment and the second trial includes 22 adolescent girls (ages 12–16) with ADHD enrolled in a 12-week treatment. Measures of treatment feasibility and acceptability and measures of social functioning and psychopathology were collected in both trials. High levels of treatment feasibility and acceptability were reported in both the preadolescent and adolescent trial. In addition, improvements were reported in areas of social functioning and reductions in psychopathology, although the magnitude and specific areas of improvement differed somewhat in the preadolescent versus adolescent group. These preliminary findings provide a first step toward addressing the widespread social-emotional difficulties of girls with ADHD and offer insight into continuing efforts to address their treatment needs.

EP30 Understanding which patient-reported outcomes are important to rheumatology patients: findings from ArthritisPower

Abstract Background Little is known about PRO measures patients find most important for disease, treatment effectiveness/health outcomes. In this study, we examined PROs selected by patients with rheumatologic conditions to further elucidate which disease symptoms they found most important to track within ArthritisPower registry. As the study is ongoing, we discuss initial PRO selections of study participants. Methods Adult US patients with self-reported rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), osteoporosis (OP), osteoarthritis (OA), fibromyalgia syndrome (FMS) in ArthritisPower were invited to participate and prompted to select up to ten PRO (symptom) measures they felt were important to track their condition at baseline via ArthritisPower smartphone and Web-based app. PROs Measurement Information System (PROMIS) instruments focusing on symptoms of pain, physical and cognitive function, mental health, fatigue, social function, work impact, sexual function, and sleep, and Outcomes Measures in Rheumatology (OMERACT) RA flare instrument (only for those with RA) and Lilly-developed morning joint-stiffness duration question were offered. At Month (m)1, m2, m3, participants were given the option to continue tracking their selected PRO measures or change. At m3, participants complete an exit survey prioritizing all measures selected during participation and specifying other symptoms not available they would have wanted to track. Descriptive statistics were conducted on baseline data. Results As of May 2019, 292 participants enrolled (251 completed baseline assessments). Mean age was 55.6 (9.2) years, 89.6% female, 91.2% White, mean disease duration of 12 (10.7) years; similar to the overall ArthritisPower population. Majority (64.1%) self-reported OA, followed by RA (49.0%), FMS (40.6%), PsA (26.3%), OP (20.3%), AS (15.5%), SLE (5.6%), not mutually exclusive. Top 3 PRO domains chosen at baseline were fatigue, mental health, pain (Table 1). Average number of instruments selected for baseline completion was 6.9 (2.4). Conclusion Participants prioritised tracking fatigue, aspects of mental health, pain, physical function, social function, sleep, morning stiffness. These findings provide insights into symptoms rheumatology patients find most important; useful to inform the design of future patient-centric clinical trials and real-world evidence generation. Disclosures T. Daud (Non-Author Presenter) None. W.B. Nowell: Shareholder/stock ownership; WN has Ownership Interest (stocks, stock options, or other ownership interest excluding diversified mutual funds). C.L. Kannowski Corporate appointments; CLK is an employee of Eli Lilly and Company. Shareholder/stock ownership; CLK owns stock options at Eli Lilly and Company. K. Gavigan: None. Z. Cai: Corporate appointments; ZC is an employee of Eli Lilly and Company. Shareholder/stock ownership; shareholder of Eli Lilly and Company. A. Cardoso: Corporate appointments; AC is an employee of Eli Lilly and Company. Shareholder/stock ownership; AC is a stockholder of Eli Lilly and Company. T. Hunter: Corporate appointments; TH is an employee of Eli Lilly and Company. Shareholder/stock ownership; TH is a shareholder of Eli Lilly and Company. J. Birt: Corporate appointments; JB is an employee of Eli Lilly and Company. Shareholder/stock ownership; JB is a shareholder of Eli Lilly and Company. J. Workman: Corporate appointments; JW is an employee of Eli Lilly and Company. J. Curtis: Consultancies; JC has received Consulting Fees from AbbVie, Amgen, BMS, Corrona, Eli Lilly, Janssen, Myriad, Pfizer, Regeneron, Roche, UCB. Grants/research support; JC has received grants/research support from AbbVie, Amgen, BMS, Corrona, Eli Lilly, Janssen, Myriad, Pfizer, Regeneron, Roche, UCB.

Social skills and autism spectrum disorder symptoms in children with neurofibromatosis type 1: evidence for clinical trial outcomes.

