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Abstract The Brief Resilience Scale (BRS) was developed to assess individual differences in the ability to recover from stress despite adversity and has been translated into several languages. This study aimed to examine the psychometric properties (i.e., item characteristics, reliability, factor structure, measurement invariance, and validity) of the German version of the BRS in persons with mental disorders. A total of N = 5,986 persons admitted to inpatient treatment completed the German version of the BRS and other questionnaires. The discriminating power of the items, the difficulty of the items, and the internal consistency were all sufficient. Moreover, confirmatory factor analysis supported the two–factor structure of the BRS, consistent with the findings of the German validation study in a non–clinical sample. The BRS also had strict measurement invariance across diagnostic groups for mental disorders according to ICD–10. Validity was examined using a network analysis, in which the BRS demonstrated positive correlations with life satisfaction, self–efficacy and optimism and negative correlations with somatic symptoms, anxiety, insomnia, and depression. The BRS can serve as a reliable and valid tool for assessing resilience in clinical settings, facilitating the identification of persons with potentially lower psychosocial resources.

Abstract Background Some persons with obsessive–compulsive disorder (OCD) refuse or drop out of treatment because of the aversive nature of exposure and response prevention therapy when they have to face and tolerate unpleasant thoughts, emotions, and bodily sensations. Indeed, one study suggested that a higher willingness to experience unpleasant thoughts, emotions, and bodily sensations (WTE) predicts a better treatment outcome, but this finding has not been replicated yet. Methods We examined whether WTE at admission predicted treatment outcome in a sample of 324 inpatients with OCD who received a multimodal treatment that included cognitive-behavioral therapy with exposure and response prevention sessions. Results Obsessive–compulsive symptoms (based on OCD-specific self-report questionnaires) decreased with medium-to-large effect sizes (all ps 0.005). The effect of WTE on treatment outcome remained non-significant when controlling for any comorbidity, age, sex, length of stay, and antidepressant medication and was not moderated by these variables. Conclusions Results indicate that higher WTE at the beginning of inpatient treatment does not facilitate improvements in obsessive–compulsive symptoms from admission to discharge. However, they also indicate that lower WTE at the beginning of inpatient treatment does not adversely affect treatment outcome, that is, even patients who indicate that they are unwilling to face the negative experiences associated with exposure and response prevention can still achieve considerable symptom reductions.

Research has highlighted the relevance of biological measures in explaining antisocial behavior, but the inclusion of such measures in clinical practice is lagging behind. According to the integrative biopsychosocial model, biological measures should be studied together with psychological and social-environmental factors. In this data-driven study, we applied this comprehensive model to explain non-violent and violent delinquency of 876 at-risk youth (715 male, 9–27 years), by combining nine biological (autonomic-nervous-system; endocrinological), nine psychological, and seven social-environmental measures. Using latent-class-regression analysis we uncovered four distinct psychologically-driven biological clusters, which differed in non-violent and violent delinquency-risk, moderated by social-environmental variables: a biological–psychopathic traits; low problem; high problem; and biological–reactive group. Individual vulnerabilities to (non-)violent delinquency depended on social-environmental context that differed between clusters. These findings highlight the importance of biological and psychological factors, in the context of social-environmental factors, in explaining (non)-violent delinquency.

Teaching practical skills is of particular interest in the study of human medicine. With regard to medical statistics this means the use of statistical software, which may be effectively taught by a flipped classroom approach. As a pilot study, we designed and implemented an elective course on medical statistics that focused on hands-on data analysis in SAS Studio. Students independently prepared for class using materials such as pretaped asynchronous lectures, and worked on exercises during synchronous class sessions. On course evaluations completed by n 15 students out of 26, students rated their satisfaction with the course a mean of 1.3 (SD 0.6) on a scale where 1 best and 6 worst. Twelve (80%) indicated that they processed all materials provided, and 11 students (73%) rated the frequency of direct contact with the instructor as sufficient. Nearly all (14 out of 15) viewed the course as an adequate substitute for a full face-to-face course. Our results suggest that the proposed course design is well-accepted. The flipped classroom format offers high flexibility and can be implemented easily online. Our pilot data are encouraging regarding the aim of designing a prospective follow-up study which compares the flipped classroom approach to a teaching format based on attendance.

Teaching medical statistics for students of human medicine should include both theoretical content as well as its implementation in practice using statistical software. The training period with a software may be time-consuming individually, so there is a risk that imparting methodological skills comes up short in such courses. The flipped classroom concept aims at students to familiarize themselves with both the statistical software and the theoretical content in an individual learning phase prior to the course. Then, within an attendance course deepening both aspects under the lecturer’s supervision is possible. Availability of the software as well as a variety of material to prepare the course are essential presumptions for the flipped classroom to be successful. We present the concept and implementation of an online flipped classroom course using the software SAS Studio. Students used their own devices (laptops or tablets) during the self-learning and examination phases, respectively. The pure online implementation in the flipped classroom setting enabled to contribute to an equalisation of the study plan. Moreover, even more students had the opportunity to participate in this practically oriented course in medical statistics. Initial evaluation results demonstrated that the course is well-accepted among students, while the students’ performance level was similar when compared to a non-flipped teaching approach.

