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"Interview, Psychological methods"
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User's guide for the SCID-5-AMPD : structured clinical interview for the DSM-5 alternative model for personality disorders
The paramount tool for the use of SCID-5-AMPD, the User's Guide for the SCID-5-AMPD provides readers with an essential manual to effectively understand and use the three SCID-5-AMPD modules. Integrating an overview of the DSM-5 Alternative Model, this companion guide provides instructions for each SCID-5-AMPD module and features completed samples of all modules in full, with corresponding sample patient cases and commentary-- back cover
Impact on routine psychiatric diagnostic practice from implementing the DSM-5 cultural formulation interview: a pragmatic RCT in Sweden
by
Wallin, Malin Idar
,
Lewis-Fernández, Roberto
,
Galanti, Maria Rosaria
in
Anxiety Disorders
,
Clinical assessment
,
Cultural formulation
2022
Background
Culture and social context affect the expression and interpretation of symptoms of distress, raising challenges for transcultural psychiatric diagnostics. This increases the risk that mental disorders among migrants and ethnic minorities are undetected, diagnosed late or misdiagnosed. We investigated whether adding a culturally sensitive tool, the DSM-5 core Cultural Formulation Interview (CFI), to routine diagnostic procedures impacts the psychiatric diagnostic process.
Method
We compared the outcome of a diagnostic procedure that included the CFI with routine diagnostic procedures used at Swedish psychiatric clinics. New patients (
n
= 256) admitted to a psychiatric outpatient clinic were randomized to a control (
n
= 122) or CFI-enhanced diagnostic procedure (
n
= 134) group. An intention-to-treat analysis was conducted and the prevalence ratio and corresponding 95% confidence intervals (CI) were calculated across arms for depressive and anxiety disorder diagnoses, multiple diagnoses, and delayed diagnosis.
Results
The prevalence ratio (PR) of a depressive disorder diagnosis across arms was 1.21 (95% CI = 0.83-1.75), 33.6% of intervention-arm participants vs. 27.9% of controls. The prevalence ratio was higher among patients whose native language was not Swedish (PR =1.61, 95% CI = 0.91-2.86). The prevalence ratio of receiving multiple diagnoses was higher for the CFI group among non-native speaking patients, and lower to a statistically significant degree among native Swedish speakers (PR = .39, 95% CI = 0.18-0.82).
Conclusions
The results suggest that the implementation of the DSM-5 CFI in routine psychiatric diagnostic practice may facilitate identification of symptoms of certain psychiatric disorders, like depression, among non-native speaking patients in a migration context. The CFI did not result in a reduction of patients with a non-definite diagnosis.
Trial registration
ISRCTN51527289
, 30/07/2019. The trial was retrospectively registered.
Journal Article
Being taken in : the framing relationship
Why is love not enough for children whose early lives have been disturbing? What makes it so hard for such children to make the most of new relationships? How can we help children whose minds are adapted to adversity take in new experience? In the new era of brain research, neuroscience shows the way ahead. Being Taken In looks at the neuroscience showing how the mother/infant framing relationship wires in our way of understanding the world, and sets a navigation system, complete with built-in danger alerts.
Quality of Care Perceived by Older Patients and Caregivers in Integrated Care Pathways With Interviewing Assistance From a Social Robot: Noninferiority Randomized Controlled Trial
by
Albers, Joyce
,
van de Poll, Alexandra
,
Hindriks, Koen
in
Aged
,
Aged, 80 and over
,
Caregivers - psychology
2020
Society is facing a global shortage of 17 million health care workers, along with increasing health care demands from a growing number of older adults. Social robots are being considered as solutions to part of this problem.
Our objective is to evaluate the quality of care perceived by patients and caregivers for an integrated care pathway in an outpatient clinic using a social robot for patient-reported outcome measure (PROM) interviews versus the currently used professional interviews.
A multicenter, two-parallel-group, nonblinded, randomized controlled trial was used to test for noninferiority of the quality of care delivered through robot-assisted care. The randomization was performed using a computer-generated table. The setting consisted of two outpatient clinics, and the study took place from July to December 2019. Of 419 patients who visited the participating outpatient clinics, 110 older patients met the criteria for recruitment. Inclusion criteria were the ability to speak and read Dutch and being assisted by a participating health care professional. Exclusion criteria were serious hearing or vision problems, serious cognitive problems, and paranoia or similar psychiatric problems. The intervention consisted of a social robot conducting a 36-item PROM. As the main outcome measure, the customized Consumer Quality Index (CQI) was used, as reported by patients and caregivers for the outpatient pathway of care.
