Personality Functioning Research Articles

Evaluation of occupational therapy in persons with COVID-19: a pre-post observational cohort study.

Persons with COVID-19 may experience limitations in daily functioning and can be referred to occupational therapy. To evaluate changes in daily functioning, cognitive complaints, fatigue and self-management of persons with COVID-19 who received occupational therapy in primary care.To get insights in the volume and duration of occupational therapy. A pre-post observational cohort study from October 2020 until April 2021. Fifty-eight occupational therapy practices in primary care throughout the Netherlands participated with 68 occupational therapists. 228 adults (≥18 years) with COVID-19, referred to occupational therapy, gave informed consent and participated in the pre-post evaluation. The mean age was 49 years (SD 13) and 79% of the patients was female. The most frequently reported complaints included fatigue and cognitive complaints. Occupational therapy using Dutch guidelines for occupational therapy in clients with COVID-19. Performance and satisfaction with performance using the Canadian Occupational Performance Measure (COPM); the impact of Cognitive Complaints on Participation (CoCo-P); and daily activities, self-management and perceived contribution of occupational therapy using the Patient Reported Outcome Measure for Occupational Therapy (PROM-OT). COPM-performance score improved with a mean difference of 2.9 points (95% CI 2.7 to 3.2), and COPM-satisfaction score improved with 3.2 points (95% CI 2.9 to 3.5). CoCo-P score improved with a mean difference of 20.9 points (95% CI from 14.4 to 27.4), and PROM-OT improved with 42.8 points (95% CI from 40.2 to 45.4). Participants received a median of seven sessions of occupational therapy (IQR 5-10) with a median duration of 18 weeks (IQR 12-25). They valued the contribution of occupational therapy to their improved functioning with a mean score of 8 (SD 1.4) and recommended this to others with a mean score of 9 (SD 1.2). Persons with COVID-19 who received occupational therapy in primary care improved significantly in daily functioning and highly valued occupational therapy.

Bimanual Arm Trainer Versus Traditional Occupational Therapy Services in Upper Extremity Function.

Upper extremity (UE) dysfunction resulting from stroke significantly affects a person's ability to complete self-care activities, consequently diminishing functional independence. Effective interventions that improve UE function in persons with stroke are needed. To explore the effectiveness of the Bimanual Arm Trainer (BAT) compared with traditional occupational therapy treatment sessions (i.e., a control group) on improving UE function after acute ischemic stroke. Clinical trial, two-group, nonrandomized repeated-measures design. Inpatient rehabilitation facility. Twenty-seven persons with ischemic stroke and an Action Research Arm Test (ARAT) score ≤17. Minimum of three 10-min sessions on the BAT. ARAT, Upper Extremity Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA-UE). Both the intervention and control groups showed significant improvement on the ARAT from evaluation to discharge (main effect of time: p = .02). There was no statistically significant main effect of group and no significant Time × Group interaction (p = .63). FMA-UE scores also improved significantly in the intervention group from evaluation to discharge (p < .001). FMA-UE scores were not available for the control group. Both the intervention and control groups demonstrated significant improvements in UE function from evaluation to discharge. There were no statistically significant differences between groups, indicating that the BAT results in similar improvements in UE function, as would be expected in traditional occupational therapy. Further research is warranted to examine additional BAT programs, use different outcome measures, and assess participants over a longer time span. Plain-Language Summary: The Bimanual Arm Trainer (BAT) is a novel device that can be used in occupational therapy to improve arm function among stroke patients. There is limited research on BAT's effectiveness in improving arm function among stroke patients. In an acute inpatient rehabilitation setting, we compared outcome scores of patients who received traditional occupational therapy services with those who also used the BAT. Both groups achieved significant improvements in arm function from evaluation to discharge. We found that the addition of the BAT interventions did not significantly affect the outcome measure scores for either group. We conclude that more research is needed to examine additional BAT programs, use different outcome measures, and assess participants over a longer period of time.

Time Since Injury Is Key to Modeling Trends in Aging and Overall Functioning of Persons With Spinal Cord Injury: A Longitudinal Analysis of a Swiss Community Survey.