We examined key features of two outcome measures for social dysfunction and autism spectrum disorder traits, the Social Responsiveness Scale, Second Edition (SRS-2) and the Social Skills Improvement System - Rating Scales (SSIS-RS), in children with neurofibromatosis type 1 (NF1). The aim of the study was to provide objective evidence as to which behavioural endpoint should be used in clinical trials. Cross-sectional behavioural and demographic data were pooled from four paediatric NF1 tertiary referral centres in Australia and the United States (N=122; 65 males, 57 females; mean age [SD] 9y 2mo [3y], range 3-15y). Distributions of SRS-2 and SSIS-RS scores were unimodal and both yielded deficits, with a higher proportion of severely impaired scores on the SRS-2 (16.4%) compared to the SSIS-RS (8.2%). Pearson's product-moment correlations revealed that both questionnaires were highly related to each other (r=-0.72, p<0.001) and to measures of adaptive social functioning (both p<0.001). Both questionnaires were significantly related to attention-deficit/hyperactivity disorder symptoms, but only very weakly associated with intelligence. The SRS-2 and SSIS-RS capture social dysfunction associated with NF1, suggesting both may be suitable choices for assessing social outcomes in this population in a clinical trial. However, careful thought needs to be given to the nature of the intervention when selecting either as a primary endpoint. The Social Responsiveness Scale, Second Edition yielded a large deficit relative to population norms. The Social Skills Improvement System - Rating Scales yielded a moderate deficit relative to population norms. Both scales were highly correlated, suggesting that they are measuring a unitary construct.

Cognitive behavior therapy for comorbid dissociative seizures in patients with epilepsy

ObjectivesThe main aim of this study was to assess the effectiveness of cognitive behavior therapy (CBT) for comorbid dissociative seizures (DS) in patients with epilepsy. MethodsWe conducted a retrospective case note review of 14 patients with epilepsy who underwent outpatient CBT for DS in a tertiary neuropsychiatry service. The diagnosis of DS was confirmed by neurologists clinically and/or following video-telemetry electroencephalogram (EEG). We evaluated the outcome of the CBT treatment with respect to frequency of DS, measures of depression, anxiety, and social functioning. ResultsMeasures of depression and anxiety significantly reduced following CBT treatment. Overall, frequency of DS reduced following CBT treatment but did not reach statistical significance. SignificanceThis study provides evidence that CBT can be effective in reducing depression and anxiety in patients with both epilepsy and DS. Anxiety and depression are likely to be associated with DS. Further research in larger samples and longitudinal studies are recommended to evaluate the long-term efficacy of CBT in this patient group.

Between a rock and a hard place: Associations between Mentzos' "dilemma", self-reported interpersonal problems, and psychosocial functioning in individuals with non-affective psychoses.

Primary aim of this study was to determine the extent and type of self-reported interpersonal problems in patients with non-affective psychoses and their impact on psychosocial functioning. Furthermore, we aimed to explore potential links with the psychodynamic construct of Stavros Mentzos' "psychotic dilemma", which describes an insufferable inner tension caused by an individual's struggle of being torn between "self-oriented" and "object-oriented" tendencies. In a cross-sectional study among 129 patients with non-affective psychoses, measures of cognition, symptom load and social functioning as well as a tentative, psychodynamic assessment of Mentzos' "dilemma" were obtained during a clinical research visit. Self-report data on interpersonal problems were gathered using the Inventory of Interpersonal Problems (IIP-64D) and compared with a German representative standard sample. Second, IIP-64D scores were compared between groups with or without Mentzos' "dilemma". Hierarchical regression analyses were performed to test for the impact of interpersonal problems on psychosocial functioning, while controlling for cognitive deficits and psychopathology. Results showed that IIP-64D scores differed significantly from healthy controls, except for "self-centred" and "intrusive" interpersonal styles. Participants with a potential "psychotic dilemma" scored significantly higher on the subscales: "domineering", "self-centred", "cold", and "socially avoidant" than the group without a "psychotic dilemma". The total amount of interpersonal problems, and particularly high scores on the IIP-64D "socially avoidant" subscale, predicted psychosocial dysfunction, whereas a "cold" interpersonal style had an opposite effect. In conclusion, specific interpersonal problems may predict psychotherapeutic outcome measures like psychosocial functioning and are partly compatible with the psychodynamic construct of Stavros Mentzos' "psychotic dilemma".

