Development and Validation of the Young Parenting Inventory (YPI-R3) for Measuring Past Deviant and Normal Variations in Parenting.

Most measures of past parenting patterns have a restricted range of about two to three negative parenting constructs. The Young Parenting Inventory (YPI-R2) provides a more nuanced framework that measures a fuller spectrum of these negative parenting patterns and, therefore, holds the potential of being a more useful guide to parents and caretakers. The YPI-R2 is made up of six validated subscales. An additional four were identified but were not sufficiently robust to be included. The purpose of this study is to determine if these four scales can be strengthened through the development of additional items and be empirically validated. Using non-clinical, English-speaking community samples from Singapore (n = 592, 628) and Malaysia (n = 222, 229), these revised scales were tested using multiple exploratory factor analyses with fathers and mothers rated separately. After further scale refinement, the final model, which consisted of 10 subscales and 41 items, was then subjected to confirmatory factor analysis using 4 other non-clinical international samples with separate ratings for fathers and mothers-USA (n = 259, 281), South Africa (n = 318, 372), Nigeria (n = 328, 344) and India (n = 277, 289). The results show that the YPI-R3 with 10 subscales is a robust and cross-culturally acceptable model. Correlations and hierarchical multiple regression analyses showed that the YPI-R3 has good convergent validity and predictive capabilities with measures of psychopathology, personality traits, emotional distress, negative schemas and other distal measures of functioning in everyday life-gratitude, humor and satisfaction with life.

Effectiveness of Predominantly Group Schema Therapy and Combined Individual and Group Schema Therapy for Borderline Personality Disorder: A Randomized Clinical Trial.

IMPORTANCE: Schema therapy (ST), delivered either in an individual or group format, has been compared with other active treatments for borderline personality disorder (BPD). To our knowledge, the 2 formats have not been compared with treatment as usual (TAU) or with each other. Such comparisons help determine best treatment practices. OBJECTIVE: To evaluate whether ST is more effectively delivered in a predominantly group or combined individual and group format and whether ST is more effective than optimal TAU for BPD. DESIGN, SETTING, AND PARTICIPANTS: In this multicenter, 3-arm randomized clinical trial conducted at 15 sites in 5 countries (Australia, Germany, Greece, the Netherlands, and the UK), outpatients aged 18 to 65 years who had BPD were recruited between June 29, 2010, and May 18, 2016, to receive either predominantly group ST (PGST), combined individual and group ST (IGST), or optimal TAU. Data were analyzed from June 4, 2019, to December 29, 2021. INTERVENTIONS: At each site, cohorts of 16 to 18 participants were randomized 1:1 to PGST vs TAU or IGST vs TAU. Both ST formats were delivered over 2 years, with 2 sessions per week in year 1 and the frequency gradually decreasing during year 2. Assessments were collected by blinded assessors. MAIN OUTCOMES AND MEASURES: The primary outcome was the change in BPD severity over time, assessed with the Borderline Personality Disorder Severity Index (BPDSI) total score. Treatment retention was analyzed as a secondary outcome using generalized linear mixed model survival analysis. RESULTS: Of 495 participants (mean [SD] age, 33.6 [9.4] years; 426 [86.2%] female), 246 (49.7%) received TAU, 125 (25.2%) received PGST, and 124 (25.0%) received IGST (1 of whom later withdrew consent). PGST and IGST combined were superior to TAU with regard to reduced BPD severity (Cohen d, 0.73; 95% CI, 0.29-1.18; P < .001). For this outcome, IGST was superior to TAU (Cohen d, 1.14; 95% CI, 0.57-1.71; P < .001) and PGST (Cohen d, 0.84; 95% CI, 0.09-1.59; P = .03), whereas PGST did not differ significantly from TAU (Cohen d, 0.30; 95% CI, -0.29 to 0.89; P = .32). Treatment retention was greater in the IGST arm than in the PGST (1 year: 0.82 vs 0.72; 2 years: 0.74 vs. 0.62) and TAU (1 year: 0.82 vs 0.73; 2 years: 0.74 vs 0.64) arms, and there was no significant difference between the TAU and PGST arms (1 year: 0.73 vs 0.72; 2 years: 0.64 vs 0.62). CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, IGST was more effective and had greater treatment retention compared with TAU and PGST. These findings suggest that IGST is the preferred ST format, with high retention and continuation of improvement in BPD severity after the completion of treatment. TRIAL REGISTRATION: trialregister.nl Identifier: NTR2392.