The aim of the study is to model the health indicator of functioning for persons with spinal cord injury or disorder living in Switzerland in the long-term context, considering chronological age, time since injury, and age at injury. This is a longitudinal analysis of three waves of a community survey. An interval-scaled functioning metric was constructed using modern test theory. Random effects within-between mixed models were used to investigate trends in functioning over time. Persons with complete injuries have lower levels of functioning than persons with incomplete injuries, and persons with complete tetraplegia have the lowest levels of functioning. The person's age when injured, the level and completeness of the injury, the presence of secondary health conditions, and various combinations of these factors significantly influenced how functioning changed over time. Our study shows that chronological age is not necessarily the best time variable for understanding the aging process of people with spinal cord injury in terms of changes in functioning over time and that modeling functioning over time since injury provides important insights into how functioning of people with complete or incomplete injuries declines with increasing time living with the injury.

Integrating personality functioning in brief psychotherapy for substance use disorders: a case study

A large treatment gap exists for substance use disorders (SUDs) in India. Among other factors, personality vulnerabilities are widely implicated in the initiation and maintenance of SUDs leading to poor outcomes. Available brief interventions do not adequately address this. Longer term therapies are resource intensive and therefore difficult to incorporate in tertiary care settings due to poor treatment provider-patient ratio. Further, trait-based and categorical models have limited application in brief psychotherapies. Core pathology seen across personality disorders such as the impairments in self and interpersonal functioning present as modifiable characteristic adaptations of more stable personality structures. Therefore, the present article attempts to explore the possibility of integrating the personality functioning model as proposed by the alternative model of personality disorders (AMPD) in the DSM-5, within brief psychotherapies for SUDs. Modifications to the routine treatment structure, assessment, formulation and content are suggested with a focus on personality functioning. The clinical utility of the level of personality functioning scale (LPFS) is also demonstrated using a brief case illustration. Further research is required to explore the feasibility and effectiveness of utilizing a personality functioning model among patients with SUDs in India.

Psychological resilience and post-traumatic stress disorder as chain mediators between personality traits and cognitive functioning in patients with breast cancer

BackgroundPersonality is a unique behavioral trait; cognition is how an individual knows and understands things. It is essential for everyday daily living. In patients with breast cancer, despite the growing body of research on personality and cognitive functioning, exploration of the underlying mechanisms is still relatively scarce. Therefore, this study aimed to investigate the impact of Big Five personality traits on cognitive functioning and the mediating role of psychological resilience and post-traumatic stress disorder(PTSD) between personality traits and cognitive functioning in patients with breast cancer.MethodsConvenience sampling was used, and a cross-sectional survey of 288 patients clinically diagnosed with breast cancer was conducted in the Department of Breast Surgery of the First Hospital of Jinzhou Medical University. The general information questionnaire, the Ten-Item Personality Inventory in China, the 10-item Connor-Davidson Resilience Scale, the Post-traumatic Stress Disorder Checklist-Civilian Version, and the Montreal Cognitive Assessment were used to measure the patient's general condition, personality traits, psychological resilience, PTSD, and cognitive function, respectively. Descriptive and correlation analyses were performed using SPSS 26.0 software, and mediation effect tests using SPSS PROCESS macro 3.3 software.Results(1) Psychological resilience, PTSD, Big Five personality traits, and cognitive functioning were significantly correlated. (2) The effects of the Big Five personality traits (extraversion, conscientiousness, agreeableness, emotional stability, and openness) on cognitive functioning can be mediated through three indirect pathways: the separate mediating effects of psychological resilience and PTSD and the chain mediating effects of psychological resilience and PTSD, with a chain mediation effect of 0.014, 0.018, 0.014, 0.018, and 0.014, respectively. None of the 95% CI contained 0.ConclusionPersonality traits can indirectly influence cognitive functioning in patients with breast cancer through the separate mediating roles of psychological resilience and PTSD and their chained mediating roles. This result suggests we pay more comprehensive attention to patients' cognitive function. Workers can be guided to assess patients' personality, psychological, and spiritual characteristics promptly in their work and adopt personalized care to safeguard good cognitive functioning.

Cyberbullying Victimization and Perpetration in Adolescents: A Longitudinal Moderated Mediation Model.

