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Introduction: The demands on psychometric procedures for therapy research in hyperacusis (HC) and their differentiation from phonophobia, misophonia and recruitment have increased. The widely used noise hypersensitivity questionnaires (GÜF, Nelting and Finlayson, 2004, Germany; Hyperacusis Questionnaire, HQ, Khalfa et al., 2002, France) are partly invalid and repeatedly criticized (Blasing et al., 2010; Fackrell et al., 2015), partly without instructions and without quartiles, implausible cut-point of the HQ. Material and method: We retrospectively evaluated 216 tin-nitus-inpatients (47% women, age 49 ± 10) with the evaluated Structured Tinnitus Interview (STI, Goebel and Hiller, 2002): 60% HC; 15% phonophobia/misophonia; 24.4% without HC. At T1 and T2, we evaluated the sensitivity to change of the individual items of GÜF and HQ, numerical analog scales (NAS), Tinnitus Questionnaire (TF, Goebel and Hiller, 1998), discomfort thresholds (UBS), factor analysis, internal consistency, retest reliability (rtt), d, convergent and discriminative validity, BDI, BDI-II, BSI. Results: Reevaluation GÜF: reliability: α = .93; best test quality item 5, 6, 10, 12, 13; quartiles 0-45, cut-off (AUC) > 16; correlation NAS-HK r = .68, HQ r = .88; TF r = 0.44; Pearson: rtt.83; ICC.93; UBS ≤ .2;; d: r = .57. Reevaluation HQ: reliability: α = .92; best test quality item 5, 8, 9, 12t; quartiles 0-42, cut-off (AUC) > 18; correlation NAS-HK r = .63, GÜF r = .95; TF r = 0.35; Pearson: rtt.84; ICC.87; UBS ≤ .2; d: r = .47. The multidimensional structure of the GÜF and HQ could not be confirmed. Evaluation Mini-HQ9: after a comprehensive individual item analysis, we merged the 9 most change-sensitive (Pearson) and most stable (rit) items from GÜF and HQ into a new "Mini-HQ9": reliability: α = .93; quartiles 0-27; cut-off (AUC) > 11; corr. CFT r = .95; HQ r = .88; common variance 77%; corr. NAS-HK r = .63; TF r = .35; Pearson: rtt.83; ICC. 79; UBS ≤ .2; test-retest d: r = .48. One-dimensional structure. Conclusions: The Mini-HQ9 summarizes the advantages of the GÜF and HQ and has proven itself as a standard instrument for graduation and effect studies of the HK in pilot studies with only 9 items. Women are more sensitive to noise (r = .21). HC instruments are not suitable for misopho-nia. The UBS only for recording relevant side differences. [ABSTRACT FROM AUTHOR]

Background: The length of stay (LOS) strongly influences anorexia nervosa (AN) inpatient weight outcomes. Hence, understanding the predictors of LOS is highly relevant. However, the existing evidence is inconsistent and to draw conclusions, additional evidence is required.Methods: We conducted a prospective, multi-center study including adult female inpatients with AN. Using stepwise linear regression, the following demographic and clinical variables were examined as potential predictors for LOS: admission BMI, AN-subtype, age, age of onset, living situation, partnership status, education, previous hospitalization, self-rated depression, anxiety and somatic symptoms (PHQ-9, PHQ-15, GAD-7), self-rated therapy motivation (FEVER) and eating disorder psychopathology (EDI-2 subscale scores).Results: The average LOS of the sample (n = 176) was 11.8 weeks (SD = 5.2). Longer LOS was associated with lower admission BMI (ß = -1.66; p < .001), purging AN-subtype (ß = 1.91; p = .013) and higher EDI-2 asceticism (ß = 0.12; p = .030). Furthermore, differences between treatment sites were evident.Conclusions: BMI at admission and AN-subtype are routinely assessed variables, which are robust and clinically meaningful predictors of LOS. Health care policies might consider these variables. In light of the differences between treatment sites future research on geographical variations in mental health care seems recommended. [ABSTRACT FROM AUTHOR]

