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Psychodynamic case formulations without technical language: a reliability study.

ABSTRACT: BACKGROUND:To bridge the gap between symptoms and treatment, constructing case formulations is essential for clinicians. Limited scientific value has been attributed to case formulations because of problems with quality, reliability, and validity. For understanding, communication, and treatment planning beyond each specific clinician-patient dyad, a case formulation must convey valid information concerning the patient, as well as being a reliable source of information regardless of the clinician's theoretical orientation. The first aim of the present study is to explore the completeness of unstructured psychodynamic formulations, according to four components outlined in the Case Formulation Content Coding Method (CFCCM). The second aim is to estimate the reliability of independent formulations and their components, using similarity ratings of matched versus mismatched cases. METHODS:This study explores psychodynamic case formulations as made by two or more experienced clinicians after listening to an evaluation interview. The clinicians structured the formulations freely, with the sole constraint that technical, theory-laden terminology should be avoided. The formulations were decomposed into components after all formulations had been written. RESULTS:The results indicated that most formulations were adequately comprehensive, and that overall reliability of the formulations was high (>?0.70) for both experienced and inexperienced clinician raters, although the lower bound reliability estimate of the formulation component deemed most difficult to rate - inferred mechanisms - was marginal, 0.61. CONCLUSIONS:These results were achieved on case formulations made by experienced clinicians using simple experience-near language and minimizing technical concepts, which indicate a communicative quality in the formulations that make them clinically sound. TRIAL REGISTRATION:linicalTrials.gov Identifier: NCT00423462 . https://doi.org/10.1007/s00432-018-2781-7 ., January 18, 2007.

SUBMITTER: Sorbye O

PROVIDER: S-EPMC6813052 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Psychodynamic case formulations without technical language: a reliability study.

Sørbye Øystein Ø Dahl Hanne-Sofie J HJ Eells Tracy D TD Amlo Svein S Hersoug Anne Grete AG Haukvik Unn K UK Hartberg Cecilie B CB Høglend Per Andreas PA Ulberg Randi R

BMC psychology 20191024 1

<h4>Background</h4>To bridge the gap between symptoms and treatment, constructing case formulations is essential for clinicians. Limited scientific value has been attributed to case formulations because of problems with quality, reliability, and validity. For understanding, communication, and treatment planning beyond each specific clinician-patient dyad, a case formulation must convey valid information concerning the patient, as well as being a reliable source of information regardless of the c ...[more]

PMID: 31651367

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Project description:A large body of psycholinguistic research demonstrates that both language processing and language acquisition are sensitive to the distributions of linguistic constructions in usage. Here we investigate how statistical distributions at different linguistic levels - morphological and lexical (Experiments 1 and 2), and phrasal (Experiment 2) - contribute to the ease with which morphosyntax is processed and produced by second language learners. We analyze Chinese ESL learners' knowledge of four English inflectional morphemes: -ed, -ing, and third-person -s on verbs, and plural -s on nouns. In Elicited Imitation Tasks, participants listened to length- and difficulty-matched sentences each containing one target morpheme and typed the whole sentence as accurately as they could after a short delay. Experiment 1 investigated lexical and morphemic levels, testing the hypotheses that a morpheme is expected to be more easily processed when it is (1) highly available (i.e., occurring in frequent word-forms), and (2) highly reliable (i.e., occurring in lemma words that are consistently conjugated in the form containing this morpheme). Thirty sentences were made for each morpheme, divided into three Availability-Reliability Distribution (ARD) groups on the basis of corpus analysis in the Corpus of Contemporary American English (COCA; Davies, 2008-): 10 target words high in availability, 10 high in reliability, and 10 low in both reliability and availability. Responses were scored on whether the target morpheme was accurately reproduced given the provision of the correct lemma. A generalized linear mixed-effects logit model (GLMM) revealed fixed effects of morpheme type, availability, and reliability on the accuracy of morpheme provision. There were no effects of lemma frequency. Experiment 2 successfully replicated these results and extended the investigation to explore phrasal formulaicity by manipulating the frequency of the four-word strings in which the morpheme was embedded. GLMMs replicated the effects of word-form availability and reliability and additionally revealed independent phrase-superiority effects where morphemes were better reproduced in contexts of higher string-frequency. Taken together, these findings demonstrate that morpheme acquisition reflects the distributional properties of learners' experience and the mappings therein between lexis, morphology, phraseology, and semantics. These conclusions support an emergentist view of the statistical symbolic learning of morphology where language acquisition involves the satisfaction of competing constraints across multiple grain-sizes of units.