Although cyberbullying victimization significantly impacts cyberbullying behaviors, research on its longitudinal mechanisms and protective factors remains scarce. A total of 1465 Chinese adolescents (52.2% female) with an average age of 16.14 (SD = 0.40) participated in a three-wave longitudinal study with 3-month intervals. Cyberbullying victimization positively predicted cyberbullying perpetration 6 months later, and this effect was mediated by impairment in personality functioning. Mindfulness buffered the predictive effect of cyberbullying victimization on impairment in personality functioning and mitigated the negative impact of impairment in personality functioning on cyberbullying perpetration. Further findings revealed that the indirect effect of impairment in personality functioning was more pronounced when levels of mindfulness were low, and higher levels of mindfulness could disrupt the mediating pathway of impairment in personality functioning between cyberbullying victimization and perpetration. The findings highlighted the importance of promoting the positive development of adolescents' personality functioning and fostering mindfulness skills to reduce cyberbullying among adolescents.

Impairments in personality functioning in adolescents with anorexia nervosa.

Impairments in personality functioning (PF) according to the Alternative Model of Personality Disorders (AMPD) may affect anorexia nervosa (AN) and its treatment. However, PF impairments in adolescents with AN have not been studied. This case-control study analysed PF impairments in adolescent inpatients suffering from AN compared to a clinical control group (CC) and investigated the relationship of PF with AN severity. Adolescent patients with AN (n=43) and CC (n=127) were matched by age, sex, and global functioning. Validated interviews were applied to assess impairments in PF (Semi-Structured Interview for Personality Functioning, STiP-5.1) and severity of AN (Eating Disorder Examination, EDE), as well as weight measures. Group comparisons of PF impairment and the relationship between PF impairment and AN severity were analysed using multiple linear regression. AN patients showed greater impairment in the facet 'self-esteem' (p=0.033, Cohen's f2=0.036) than CC. In AN patients, impairments in the domain 'self-functioning' (p=0.003, Cohen's f2=0.254) and its underlying element 'identity' (p=0.016, Cohen's f2=0.172) were associated with AN severity (EDE). Additionally, higher impairments in two facets of 'empathy' (p=0.019, Cohen's f2=0.223) and 'intimacy' (p=0.026, Cohen's f2=0.199) were associated with higher AN severity (lower BMI percentiles). These results support theoretical frameworks of AN and highlight the importance of PF impairments in understanding and treating AN. Future research should investigate how impairments in PF affect AN development and treatment response through longitudinal studies.

Cardiorespiratory fitness and working memory in persons with traumatic brain injury: a cross-sectional analysis

ABSTRACT Introduction Cognitive impairment is a highly impactful consequence of traumatic brain injury (TBI) and there are limited evidence-based treatment practices to combat these impairments. Evidence from other populations suggest that aerobic exercise training (AET) is beneficial for a variety of cognitive deficits, but the research in persons with TBI to date is equivocal. One potential reason is the heterogeneity of exercise prescriptions and outcome measures. This stems from the fact that studies have not been designed based on previous data supporting a specific AET prescription to target a cognitive domain. The primary purpose of this cross-sectional analysis was to examine the relationship between cardiorespiratory fitness (CRF), as a cross-sectional surrogate of AET, and cognition in persons with TBI to inform future research. Methods Cross-sectional analysis was conducted on baseline data of persons with TBI who completed neuropsychological assessments to evaluate several cognitive domains and a cardiopulmonary exercise test (CPET) to measure CRF. Based on the normal distribution of an outcome, Pearson’s r or Spearman’s ρ was calculated to measure the relationship between CRF and cognition. Results Data were analyzed for all participants who demonstrated valid CPETs (n = 21 of 29). Based on the cycle ergometer-based norms of CRF, males in this sample were in the 69th percentile and females in this sample were in the 56th percentile, with high variability across individuals. Higher CRF, as measured by peak power output (Wpeak), was significantly associated with greater working memory (ρ = 0.465, p = 0.017), even after post-hoc corrections. Conclusions These data suggest average and highly variable CRF in persons with TBI of all severity and support cycle ergometry-based CPET testing in this population. Further, these data provide support for future research applying AET to target working memory and possibly other executive functions in persons with TBI. This research is a small step toward large-scale randomized controlled trials that can directly impact clinical care to treat cognitive symptoms post-TBI.

