Erik Simonsen

IT University of Copenhagen, København, Capital Region, Denmark

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Publications (121)339.78 Total impact

  • Ole Jakob Storebø · Erik Simonsen · Christian Gluud
    No preview · Article · Apr 2016 · European Child & Adolescent Psychiatry
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    [Show abstract] [Hide abstract] ABSTRACT: There is growing evidence that metacognitive abilities which include the ability to synthesize knowledge regarding mental states in self and others and use this ability to solve problems are impaired in non-affective psychosis and associated with positive and negative symptom severity. We sought to (a) investigate the severity of metacognitive impairments in first-episode psychosis (FEP) compared to non-clinical controls and (b) explore associations with positive and negative symptom profiles. Ninety-seven people with FEP were compared to 101 control persons. Metacognition was assessed with interviews and the Metacognitive assessment scale-abbreviated. Four groups based on positive and negative symptoms were identified by cluster analysis and compared on metacognition, childhood adversities, duration of untreated psychosis and premorbid social and academic adjustment. Those with high levels of negative symptoms had poorer metacognitive abilities. Those with high positive and low negative symptoms did not have poorer metacognitive abilities than those with low positive and negative symptoms. None of the other predictors differed between the groups. The FEP group had poorer metacognitive abilities than the control group. Inclusion of metacognition in psychosis models may improve our understanding of negative symptoms, while previous findings of a relation with positive symptoms may have been confounded. Implications for current interventions are discussed.
    Full-text · Article · Apr 2016 · Psychiatry Research
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    [Show abstract] [Hide abstract] ABSTRACT: Methods: A representative sample of 272 patients with a first episode psychotic disorder was included from 1997 through 2000. At 10year follow-up 186 patients participated. QoL was measured by the Lehman's Quality of Life Interview. Linear mixed model analyses were performed to investigate longitudinal effects of baseline psychiatric symptoms and socio-economic variables and the effects of changes in the same variables on S-QoL-development. Results: S-QoL improved significantly over the follow-up period. More contact with family and a better financial situation at baseline had a positive and longstanding effect on S-QoL-development, but changes in these variables were not associated with S-QoL-development. Higher depressive symptoms and less daily activities at baseline both had a negative independent effect, but a positive interaction effect with time on S-QoL-development indicating that the independent negative effect diminished over time. In the change analysis, increased daily activities and a decrease in depressive symptoms were associated with a positive S-QoL-development. Conclusions: Treatment of depressive symptoms and measures aimed at increasing daily activities seem important to improve S-QoL in patients with psychosis. More contact with family and a better financial situation at baseline have a long-standing effect on S-QoL-development in FEP patients.
    Full-text · Article · Mar 2016 · Schizophrenia Research
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    Full-text · Dataset · Feb 2016
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    [Show abstract] [Hide abstract] ABSTRACT: Aim: Interpersonal traumas are highly prevalent in patients with psychotic disorders. Trauma caused by those close to the patient might have a more profound impact than other types of trauma and may influence early life social functioning. The aim is to investigate the associations between different types of trauma, in particular close interpersonal traumas experienced before the age of 18, premorbid factors and baseline clinical characteristics in a sample of first-episode psychosis patients. Methods: A total of 191 patients from the 'TIPS' cohort completed assessment with the Brief Betrayal Trauma Survey at their 5 years follow-up interview. Results: Half of the patients reported that they had experienced interpersonal trauma and one-third reported having experienced close interpersonal trauma before the age of 18. Women reported more sexual abuse, physical attacks and emotional and physical maltreatment than men. There were significant associations between early interpersonal trauma and premorbid adjustment and duration of untreated psychosis, but no significant associations with length of education, comorbid substance use or baseline clinical symptomatology. Conclusions: Close interpersonal trauma before the age of 18 is associated with poorer premorbid adjustment and a longer duration of untreated psychosis. This may indicate that traumatic experiences delay help-seeking behaviour.
