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"Clinical interviews"
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Speaking of sadness : depression, disconnection, and the meanings of illness
\"Speaking of Sadness, based on fifty in-depth interviews, provides first-hand accounts of the depression experience while discovering clear regularities in the ways that personal identities are shaped over the course of an \"illness career.\" The new edition of the book is highlighted by a thoroughly new and extensive introduction\"-- Provided by publisher.
Book
Reduced interpersonal head synchrony in youth at clinical high risk for psychosis
Impaired social functioning is commonly observed in youth at clinical high risk (CHR) for psychosis. Interpersonal synchrony, defined as the temporal alignment of movement between interacting partners, is a key component of successful social interactions. This study aimed to investigate interpersonal head synchrony in naturalistic virtual settings among CHR individuals using automated video analysis tools.
We analyzed short video recordings from virtual clinical interviews involving 116 participants including 50 CHR participants, 36 individuals with sub-threshold positive symptoms (SUB), and 30 healthy controls (HC). Vertical head movement time series were extracted using an open-access video-based head-tracking tool. Interpersonal head synchrony was computed using Windowed Cross-Correlation to assess group differences and associations with clinical symptoms and functioning.
CHR participants showed significantly reduced strength of synchrony compared to HC (β = -0.05, 95% CI [-0.09, -0.02],
= .004), although 14% of variance in strength of synchrony was attributable to assessor identity. No significant group differences were found for delay of synchrony. Within the CHR group, delay of synchrony was positively associated with social anhedonia (
= 0.29). Strength of synchrony correlated with better social (
= 0.33) and role (
= 0.28) functioning.
Our findings suggest that impaired interpersonal head synchrony is already present in the psychosis-risk state and relates to negative symptoms and social and role functioning. These findings support the utility of nonverbal synchrony as a potential biomarker and demonstrate the feasibility of automated tools and virtual assessments to study social processes in at-risk populations.
Journal Article
A Blended Learning Course on the Diagnostics of Mental Disorders: Multicenter Cluster Randomized Noninferiority Trial
Clinical diagnoses determine if and how therapists treat their patients. As misdiagnoses can have severe adverse effects, disseminating evidence-based diagnostic skills into clinical practice is highly important.
This study aimed to develop and evaluate a blended learning course in a multicenter cluster randomized controlled trial.
Undergraduate psychology students (N=350) enrolled in 18 university courses at 3 universities. The courses were randomly assigned to blended learning or traditional synchronous teaching. The primary outcome was the participants' performances in a clinical diagnostic interview after the courses. The secondary outcomes were diagnostic knowledge and participants' reactions to the courses. All outcomes were analyzed on the individual participant level using noninferiority testing.
Compared with the synchronous course (74.6% pass rate), participation in the blended learning course (89% pass rate) increased the likelihood of successfully passing the behavioral test (odds ratio 2.77, 95% CI 1.55-5.13), indicating not only noninferiority but superiority of the blended learning course. Furthermore, superiority of the blended learning over the synchronous course could be found regarding diagnostic knowledge (β=.13, 95% CI 0.01-0.26), course clarity (β=.40, 95% CI 0.27-0.53), course structure (β=.18, 95% CI 0.04-0.32), and informativeness (β=.19, 95% CI 0.06-0.32).
Blended learning can help to improve the diagnostic skills and knowledge of (future) clinicians and thus make an important contribution to improving mental health care.
ClinicalTrials.gov NCT05294094; https://clinicaltrials.gov/study/NCT05294094.
Journal Article
Assessing changes in thinking about troubleshooting in physical computing: a clinical interview protocol with failure artifacts scenarios
Purpose
The purpose of this paper is to examine how a clinical interview protocol with failure artifact scenarios can capture changes in high school students’ explanations of troubleshooting processes in physical computing activities. The authors focus on physical computing, as finding and fixing hardware and software bugs is a highly contextual practice that involves multiple interconnected domains and skills.
Design/methodology/approach
This paper developed and piloted a “failure artifact scenarios” clinical interview protocol. Youth were presented with buggy physical computing projects over video calls and asked for suggestions on how to fix them without having access to the actual project or its code. Authors applied this clinical interview protocol before and after an eight-week-long physical computing (more specifically, electronic textiles) unit. They analyzed matching pre- and post-interviews from 18 students at four different schools.