While there is a plethora of evidence for the efficacy of cognitive-behavioural therapy (CBT) in obsessive-compulsive disorder (OCD), studies on change factors of the therapeutic process that account for this success are scarce. In the present study, 155 participants with primary OCD were investigated during CBT inpatient treatment. The Yale-Brown Obsessive-Compulsive Scale-SR served as a measure of symptom severity. In addition, the following process change factors were measured: therapeutic relationship, experience of self-esteem during therapy, experience of mastery, problem actualization and clarification. All variables were assessed on a weekly basis for seven weeks. Linear mixed growth curve analyses were conducted to model the decrease of symptoms over time and to analyse whether the change factors predicted symptom reduction. The analyses revealed a linear decrease of symptoms with high inter-individual variation. Results further showed that increase in self-esteem and mastery experiences as well as the initial score on mastery experience and clarification predicted decrease on the Y-BOCS. We conclude that CBT therapists should focus on clarification in the very first sessions, and try to boost self-esteem and self-efficacy, which is related to mastery, throughout the treatment of OCD. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Increase in mastery and self-esteem experiences are associated with symptom decrease in obsessive-compulsive disorder (OCD) during cognitive-behavioural therapy (CBT)., Initial score of mastery experiences and problem clarification predict symptom decrease in OCD during CBT., CBT therapists should focus on problem clarification in the very first sessions and try to boost self-esteem and self-efficacy throughout the treatment of OCD. [ABSTRACT FROM AUTHOR]

Aim: Empathy is a core element in the doctor-patient relationship. This study examined whether empathy in medical students can be improved by specific training. Methods: 158 medical students were randomized into two groups. The intervention group participated in an empathy skills training with simulated patients (SPs). The control group participated in a history course. After the intervention, empathy was assessed by blinded SPs and experts in an Objective Structured Clinical Examination (OSCE). Students also filled out a self-assessment concerning their attitude on empathy (Jefferson Scale of Physician Empathy Student Version, JSPE-S-S). Results and Conclusions: Participants of the intervention group showed significantly higher levels of empathy when rated by SPs and experts than the control group. In contrast to that, no significant group differences were observed in self-rated empathy. The results underpin the value of empathy skills trainings in medical school study programs. [ABSTRACT FROM AUTHOR]

Introduction: Antidepressant drugs vary in their effects on sleep, day-time sedation and performance. Up to now, no data are available for either escitalopram (ESCIT) or amitriptyline (AMI), measuring these by an objective test, such as the multiple sleep latency test (MSLT). Subjects and Methods: We therefore investigated the impact of a single evening dose of 10 mg ESCIT on polysomnographically recorded nocturnal sleep, day-time sleepiness and performance in comparison to 75 mg AMI and placebo (PLAC) in healthy male subjects. Results: Both antidepressants significantly suppressed REM sleep (p<0.001). Although polysomnographically measured sleep continuity was impaired after ESCIT (p=0.006), subjective estimates of sleep parameters did not differ. Periodic limb movements (PLMS) were increased after AMI (p<0.001) but not after ESCIT. Processing speed and performance were enhanced after ESCIT compared with AMI (p=0.011), but not with PLAC. Next-day alertness was significantly impaired by AMI (p=0.012), but not by ESCIT. Mean day-time sleep onset latencies increased significantly after evening ESCIT (p<0.001). In contrast, AMI led to a pronounced increase of day-time sleepiness (p=0.007). Discussion: This study demonstrates that single evening doses of either AMI or ESCIT exhibit different effects on next-day vigilance and alertness in terms of a slightly stimulating effect of ESCIT and a significant reduction after AMI. [ABSTRACT FROM AUTHOR]

Sleep, Depression and Insomniac Complaints It has been known for long that depressive disorders are almost always accompanied by disturbances of sleep. Neurobiologically oriented sleep research was able to demonstrate that besides unspecific changes of sleep continuity (prolonged sleep onset latency, increased number of waking periods and early morning awakening) there are also specific changes of sleep, like a reduction of slow-wave sleep and a disinhibition of REM sleep in depression. Disinhibition of REM sleep includes phenomena like a shortening of REM latency (i.e. the time between sleep onset and the occurrence of the first REM period) and intensified REM sleep especially at the beginning of the night with an increased REM density (increased frequency of eye movements during REM sleep). These changes have been interpreted within the framework of an animal model of NREM and REM sleep called the reciprocal interaction model. This model postulates that the early occurrence of REM sleep in depression is based on a central nervous imbalance between cholinergic and aminergic neurotransmission. Besides baseline findings of sleep in depression there are other data suggesting a prominent role of sleep and REM sleep regulation for depression. Almost all antidepressants suppress REM sleep, there is a specific therapeutic effect of sleep deprivation in depression and a close link between the occurrence of insomniac symptoms and depression. In this context, it is also worthwhile mentioning that specific cognitive behavioral interventions for insomniac symptoms, such as sleep hygiene, sleep-wake rhythm structuring and cognitive techniques to reduce nocturnal rumination are very effective in the treatment of insomnia. It is also hypothesized that these techniques may serve as a preventive strategy for ensuing depressive disorders. [ABSTRACT FROM AUTHOR]