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Validation of the Dysmorphic Concern Questionnaire (DCQ) in First- Episode Schizophrenia
No full textArticle n. :e70114Acknowledgements
The authors would like to thank all participants.Background: There is evidence that suggests that body dysmorphia represents a risk factor that may occur at the prodromal phase of schizophrenia, affecting ongoing developmental processes and conferring vulnerability to the disease. This study examined the psychometric properties of the Arabic Dysmorphic Concern Questionnaire (DCQ) among patients with a first- episode schizophrenia in a Tunisian, Arabic- speaking context. Method: A cross- sectional study was conducted. Data collection was performed using a traditional paper- and- pencil approach by a single interviewer, who was one of the study's authors. Results: Our findings showed that the unidimensional factor structure of the DCQ holds up in patients with schizophrenia from a Tunisian culture and at an early stage of their disease, and shows excellent reliability (Cronbach's α of 0.91) in this specific population. Measurement invariance was supported in terms of three levels (configural, scalar and metric). Convergent validity of the DCQ was evidenced through significant positive correlations of the scale with abnormal bodily phenomena, muscle dysmorphia and body dissatisfaction. Besides, concurrent validity was demonstrated via significant positive correlations between the DCQ and four other measures: psychological distress, disordered eating, insight and psychotic symptoms severity. Conclusion: The DCQ showed good validity and reliability for measuring dysmorphic concerns in patients with schizophrenia from a Tunisian culture and at an early stage of their disease. The sound psychometric performance of the DCQ, its short administration time, as well as easy scoring and interpretability make it an excellent instrument for use in future clinical and research endeavours
Early Detection of Psychosis – Helpful or Stigmatizing Experience for Those Concerned?
No full textThis chapter provides an overview of the literature on early detection of psychosis concerning stigma and discrimination in individuals with an at-risk mental state (ARMS) for psychosis. Extended surveys about stigma and psychosis/schizophrenia show that these patients belong to the most stigmatized patient groups. Therefore, ARMS individuals are conceivably affected by stigma and its consequences. In response to the recent scientific debate concerning potential stigma associated with an ARMS for psychosis, a small but growing number of studies on the topic have been carried out. The following two questions are addressed in this chapter: (1) do ARMS individuals experience stigma - and if so, what kind of stigma, and (2) are early detection centers contributing to stigma in any form or is the support offered rather experienced as helpful? Special emphasis is placed on the subjective perspective of ARMS individuals. Research reviewed in this chapter suggests that ARMS individuals fear stigma rather than having experienced it. They suffer from fear of negative reactions from peers, leading to concealment of mental issues, social withdrawal and delayed help-seeking. According to the literature reviewed, early detection services help individuals coping with symptoms, social isolation and potential stigma instead of enhancing or causing the latter. More emphasis should be placed on the subjective experiences and perspectives of those concerned in future research. Potential stigma including self-stigmatization should be assessed and included into treatment recommendations for individuals with an ARMS
Duration of untreated psychosis:definition, measurement and association with outcome
No full textIntroduction The course of schizophrenia and other psychotic disorders shows substantial individual variation, suggesting that perhaps something can be done to improve outcome (Wiersma et al., 1998). However, most of the established predictors of outcome, such as gender, age of onset and premorbid adjustment (Harrigan, McGorry & Krstev, 2003), cannot be easily changed. In this respect, duration of untreated psychosis (DUP) is exceptional, because it is potentially modifiable. This raises the exciting possibility that outcome could be improved through early detection programmes aimed at reducing DUP. In this chapter, we will systematically assess the strength and robustness of the association between DUP and outcome; however, as an essential preliminary, we will first consider the difficulties of defining and assessing DUP. Variability of findings in duration of untreated psychosis: what reason? There is much potential for measurement error in a concept as rarefied as DUP, and it is not reassuring that there is such a wide variability in estimates of DUP across studies (Norman & Malla, 2001; Perkins et al., 2005). This variability might be attributed to heterogeneity amongst different psychotic disorders (Keshavan & Schooler, 1992) or to differences between societies and health services. However, it could equally be accounted for by measurement error. We will consider some of the most likely sources of measurement error below. In summary, these are (1) difficulties in defining the onset and offset of untreated psychosis, (2) the problems of retrospective assessment, (3) discrepancies between the accounts of patients and carers, (4) sample bias, and (5) failure to use standardized assessment instruments
Neurocognition and Motor Functioning in the Prediction of Psychosis
No full textMeta-analyses suggest that - among help-seeking individuals - only about one third of those meeting internationally established criteria for an at-risk mental state (ARMS) for psychosis will later develop psychosis and about one third is having a clinical remission within 2 years. Hence, further risk stratification among ARMS individuals is urgently needed to improve the cost-benefit ratio of preventive interventions. Cognitive and motor functioning deficits are promising candidates for improving the prediction of psychosis in ARMS individuals because they are hallmark features of schizophrenic psychoses, they precede the onset of frank psychosis by many years, and they can be assessed at relatively low costs. In this chapter, we critically evaluate the potential of cognitive and motor functioning parameters for improving the prediction of psychosis in ARMS individuals. We first summarize current evidence on cognitive and motor functioning differences between ARMS individuals who later developed psychosis and those who did not and then address the question whether cognitive and motor functioning variables are independently associated with transition to psychosis. Specifically, we review all available studies that included cognitive and/or motor functioning variables into prediction models integrating variables from multiple domains and thereby evaluate their added predictive value. Finally, we provide a detailed discussion of methodological issues in the current research and give recommendations for improvements
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Violence and schizophrenia: the role of social determinants of health and the need for early intervention
No full textVariations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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