Findings
The findings demonstrate how the protocol can capture change in students’ thinking about troubleshooting by eliciting students’ explanations of specificity of domain knowledge of problems, multimodality of physical computing, iterative testing of failure artifact scenarios and concreteness of troubleshooting and problem-solving processes.
Originality/value
Beyond tests and surveys used to assess debugging, which traditionally focus on correctness or student beliefs, the “failure artifact scenarios” clinical interview protocol reveals student troubleshooting-related thinking processes when encountering buggy projects. As an assessment tool, it may be useful to evaluate the change and development of students’ abilities over time.
Journal Article
Schema therapy for Dissociative Identity Disorder (DID): rationale and study protocol
: A category of disorders frequently associated with a history of trauma are the dissociative disorders, of which Dissociative Identity Disorder (DID) is the most severe and chronic form. DID is associated with high levels of impairment, treatment utilization, and treatment costs, yet systematic research into treatment effects is scarce. Practice-based clinical guidelines advise a phase-based approach which is lengthy and has rather high reported dropout rates. Therefore, in the current proposal the efficacy of an alternative treatment for DID (i.e. schema therapy) is tested.
: The aim of this study is to critically test the effectiveness of schema therapy for DID patients, for whom at present no evidence-based treatment is available.
: In light of the low prevalence of DID, and the proposed treatment length of three years, a case series experimental approach is used (non-concurrent multiple baseline design). Ten outpatients are included, who are diagnosed with DID by an independent rater using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D-R), which is double-checked by another independent expert. Primary outcomes are a (bi)weekly assessed state measure of dissociative symptoms, a pre-, post- and follow-up measure of the presence of the DID diagnosis, and drop-out rate. Secondary outcomes include various measures of trait dissociative symptoms, comorbid symptomatology, and global symptomatic distress.
: Netherlands Trial Register (NTR): NTR4496.
Journal Article
The experience of living with a chronic disease in pediatrics from the mothers’ narratives: The Clinical Interview on Parental Sense of Grip on the Disease
The Clinical Interview on the Sense of Grip on Chronic Disease has been administered to 68 mothers of children affected by Hereditary Angioedema (C1-Inh HAE), Type 1 Diabetes (T1D), Juvenile Rheumatoid Arthritis (JRA). The objectives are to detect general features of the experience of parenting children with chronic illness as well as the specificities of this experience related to the different conditions. Four Profiles of Sense of Grip were identified: Adempitive, Controlling, Reactive, Dynamic. The Sense of Grip Interview is an effective clinical tool for understanding the characteristics of the disease in daily life, which can help clinicians to encourage family adjustment to disease.
Journal Article
The Structured Clinical Interview for DSM-IV Childhood Diagnoses (Kid-SCID): First Psychometric Evaluation in a Dutch Sample of Clinically Referred Youths
The Structured Clinical Interview for DSM-IV Childhood Disorders (Kid-SCID) is a semi-structured interview for the classification of psychiatric disorders in children and adolescents. This study presents a first evaluation of the psychometric properties of the Kid-SCID in a Dutch sample of children and adolescents who had been referred to an outpatient treatment centre for mental health problems. Results indicated that the inter-rater reliability of the Kid-SCID classifications and the internal consistency of various (dimensional) criteria of the diagnoses were moderate to good. Further, for most Kid-SCID diagnoses, reasonable agreement between children and parents was found. Finally, the correspondence between the Kid-SCID and the final clinical diagnosis as established after the full intake procedure, which included the information as provided by the Kid-SCID, ranged from poor to good. Results are discussed in the light of methodological issues pertaining to the assessment of psychiatric disorders in youths. The Kid-SCID can generally be seen as a reliable and useful tool that can assist clinicians in carrying out clinical evaluations of children and adolescents.
Journal Article
Validity of Chinese Version of the Composite International Diagnostic Interview-3.0 in Psychiatric Settings
Background: The Composite International Diagnostic Interview-3.0 (CIDI-3.0) is a fully structured lay-administered diagnostic interview for the assessment of mental disorders according to ICD-10 and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The aim of the study was to investigate the concurrent validity of the Chinese CIDI in diagnosing mental disorders in psychiatric settings.
