Cognitive Therapy and Task Concentration Training Applied as Intensified Group Therapies for Social Anxiety Disorder with Fear of Blushing-A Randomized Controlled Trial.

The current study examines the efficacy of intensified group therapy for social anxiety disorder with fear of blushing. Task concentration training (TCT) and cognitive therapy (CT) were applied during one weekend and compared with a waiting list condition in a randomized controlled trial including 82 patients. On a second weekend, another intervention was added (resulting in TCT-CT and CT-TCT sequences) to examine order effects. Task concentration training and CT were both superior to the waiting list and equally effective after the first therapy weekend. Also, no differences were found between the sequences TCT-CT and CT-TCT at post-assessment. At 6- and 12-month follow-up, effects remained stable or further improved. At the 6-month follow-up, remission rates in completers, established by diagnostic status, were between 69% and 73%. Intensified group therapy is highly effective in treating social anxiety disorder with fear of blushing. Group formats for patients sharing a common primary concern may contribute to the dissemination of cognitive-behavioural therapy. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message: This study focuses on blushing from fearful individuals within the SAD spectrum to improve evidence for treatment efficacy in those whose social fears are centred around observable bodily sensations. This study integrates task concentration training into the SAD model of Clark and Wells to combine two evidence-based treatments for SAD under one treatment model. This study uses an innovative format of brief, intensified group therapy, conducted on two full-day weekend group sessions delivered over two weekends, with strong observed effect sizes.

Genetic identification of highly putrefied bodies using DNA from soft tissues.

The identification of putrefied bodies is a common task in forensic routine work. The deceased are usually identified by dental records, fingerprinting, or--in cases where no such data are available--DNA analysis. However, with progressive putrefaction, DNA integrity is rapidly decreasing. Genetic analysis may then be greatly impaired, if not impossible. The aim of our study was to establish an efficient procedure to successfully extract and amplify DNA from soft tissues of bodies in different stages of putrefaction. Soft tissues-unlike teeth or bones-usually allow the application of fast and easy-to-use extraction protocols. DNA was extracted from different tissues (aorta, kidney, liver, and skeletal muscle) taken at autopsy using a commercially available DNA extraction kit, and DNA quality and quantity were controlled by agarose gel electrophoresis and real-time polymerase chain reaction (PCR). Presence of mitochondrial DNA was tested using a highly sensitive duplex PCR. Short tandem repeat analysis was done using the AmpFlSTR Identifiler kit. Additionally, mitochondrial DNA sequencing was performed. After DNA extraction from at least two different tissues-preferably the kidney and the aorta-with the extraction kit based on the Nucleobond method, a successful amplification of at least eight loci was possible in 17 out of 18 cases, and 12 or more loci could be amplified in 15 cases.

The impact of DNA contamination of bone samples in forensic case analysis and anthropological research.

Contamination precautions and quality control are great issues when human bones are investigated genetically. This is especially true for historical samples with only minute amounts of usually highly degraded DNA. But also in forensic routine analysis, sometimes DNA has to be isolated from bones in equally bad conditions, e.g. from burned victims. In such cases, there are several eventualities to contaminate the sample with foreign DNA, for example caused by the recovery of the bones, by trace investigation on a crime scene, or - of course - during handling in the lab. We present the investigation of artificially contaminated historical bone samples which contained no original DNA. Three different kind of contamination were studied: (1) touching of the samples, (2) application of saliva, and (3) application of pure DNA. The samples were genetically investigated without and with the employment of a defined cleaning protocol of the bones. The results show that pure DNA can usually not be removed from the bones and that saliva is a similar thread for subsequent DNA analysis. After the cleaning procedure about 70% of saliva contaminated samples still yielded reproducible STR profiles implicating severe problems for the investigation of highly degraded bone fragments. Simple touching of the specimens seems not to be a real problem for genetic investigations since the obtained signals were not reproducible.

Is trait resilience characterized by specific patterns of attentional bias to emotional stimuli and attentional control?

BACKGROUND AND OBJECTIVES: Attentional processes have been suggested to play a crucial role in resilience defined as positive adaptation facing adversity. However, research is lacking on associations between attentional biases to positive and threat-related stimuli, attentional control and trait resilience. METHODS: Data stem from the follow-up assessment of a longitudinal study investigating mental health and related factors among German soldiers. Trait resilience was assessed with the Connor-Davidson Resilience Scale and attentional control with the Attentional Control Scale. A subset of n = 198 soldiers also completed a dot probe task with happy, neutral and threatening faces. RESULTS: Attentional control was positively related to trait resilience. Results revealed no associations between both attentional biases and trait resilience. However, there was a negative association between attentional bias to threat and trait resilience when attentional control was low and a positive association between attentional bias to threat and trait resilience when attentional control was high. No such associations were found for attentional bias to positive stimuli. LIMITATIONS: Generalizability to other populations may be limited since we exclusively focused on male soldiers. Also, the cross-sectional design does not allow for causal conclusions. CONCLUSIONS: Findings suggest that attentional processing may promote trait resilience. Future research on preventive interventions should consider these findings.

