The Mediating Role of Emotion Regulation Difficulties in the Relationship Between Self-Compassion and OCD Severity in a Non-Referred Sample.

Self-compassion involves extending kindness and understanding to one's self. Research has demonstrated inverse relationships between self-compassion and maladaptive constructs associated with obsessive-compulsive disorder (OCD), including emotion regulation (ER) difficulties. The current study sought to explore associations between self-compassion, ER difficulties, and OCD severity. Data were collected at the International Obsessive-Compulsive Disorder Foundation convention from 62 attendees who reported having a diagnosis of OCD (51% male, mean age 35.9 years). Findings demonstrated that self-compassion and ER difficulties were associated with overall OCD severity. Results also indicated that ER difficulties mediated relationships between self-compassion and overall OCD severity, as well as the severity of two OCD symptom dimensions, responsibility for harm and unacceptable thoughts. These findings suggest that self-compassion and ER difficulties may be involved in the maintenance and severity of OCD.

Need to screen for clinical levels of OCD? Four questions are the key.

The aim of this study was to investigate a new measure, the Wetterneck-Hart OCD Screener (WHOS), as a self-report screening tool for obsessive-compulsive disorder (OCD). The authors examined relationships between the WHOS and severity scores of OCD measures taken via three methods of data collection: online, at OCD consumer conferences, and from an intensive, residential OCD program. Severity measures included the Yale-Brown Obsessive-Compulsive Scale-Self Report (Y-BOCS-SR), the Dimensional Obsessive-Compulsive Scale (DOCS), and the Obsessive-Compulsive Inventory-Revised (OCI-R). A total of 525 participants took the measures: 298 from online websites, 100 from OCD conferences, and 127 from a residential OCD program. Significant differences were found between the OCD and non-OCD groups classified by the WHOS for each of the OCD severity measures. The authors conclude that the WHOS is useful in predicting the presence of clinically severe OCD symptoms and could be employed in clinical and research endeavors.

Improving the interview skills of college students using behavioral skills training.

Obtaining a job as a college graduate is partly dependent on interview performance. We used a multiple baseline design across skills to evaluate the effects of behavioral skills training with self-evaluation for five college students. Training effects were evaluated using simulated interviews as baseline and posttraining assessments. All participants acquired targeted skills, but we observed some individual differences. Participants were satisfied with training outcomes and rated the procedures as acceptable. Furthermore, ratings from university staff who provide interview training indicated that training improved performance across several skills for the majority of participants.

Erratum to: intensive inpatient treatment improves emotion-regulation capacities among adults with severe mental illness.

[This corrects the article DOI: 10.1186/2051-6673-1-19.].

Teaching Tacting of Private Events Based on Public Accompaniments: Effects of Contingencies, Audience Control, and Stimulus Complexity.

Our current understanding of the role of private events in the science of behavior is based largely on Skinner's natural science interpretation of private events. Skinner described public accompaniments as one source of control for a verbal community to differentially reinforce verbal behavior regarding private events. In this study, we developed an experimental analogue to study variables influencing tacting of private events. The participant had exclusive access to one set of stimuli (the private stimuli), and the experimenter attempted to teach tacts for private stimuli based on their correspondence with public stimuli accessible to both the experimenter and participant. Results of experiments 1 and 2 demonstrated that reports of private stimuli were a function of degree of public-private correspondence, reinforcement contingency, and audience control. In some cases, we encountered reports controlled exclusively by public stimuli. Results of experiment 3 showed that public control was less likely when public stimuli were more complex and the experimenter had a unique behavioral history with respect to those stimuli that was not shared by the learner. The orderly patterns of data obtained suggest that analogue arrangements might be a useful, and even necessary, starting point for experimental investigations of how private events may enter into the analysis of behavior.

Perfectionism dimensions as predictors of symptom dimensions of obsessive-compulsive disorder.

The correlation between obsessive-compulsive disorder (OCD) and perfectionism is well documented, yet it remains unclear if dimensions of perfectionism vary as a function of OCD symptom dimensions. To this end, the present study investigated the unique associations between dimensions of perfectionism (i.e., concern over mistakes, doubts about actions, personal standards, parental criticism, parental expectations, and organization) and OCD symptom dimensions (i.e., hoarding, washing, checking, ordering, obsessing, and neutralizing). The study included adult patients with OCD (N = 46) from a residential OCD treatment program. Consistent with previous research, doubts about actions was a significant predictor of overall OCD severity and OCD checking symptoms. The organization dimension of perfectionism was a significant predictor of OCD ordering symptoms. The current study provides evidence for the unique relationships between OCD symptoms and perfectionism dimensions that encourage a movement toward greater phenotypic specificity within existing models of OCD.

Intensive inpatient treatment improves emotion-regulation capacities among adults with severe mental illness.