In total, 75 intermediately frail older patients were included in the study, randomly assigned to the intervention and control groups, and processed: 36 female (48%) and 39 male (52%); mean age 77.4 years (SD 7.3), range 60-91 years. There was no significant difference in the total patient CQI scores between the patients included in the robot-assisted care pathway (mean 9.27, SD 0.65, n=37) and those in the control group (mean 9.00, SD 0.70, n=38): P=.08, 95% CI -0.04 to 0.58. There was no significant difference in the total CQI scores between caregivers in the intervention group (mean 9.21, SD 0.76, n=30) and those in the control group (mean 9.09, SD 0.60, n=35): P=.47, 95% CI -0.21 to 0.46. No harm or unintended effects occurred.
Geriatric patients and their informal caregivers valued robot-assisted and nonrobot-assisted care pathways equally.
ClinicalTrials.gov NCT03857789; https://clinicaltrials.gov/ct2/show/NCT03857789.
Journal Article
DSM-5 : handbook on the cultural formulation interview
by
Lewis-Fernández, Roberto
in
Culturally Competent Care -- methods
,
Ethnopsychology -- methods
,
Interview, Psychological -- methods
2016,2015
Clinicians will, of course, find the DSM-5® Handbook of the Cultural Formulation Interview indispensable, but administrators, policy makers, advocates, and other practitioners who work collaboratively to engage patients in the mental health care process will also value its clarity and comprehensiveness.
Effects of a Sexual Health Interview among Arab American Women: An Experimental Disclosure Study
by
Holmes, Hannah J.
,
Krohner, Shoshana
,
Grekin, Emily R.
in
Adolescent
,
Adult
,
Analysis of covariance
2021
Although sexuality is an important aspect of peoples’ health and well-being, many people—professionals and patients alike—find sexuality uncomfortable to discuss. In Arab culture, certain sexual thoughts and behaviors are taboo, particularly for women, and it is not known whether an interview in which Arab American women disclose their sexuality to a health professional would be well-received and beneficial or upsetting and harmful. This experimental study tested whether engaging in a disclosure-oriented sexual health interview affects Arab American women’s sexual and psychological health. A sample of 134 Arab American women, ages 18–35 years (
M
= 20.6), completed self-report measures of sexual health and attitudes and psychological symptoms, and then were randomized to an interview or control (waitlist) condition. The 60-min disclosure interview inquired about sexual attitudes, experiences, and conflicts. Five weeks later, all participants completed follow-up measures. Post-interview reports suggest that participants responded favorably to the interview and generally benefited from participation. Analyses of covariance (controlling for baseline levels of the outcome measure) indicated that the interview led to significantly greater sexual satisfaction and less discomfort with sexual self-disclosure at 5-week follow-up, compared to controls; the two conditions did not differ on follow-up sexual self-schema, sexual self-esteem, or psychological symptoms. Moderation analyses revealed that participation in the interview differentially improved the sexual self-schema of women with no past sexual experience, compared to women with sexual experience. These experimental findings suggest the value, rather than the risk, of clinicians encouraging Arab American women to openly disclose and discuss their sexual experiences and attitudes in a confidential, empathic setting.
Journal Article
The Use of Simulation to Teach Suicide Risk Assessment to Health Profession Trainees—Rationale, Methodology, and a Proof of Concept Demonstration with a Virtual Patient
by
Chaudhary, Neelam
,
Lok, Benjamin
,
Waller, Jennifer
in
Adult
,
Attitudes
,
Bipolar Disorder - diagnosis
2015
Objective
There is increasing use of educational technologies in medical and surgical specialties. Described herein is the development and application of an interactive virtual patient (VP) to teach suicide risk assessment to health profession trainees. We studied the effect of the following: (1) an interaction with a bipolar VP who attempts suicide or (2) completion of a video-teaching module on interviewing a bipolar patient, on medical students’ proficiency in assessing suicide risk in standardized patients. We hypothesized that students who interact with a bipolar VP will be at least as likely to assess suicide risk, as their peers who completed a video module.
Methods
In a randomized, controlled study, we compared the frequency with which second-year students at the Medical College of Georgia asked suicide risk and bipolar symptoms questions by VP/video group.