The Good Enough Parenting early intervention schema therapy based program: Participant experience.

BACKGROUND AND OBJECTIVES: Schema therapy (ST) has become a mainstream therapy for the treatment of psychopathology and has been validated through a series of large scale, international randomized control trials. Among other things, schema therapy emphasizes the meeting of core emotional needs in children by primary caregivers as these unmet needs continue to adversely affect their lives into adulthood. An early intervention parenting program has been developed to help parents meet these core emotional needs in order to prevent the development of psychopathology in the first place. The program, Good Enough Parenting, is equally focused on reducing problems and strengthening parenting practices, regardless of where the child is on the "disordered to well-being continuum". This study aims to explore "patient experience" by users of this program. Best clinical research guidelines advocate that participants should be used as collaborators rather than pure recipients; this process should predate large scale trials. DESIGN: An exploratory qualitative study with 55 parent-participants of Good Enough Parenting was conducted. METHODS: One-to-one interviews were conducted with participants, using critical incident technique and guided by semi-structured interview schedule, to explore their experiences with the program. Transcripts were then analyzed using thematic analysis. RESULTS: Coding showed a high degree of inter-rater reliability (kappa value of 0.78). The themes that emerged were Cultivating Awareness of Parents' Own Schemas, Cultivating Intentionality, Working through Developmental Issues, Responses to Challenges at Home, Performing Multiple Roles, and the Learning Process. Participants overwhelmingly reported satisfaction within these key themes. CONCLUSIONS: The results support the development of the program and the choice of "participant reported outcome measures" for use in subsequent randomized controlled trials.

Development and Validation of the Positive Parenting Schema Inventory (PPSI) to Complement the Young Parenting Inventory (YPI) for Schema Therapy (ST).

The factor structure of an initial item pool of 207 positive parenting items was investigated (Manila; n = 520, 538) to develop the Positive Parenting Schema Inventory. Single group and multigroup confirmatory factor analyses of the Positive Parenting Schema Inventory showed invariance of the factor structure in six out of the seven levels on two other independent samples (Eastern, Indonesia; n = 366, 383; Western, the United States; n = 204, 214). Good values for reliability were obtained for its seven subscales (50 items) using coefficient omegas (.71 to .95). Evidence of validity based on test content, response processes (item responses to desired inferences), internal structure (exploratory and confirmatory factor analyses), relations to other variables (correlations with other instruments), and consequences of testing (correlations with positive schemas) were demonstrated. A core tenet of schema therapy theory was supported in that recall of past positive parenting patterns were associated with current levels of positive schemas.

Modulating autophagy as a therapeutic strategy for the treatment of paediatric high-grade glioma.

Paediatric high-grade gliomas (pHGG) represent a therapeutically challenging group of tumors. Despite decades of research, there has been minimal improvement in treatment and the clinical prognosis remains poor. Autophagy, a highly conserved process for recycling metabolic substrates is upregulated in pHGG, promoting tumor progression and evading cell death. There is significant crosstalk between autophagy and a plethora of critical cellular pathways, many of which are dysregulated in pHGG. The following article will discuss our current understanding of autophagy signaling in pHGG and the potential modulation of this network as a therapeutic target.

Psychometric validation of the Young Parenting Inventory - Revised (YPI-R2): Replication and Extension of a commonly used parenting scale in Schema Therapy (ST) research and practice.