BACKGROUND: Impaired capacity for emotion regulation is associated with a broad spectrum of psychiatric disturbances; however, little is known about treatment response in emotion regulation functioning among patients with severe mental illness. This study examined treatment response and the role that experiential avoidance plays in mediating the relationship between attachment anxiety/avoidance and change in emotion regulation. METHODS: Difficulties in emotion regulation were assessed at admission and at discharge, and rates of improvement and deterioration in emotion regulation were calculated. Attachment anxiety and avoidance were assessed in conjunction with experiential avoidance at baseline in a large cohort (N = 493) of adults admitted to a specialized adult psychiatric hospital. RESULTS: Inpatient treatment was associated with clinically significant improvement in emotion-regulation capacities for 49 percent of patients completing at least four weeks of treatment. Fifty-six percent of patients attained a status of recovery. Greater attachment avoidance and anxiety were related to positive change in emotion regulation at discharge. Experiential avoidance fully mediated the relationship between insecure attachment and change in emotion-regulation capacities. CONCLUSIONS: Contrary to expectation, greater attachment insecurity (anxiety and avoidance) as well as greater experiential avoidance predicted improvement in emotion regulation. These counterintuitive findings add to a growing evidence base indicating that severity of psychopathology is associated with greater improvement in hospitalized patients. Results of the mediation analysis suggest that targeting experiential avoidance may be an effective augmentation in the treatment of impaired emotion regulation functioning.

Red blood cell transfusions and the risk of allosensitization in patients awaiting primary kidney transplantation.

BACKGROUND: Most studies of HLA sensitization after red blood cell transfusion in transplant candidates were done before widespread use of leuko reduced blood and based on relatively insensitive, nonspecific antibody assays. We evaluated the effect of transfusion on the breadth and magnitude of HLA antibody formation using current, sensitive, HLA-specific immunoassays. METHODS: Serial HLA antibody data were merged with transfusion data from the US Renal Data System for 1324 patients on the kidney transplant wait list (2004-2010). Two study groups were identified: a matched cohort consisting of 89 patients who received transfusion and 251 patients who did not receive transfusion and a crossover cohort consisting of 69 patients. Changes in antibody levels and calculated panel-reactive antibody (CPRA) were compared using χ and Sign tests, respectively. Logistic regression was used to estimate the relative risk of antibody responses. RESULTS: Among the matched cohort, 20% of those who received transfusion compared to 3% of those who did not receive transfusion exhibited an antibody response (P=0.001), whereas in the crossover cohort, 19% exhibited a response in those who received transfusion compared to 1% of those who did not receive transfusion (P=0.0001). Moreover, 26.3% of those who received transfusion had increased CPRA compared to 5.8% of those who did not receive transfusion . These effects were greater in women and blacks compared to men and whites, respectively. Importantly, patients who received transfusion were at an increased risk of a potentially crossmatch positive response (odds ratio=9.6, 95% confidence interval=3.0-30.7). CONCLUSIONS: Sensitization from transfusion can occur in up to 20% of transplant candidates, resulting in higher antibody levels and CPRA values that adversely impact access to transplantation. These results support transfusion avoidance whenever possible.

Obsessive-compulsive personality traits: how are they related to OCD severity?

Previous research has demonstrated that comorbid obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD) is associated with greater overall OCD severity, functional impairment, and poorer treatment outcomes (Coles et al., 2008; Lochner et al., 2010; Pinto, 2009). However, research has only examined the effects of OCPD categorically and has yet to thoroughly examine the impact of individual OCPD characteristics dimensionally. Thus, the present study sought to investigate the relationships between various OCPD-related dimensions (e.g., perfectionism, rigidity) and OCD symptomology and severity. The study recruited a sample of OCD patients (n=51) in the OCD units of two residential treatment facilities. Findings yielded significant relationships between OCD severity and the following OCPD dimensions: flexibility, doubts about actions (a dimension of perfectionism), and hoarding. Interpretations of these results and the implications for diagnosis, prognosis, and treatment outcome are discussed. Furthermore, the current study provides insight into a unique perspective which leaves room for more symptom overlap and variability between OCD and OCPD.

The co$t of mi$matching.

We have shown that the number of HLA mismatched antigens correlates with the development of new or changes in existing HLA-specific antibodies. We have further shown that the magnitude of the effect varies among groups defined by whether or not HLA-specific antibody was present prior to transplant, by the transplant number, by recipient race, and by donor type. The increases in antibody, which increase with increasing degree of mismatch, result in differences in waiting times reflective of the number of previous mismatches. For many patients, increased waiting time represents not only reduced quality of life but deteriorating health and shortened life expectancy. Globally, increased waiting times translate into increased costs for dialysis, antibody testing, and health care. These factors suggest that HLA matching should not be abandoned but should be given consideration for those patients most affected by mismatches.

A computer match program for paired and unconventional kidney exchanges.

The number of renal transplants can be increased by implementing an exchange program involving donor-recipient pairs for whom the donors are each incompatible with their original patient but compatible with each other's patient. The number can be further increased if the exchanges are not limited to ABO incompatible pairs or combinations of two donor-recipient pairs. However, as the number of donor-recipient pairs willing to participate in such a program increases, there is a substantial increase in both the time taken to identify such matches and the potential for error. We have developed a computer program that accounts for ABO and HLA compatibility and is not limited to two-way exchanges. With our database of 60 patients and 83 donors, we have been able to identify 122 two-way and 1230 three-way exchanges with an average run time of 30 s.