A Comparative Analysis of Neurocognitive Function in Community- and Hospital-Based Patients With Schizophrenia.

The study compared differences in various neurocognitive characteristics across treatment modalities among schizophrenia patients recruited in one city between July 2020 and June 2023 who were on regular medication. Of the 151 participants, 113 were included in the analysis. Participants were divided into community-based and hospital-based groups, and their demographics and clinical characteristics, including insight, quality of life, positive and negative symptoms, and personal and social functioning, were examined. In addition, several aspects of cognition were assessed using neurocognitive assessments such as the Trail Making Test (TMT), Stroop test, and Wisconsin Card Sorting Test (WCST). After adjusting for age differences between groups, the final analysis included data from 42 participants in the community-based group and 33 participants in the hospital-based group. Hospital-based group participants completed Stroop-W more rapidly, excelled in Rey-Osterrieth Complex Figure Test recall and recognition, and incurred fewer TMT Part B (TMT-B) and Stroop-C errors. Additionally, they outperformed in WCST total, non-persistent errors, and categories completed. Contrastingly, community-based group participants showed superior outcomes in WCST persistent responses and errors, suggesting specific neurocognitive strengths. We found differences in neurocognitive characteristics between the two groups. These differences were consistent across a range of cognitive domains, including attention, visual discrimination, memory, and executive functioning. Further large-scale study is needed to generalize cognitive characteristics across treatment modalities.

Depression, anxiety and cognitive function in persons with inflammatory rheumatic diseases: cross-sectional results from the German National Cohort (NAKO)

ObjectiveTo assess the presence of mental health disorders in persons with rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and Sjögren’s disease (SjD) (all: inflammatory...

Transcranial Direct Current Stimulation for Improving Balance in Healthy Older Adults and Older Adults with Stroke: A Scoping Review.

Background/Objectives: Age-related decline in balance and postural control is common in healthy elders and is escalated in aging adults with stroke. Transcranial direct current stimulation (tDCS) has emerged as one of the promising brain stimulations adjoining therapeutic exercise to enhance the recovery of balance and motor functions in persons with and without neurological disorders. This review aims to summarize and compare the available evidence of the tDCS on improving balance in the older adults without neurological disorders and the older adults with stroke. Methods: The Ovid (Medline) database was searched from its inception through to 06/15/2024 for randomized controlled trials investigating tDCS for improving balance in older adults with and without stroke. Results: Overall, 20 appropriate studies (including 271 stroke subjects and 259 healthy older adults) were found. The data indicate mixed results of tDCS for improving balance in older adults with and without stroke. Conclusions: Based on current research evidence, we have not found a specific tDCS protocol that is more effective than other tDCS protocols for improving balance and postural control in healthy older adults and older adults with stroke. Further research should explore the ideal tDCS approach, possibly in conjunction with standard interventions, to optimize postural control and balance in healthy older adults and older adults with stroke.

Oral functions in adult persons with spinal muscular atrophy compared to a healthy control group: a prospective cross-sectional study with a multimodal approach

BackgroundOral function tests have been shown to reliably detect impaired bulbar function in adults with spinal muscular atrophy (SMA). Although not routinely recorded, it is known that persons with SMA are affected to varying degrees. Detecting differences in bite and tongue force, endurance, and maximum mouth opening has become particularly promising since the introduction of causal therapy for SMA. This study aimed to compare oral function among adult persons with SMA with different SMA types, walking abilities, and treatment status to a healthy control group.MethodsData from oral function tests conducted on 58 persons with SMA and 45 healthy individuals were analyzed. Differences in oral function between SMA subgroups were pairwise tested and compared to the healthy control group using Wilcoxon rank sum tests.ResultsIn an overall comparison, three out of five oral function tests revealed lower values for the SMA group compared to the control group. Subgroup analyses indicated lower scores for most oral function tests in non-ambulatory, untreated patients with SMA type 2 compared to controls. Ambulatory, treated patients with SMA type 3 achieved strength and endurance values comparable to those of healthy individuals.ConclusionsThe impairment of oral function varies across persons with SMA. Routine measurement of oral function is warranted to determine individual bulbar involvement stages. Further evaluation should be scheduled if indicators such as restricted maximum mouth opening arise.Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/register/de/trial/DRKS00015842/preview.