BackgroundTherapist-guided exposure and response prevention (ERP) for the treatment of obsessive-compulsive disorder (OCD) is frequently conducted within clinical settings but rarely at places where patients are usually confronted with OCD symptom-provoking situations in daily life (eg, at home). ObjectiveThis study aimed to investigate patients’ views on 1 ERP session at home via videoconference and its impact on treatment outcome. MethodsA total of 64 inpatients with OCD received 1 session of therapist-guided videoconference-based ERP at home in adjunction to a multimodal inpatient treatment between 2015 and 2020. ResultsCompared with 64 age- and sex-matched controls who received a multimodal inpatient treatment without 1 session of videoconference-based ERP at home, patients who received 1 session of videoconference-based ERP in adjunction to a multimodal inpatient treatment showed stronger reductions in OCD symptom severity from admission to discharge. Before the videoconference-based ERP session, patients reported high rationale credibility and treatment expectancy. After the videoconference-based ERP session, patients reported medium-to-high positive mood as well as depth and smoothness of the session, and they perceived the working alliance as high. ConclusionsResults highlight the importance of administering therapist-guided ERP sessions in patients’ natural environment to enhance treatment response in OCD. Videoconference-based ERP as add-on to treatment as usual is, therefore, a promising approach to facilitate the application of ERP in patients’ natural environment and foster the generalization of ERP conducted in clinical settings.

Plain English summary This study shows that obsessive–compulsive symptoms decrease during inpatient treatment of anorexia nervosa. That is, there is no “symptom shift”, which refers to the idea that a reduction of anorexia nervosa symptoms may result in an increase in other symptoms. However, obsessive–compulsive symptoms should still be targeted during psychotherapeutic aftercare in patients who show obsessive–compulsive tendencies.

ABSTRACT Objective Method Results Discussion It is often stated that a higher body mass index (BMI) at the beginning of treatment predicts a better weight outcome at the end of treatment in persons with anorexia nervosa (AN). However, this interpretation is based on the between‐persons relationship of BMI at the two measurements, which primarily reflects the fact that the rank‐ordering of persons according to their BMI is quite stable over time. In contrast, a lower BMI at baseline is related to a larger BMI change, which primarily reflects the fact that the variance of BMI at the end of treatment is larger than that at baseline. This study aimed to demonstrate these relationships empirically and caution against interpreting BMI at baseline as a predictor of BMI at discharge or BMI change.Changes of BMI from admission to discharge were analyzed based on 4863 persons with AN (97% female) who received inpatient treatment between 2015 and 2024.BMI at admission was positively related to BMI at discharge (r = 0.55) but negatively related to BMI change from admission to discharge (r = −0.39).While it is true that a higher BMI at baseline is associated with a higher BMI at the end of treatment, a lower BMI at baseline is actually related to a larger weight gain during treatment. Yet, concluding that the treatment is more effective for patients with low or high BMI at baseline would be incorrect in either case, as the independent and dependent variables are the same variables measured at different time points. [ABSTRACT FROM AUTHOR]

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.

Teaching practical skills is of particular interest in the study of human medicine. With regard to medical statistics this means the use of statistical software, which may be effectively taught by a flipped classroom approach. As a pilot study, we designed and implemented an elective course on medical statistics that focused on hands-on data analysis in SAS Studio. Students independently prepared for class using materials such as pre-taped asynchronous lectures, and worked on exercises during synchronous class sessions. On course evaluations completed by n = 15 students out of 26, students rated their satisfaction with the course a mean of 1.3 (SD 0.6) on a scale where 1 = best and 6 = worst. Twelve (80%) indicated that they processed all materials provided, and 11 students (73%) rated the frequency of direct contact with the instructor as sufficient. Nearly all (14 out of 15) viewed the course as an adequate substitute for a full face-to-face course. Our results suggest that the proposed course design is well-accepted. The flipped classroom format offers high flexibility and can be implemented easily online. Our pilot data are encouraging regarding the aim of designing a prospective follow-up study which compares the flipped classroom approach to a teaching format based on attendance.

Objective Method Results Conclusions In the Diagnostic and Statistical Manual of Mental Disorders‐5, severity of bulimia nervosa (BN) is defined by the frequency of purging behaviour. Previous research suggests the number of purging methods as an alternative rating. The current analysis investigated characteristics (sociodemographic and treatment‐related variables, body mass index [BMI], eating disorder‐specific and general psychopathology) of persons with BN as a function of purging frequency and number of purging methods in order to examine which approach might be better suited for indicating severity of BN.Two‐hundred and sixty‐one persons (98.5% female; mean age 25.2 years, SD = 9.41; mean BMI 22.0 kg/m2, SD = 3.79) with BN completed self‐report questionnaires on eating disorder‐specific and general psychopathology at admission to inpatient (n = 214) or daypatient (n = 47) treatment.Higher severity based on either purging frequency or number of purging methods tended to relate to lower BMI and higher eating disorder‐specific and general psychopathology. In addition, binge‐eating frequency differentially related to eating disorder‐specific and general psychopathology as a function of severity groups.This study partially supports the utility of both purging frequency and the number of purging methods as indicators of severity in persons with BN. However, focussing only on purging behaviours may be short‐sighted as it appears necessary to consider the number of binge‐eating episodes as well when evaluating severity of BN. [ABSTRACT FROM AUTHOR]

The Barratt Impulsiveness Scale–short form (BIS–15) is a questionnaire used to measure impulsivity as a trait. It is a shorter version of the BIS–11. There is no specific cut-off score for the BIS–15 because impulsivity is not a mental disorder and cannot be classified into categories. However, mean scores on the BIS–15 in different samples ranged between 29 and 42, with higher scores seen in samples with conditions associated with elevated impulsivity. The author suggests that scores around 40-45 can be considered "moderately impulsive," while scores above 45 can be seen as "markedly impulsive." It is important to use BIS–15 scores as continuous variables and further research is needed to validate the interpretation guidelines provided. [Extracted from the article]