Browsing by Author "Behn, Alex"
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- ItemATTITUDES, CLINICAL PRACTICES, AND PERCEIVED ADVOCACY NEEDS OF PROFESSIONALS WITH INTERESTS IN PERSONALITY DISORDERS(2023) Ellison, William D.; Huprich, Steven; Behn, Alex; Goodman, Marianne; Kerr, Sophie; Levy, Kenneth N.; Nelson, Sharon M.; Sharp, CarlaExperts in personality disorders (PDs) generally prefer dimensional diagnostic systems to categorical ones, but less is known about experts' attitudes toward personality pathology diagnoses in adolescents, and little is known about public health shortfalls and advocacy needs and how these might differ geographically. To fill these gaps, the International Society for the Study of Personality Disorders surveyed 248 professionals with interests in PDs about their attitudes toward different diagnostic systems for adults and adolescents, their PD-related clinical practices, and perceived advocacy needs in their area. Results suggested that dimensional diagnostic systems are preferable to categorical and that skepticism about personality pathology in adolescents may not be warranted. The most pressing advocacy need was the increased availability of PD-related services, but many other needs were identified. Results provide a blueprint for advocacy and suggest ways that professional societies can collaborate with public health bodies to expand the reach of PD expertise and services.
- ItemMultinational Evaluation of the Measurement Invariance of the Level of Personality Functioning Scale-Brief Form 2.0: Comparison of Student and Community Samples Across Seven Countries(2022) Natoli, Adam P.; Bach, Bo; Behn, Alex; Cottin, Marianne; Gritti, Emanuela S.; Hutsebaut, Joost; Lamba, Nishtha; Le Corff, Yann; Zimmermann, Johannes; Lapalme, MelaniePublic Significance Statement The Level of Personality Functioning Scale-Brief Form 2.0 is a brief self-report measure of personality functioning that appears to assess self- and interpersonal functioning impairment similarly across many different countries, which offers encouraging evidence supporting its international use.
- ItemPopulation-attributable risk of adverse childhood experiences for high suicide risk, psychiatric admissions, and recurrent depression, in depressed outpatients(2021) Gloger, Sergio; Martinez, Pablo; Behn, Alex; Victoria Chacon, M.; Cottin, Marianne; Diez de Medina, Dante; Vohringer, Paul A.Background: Population-attributable risk (PAR) may help estimate the potential contribution of adverse childhood experiences (ACEs) to serious clinical presentations of depression, characterized by suicidality, previous psychiatric admissions, and episode recurrence.
- ItemReliability and Validity of the Spanish Adaptation of the Stanford Proxy Test for Delirium in 2 Clinical Spanish-Speaking Communities(Elsevier B.V., 2023) Infante Reyes, Sanndy Paullethe; Behn, Alex; Gonzalez M.; Pintor, Luis; Franco, Eduardo; Araya, Pablo; Maldonado, José R.Delirium is the most prevalent neuropsychiatric syndrome experienced by patients admitted to inpatient clinical units, occurring in at least 20% of medically hospitalized patients and up to 85% of those admitted to critical care units. Although current guidelines recommend the implementation of universal prevention strategies, the use of management strategies largely depends on constant surveillance and screening. This allows for the timely diagnosis and correction of its underlying causes and implementation of management strategies. Objective: It was to adapt and analyze the Spanish adaptation of the Stanford Proxy Test for Delirium (S-PTDsv) instrument for its use among Spanish-speaking populations. The S-PTD is an instrument consisting of 13 observational items to be completed by a clinician observer, usually the patient's nurse. The completion of the questionnaire takes about 1 minute and does not require the active participation of the person evaluated, which has important clinical advantages compared to other available instruments (e.g., the Confusion Assessment Method). Methods: The psychometric properties of the S-PTDsv were evaluated in a population of 123 patients using a quantitative, cross-sectional design. All subjects were over 18 years of age and hospitalized in various inpatient medico-surgical and intensive care unit services, either at the Barcelona Clinical Hospital (Barcelona, Spain) or the UC-Christus Health Network Clinical Hospital (Santiago, Chile, S.A.). The ultimate diagnosis of delirium was made by a member of the Psychiatry Consult Service by means of an independent neuropsychiatric evaluation based on the fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, published in 2013, which is the latest version of the diagnostic manual. All study tests were performed by study personnel who were blinded to each other's test results within an hour of each other. Results: In the ROC (curve that considers sensitivity points [Y axis] and specificity [X axis]) analysis, the S-PTDsv demonstrated excellent classification qualities when compared with the DSM-5 as the classification gold standard. Using a cutoff point of ≥3, the S-PTDsv had a sensitivity of 94% and a specificity of 97%. The area under the curve indicator was equal to 0.95, suggesting the S-PTDsv has an excellent overall performance in accurately identifying cases of delirium. Accordingly, the S-PTDsv's positive predictive value = 0.93, and the negative predictive value = 0.97. The internal reliability measured with Cronbach's alpha was 0.96. Confirmatory factor analysis revealed a 1-dimensional structure with high loadings (>0.72), demonstrating that all items similarly contribute to the total diagnostic dimension, suggesting adequate construct validity. This provided evidence of convergent validity. Conclusions: The performance of the S-PTDsv, as compared to a blinded neuropsychiatric assessment based on DSM-5, indicates that it is an effective instrument for the detection of delirium, in the Spanish-speaking populations. These results are comparable and consistent with previously published studies in the English language version.
- ItemThe contribution of early adverse stress to complex and severe depression in depressed outpatients(2021) Gloger, Sergio; Vohringer, Paul A.; Martinez, Pablo; Victoria Chacon, M.; Caceres, Cristian; Diez de Medina, Dante; Cottin, Marianne; Behn, AlexBackground To assess whether linear effects or threshold effects best describe the association between early adverse stress (EAS) and complex and severe depression (i.e., depression with treatment resistance, psychotic symptoms, and/or suicidal ideation), and to examine the attributable risk of complex and severe depression associated with EAS.
- ItemWorking with clients at the intersection of depression and personality dysfunction: Scientific and clinical findings regarding complex depression(2019) Behn, AlexDepression is often complicated by concurrent personality dysfunction, which poses significant challenges for clinicians and researchers. Complicated depression is thus broadly presented as a useful clinical and scientific entity, describing clients presenting with depressive symptoms that are further complicated by personality dysfunction or personality pathology. The article introduces a collection of research-based papers addressing the clinical management of patients with complicated depression. The articles in the issue provide an up-to-date framework for understanding different forms of complicated depression and provide useful clinical information to illuminate the treatment of clients presenting with difficulties at the intersection of depression and personality dysfunction.