Narcissism and Problematic Social Media Use: A Moderated Mediation Analysis of Fear of Missing out and Trait Mindfulness in Youth

Social media use has increased worldwide, facilitating social relationships as well as the widespread exchange of information, images, and ideas. However, some individuals may develop a compulsive and unregulated engagement with social media platforms, known as problematic social media use (PSMU), which can result in adverse consequences for personal, social, and professional functioning. This scenario leads to considering which factors are implicated in PSMU and how they can affect the disposition toward PSMU. The present study aimed to explore the mediating role of fear of missing out (FoMO) in the association between both grandiose and vulnerable facets of narcissism and PSMU while also investigating the moderating effect of trait mindfulness. The research was conducted with 208 youth participants from 19 to 28 years old through an online cross-sectional design. Participants completed the Narcissistic Personality Inventory-13, the Hypersensitive Narcissism Scale, the Fear of Missing Out Scale, the Cognitive and Affective Mindfulness Scale-Revised, the Bergen Social Media Addiction Scale, and a short socio-demographic questionnaire. Results revealed that FoMO mediated the association between both facets of narcissism and PSMU, while trait mindfulness moderated the interplay between FoMO and PSMU, dampening the effect of FoMO. These findings provide theoretical insights into the main mechanisms underlying PSMU as well as promising practical implications for the development of mindfulness-based interventions aimed at mitigating PSMU. Limitations and future research directions are also discussed.

Acetazolamide Therapy and Kidney Function in Persons with Non-albuminuric Diabetes Mellitus Type 1

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) lower the risk of kidney failure in persons with type 2 diabetes. The presumed mechanism of action is through greater delivery of sodium to the distal tubule, activation of tubuloglomerular feedback which lowers glomerular filtration rate (GFR) and intra-glomerular pressure. SGLT2is are not approved for use in persons with type 1 diabetes due to the risk of diabetic ketoacidosis. Acetazolamide, a proximal tubule diuretic, delivers more sodium to the distal nephron, and may activate tubuloglomerular feedback in a similar way to SGLT2is without a higher risk of diabetic ketoacidosis. The kidney effects and safety of acetazolamide in persons with type 1 diabetes have not been well studied. Methods: We conducted a dose-escalation trial to determine the effects of 3 dosages of oral acetazolamide (62.5mg, 125mg, and 250mg, all twice-daily) in 12 persons with type 1 diabetes. Participants were treated for 2 weeks followed by a 2-week washout before exposure to the next dosage level. Blood and urine chemistries, as well as iohexol measured GFR, were assessed before and after each treatment interval. We aimed to identify a dose that maximized measured GFR reductions while minimizing adverse effects. Results: The mean age was 46±17 years, 100% were White, and 75% were female. The mean measured GFR was 89±18ml/min/1.73m2 at baseline. Acetazolamide reduced measured GFR by 15% (95% CI 9, 21), 14% (95% CI 7, 21), and 15% (95% CI 10, 21) after 2 weeks at the 62.5mg, 125mg, and 250mg twice-daily dosage levels respectively. The measured GFR reduction was fully reversed after each 2-week washout. Serum bicarbonate was reduced by 2.3, 4.2 and 4.4 mEq/L with escalating doses, and no episodes of hypokalemia (&lt; 3.5 mEq/L) were observed. Conclusions: Among persons with type 1 diabetes and preserved kidney function, acetazolamide caused an acute, reversible reduction in measured GFR without effects on glucose metabolism.

Impact of International Classification of Functioning, Disability and Health personal factors on outcomes following lower limb orthopaedic surgery in children with cerebral palsy: a systematic review

