Visual Assessment of Therapeutic Relationships in Psychiatric Patients: A Pilot Study Using the Pictorial Representation of Illness and Self Measure.

BACKGROUND: Although the therapeutic relationship (or 'alliance') is well known to be a key component of psychiatric treatment, there has been no simple way to objectively measure the patient-therapist relationship. Here, we measured the psychological distance between patients and their therapists by using the Pictorial Representation of Illness and Self Measure (PRISM). PATIENTS AND METHODS: We analyzed the patient-therapist relationship of 112 patients from two hospitals in Japan (54 males, 57 females, 1 unknown; age 46.20 ± 15.03 years [mean ± SD]) who completed the PRISM and self report questionnaires (LSNS-6, K6, and BASIS-32) about their social network, psychological distress, and outcomes of mental health treatment. RESULTS: PRISM measurements were available for all patients who consented to participate. In the comparison by disease category, schizophrenia recorded the closest distance to the psychiatrist in charge, followed by bipolar disorder, depression, and neurotic disorder. Regarding the distance to the psychiatrist in charge, PRISM showed a weak negative correlation (r = -0.23, p < 0.05) with age, indicating that with increasing age, the therapeutic rela tionship was more important to the patients. CONCLUSION: Our findings indicate the possibility of implementing PRISM to assess the impact of the therapeutic relationship in patients with a wide range of psychiatric disorders, and they suggest that PRISM holds great potential for clinical application.

Screening for psychotrauma related symptoms: Japanese translation and pilot testing of the Global Psychotrauma Screen.

Background: The impact of traumatic experiences or adverse life experiences has been shown to potentially affect a wide range of mental health outcomes. However, there was no brief instrument to screen for a range of psychological problems in different domains after a potentially traumatic event, and for risk factors and protective factors. Objective: The aim of this study is to examine the internal consistency and concurrent validity of the Japanese version of the Global Psychotrauma Screen (GPS) in a traumatized sample in Japan. Method: A total sample (n = 58) with varying levels of potential posttrauma symptoms due to domestic violence or other events were recruited into this study. Self-rating measures of posttraumatic stress disorder (PTSD), depression, anxiety, and alcohol problems were conducted to investigate the concurrent validity. Results: The results show that a range of posttrauma symptoms assessed by the GPS were highly endorsed by this traumatized sample in all domains except for self-harm, derealization, and depersonalization. The GPS sum score was highly correlated (r > 0.79) with other measures of PTSD, depression, and anxiety symptoms. Also, the subdomain scores showed acceptable correlations with corresponding domain measures. Participants who had been sexually assaulted or had unwanted sexual experiences, and participants who had been physically assaulted during childhood, had higher scores on the total GPS and on subdomains of PTSD, as well as symptoms associated with Complex PTSD. Conclusions: This study provides an initial indication that the GPS may be a useful screening tool for trauma survivors and elucidates that the consequences of trauma are not limited to PTSD.

Antecedentes: Se ha demostrado que el impacto de las experiencias traumáticas o de las experiencias vitales adversas tiene el potencial de comprometer la salud mental dentro de un amplio rango de consecuencias. Sin embargo, no existía ningún instrumento breve para tamizar una variedad de problemas psicológicos, en diferentes dominios, después de un evento potencialmente traumático, ni para los factores de riesgo, ni para los factores protectores.Objetivo: El objetivo de este estudio es el de examinar la consistencia interna y la validez concurrente de la versión japonesa del Mapeo Global de Psicotrauma (GPS, por sus siglas en ingles) en una muestra de personas traumatizadas en Japón.Método: Para este estudio, se reclutó una muestra total (n=58) con distintos niveles de síntomas postraumáticos potenciales secundarios a violencia domestica u otros eventos. Para investigar la validez concurrente, se realizaron mediciones auto reportadas para el trastorno de estrés postraumático (TEPT), la depresión, la ansiedad y para problemas asociados al consumo de alcohol.Resultados: Los resultados muestran que un espectro de síntomas postraumáticos, evaluados mediante el GPS, se encontraba altamente vinculado a esta muestra de personas traumatizadas en todos los dominios, a excepción de las autolesiones, la desrealización, y la despersonalización. El puntaje final del GPS se encontraba altamente correlacionado (r > 0,79) con otras mediciones del TEPT, la depresión y los síntomas ansiosos. Además, los puntajes de los subdominios del GPS mostraron una correlación aceptable con las medidas de dominios correspondientes. Los participantes que habían sido agredidos sexualmente o habían tenido experiencias sexuales no deseadas, y los participantes que habían sido agredidos físicamente durante su infancia mostraban puntajes más altos en el GPS total y en los subdominios del TEPT, así como para los síntomas asociados al TEPT complejo.Conclusiones: Este estudio proporciona un primer indicio de que el GPS podría ser una herramienta de tamizaje útil para sobrevivientes al trauma, y esclarece que las consecuencias del trauma no se limitan al TEPT.

The C-terminal region of the 2a protein and 2b protein of cucumber mosaic virus are involved in the induction of shoestring-like leaf blade in tomato.

