1,721,003 research outputs found
Interventions aimed at restricted and repetitive behaviours (RRBs) in Autism Spectrum Disorder: systematic review and meta-analysis
Full text linkBackground: Despite being considered a core feature of ASD, restricted and repetitive behaviours (RRBs) have received less attention, if compared to the domain of social interaction and communication, and less frequently targeted by interventions. This is surprising, given their role as major management challenges, obstacles to adaptive functioning and cause of distress for subjects and their families. We conducted a systematic, exhaustive, and up-to-date systematic review and meta-analysis of randomized controlled interventions (RCTs) aimed specifically at RRBs. To avoid methodological limitations found in other reviews, no limitations to the age of the sample, timespan of search and type of intervention were set.
Methods: Web of Knowledge database (including Web of Science, MEDLINE®, KCI – Korean Journal Database, Russian Science Citation Index and SciELO Citation Index) was searched from inception up to January 1st, 2020. Randomized controlled trials in ASD individuals, specifically aimed at RRBs or both core domains were included, following PRISMA guidelines. In a systematic review we analysed the main characteristics of included studies, such as mean age, sample sizes, mean follow up duration, diagnosis of ASD, assessments of IQ and psychiatric comorbidities. Primary outcome of the meta-analysis was the mean reduction of RRBs; effect sizes reported as Hedges’ g and 95% CIs, calculated as differences, from baseline to endpoint, between two compared interventions. Assessments of biases, comprising publication bias, and cumulative analyses were also performed.
Results: Overall, 80 studies (3114 subjects) were included in the systematic review and 46 studies (1339 subjects) in the meta-analytic phase. Included studies were published between 1992 and 2019, mean sample size was 40 patients (in intervention arm), with mean age of 10.5 years and average 19% female participants. Mean follow up was 4 months. IQ assessment was unclear in half of the studies, other psychiatric comorbidities were not disclosed in 61% of the studies. Risk of bias was low in 14 studies (17.5%).
Overall effect size for interventions aimed at RRBs was small, but significantly beneficial ( g = -0.37, Cis -0.26 to -0.47), heterogeneity was moderate (I2 = 43.92%, p < 0.01). Subgroup analyses revealed similar results in the three subtypes of interventions analysed: pharmacological (g = -0.45, CI -0.26 to -0.64), psychotherapy and education (g = -0.42, CI -0.19 to -0.65) and complementary interventions (g = -0.25, CI -0.12 to -0.38). Differences were not significant among intervention types (p = 0.16). Inspection of forest and funnel plots revealed the presence of five outliers, which exclusion reduced heterogeneity significantly, but did not affected substantially the magnitude of overall and subgroup effect sizes. Results were also not affected by small-study effects, but publication bias was probably present since grey/unpublished literature was not searched.
Conclusions: on the basis of current literature aimed specifically at RRBs, there is no robust evidence to favour any specific intervention for improving RRBs in subjects with ASD, even if small effects were detected for any intervention type analysed
Psychological, psychiatric, and behavioral sciences measurement scales: best practice guidelines for their development and validation
No full textPsychiatric, psychological, and behavioral sciences scales provide quantitative representations of phenomena such as emotions, beliefs, functioning, and social role perceptions. Methodologists and researchers have criticized current scale development practices, emphasizing that inaccurate measurements can derail theory development and clinical decisions, thereby impeding progress in mental health research and practice. These shortcomings often stem from a lack of understanding of appropriate scale development techniques. This article presents a guide to scope, organize, and clarify the process of scale development and validation for psychological and psychiatric use by integrating current methodological literature with the authors’ real-world experience. The process is divided into five phases comprising 18 steps. In the Preliminary Phase, the need for a new scale is assessed, including a review of existing measures. In the Item Development Phase, the construct is defined, and an initial pool of items is generated, incorporating literature reviews, expert feedback, and target population evaluation to ensure item relevance and clarity. During the Scale Construction Phase, the scale is finalized through the administration of surveys to a large sample, followed by parallel analysis, exploratory factor, and item descriptive statistics to identify functional items. In the Scale Evaluation Phase, the dimensionality, reliability, and validity of the scale are rigorously tested using both classical and modern psychometric techniques. Finally, in the Finalization Phase, the optimal item sequence is decided, and a comprehensive inventory manual is prepared. In sum, this structured approach provides researchers and clinicians with a comprehensive methodology for developing reliable, valid, and user-friendly psychological, psychiatric, and behavioral sciences measurement scales
Complementary and Alternative Therapies for Autism Spectrum Disorder