    Full-text · Article · Feb 2016 · Early Intervention in Psychiatry
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    Bo Bach · Jaime L. Anderson · Erik Simonsen
    [Show abstract] [Hide abstract] ABSTRACT: The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Section III offers an alternative model for the diagnosis of personality disorders (PDs), including 25 pathological personality trait facets organized into 5 trait domains. To maintain continuity with the categorical PD diagnoses found in DSM-5 Section II, specified sets of facets are configured into familiar PD types. The current study aimed to evaluate the continuity across the Section II and III models of PDs. A sample of 142 psychiatric outpatients were administered the Personality Inventory for DSM-5 and rated with the Structured Clinical Interview for the DSM-IV Axis II disorders. We investigated whether the DSM-5 Section III facet-profiles would be associated with their respective Section II counterparts, as well as determining whether additional facets could augment the prediction of the Section II disorders. Results showed that, overall, the interview-rated DSM-5 Section II disorders were most strongly associated with expected self-reported Section III traits. Results also supported the addition of facets not included in the proposed Section III PD criteria. These findings partly underscore the continuity between the Section II and III models of PDs and suggest how it may be enhanced; however, additional research is needed to further evaluate where continuity exists, where it does not exist, and how the traits system could be improved. (PsycINFO Database Record
    Full-text · Article · Jan 2016 · Personality Disorders: Theory, Research, and Treatment
  • [Show abstract] [Hide abstract] ABSTRACT: Objective: The establishment of childhood adversities as risk factors for non-affective psychosis has derived a need to consider alternative interpretations of several psychosis-related factors. This paper sought to examine premorbid adjustment trajectories and social outcome factors in relation to childhood adversities. Perceived support has been found to decrease the risk of post-traumatic stress disorder, and we wished to compare perceived support in people with first-episode psychosis to non-clinical control persons and explore its relation to childhood adversities. Method: Every individual presenting with a non-affective first-episode psychosis (F20-29, except F21) in Region Zealand over a 2-year period was approached for participation and the 101 consenting participants were matched to 101 people with no psychiatric disorders. Comprehensive demographic data were collected. Assessment instruments included the Premorbid Assessment Scale, the Global Assessment of Functioning scale and the Childhood Trauma Questionnaire. The latter represented the childhood adversities in addition to parental separation and institutionalization. Results: There were no associations between number of childhood adversities and different social or academic premorbid trajectories. Those with more adversities had lower global functioning the year prior to treatment start and reported lower rates of perceived support during childhood along with less current face-to-face contact with family members. Lack of peer support remained a significant predictor of psychosis when adversities were adjusted for and it diminished the risk of psychosis caused by childhood adversities by 10%. Conclusion: Childhood adversities may not predict specific premorbid trajectories, but have an effect on global functioning when the psychosis has begun. Perceived support, especially from peers, may be important in the development of psychosis, and those with more adversities may represent a vulnerable subgroup who need more assistance to increase and maintain supportive networks.
    No preview · Article · Jan 2016 · Australian and New Zealand Journal of Psychiatry
  • [Show abstract] [Hide abstract] ABSTRACT: Persons with schizophrenia spectrum disorders often report high levels of childhood trauma, which often exacerbates symptoms and impede the process of recovery. However, little is known about how these traumas are experienced by service users and how they are integrated in their life stories. To examine this, we conducted in-depth interviews with 15 service users with a diagnosis of a first-episode nonaffective psychosis who had reported 1 or more childhood traumas in self-report measures. There was an unexpected discrepancy between the number of traumas reported in self-report measures and in semistructured interviews, and many of the traumas did not seem integrated in their personal narratives. The analyses further revealed that although participants often described complicated and traumatic childhood environments, they still felt supported by their families; they reported a range of ways in which they tried to cope with and gain control of their psychotic disorder, and they described a general optimistic view of the future.