Project description:Chronic lymphocytic leukaemia (CLL) is renowned for its variable clinical course and response to therapy, suggesting a role for precision medicine. However, the molecular basis of CLL variability remains incompletely understood. Recent developments in data independent acquisition (DIA) -MS technologies, such as SWATH (Sequential Windowed Acquisition of all THeoretical fragments), provide an opportunity to study the pathophysiology of CLL at the proteome level. This report describes the sample replication and data handling requirements for SWATH-MS analysis of clinical samples. A CLL-specific spectral library compromising over 1,500,000 spectra with digital information for over 150,000 peptides has been generated to enable the quantification of up to 7736 proteins. To assess the reproducibility of the assay, SWATH-MS analysis was performed on 6 cryopreserved CLL patient samples, incorporating biological (IGHV mutational status), sample preparation and MS technical replicates. Quantitative information was obtained for 5169 proteins (<1% FDR) across 54 SWATH-MS acquisitions. These analyses showed that SWATH-MS is a highly reproducible technique. However, replicate sample preparations on different days was identified as the main source of variation. To overcome the effect of variation between sample preparation batches, different computational approaches for batch correction were tested. All approaches successfully removed technical variability whilst retaining proteomic differences between clinical subgroups. Functional enrichment analysis of proteins associated to IGHV mutational status highlighted the importance of metabolic remodelling in the biology of CLL and overlapped significantly with previous studies based on gene expression profiling. Finally, an approach to perform statistical power analysis in proteomics studies was developed. This approach could be used to drive the design of future CLL SWATH-MS studies. These fundamental requirements for DIA approaches should be widely applicable to other clinical proteomics studies.

Project description:ObjectiveIntraoperative tasks for awake language mapping are typically selected based on the language tracts that will likely be encountered during tumor resection. However, diminished attention and arousal secondary to perioperative sedatives may reduce a task's usefulness for identifying eloquent cortex. For instance, accuracy in performing select language tasks may be high preoperatively but decline in the operating room. In the present study, the authors sought to identify language tasks that can be performed with high accuracy in both situational contexts so the neurosurgical team can be confident that speech errors committed during awake language mapping result from direct cortical stimulation to eloquent cortex, rather than from poor performance in general.MethodsWe administered five language tasks to 44 patients: picture naming (PN), text reading (TR), auditory object naming (AN), repetition of 4-syllable words (4SYL), and production of syntactically intact sentences (SYNTAX). Performance was assessed using the 4-point scale of the quick aphasia battery 24 hours preoperatively and intraoperatively. We next determined whether or not accuracy on each task was higher preoperatively than intraoperatively. We also determined whether 1) intraoperative accuracy on a given task predicted intraoperative performance on the other tasks and 2) low preoperative accuracy on a task predicted a decrease in accuracy intraoperatively.ResultsRelative to preoperative accuracy, intraoperative accuracy declined on PN (3.90 vs 3.82, p = 0.0001), 4SYL (3.96 vs 3.91, p = 0.0006), and SYNTAX (3.85 vs 3.67, p = 0.0001) but not on TR (3.96 vs 3.94, p = 0.13) or AN (3.70 vs 3.58, p = 0.058). Intraoperative accuracy on PN and AN independently predicted intraoperative accuracy on the remaining language tasks (p < 0.001 and p < 0.01, respectively). Finally, low preoperative accuracy on SYNTAX predicted a decrease in accuracy on this task intraoperatively (R2 = 0.36, p = 0.00002).ConclusionsWhile TR lacks sensitivity in identifying language deficits at baseline, accuracy on TR is stable across testing settings. Baseline accuracy on the other four of our five language tasks was not predictive of intraoperative performance, signifying the need to repeat language tests prior to stimulation mapping to confirm reliability.

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Psychodynamic case formulations without technical language: a reliability study.

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Psychodynamic case formulations without technical language: a reliability study.

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