Full text linkBackground. Complementary and alternative medicine (CAM) represents a popular therapeutic option for patients with autism spectrum disorder (ASD). Unfortunately, there is a paucity of data regarding the efficacy of CAM in ASD. The aim of the present systematic review is to investigate trials of CAM in ASD. Material and Methods. We searched the following databases: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, Psychology and Behavioral Sciences Collection, Agricola, and Food Science Source. Results. Our literature search identified 2687 clinical publications. After the title/abstract screening, 139 publications were obtained for detailed evaluation. After detailed evaluation 67 studies were included, from hand search of references we retrieved 13 additional studies for a total of 80. Conclusion. There is no conclusive evidence supporting the efficacy of CAM therapies in ASD. Promising results are reported for music therapy, sensory integration therapy, acupuncture, and massage
Prevalence of tobacco smoking in people at clinical high-risk for psychosis: Systematic review and meta-analysis
No full text: Several hypotheses have been proposed to explain why individuals with psychosis consume more tobacco compared with the general population, but the reasons remain unclear. The phases predating the onset of psychosis could provide an interesting framework to clarify this association. The aim of this systematic review and meta-analysis is to provide an updated and comprehensive synthesis of the association between tobacco smoking and Clinical High Risk for Psychosis (CHRP) status. We performed a multistep systematic PRISMA/MOOSE-compliant electronic search for articles published from inception until October 1st, 2021. Web of Science was searched, complemented by a manual search of original articles reporting the outcome of tobacco consumption (defined as the number of individuals which were smoking tobacco at baseline) in a group of CHR-P patients versus healthy controls (HC). We employed quality assessment of the included studies with Newcastle Ottawa Scale (NOS). The effect size for the primary outcome was the odds ratio (OR) of smoking tobacco in CHR-P samples vs HC. We performed a random-effects model meta-analysis, assessment of heterogeneity with I2 index, sensitivity analyses excluding one study at a time for primary outcome, meta-regressions with four independent moderators (mean age, female ratio, sample size, NOS) and assessment of publication bias with funnel plot and Egger's test. We included 21 independent articles, totalling 2018 CHR-P individuals (mean age of 21.35 ± 2.91 years and average female ratio of 41 ± 7 %) and 1160 HC (mean age of 22.42 ± 3.70 years and average female ratio of 45 ± 11 %). The NOS score was 6.52 ± 1.25 (range from 0 to 9). The OR of smoking status was 2.22 (95%CI 1.74-2.84, p < 0.01). Heterogeneity (I2) was 24.09 (p = 0.16). Sensitivity analyses, removing one study at a time, revealed the robustness of our main finding. Meta-regressions did not reveal any significant association between the moderators and the main outcome. Visual inspection of the funnel plot and Egger's test did not reveal evident publication bias. Our main finding of an increased OR of smokers in the CHR-P individuals compared to healthy controls corroborates the accumulation of unhealthy lifestyles in this vulnerable group. This does not demonstrate any causal association between tobacco smoking and incidence of psychosis, which should be investigated in future prospective cohorts. In conclusion, the window of opportunity represented by CHR-P status should involve more efficient physical health screening and better investigating the aetiological impact of smoking in the development of psychosis
Physical Health in Clinical High Risk for Psychosis Individuals: A Cross-Sectional Study
No full textBackground: The clinical high risk for psychosis (CHR-P) phase represents an opportunity for prevention and early intervention in young adults, which also could focus on improving physical health trajectories. Methods: We conducted a RECORD-compliant clinical register-based cohort study. The primary outcome was to describe the physical health of assessed CHR-P individuals, obtained via Electronic Health Records at the South London and Maudsley (SLaM) NHS Foundation Trust, UK (January 2013–October 2020). Results: The final database included 194 CHR-P subjects (46% female). Mean age was 23.70 ± 5.12 years. Percentage of tobacco smokers was 41% (significantly higher than in the age-matched general population [24%]). We found that 49% of subjects who consumed alcohol had an AUDIT-C (Alcohol Use Disorder Identification Test) score above 5 (hazardous drinking), with an average score of 4.94 (significantly higher than in the general population [2.75]). Investigating diet revealed low fiber intake in most subjects and high saturated fat intake in 10% of the individuals. We found that 47% of CHR-P subjects met the UK recommended physical activity guidelines (significantly lower than in the general population [66%]). Physical parameters (e.g., weight, heart rate, blood pressure) were not significantly different from the general population. Conclusions: This evidence corroborates the need for monitoring physical health parameters in CHR-P subjects, to implement tailored interventions that target daily habits
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Variations on the Author
Full text link“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
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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