Methods: We recruited 208 participants, of whom 148 were patients from two psychiatric hospitals and 60 healthy people from communities. These participants were administered with CIDI by six trained lay interviewers and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I, gold standard) by two psychiatrists. Agreement between CIDI and SCID-I was assessed with sensitivity, specificity, positive predictive value and negative predictive value. Individual-level CIDI-SCID diagnostic concordance was evaluated using the area under the receiver operator characteristic curve and Cohen′s K.
Results: Substantial to excellent CIDI to SCID concordance was found for any substance use disorder (area under the receiver operator characteristic curve [AUC] = 0.926), any anxiety disorder (AUC = 0.807) and any mood disorder (AUC = 0.806). The concordance between the CIDI and the SCID for psychotic and eating disorders is moderate. However, for individual mental disorders, the CIDI-SCID concordance for bipolar disorders (AUC = 0.55) and anorexia nervosa (AUC = 0.50) was insufficient.
Conclusions: Overall, the Chinese version of CIDI-3.0 has acceptable validity in diagnosing the substance use disorder, anxiety disorder and mood disorder among Chinese adult population. However, we should be cautious when using it for bipolar disorders and anorexia nervosa.
Journal Article
Discourse Marker Na (那) as an Interpersonal-Level Compensatory Strategy in Clinical Interviews
Discourse markers (DMs) are characterized by multifunctionality in different contexts. This study addressed the use of the Chinese DM,
(那), as a solution to topical divergence, during clinical interactions with right-hemisphere-damaged (RHD) patients. Drawing on data collected from clinical interviews between psychotherapists and RHD patients, this study examined the functions of
in response to RHD topical divergence, focusing on the topic and attitudinal aspects. It was found that
was mainly employed by psychotherapists to mark a reproffer of interview topics (i. e., an attempt to return to earlier topics), and a display of disalignment and disaffiliation with RHD topical divergence. These functions of
reflect the psychotherapists’ attempts to overcome communicative problems arising from RHD topical divergence, so as to ensure the achievement of the communicative goal. Thus,
can be interpreted as a compensatory strategy for dealing with RHD topical divergence on an interpersonal level. These findings not only expand our knowledge about the function spectrum of
, but also offer insights for RHD patients’ interlocutors to enhance conversational communication with RHD patients via the compensatory strategy.
Journal Article
Psychophysiological stress response and memory in borderline personality disorder
Background: Previously, we found that patients with borderline personality disorder (BPD) but not healthy controls (HC) showed improved memory retrieval after hydrocortisone administration.
Objective: In this study, we examined whether increases in endogenous cortisol after psychosocial stress are associated with memory function in patients with BPD and in healthy individuals.
Methods: We recruited 49 female patients with BPD and 49 female HC. All participants were exposed to a psychosocial stressor, the Trier Social Stress Test (TSST) and a control condition (Placebo (P-)TSST) in randomized order. Salivary cortisol, alpha amylase (sAA) and blood pressure were measured in response to stress. Subsequently, we examined free recall of a previously learned word list, autobiographical memory, and working memory.
Results: We found a stress*time*group interaction effect for the cortisol response and for sAA to stress, which is mainly triggered by a slightly different increase in cortisol between groups from pre to post TSST. Furthermore, BPD patients showed a less pronounced increase in diastolic blood pressure compared to HC after stress. There was no effect of stress on memory performance in any tests, either in healthy controls or in patients with BPD.
Conclusion: Our results suggest a slightly blunted response of the HPA axis and the sympathetic nervous system to stress in BPD compared to healthy women. In contrast to hydrocortisone administration, psychosocial stress did not improve memory retrieval in BPD patients. This might be explained by lower cortisol concentrations and parallel increases in norepinephrine and negative affect after stress.
* Previously, we found that patients with BPD showed improved memory retrieval after hydrocortisone. * Here, we examined the effects of psychosocial stress on memory in patients with BPD. * Patients with BPD had a blunted response of the sympathetic nervous system to stress. * There were only small differences in cortisol release between BPD patients and healthy controls. * Psychosocial stress did not improve memory retrieval in BPD patients.
Journal Article