Effects of a 12-Week Cycling Intervention on Successful Aging Measures in Mid-Aged Adults

ABSTRACT Purpose: To compare the effect of 12-weeks of cycling training and competition versus recreational cycling on successful aging across physical, psychological, cognitive, and social functioning domains in mid-aged adults. Methods: Recreational cyclists were randomly assigned to an intervention (n = 13, M age = 47.18 years) and comparison (n = 13, M age = 46.91 years) group. Analysis of Covariance was used on self-reported pre-post data to determine changes across time and differences between groups on outcomes. Results: The intervention group scored higher on the role limitation due to physical problems measure of physical functioning (p = .045) and the social activity measure of social functioning (p = .008) with large effect sizes (ηp 2 > .14). The remaining physical, psychological, cognitive, and social functioning measures were not significantly different (p > .05) between groups with small to medium effect sizes (ηp 2 > .01 to ≤ .06). Conclusion: Cycling training and competition promotes better physical and social functioning than recreational cycling. This finding indicates that an intervention that incorporates the training and competition aspects of sport may promote positive outcomes that are above and beyond those that can be gained from participation in recreational physical activity. Objective measurements on larger samples across a broader range of sports are required to confirm and extend these findings.

Responsiveness to Change Over Time: An Examination of the Neuro-QoL Social Function Measures in Persons with Huntington's Disease.

Social health is an important concern in persons with Huntington's disease (HD); however, there is little literature examining this construct in this population. While cross-sectional data supports the clinical utility of two Neuro-QoL social health measures in persons with HD, data is still needed to establish their longitudinal validity. Participants (N = 358) completed baseline and at least one follow-up (12- and 24-month) assessment that included the completion of Neuro-QoL Social Health computer adaptive tests (CATs) and short forms (for Ability to Participate in Social Roles and Activities [SRA] and Satisfaction with SRA). Test-retest reliability was examined using intra class correlations, and one-way ANOVAs with Bonferroni post-hoc contrasts were used to determine whether there were group differences among premanifest, early- and late-stage HD participants on the Social health measures. In addition, standardized response means were used to examine longitudinal responsiveness, and mixed or general linear models were used to examine change over time (relative to self-reported change on an associated anchor item about social health and clinician-rated change based on Total Functional Capacity scores from the UHDRS). Test-retest reliability of the measures was excellent (ICCs ranged from 0.82 to 0.87 across the different measures) and persons with greater disease burden reported more problems with social health than those at earlier stages in the disease process (all p < 0.0001). Responsiveness was supported for all measures except the Ability to Participate in SRA CAT; participants who had self-reported or clinician-rated declines in health generally had 12- and 24-month declines on the Neuro-QoL measures. Findings indicate that these measures may be useful for studies attempting to assess change in social health over time.

Clinical features of adolescents diagnosed with eating disorders and at risk for psychosis.

The presence of subthreshold psychotic symptoms in adolescents with eating disorders is poorly described. This study provides a detailed characterization of adolescents affected by eating disorders in the absence or presence of subthreshold psychotic symptoms, taking into account a wide set of sociodemographic, psychological, and clinical variables. Ninety-four adolescents diagnosed with eating disorders were interviewed, focusing on clinical anamnesis and sociodemographic data collection. The Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to assess the presence (HR+) or absence (HR-) of subthreshold psychosis. The clinicians completed a questionnaire on eating disorders severity, whereas patients provided self-report measures of global social functioning and psychological symptoms associated with eating disorders. Attenuated psychotic symptoms were highly frequent (84% of subjects). HR+ patients experienced more frequently purging behaviors and dysmorphophobia and received a greater amount of antipsychotic drugs. Compared to HR- counterparts, HR+ patients reported higher eating disorders severity and psychological symptoms (i.e., ineffectiveness, interpersonal and affective problems) associated with eating disorders. Finally, a significant correlation between global social functioning and eating disorders severity emerged only for HR- subjects. These descriptive data are warranted to identify a potential psychotic core in eating disorders, mainly concerning body image and weight as well as specific psychological features. The availability of reliable and valid markers of risk can further increase our capacity to detect the early emergence of psychosis in adolescents with eating disorders, whose outcome might be worsened by the presence of psychotic symptoms.

Embedding third sector psychology services within the probation environment: an alternative to MHTRs

Purpose The use of mental health treatment requirements (MHTRs) has not proven to be successful at meeting the mental health needs of the probation population in the UK, largely through underuse of the requirement or lack of available services. The paper aims to discuss this issue. Design/methodology/approach This paper investigates a method of meeting those needs without the use of MHTRs by embedding third sector services within the probation environment. Findings Results indicate a significant impact after a six-month follow-up in symptomology across measures of depression, anxiety, general distress and social functioning; also indicated is a significant result on recidivism, with 74 per cent of participants committing no further offences in the 12 months following treatment. Originality/value These results represent the only evaluation of embedded, third sector mental health services in a probation environment in the UK, and highlight a further need to embed specialist mental health services within the probation environment and generalise that practice to other forms of service structure and therapeutic methodology.