Purpose To investigate impact of International Classification of Functioning, Disability and Health (ICF) personal factors on pain, function, or quality of life following lower limb orthopaedic surgery in children with cerebral palsy (CP). Materials and methods Systematic review of prospective studies of lower limb orthopaedic surgery in children with CP reporting relationships between ICF personal factors, and pain, function, or quality of life. Results Eight prospective studies reporting various orthopaedic procedures (median follow-up 2.1 years) were eligible, but not sufficiently homogenous for meta-analysis. Functional outcomes most reported (n = 6), then pain (n = 3) and quality of life (n = 1). Personal factors were age (n = 3), sex (n = 4), child education (n = 1), and co-morbidities (n = 1). Older children had lower function (p < 0.01), and children in “special education” greater improvement in function compared to those in “regular” education (p = 0.001) post-single-event multi-level surgery (SEMLS). Age and sex not associated with function, pain, or quality of life post-single-joint procedures (p > 0.05), except females with higher pain intensity (p = 0.019) and lower function (p = 0.018) post-Schanz procedure. No association between sex and function post-SEMLS (p > 0.05). Conclusions Further prospective cohort studies are needed to understand the influence of personal factors identified in this review and investigate the effect of other personal factors on pain, quality of life, and function.

Animal health as a function of farmer personality and attitude: using the HEXACO model of personality structure to predict farm-level seropositivity for Fasciola hepatica and Ostertagia ostertagi in dairy cows.

Infections with Fasciola hepatica and Ostertagia ostertagi impinge upon dairy cow health and welfare and represent a major economic factor in livestock industry. Control measures largely rely on the use of anthelminthic drugs. However, reports of anthelmintic resistance necessitate sustainable approaches. Farmer characteristics such as attitude and personality are crucial for the implementation of control strategies and on-farm practices. In the present study, the HEXACO (Honesty-Humility, Emotionality, eXtraversion, Agreeableness, Conscientiousness, Openness to experience) model of personality structure, which conceptualizes human personality, was used to evaluate the relationship of farmer aspects with on-farm bulk tank milk seropositivity for F. hepatica and O. ostertagi. Moreover, information on farm structure, housing, management, and farmers' attitude was collected in a face-to-face interview. Farm-level seropositivity for F. hepatica and O. ostertagi was predicted via elastic net regression. Out of 193 farms housing 8,774 cows in the German Federal State of Bavaria, 47 farms (24.4%) were seropositive for F. hepatica, 77 farms (39.9%) for O. ostertagi, and 42 farms (21.8%) for both endoparasites. The model for F. hepatica seropositivity selected the covariates pasture access, O. ostertagi seropositivity, higher farmer conscientiousness, and organic farming as relevant predictors. Seropositivity for O. ostertagi was predicted by F. hepatica seropositivity, pasture access, organic farming, and farmers being neutral regarding their satisfaction with animal health on their farm. Higher values for the HEXACO factors extraversion and emotionality were inversely associated with O. ostertagi seropositivity. The present work emphasizes the importance of farmer traits in regard to animal health and parasite occurrence. For the effective acceptance and implementation of sustainable control strategies for livestock helminth infections, it is crucial to consider these aspects to holistically address the challenges of managing parasitic diseases. Moreover, tailored communication strategies can be developed incorporating the understanding of individual stockman characteristics and subsequently ensuring encouragement of stakeholders.

Manual wheelchair training approaches and intended training outcomes for adults who are new to wheelchair use: A scoping review.

Wheelchair training is pivotal for safety, independence, and occupational engagement in the community, yet adults coming into wheelchair use often receive insufficient or untailored training. This research aimed to understand the range and type of manual wheelchair training approaches that exist for adults commencing wheelchair use. A systematic scoping review involved searching eight electronic databases and grey literature up to September 2023. Papers relating to manual wheelchair training for adults and their caregivers were included for data extraction. Eighty-seven articles were included in this review. The International Classification of Functioning (ICF) was used to organise and analyse data related to intended training outcomes. Consumer consultation was not included in this review; however, the outcomes suggest that involving consumers in future wheelchair training research is critical to assure community participation outcomes. Data were extracted from 87 papers. Manual wheelchair training was delivered across diverse contexts encompassing varied support structures, trainer backgrounds, and technology and was commonly directed towards wheelchair users with spinal cord injury. Intended training outcomes most frequently mapped to the activity and participation component of the ICF (n= 39), followed by personal factors (n= 27), body structures and functions (n= 18), and environmental factors (n= 3), with limited focus on longer term occupational engagement outcomes. Most existing manual wheelchair training focussed on the acquisition of individual wheelchair skill and may not facilitate generalised and long-term occupational participation outcomes. Further exploration into the contexts that support occupational engagement, particularly for older adults with progressive conditions, is required to support service provision. We looked at what manual wheelchair training approaches exist for adults who need to use a manual wheelchair and what training helps people to do/achieve. We did a scoping review that looked at literature about manual wheelchair training programs for adult wheelchair users. We found 87 research papers and training programs that we included in our review. We recorded and analysed information from all the papers about the wheelchair training programs and outcomes for people who do these programs. We found that manual wheelchair training can be done in structured or ad hoc ways, can have different amounts of training, can be provided face-to-face or online, and can be given by different allied health professionals and other wheelchair users. Most training programs had short-term outcomes like learning manual wheelchair skills, being able to use the wheelchair properly, and feeling confident about using a wheelchair. Some had longer term outcomes about being able to use the manual wheelchair in everyday activities. Most people who did the training programs that we looked at in this review were manual wheelchair users with spinal cord injury. Because not many wheelchair programs have been tried with people who do not have a spinal cord injury, it is hard for occupational therapists to make recommendations about training for other people who use a manual wheelchair. Manual wheelchair training that is done in the community and made to meet the needs of individuals may help people with using their wheelchair for their everyday activities and participate in their community.