Results
We recruited 67 students. The VP group inquired more frequently than the video group in 4 of 5 suicide risk areas and 11 of 14 other bipolar symptomatology areas. There were minimal to small effect sizes in favor of the VP technology. The students preferred the video over the VP as an educational tool (
p
= 0.007).
Conclusions
Our study provides proof of concept that both VP and video module approaches are feasible for teaching students to assess suicide risk, and we present evidence about the role of active learning to improve communication skills. Depending on the learning context, interviewing a VP or observation of a videotaped interview can enhance the students’ suicide risk assessment proficiency in an interview with a standardized patient. An interactive VP is a plausible modality to deliver basic concepts of suicide risk assessment to medical students, can facilitate individual preferences by providing easy access and portability, and has potential generalizability to other aspects of psychiatric training.
Journal Article
The effects of low-intensity narrow-band blue-light treatment compared to bright white-light treatment in sub-syndromal seasonal affective disorder
by
Meesters, Ybe
,
Hommes, Vanja
,
Duijzer, Wianne B.
in
Adult
,
Affect - radiation effects
,
Carbohydrates
2016
Background
The discovery of a novel photoreceptor in the retinal ganglion cells with a highest sensitivity of 470-490 nm blue light has led to research on the effects of short-wavelength light in humans. Several studies have explored the efficacy of monochromatic blue or blue-enriched light in the treatment of SAD. In this study, a comparison has been made between the effects of broad-wavelength light without ultraviolet (UV) wavelengths compared to narrow-band blue light in the treatment of sub-syndromal seasonal affective disorder (Sub-SAD).
Method
In a 15-day design, 48 participants suffering from Sub-SAD completed 20-minute sessions of light treatment on five consecutive days.
22 participants were given bright white-light treatment (BLT, broad-wavelength light without UV 10 000 lux, irradiance 31.7 Watt/m
2
) and 26 participants received narrow-band blue light (BLUE, 100 lux, irradiance 1.0 Watt/m
2
). All participants completed daily and weekly questionnaires concerning mood, activation, sleep quality, sleepiness and energy. Also, mood and energy levels were assessed by means of the SIGH-SAD, the primary outcome measure.
Results
On day 15, SIGH-SAD ratings were significantly lower than on day 1 (BLT 54.8 %, effect size 1.7 and BLUE 50.7 %, effect size 1.9). No statistically significant differences were found on the main outcome measures.
Conclusion
Light treatment is an effective treatment for Sub-SAD. The use of narrow-band blue-light treatment is equally effective as bright white-light treatment.
Trial registration
This study was registered in the Dutch Trial Register (Nederlands Trial Register TC =
4342
) (20-12-2013).
Journal Article
Clinical applications of the adult attachment interview
by
Steele, Miriam
,
Steele, Howard
in
Attachment behavior
,
Attachment behavior -- Testing
,
Attachment disorder
2008,2013
The Adult Attachment Interview (AAI) is both a mainstay of attachment research and a powerful clinical tool. This unique book provides a thorough introduction to the AAI and its use as an adjunct to a range of therapeutic approaches, including cognitive-behavioral therapy, psychoanalytic psychotherapy, parent-infant psychotherapy, home visiting programs, and supportive work in the context of foster care and adoption. Leading authorities provide detailed descriptions of clinical procedures and techniques, illustrated with vivid case material. Grounded in research, the volume highlights how using the AAI can enhance assessment and diagnosis, strengthen the therapeutic alliance, and facilitate goal setting, treatment planning, and progress monitoring.
Consumer Empowerment and Self-Advocacy Outcomes in a Randomized Study of Peer-Led Education
2012
This study examined the effectiveness of the Building Recovery of Individual Dreams and Goals (BRIDGES) peer-led education intervention in empowering mental health consumers to become better advocates for their own care. A total of 428 adults with mental illness were randomly assigned to BRIDGES (intervention condition) or a services as usual wait list (control condition). Interviews were conducted at enrollment, at the end of the intervention, and 6-months post-intervention. Random regression results indicate that, compared to controls, BRIDGES participants experienced significant increases in overall empowerment, empowerment-self-esteem, and self-advocacy-assertiveness, and maintained these improved outcomes over time. Peer-led education interventions may provide participants with the information, skills and support they need to become more actively involved in the treatment decision-making process.
Journal Article