Cucumber mosaic virus (CMV) has numerous strains with distinct pathological properties in nature. In this study, we focused on the distinct host-specificity of two isolates of CMV regarding induction of the shoestring-like leaf blade (SLB) in tomato (Solanum lycopersicum cv. Sekaiichi). During the initial infection stage, plants inoculated with CMV-D8 and CMV-Y developed green/yellow systemic mosaic and stunting. Late in infection, CMV-D8 caused severe systemic symptoms with SLB on the newly emerged leaves, whereas CMY-Y caused severe yellow mosaic with stunting. Accumulation of viral RNA of CMV-D8 during initial infection was higher than for CMV-Y, but their levels did not differ significantly at 5 weeks post inoculation. Pseudorecombination and recombination analyses between CMV-D8 and CMV-Y genomic RNAs showed that recombinant that contained the C-terminal region of 2a and the entire 2b protein of CMV-D8 (D2a-C/D2b) induced SLB. Changing isoleucine to valine at position 830 in the 2a ORF played an important role in formation of chronic SLB. We further elucidated that infection with CMV-D8 or the recombinant Y1Y2(D2a-C/D2b)D3, but not with CMV-Y, upregulated miRNAs and transcript levels of AGO1, which is involved in RNA silencing, and of HD-ZIP, TCP4, and PHAN, which are essential for leaf morphogenesis. The present results first demonstrated that the cooperative function of D2a-C/D2b is involved indispensably in SLB formation. In addition, we suggest that D2a-C/D2b region interferes with the miRNA pathway that is associated with RNA silencing and leaf morphogenesis, leading to the enhanced virulence of CMV-D8.

Workplace Violence and Its Effects on Burnout and Secondary Traumatic Stress among Mental Healthcare Nurses in Japan.

Workplace violence (WPV) in healthcare settings has drawn attention for over 20 years, yet few studies have investigated the association between WPV and psychological consequences. Here, we used a cross-sectional design to investigate (1) the 12-month prevalence of workplace violence (WPV), (2) the characteristics of WPV, and (3) the relationship between WPV and burnout/secondary traumatic stress among 599 mental healthcare nurses (including assistant nurses) from eight hospitals. Over 40% of the respondents had experienced WPV within the past 12 months. A multivariate logistic regression analysis indicated that occupation and burnout were each significantly related to WPV. Secondary traumatic stress was not related to WPV. Our results suggest that WPV may be a long-lasting and/or cumulative stressor rather than a brief, extreme horror experience and may reflect specific characteristics of psychological effects in psychiatric wards. A longitudinal study measuring the severity and frequency of WPV, work- and non-work-related stressors, risk factors, and protective factors is needed, as is the development of a program that helps reduce the psychological burden of mental healthcare nurses due to WPV.

The 2b protein and C-terminal region of the 2a protein indispensably facilitate systemic movement of cucumber mosaic virus in radish with supplementary function by either the 3a or the coat protein.

BACKGROUND: In Raphanus sativus (Japanese radish), strain D8 of cucumber mosaic virus (CMV-D8) establishes a systemic infection and induces mild mosaic on upper, non-inoculated leaves, whereas strain Y of CMV (CMV-Y) causes only a local infection in the inoculated leaves. Here, we further analyzed the specific viral factor(s) of CMV-D8 that is (are) indispensable for systemic infection in Japanese radish. METHODS: To identify which genomic RNA(s) is (are) involved in systemic infection in radish, we carried out a pseudorecombination analysis between CMV-D8 and CMV-Y. With recombination analyses between CMV-D8 and CMV-Y using mutant/recombinant RNA2s, chimeric and point-mutated RNA3s, we identified viral factors that are indispensable for systemic infection. RESULTS: Viral RNA2 and RNA3 of CMV-D8 facilitated efficient virus spread into the upper, non-inoculated plant tissues of radish (cv. Tokinashi), but not those of CMV-Y. Recombinant RNA2s demonstrated that the 2b protein (2b) and the C-terminus of the 2a protein (2a) of CMV-D8 have a crucial role in systemic infection. In addition, we used chimeric and point-mutated RNA3s to that Pro17 and Pro129 in the coat protein (CP) of CMV-D8 are involved in efficient systemic infection and that Ser51 in the 3a protein (3a) of CMV-D8 has positive effects on systemic spread. The results suggested that these viral factors facilitate systemic infection of CMV-D8 in Japanese radish. CONCLUSION: The C-terminal region of 2a, the entire region of 2b, and supplementary function of either Ser51 in 3a or Pro17/Pro 129 in CP confer systemic infectivity on CMV-D8 in radish. These results further elucidate the complex interaction of viral proteins of CMV to complete systemic infection as a host-specific manner.

Role of salicylic acid glucosyltransferase in balancing growth and defence for optimum plant fitness.

Salicylic acid (SA), an essential secondary messenger for plant defence responses, plays a role in maintaining a balance (trade-off) between plant growth and resistance induction, but the detailed mechanism has not been explored. Because the SA mimic benzothiadiazole (BTH) is a more stable inducer of plant defence than SA after exogenous application, we analysed expression profiles of defence genes after BTH treatment to better understand SA-mediated immune induction. Transcript levels of the salicylic acid glucosyltransferase (SAGT) gene were significantly lower in BTH-treated Nicotiana tabacum (Nt) plants than in SA-treated Nt control plants, suggesting that SAGT may play an important role in SA-related host defence responses. Treatment with BTH followed by SA suppressed SAGT transcription, indicating that the inhibitory effect of BTH is not reversible. In addition, in BTH-treated Nt and Nicotiana benthamiana (Nb) plants, an early high accumulation of SA and SA 2-O-ß-d-glucoside was only transient compared to the control. This observation agreed well with the finding that SAGT-overexpressing (OE) Nb lines contained less SA and jasmonic acid (JA) than in the Nb plants. When inoculated with a virus, the OE Nb plants showed more severe symptoms and accumulated higher levels of virus, while resistance increased in SAGT-silenced (IR) Nb plants. In addition, the IR plants restricted bacterial spread to the inoculated leaves. After the BTH treatment, OE Nb plants were slightly larger than the Nb plants. These results together indicate that SAGT has a pivotal role in the balance between plant growth and SA/JA-mediated defence for optimum plant fitness.