Validation of a suite of ERP and QEEG biomarkers in a pre-competitive, industry-led study in subjects with schizophrenia and healthy volunteers.

OBJECTIVE: Complexity and lack of standardization have mostly limited the use of event-related potentials (ERPs) and quantitative EEG (QEEG) biomarkers in drug development to small early phase trials. We present results from a clinical study on healthy volunteers (HV) and patients with schizophrenia (SZ) that assessed test-retest, group differences, variance, and correlation with functional assessments for ERP and QEEG measures collected at clinical and commercial trial sites with standardized instrumentation and methods, and analyzed through an automated data analysis pipeline. METHODS: 81 HV and 80 SZ were tested at one of four study sites. Subjects were administered two ERP/EEG testing sessions on separate visits. Sessions included a mismatch negativity paradigm, a 40 Hz auditory steady-state response paradigm, an eyes-closed resting state EEG, and an active auditory oddball paradigm. SZ subjects were also tested on the Brief Assessment of Cognition (BAC), Positive and Negative Syndrome Scale (PANSS), and Virtual Reality Functional Capacity Assessment Tool (VRFCAT). RESULTS: Standardized ERP/EEG instrumentation and methods ensured few test failures. The automated data analysis pipeline allowed for near real-time analysis with no human intervention. Test-retest reliability was fair-to-excellent for most of the outcome measures. SZ subjects showed significant deficits in ERP and QEEG measures consistent with published academic literature. A subset of ERP and QEEG measures correlated with functional assessments administered to the SZ subjects. CONCLUSIONS: With standardized instrumentation and methods, complex ERP/EEG testing sessions can be reliably performed at clinical and commercial trial sites to produce high-quality data in near real-time.

Relapse prevention in serious mental illness.

The current emphasis on relapse prevention in serious mental illness offers psychologists new opportunities and roles for which they are uniquely suited.

Refining quality of life: validating a multidimensional factor measure in the severe mentally ill.

Quality of life measurement has historically been characterized by a focus on physical functionality, great variability in definitions and insufficient attention to psychometric properties of measures. The present study examined four core subscales of the Quality of Life Enjoyment Scale (Q-LES-Q) designed to assess subjective quality of life (i.e. physical health, subjective feelings, leisure activities and social relationships) administered to 151 male and female subjects with severe mental illness admitted to a residential community treatment center or a university psychiatric hospital. The use of factor analysis is a common approach to examining construct validity of instruments through the examination of correlated clusters of item responses. Those sets of highly correlated item responses should identify a construct or dimension of related items (i.e. a factor). Two factor approaches, exploratory (i.e. the maximum number of possible factor is unspecified) and restricted (i.e. the maximum number of factors allowed is specified), were employed to examine construct validity of the four Q-LES-Q subscales. In addition, both orthogonal (i.e. independence between factors is maximized) and oblique (i.e. correlated factors are allowed) rotations (arrangements) of factor structure were also investigated to define subscale validity further. Results supported good construct validity for each subscale with either factor approach, i.e. the four proposed subscales were clearly identifiable in the factors (groupings) of correlated item responses from the sample. In both cases, the orthogonal (independent) rotation produced the simplest structure, i.e. the clearest groupings of items. These results indicate that the Q-LES-Q does appear to measure valid dimensions matching those proposed by the subscales and, thus, may be a useful and reliable tool for clinical applications.

Scope of hypnosis education in academia: results of a national survey.

The present article examines the current status of hypnosis training and the attitudes of program chairs toward inclusion of such training in doctoral education. A brief survey on hypnosis training was sent to all psychology doctoral programs accredited by the American Psychological Association (n = 218) as well as 24 nonaccredited doctoral programs. Twenty-six percent of responding programs (n = 44/170) report offering either required or elective coursework in hypnosis. Of those programs offering a course in hypnosis, the mean semester credit hours earned was 3. Although many program directors support opportunities for hypnosis education in doctoral education, other constraints (e.g., available faculty, required coursework) limit its availability.

Power in the hypnotic relationship: therapeutic or abusive?

The unique relationship between hypnotist and subject has been theorized as one explanation for the effectiveness of hypnosis. This relationship carries a power differential, present in most therapeutic relationships, but accentuated by hypnosis. The power differential is sometimes perceived as the ability of the hypnotist to control the subject. Perceptions of hypnosis offered by stage hypnotists, the popular media, and some clinicians perpetuate the notion that the hypnotist has the ability to exert undue influence upon the client. The present article examines the relationship between hypnotist and subject focusing on issues of power and control. The authors examine the unique dynamics accompanying the use of hypnosis and their impact on the therapeutic dyad. Evidence is offered demonstrating the power differential, and how this differential can serve as either a positive or negative agent of change. Therapists should be aware of the dynamics created by using hypnosis. Implications for training therapists in the use of hypnosis are suggested.

A national survey of hypnosis training--its status in psychiatric residency programs: a brief communication.

Hypnosis training in psychiatric residency programs has not previously been well documented in the literature. This article examines the extent of such training in residency programs and the attitudes of residency directors to training and the use of hypnosis. A brief survey requesting information on hypnosis training was sent to all psychiatric residency directors in the United States. Sixty-three percent of responding program directors (n = 154) report offering either required or elective coursework in hypnosis. Of programs offering hypnosis training, the mean number of hours was 8, suggesting that many psychiatrists have only limited exposure to hypnosis during residency. The authors conclude that hypnosis training is widely variable within psychiatric residency programs and is dependent on the faculty and training director interests within individual programs.

Hypnosis training in psychology intern programs.

The use of hypnosis is becoming increasingly common in clinical practice. This article examines hypnosis training in psychology internship programs. A survey was sent to all APA intern programs listed in the APPIC directory requesting information about opportunities for training and utilizing hypnosis during the intern year. Thirteen percent of responding programs (n = 424) reported regular seminars in hypnosis, while another 37% offer elective opportunities. However, of those programs that provide training, the average amount of time was approximately seven hours. The authors conclude that while training is provided to a significant percentage of interns, the amount of time is not enough to allow for its ethical use. It is suggested that as the use of hypnosis increases, training programs may want to consider opportunities for more adequate hypnosis training.