Stress exposure and the risk for the onset of alcohol use disorders and nicotine dependence in deployed military personnel: the role of prior internalizing disorders.

OBJECTIVE: This prospective study aimed to investigate whether prior internalizing disorders (PIDs) moderate the relationship between stress exposure (SE) and the onset of alcohol use disorders (AUDs) and nicotine dependence (ND) in deployed military personnel. METHODS: 358 male soldiers were examined directly before and 12months after return from deployment using standardized interviews. Combat experiences, concerns about family disruptions, and difficult living and working environment were assessed as different aspects of SE. PID diagnoses (mood disorders (PMDs), anxiety disorders (PADs)) and substance use disorders were defined according to the DSM-IV-TR. RESULTS: PMDs were related to a stronger association between concerns about family disruptions and the risk of AUD onset (OR=7.7, 95% CI 1.8-32.8, p=0.006). The number of PID diagnoses (OR per diagnosis: 1.7, 95% CI 1.0-2.8, p=0.036) and PADs (OR: 2.6, 95% CI 1.1-6.3, p=0.038) were further related to a stronger association between difficult living and working environment and the risk of AUD onset. With regard to ND, PMDs were related to a weaker association between difficult living and working environment and the risk of ND onset (OR=0.4, 95% CI 0.2-0.8, p=0.013). CONCLUSIONS: PIDs might be related to an increased risk for the onset of AUDs but not ND following SE. This effect is probably restricted to specific constellations of PADs, PMDs, comorbid PIDs and specific aspects of SE. These critical constellations of PIDs and SE might be a promising target for future research and could contribute to the development of preventive measures to reduce the risk of AUDs following SE.

Reliable genetic identification of burnt human remains.

The identification of severely burnt human remains by genetic fingerprinting is a common task in forensic routine work. In cases of extreme fire impact, only hard tissues (bones, teeth) may be left for DNA analysis. DNA extracted from burnt bone fragments may be highly degraded, making an amplification of genetic markers difficult or even impossible. Furthermore, heavily burnt bones are very prone to contamination with external DNA. We investigated whether authentic DNA profiles can be generated from human bones showing different stages of fire induced destruction (well preserved, semi-burnt, black burnt, blue-grey burnt, blue-grey-white burnt). DNA was extracted from 71 bone fragments derived from 13 individuals. Obtained genetic patterns (STRs and mtDNA sequences) were compared to the genetic pattern of the respective bodies. Our results show that the identification via DNA analysis is reliably and reproducibly possible from well preserved and semi-burnt bones. In black burnt bones the DNA was highly degraded and in some cases no nuclear DNA was left, leaving mitochondrial DNA analysis as an option. Blue-grey burnt bones lead only sporadically to authentic profiles. The investigation of blue-grey-white burnt bones barely led to reliable results.

A special family history.

Y-STR analysis is a common tool in forensic case work. Lately it has also been popular in genealogical research to determine the male lineage. We present the investigation of members of a family with a pedigree dating back to the 14th century. The aim of the study was to genetically confirm the kinship established genealogically, a method that is mainly based on the fact that individuals of the male lineage carry the same family name. We investigated fifteen male individuals who were connected to approximately forty different branches of the family tree using the Powerplex Y kit (Promega) that allows the detection of eleven Y-STRs. Our study shows that there can be differences between genealogical and genetic pedigrees indicating the need for additional genetic analysis.

A new multiplex-PCR comprising autosomal and y-specific STRs and mitochondrial DNA to analyze highly degraded material.

The analysis of short tandem repeats is one of the most powerful tools in forensic genetics. Forensic practice sometimes requires the individualization of samples that may contain only highly degraded nuclear DNA, mitochondrial DNA or PCR inhibitors that hamper DNA amplification. We designed a new multiplex PCR with reduced size amplicons (<200 bp), providing a double sex determination (amelogenin plus two Y-STRs), the detection of two autosomal markers and the amplification of mitochondrial specific fragments from the hypervariable region I (HVI). Additionally, a quality sensor was developed to check for the presence of any PCR inhibitors. The new multiplex PCR shows a reproducible detection threshold down to 25 pg and gives signals even out of highly degraded materials. All signals are reproducible and reliable as it could be shown in comparison to results from commercially available STR multiplex-PCRs. In no case DNA fragments were detectable using any other assay when the quality sensor was not detectable. There was a good correlation between detection of mitochondrial specific fragments in the multiplex-PCR and success of subsequent sequencing of HVI region. The same could be shown for STR analysis: Most samples successfully analyzed in our PCR yielded at least a partial STR profile using a commercial STR kit. We present an assay that allows an easy, reliable, and cost efficient evaluation of DNA sample quality combined with a first rough sample individualization and sex determination suitable for forensic purposes. This assay may help the forensic lab personnel to decide on further sample processing.