    No preview · Article · Dec 2015 · The Journal of nervous and mental disease
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    Bo Bach · Jessica L Maples-Keller · Sune Bo · Erik Simonsen
    [Show abstract] [Hide abstract] ABSTRACT: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013a) offers an alternative model for Personality Disorders (PDs) in Section III, which consists in part of a pathological personality traits criterion measured with the Personality Inventory for DSM-5 (PID-5). The PID-5 selfreport instrument currently exists in the original 220-item form, a short 100-item form, and a brief 25-item form. For clinicians and researchers, the choice of a particular PID- 5 form depends on feasibility, but also reliability and validity. The goal of the present study was to examine the psychometric qualities of all 3 PID-5 forms, simultaneously, based on a Danish sample (N = 1376) of 451 psychiatric outpatients and 925 community-dwelling participants. Scale reliability and factorial validity were satisfactory across all 3 PID-5 forms. The correlational profiles of the short and brief PID-5 forms with clinician-rated PD dimensions were nearly identical with that of the original PID-5 (rICC = .99 and .95, respectively). All 3 forms discriminated appropriately between psychiatric patients and community-dwelling individuals. This supports that all 3 PID-5 forms can be used to reliably and validly assess PD traits and provides initial support for the use of the abbreviated PID-5 forms in a European population. However, only the original 220-item form and the short 100-item form capture all 25 trait facets, and the brief 25-item form may be ideally limited to preliminary screening or situations with substantial time restrictions. (PsycINFO Database Record
    Full-text · Article · Dec 2015 · Personality Disorders: Theory, Research, and Treatment
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    [Show abstract] [Hide abstract] ABSTRACT: Background: Children of parents diagnosed with complex mental health problems including schizophrenia, bipolar disorder and depression, are at increased risk of developing mental health problems compared to the general population. Little is known regarding the early developmental trajectories of infants who are at ultra-high risk and in particular the balance of risk and protective factors expressed in the quality of early caregiver-interaction. Methods/design: We are establishing a cohort of pregnant women with a lifetime diagnosis of schizophrenia, bipolar disorder, major depressive disorder and a non-psychiatric control group. Factors in the parents, the infant and the social environment will be evaluated at 1, 4, 16 and 52 weeks in terms of evolution of very early indicators of developmental risk and resilience focusing on three possible environmental transmission mechanisms: stress, maternal caregiver representation, and caregiver-infant interaction. Discussion: The study will provide data on very early risk developmental status and associated psychosocial risk factors, which will be important for developing targeted preventive interventions for infants of parents with severe mental disorder. Trial registration: NCT02306551, date of registration November 12, 2014.
    Full-text · Article · Dec 2015 · BMC Psychiatry
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    [Show abstract] [Hide abstract] ABSTRACT: Study question Is methylphenidate beneficial or harmful for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents? Methods Electronic databases were searched up to February 2015 for parallel and crossover randomised clinical trials comparing methylphenidate with placebo or no intervention in children and adolescents with ADHD. Meta-analyses and trial sequential analyses (TSA) were conducted. Quality was assessed using GRADE. Teachers, parents, and observers rated ADHD symptoms and general behaviour. Study answer and limitations The analyses included 38 parallel group trials (n=5111, median treatment duration 49 days) and 147 crossover trials (n=7134, 14 days). The average age across all studies was 9.7 years. The analysis suggested a beneficial effect of methylphenidate on teacher rated symptoms in 19 parallel group trials (standardised mean difference (SMD) −0.77, n=1698), corresponding to a mean difference of −9.6 points on the ADHD rating scale. There was no evidence that methylphenidate was associated with an increase in serious adverse events (risk ratio 0.98, nine trials, n=1532; TSA adjusted intervention effect RR 0.91). Methylphenidate was associated with an increased risk of non-serious adverse events (1.29, 21 trials, n=3132; TSA adjusted RR 1.29). Teacher rated general behaviour seemed to improve with methylphenidate (SMD −0.87, five trials, n=668) A change of 7 points on the child health questionnaire (CHQ) has been deemed a minimal clinically relevant difference. The change reported in a meta-analysis of three trials corresponds to a mean difference of 8.0 points on the CHQ (range 0-100 points), which suggests that methylphenidate may improve parent reported quality of life (SMD 0.61, three trials, n=514). 96.8% of trials were considered high risk of bias trials according to the Cochrane guidelines. All outcomes were assessed very low quality according to GRADE. What this study adds The results suggest that among children and adolescents with a diagnosis of ADHD, methylphenidate may improve teacher reported symptoms of ADHD and general behaviour and parent reported quality of life. However, given the risk of bias in the included studies, and the very low quality of outcomes, the magnitude of the effects is uncertain. Methylphenidate is associated with an increased risk of non-serious but not serious adverse events. Funding, competing interests, data sharing Region Zealand Research Foundation and Copenhagen Trial Unit. Competing interests are given in the full paper on bmj.com. Full data are available in the version of this review published in The Cochrane Library.