This study aimed at developing a revised validated version of the Young Parenting Inventory (YPI) known as YPI-R2 that had 17 theoretical subscales. Using separate ratings for fathers and mothers samples from Singapore (n = 582, 617), Manila (n = 520, 538), Jakarta (n = 366, 383), and the USA (n = 204, 214), exploratory and confirmatory factor analysis (CFA) were conducted. This resulted in five subscales for fathers and six for mothers. The 17 theoretical subscales were not supported. Construct, convergent, and divergent validity of this new revised alternative YPI-R2 were also demonstrated. The stringent incremental validity test showed that the YPI-R2 accounted for additional statistically significant variance over and above that contributed by gender and three other established parenting instruments in predicting clinically relevant outcomes. Partial invariance of its factor structure was demonstrated through multigroup CFA using Eastern and Western samples. Finally, significant correlations with the 18 Early Maladaptive Schemas (EMSs) supported a central tenet of schema therapy that these are associated with early negative parenting patterns. Parenting norms in both Eastern and Western cultures that were associated with ill-being were also discussed thus showing the cross-cultural relevance of the YPI-R2.

Positive clinical psychology and Schema Therapy (ST): The development of the Young Positive Schema Questionnaire (YPSQ) to complement the Young Schema Questionnaire 3 Short Form (YSQ-S3).

Negative schemas have been widely recognized as being linked to psychopathology and mental health, and they are central to the Schema Therapy (ST) model. This study is the first to report on the psychometric properties of the Young Positive Schema Questionnaire (YPSQ). In a combined community sample (Manila, Philippines, n = 559; Bangalore, India, n = 350; Singapore, n = 628), we identified a 56-item, 14-factor solution for the YPSQ. Multigroup confirmatory factor analysis supported the 14-factor model using data from two other independent samples: an Eastern sample from Kuala Lumpur, Malaysia (n = 229) and a Western sample from the United States (n = 214). Construct validity was demonstrated with the Young Schema Questionnaire 3 Short Form (YSQ-S3) that measures negative schemas, and divergent validity was demonstrated for 11 of the YPSQ subscales with their respective negative schema counterparts. Convergent validity of the 14 subscales of YPSQ was demonstrated with measures of personality dispositions, emotional distress, well-being, trait gratitude, and humor styles. Positive schemas also showed incremental validity over and above negative schemas for these same measures, thus demonstrating that both positive and negative schemas are separate constructs that relate in unique ways to mental health. Implications for using both the YPSQ and the YSQ-S3 scales in tandem in ST as well as cultural nuances from the use of Asian samples were discussed. (PsycINFO Database Record

A new look at the schema therapy model: organization and role of early maladaptive schemas.

This study reexamined the organization of Young's 18 early maladaptive schemas and their hypothesized associations with experiences of need-thwarting parental experiences in childhood and the "vulnerable child" mode of emotional distress in adulthood. A large Danish sample (N = 1054) of 658 clinical- and 391 nonclinical adults completed measures of early maladaptive schemas, parenting styles, and the vulnerable child mode. We identified four higher-order schema domains as most appropriate in terms of interpretability and empirical indices ("Disconnection & Rejection", "Impaired Autonomy & Performance", "Excessive Responsibility & Standards", and "Impaired Limits"). All four schema domains were differentially associated with conceptually relevant need-thwarting parental experiences. Apart from "Impaired Limits", the schema domains meaningfully accounted for the association between need-thwarting parental experiences in childhood and emotional states of feeling like a "vulnerable child" in adulthood. We conclude that four domains of early maladaptive schemas are empirically and conceptually consistent with Young's schema therapy model of personality pathology and longstanding emotional disorders. Findings warrant replication using different populations and if possible a prospective multi-method design. A scoring key for computing the four schema domains is provided.

Design of an international multicentre RCT on group schema therapy for borderline personality disorder.