Relationship between homocysteine levels, vitamin D and cognitive function in persons with intellectual disability

Objectives The aim of the article is to determine the relationship between homocysteine in the plasma, vitamin D (VitD) in the serum and cognitive abilities in persons with mild intellectual disability (ID) in different age groups. Methods In a cross-sectional, observational study including younger and older participants with mild ID, a cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA), and blood samples were taken to assess plasma homocysteine and serum VitD levels. Results A total of 60 persons with mild ID were included in the study, of whom 30 were aged 9–16 and 30 were aged 35–62 years old. Increased plasma homocysteine values were detected in 85% of cases and reduced serum VitD levels in 90% of cases. Older participants had significantly higher homocysteine values than younger ones (t(58) = −4.19; p = 0.00; d = 1.082), while younger participants had significantly more pronounced VitD deficiency than older ones (t(58) = −3.91; p = 0.00; d = 1.011). A significant correlation between cognition and VitD values was found in older participants (r = −0.424, p = 0.020). Conclusions A substantial proportion of individuals with ID, both children and adults, have increased total homocysteine (tHcy) plasma levels and insufficient VitD serum, but the clinical significance of these findings remains to be determined. Homocysteine and VitD have not been found to have a protective effect on cognition among persons with mild ID.

Equine-Assisted Short-Term Psychodynamic Psychotherapy and the Role of Personality Functioning, Emphasizing Self-Control and Identity integration

Equine-Assisted Short-Term Psychodynamic Psychotherapy and the Role of Personality Functioning, Emphasizing Self-Control and Identity integration

The interplay of personality pathology and treatment outcome in psychosomatic psychotherapy: A longitudinal analysis using latent change score modelling

IntroductionWhile ample data demonstrate the effectiveness of inpatient psychosomatic treatment, clinical observation and empirical evidence demonstrate that not all patients benefit equally from established therapeutic methods. Especially patients with a comorbid personality disorder often show reduced therapeutic success compared to other patient groups. Due to the heterogeneous and categorical personality assessment, previous studies indicated no uniform direction of this influence. This complicates the derivation of therapeutic recommendations for mental disorders with comorbid personality pathology. MethodsAnalyzing n = 2094 patients from German university hospitals enrolled in the prospective “MEPP” study, we tested the dynamic interaction between dimensionally assessed personality functioning and psychopathology of anxiety and depression. ResultsLongitudinal structural equation modelling replicated the finding that the severity of symptoms at admission predicts symptom improvement within the same symptom domain. In addition, we here report a significant coupling parameter between the baseline level of personality function and the change in general psychopathology - and vice versa. Discussion and conclusionThese results imply that personality pathology at admission hinders the therapeutic improvement in anxiety and depression, and that improvement of personality pathology is hindered by general psychopathology. Furthermore, the covariance between both domains supports the assumption that personality functioning and general psychopathology cannot be clearly distinguished and adversely influence each other. A dimensional assessment of the personality pathology is therefore recommendable for psychotherapy research and targeted therapeutic treatment.