Pathways to inflated responsibility beliefs in adolescent obsessive-compulsive disorder: a preliminary investigation

Background: An inflated sense of responsibility is characteristic of obsessive-compulsive disorder (OCD). No previous studies have investigated its origins. Five potential pathways to inflated responsibility beliefs have been proposed; these are tested in this study. Method: A novel measure, the Origins Questionnaire for Adolescents (OQA), was developed to assess experiences on these five pathways. Reliability of the OQA was investigated. The experiences on the five pathways to inflated responsibility beliefs of sixteen adolescents with a history of OCD were compared to sixteen adolescents with no history of OCD. Parents also reported on adolescents’ experiences on the five pathways. Results: Inter-rater reliability was high. The internal consistency of the subscales were only partly satisfactory. The groups differed on one pathway; the clinical group reported a higher sense of responsibility for significant incidents with a negative outcome prior to onset of OCD. Conclusions: An inflated sense of responsibility, in combination with the occurrence of specific incidents, might act as a vulnerability factor for development of OCD. Future research should consider how to measure the subtle effects of experiences of responsibility over the course of development.

Early identification of stimulant treatment responders, partial responders and non-responders using objective measures in children and adolescents with hyperkinetic disorder

Background: The aim of this study was to evaluate stimulant medication response following a single dose of methylphenidate (MPH) in children and young people with hyperkinetic disorder using infrared motion analysis combined with a continuous performance task (QbTest system) as objective measures. The hypothesis was put forward that a moderate testdose of stimulant medication could determine a robust treatment response, partial response and non-response in relation to activity, attention and impulse control measures. Methods: The study included 44 children and young people between the ages of 7-18 years with a diagnosis of hyperkinetic disorder (F90 & F90.1). A single dose-protocol incorporated the time course effects of both immediate release MPH and extended release MPH (Concerta XL, Equasym XL) to determine comparable peak efficacy periods post intake. Results: A robust treatment response with objective measures reverting to the population mean was found in 37 participants (84%). Three participants (7%) demonstrated a partial response to MPH and four participants (9%) were determined as non-responders due to deteriorating activity measures together with no improvements in attention and impulse control measures. Conclusion: Objective measures provide early into prescribing the opportunity to measure treatment response and monitor adverse reactions to stimulant medication. Most treatment responders demonstrated an effective response to MPH on a moderate testdose facilitating a swift and more optimal titration process.

Identifying likely successful users of virtual reality systems

This paper suggests a method for identifying individuals who are most suited to using virtual reality (VR) systems. The aim is to help both an individual or employer to decide where that individual's skills and abilities would be best deployed. By considering a potential user's competence and temperament, a graphical representation is introduced that may then be used to crudely delineate a high-aptitude participant against those with lesser capabilities. By introducing standard tests for competence and a standard classifier for temperament, and by further weighting each measure with respect to the technology currently available and the application, a detailed representation of the effectiveness of different users is developed.

Atmospheric blocking and mean biases in climate models

Models often underestimate blocking in the Atlantic and Pacific basins and this can lead to errors in both weather and climate predictions. Horizontal resolution is often cited as the main culprit for blocking errors due to poorly resolved small-scale variability, the upscale effects of which help to maintain blocks. Although these processes are important for blocking, the authors show that much of the blocking error diagnosed using common methods of analysis and current climate models is directly attributable to the climatological bias of the model. This explains a large proportion of diagnosed blocking error in models used in the recent Intergovernmental Panel for Climate Change report. Furthermore, greatly improved statistics are obtained by diagnosing blocking using climate model data corrected to account for mean model biases. To the extent that mean biases may be corrected in low-resolution models, this suggests that such models may be able to generate greatly improved levels of atmospheric blocking.

European Union

Determination of shadow notifications of domestic support for agriculture in the European Union under the WTO (World Trade Organization) Agreement on Agriculture, and consideration of the potential impact of an agreement in the Doha Round of multilateral trade negotiations.

Bistability of the Atlantic overturning circulation in a global climate model and links to ocean freshwater transport

The possibility of a rapid collapse in the strength of the Atlantic meridional overturning circulation (AMOC), with associated impacts on climate, has long been recognized. The suggested basis for this risk is the existence of two stable regimes of the AMOC (‘on’ and ‘off’), and such bistable behaviour has been identified in a range of simplified climate models. However, up to now, no state-of-the-art atmosphere-ocean coupled global climate model (AOGCM) has exhibited such behaviour, leading to the interpretation that the AMOC is more stable than simpler models indicate. Here we demonstrate AMOC bistability in the response to freshwater perturbations in the FAMOUS AOGCM - the most complex AOGCM to exhibit such behaviour to date. The results also support recent suggestions that the direction of the net freshwater transport at the southern boundary of the Atlantic by the AMOC may be a useful physical indicator of the existence of bistability. We also present new estimates for this net freshwater transport by the AMOC from a range of ocean reanalyses which suggest that the Atlantic AMOC is currently in a bistable regime, although with large uncertainties. More accurate observational constraints, and an improved physical understanding of this quantity, could help narrow uncertainty in the future evolution of the AMOC and to assess the risk of a rapid AMOC collapse.

Randomized controlled trial of full and brief cognitive-behaviour therapy and wait-list for paediatric obsessive-compulsive disorder

Background: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to evaluate effectiveness and optimal delivery of CBT, emphasizing cognitive interventions. Methods: A total of 96 children and adolescents with OCD were randomly allocated to the three conditions each of approximately 12 weeks duration: full CBT (average therapist contact: 12 sessions) and brief CBT (average contact: 5 sessions, with use of therapist-guided workbooks), and wait-list/delayed treatment. The primary outcome measure was the child version of the semi-structured interviewer-based Yale-Brown Obsessive Compulsive Scale. Clinical Trial registration: http://www.controlled-trials.com/ISRCTN/; unique identifier: ISRCTN29092580. Results: There was statistically significant symptomatic improvement in both treatment groups compared with the wait-list group, with no significant differences in outcomes between the two treatment groups. Controlled treatment effect sizes in intention-to-treat analyses were 2.2 for full CBT and 1.6 for brief CBT. Improvements were maintained at follow-up an average of 14 weeks later. Conclusions: The findings demonstrate the benefits of CBT emphasizing cognitive interventions for children and adolescents with OCD and suggest that relatively lower therapist intensity delivery with use of therapist-guided workbooks is an efficient mode of delivery.