BACKGROUND: Borderline personality disorder (BPD) is a severe and highly prevalent mental disorder. Schema therapy (ST) has been found effective in the treatment of BPD and is commonly delivered through an individual format. A group format (group schema therapy, GST) has also been developed. GST has been found to speed up and amplify the treatment effects found for individual ST. Delivery in a group format may lead to improved cost-effectiveness. An important question is how GST compares to treatment as usual (TAU) and what format for delivery of schema therapy (format A; intensive group therapy only, or format B; a combination of group and individual therapy) produces the best outcomes. METHODS/DESIGN: An international, multicentre randomized controlled trial (RCT) will be conducted with a minimum of fourteen participating centres. Each centre will recruit multiple cohorts of at least sixteen patients. GST formats as well as the orders in which they are delivered to successive cohorts will be balanced. Within countries that contribute an uneven number of sites, the orders of GST formats will be balanced within a difference of one. The RCT is designed to include a minimum of 448 patients with BPD. The primary clinical outcome measure will be BPD severity. Secondary clinical outcome measures will include measures of BPD and general psychiatric symptoms, schemas and schema modes, social functioning and quality of life. Furthermore, an economic evaluation that consists of cost-effectiveness and cost-utility analyses will be performed using a societal perspective. Lastly, additional investigations will be carried out that include an assessment of the integrity of GST, a qualitative study on patients' and therapists' experiences with GST, and studies on variables that might influence the effectiveness of GST. DISCUSSION: This trial will compare GST to TAU for patients with BPD as well as two different formats for the delivery of GST. By combining an evaluation of clinical effectiveness, an economic evaluation and additional investigations, it will contribute to an evidence-based understanding of which treatment should be offered to patients with BPD from clinical, economic, and stakeholders' perspectives. TRIAL REGISTRATION: Netherlands Trial Register NTR2392. Registered 25 June 2010.

Serotonergic modulation of suicidal behaviour: integrating preclinical data with clinical practice and psychotherapy.

Many studies have provided important information regarding the anatomy, development and functional organization of the 5-HT system and the alterations in this system that are present within the brain of the suicidal patient. There is also a growing interest in genetic factors associated with suicide, since these may lead to the emergence of personality traits that prove to be long-term predictors of suicidal behaviour. This review will focus on presenting the scientific literature on the role of the serotonergic system in suicidal behaviour as well as dysfunctional attitudes and personality traits associated with the suicidal patient. The association of the serotonin transporter gene, the 5-HT2 receptors and its metabolite 5-hydroxyindoleacetic acid with suicidal behaviour and animal models that may capture the complexity of suicidal behaviour will be discussed. Finally, the relationship between neurobiological models and psychotherapeutic interventions for suicide prevention will be considered with a focus on Schema Therapy (an approach that has shown particular promise in the treatment of suicidal individuals with personality disorders), aiming to invite the reader to integrate some aspects of the neurobiology of human suicidal behaviour into a model of suicide that can be used in a clinical encounter.

Volatile oils from the plant and hairy root cultures of Ageratum conyzoides L.

Two lines of hairy root culture of Ageratum conyzoides L. induced by Agrobacterium rhizogenes ATCC 15834 were established under either complete darkness or 16 h light/8 h dark photoperiod conditions. The volatile oil yields from aerial parts and roots of the parent plant, the hairy root culture photoperiod line and the hairy root culture dark line were 0.2%, 0.08%, 0.03% and 0.02%, (w/w), respectively. The compositions of the volatiles from the hairy roots, plant roots and aerial parts were analysed by GC and GC-MS. The main components of the volatiles from the hairy root cultures were ß-farnesene, precocene I and ß-caryophyllene, in different amounts, depending on light conditions and also on the age of cultures. Precocene I, ß-farnesene, precocene II and ß-caryophyllene were the main constituents of the volatile oils from the parent plant roots, whereas precocene I, germacrene D, ß-caryophyllene and precocene II were the main constituents of the aerial parts of the parent plant. Growth and time-course studies of volatile constituents of the two hairy root lines were compared. Qualitative and quantitative differences were found between the volatile oils from the roots of the parent plant and those from the hairy roots.