Mcmillanmattingly9952

Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality disorder (BPD) has been adapted for a primary care setting into a 13-week group treatment for emotional intensity difficulties (STEPPS EI). This is the first study to examine the effectiveness and potential outcome and dropout predictors of STEPPS EI in a primary care setting. Severity of BPD, depression, and anxiety symptoms were measured pre- and postintervention for 148 participants. Treatment completers showed improvements in depression, anxiety, and BPD symptoms with medium to large effect sizes. A predictor of symptom improvement was higher baseline severity for each of the symptom measures. Attending a psychoeducational group prior to STEPPS EI was associated with lower odds of dropout. The findings support the use of STEPPS EI in a primary care setting, with the potential to alleviate the burden from other local services.Research shows that parental personality pathology is associated with borderline personality disorder features and internalizing/externalizing symptoms in offspring. However, studies have been limited by DSM-IV-based assessments of parental personality pathology. The authors leveraged evidence that interpersonal problems described by the Interpersonal Circumplex align with Criterion A of the DSM-5 Alternative Model for Personality Disorders and therefore used a measure of interpersonal problems to capture parental personality pathology. The authors hypothesized that parental interpersonal problems would be associated with a latent variable of borderline features in adolescent offspring. They also examined whether this relation with offspring borderline features existed above and beyond relations with offspring internalizing/externalizing symptoms, age, and gender. The sample included 524 inpatient adolescents (Mage = 15.31, 62.4% female) and their parents (80.5% female). Parental interpersonal problems demonstrated unique relationships with adolescent borderline features and externalizing symptoms, but not internalizing symptoms. Implications of the results, limitations, and future directions are discussed.The present era of major cutbacks in intensive treatment programs throughout Europe stresses the importance of evaluating the outcomes of such programs for adolescents with severe personality pathology and comorbidity. Personality pathology has proven to be a valid concept in adolescents, with relatively high prevalence, that needs to be targeted by evidence-based interventions. The present study focused on the evaluation of outcomes of a 12-month mentalization-based treatment for adolescents (MBT-A) program in 118 inpatient adolescents with personality pathology symptoms, using a multi-informant multidomain design. The results showed that during treatment, adolescents improved on general psychiatric symptoms, personality pathology dimensions, and health-related and generic quality of life. Improvement was not only statistically significant, but also clinically important, especially for internalizing domains. Implications for clinical practice and research are discussed.The two polarities model (TPM) of personality organizes psychological assessment and psychotherapy and connects to personality disorder diagnosis using the DSM-5 Alternative Model for Personality Disorders (AMPD). The authors developed scales assessing the TPM from an existing self-report measure for level of personality functioning (LPF), a core component of the AMPD. Iterative content analyses of the LPF measure yielded scales for Autonomy and Communion corresponding to dimensions of the TPM. The scales were refined via internal consistency analyses using a measure of psychological attachment and studied in development and validation samples. Associations with relevant external criteria were explored in a series of multiple regressions. The new content-based LPF scales were illustrated with a case vignette. Although the new Autonomy/Communion scales await further validation prior to clinical use, initial evidence suggests that they may bridge the nomological nets of the TPM and AMPD and potentially offer clinical utility in assessment and treatment planning.

Polypharmacy and specific medication classes are prevalent in older adults. Their relationships with swallowing disorders are not well explored, which would best be managed holistically, with consideration of medication profiles. This study aimed to establish profiles of polypharmacy in older adults and investigate the associations of polypharmacy and medication class with signs of aspiration during swallowing.

This was a secondary retrospective analysis of data from 291 adults aged 60years and older. selleck compound Polypharmacy was profiled numerically and described. Multivariate logistic regression was used to identify associations between medication classes with signs of aspiration, while controlling for independent variables of demographics, functional status, and medical history.

Three distinct profiles of polypharmacy were described. Higher numbers of medications were associated with higher age, lower functional status, nursing home residency, multimorbidity, and showing signs of aspiration. Thirty-four classes of medications were found in this study, benzodiazepines were the only class independently associated with signs of aspiration.

Different profiles of polypharmacy can be observed in older adults, but none were independently associated with signs of aspiration. In addition to known demographic and functional status variables, benzodiazepine-use was found to be independently associated with signs of aspiration (p=.005, B =7.94).

Different profiles of polypharmacy can be observed in older adults, but none were independently associated with signs of aspiration. In addition to known demographic and functional status variables, benzodiazepine-use was found to be independently associated with signs of aspiration (p = .005, B = 7.94).

To address the need for more accurate risk stratification models for cancer immuno-oncology, this study aimed to develop a machine-learned Bayesian network model (BNM) for predicting outcomes in patients with metastatic renal cell carcinoma (mRCC) being treated with immunotherapy.

Patient-level data from the randomized, phase III CheckMate 025 clinical trial comparing nivolumab with everolimus for second-line treatment in patients with mRCC were used to develop the BNM. Outcomes of interest were overall survival (OS), all-cause adverse events, and treatment-related adverse events (TRAE) over 36 months after treatment initiation. External validation of the model's predictions for OS was conducted using data from select centers from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC).

Areas under the receiver operating characteristic curve (AUCs) for BNM-based classification of OS using baseline data were 0.74, 0.71, and 0.68 over months 12, 24, and 36, respectively. AUC for OS at 12 months increased to 0.