    Full-text · Article · Nov 2015 · BMJ (online)
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    [Show abstract] [Hide abstract] ABSTRACT: Background: Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed and treated psychiatric disorders in childhood. Typically, children with ADHD find it difficult to pay attention, they are hyperactive and impulsive.Methylphenidate is the drug most often prescribed to treat children and adolescents with ADHD but, despite its widespread use, this is the first comprehensive systematic review of its benefits and harms. Objectives: To assess the beneficial and harmful effects of methylphenidate for children and adolescents with ADHD. Search methods: In February 2015 we searched six databases (CENTRAL, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, Conference Proceedings Citations Index), and two trials registers. We checked for additional trials in the reference lists of relevant reviews and included trials. We contacted the pharmaceutical companies that manufacture methylphenidate to request published and unpublished data. Selection criteria: We included all randomised controlled trials (RCTs) comparing methylphenidate versus placebo or no intervention in children and adolescents aged 18 years and younger with a diagnosis of ADHD. At least 75% of participants needed to have an intellectual quotient of at least 70 (i.e. normal intellectual functioning). Outcomes assessed included ADHD symptoms, serious adverse events, non-serious adverse events, general behaviour and quality of life. Data collection and analysis: Seventeen review authors participated in data extraction and risk of bias assessment, and two review authors independently performed all tasks. We used standard methodological procedures expected within Cochrane. Data from parallel-group trials and first period data from cross-over trials formed the basis of our primary analyses; separate analyses were undertaken using post-cross-over data from cross-over trials. We used Trial Sequential Analyses to control for type I (5%) and type II (20%) errors, and we assessed and downgraded evidence according to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach for high risk of bias, imprecision, indirectness, heterogeneity and publication bias. Main results: The studies.We included 38 parallel-group trials (5111 participants randomised) and 147 cross-over trials (7134 participants randomised). Participants included individuals of both sexes, at a boys-to-girls ratio of 5:1, and participants' ages ranged from 3 to 18 years across most studies (in two studies ages ranged from 3 to 21 years). The average age across all studies was 9.7 years. Most participants were from high-income countries.The duration of methylphenidate treatment ranged from 1 to 425 days, with an average duration of 75 days. Methylphenidate was compared to placebo (175 trials) or no intervention (10 trials). Risk of Bias.All 185 trials were assessed to be at high risk of bias. Primary outcomes. Methylphenidate may improve teacher-rated ADHD symptoms (standardised mean difference (SMD) -0.77, 95% confidence interval (CI) -0.90 to -0.64; 19 trials, 1698 participants; very low-quality evidence). This corresponds to a mean difference (MD) of -9.6 points (95% CI -13.75 to -6.38) on the ADHD Rating Scale (ADHD-RS; range 0 to 72 points; DuPaul 1991a). A change of 6.6 points on the ADHD-RS is considered clinically to represent the minimal relevant difference. There was no evidence that methylphenidate was associated with an increase in serious (e.g. life threatening) adverse events (risk ratio (RR) 0.98, 95% CI 0.44 to 2.22; 9 trials, 1532 participants; very low-quality evidence). The Trial Sequential Analysis-adjusted intervention effect was RR 0.91 (CI 0.02 to 33.2). Secondary outcomes: Among those prescribed methylphenidate, 526 per 1000 (range 448 to 615) experienced non-serious adverse events, compared with 408 per 1000 in the control group. This equates to a 29% increase in the overall risk of any non-serious adverse events (RR 1.29, 95% CI 1.10 to 1.51; 21 trials, 3132 participants; very low-quality evidence). The Trial Sequential Analysis-adjusted intervention effect was RR 1.29 (CI 1.06 to 1.56). The most common non-serious adverse events were sleep problems and decreased appetite. Children in the methylphenidate group were at 60% greater risk for trouble sleeping/sleep problems (RR 1.60, 95% CI 1.15 to 2.23; 13 trials, 2416 participants), and 266% greater risk for decreased appetite (RR 3.66, 95% CI 2.56 to 5.23; 16 trials, 2962 participants) than children in the control group.Teacher-rated general behaviour seemed to improve with methylphenidate (SMD -0.87, 95% CI -1.04 to -0.71; 5 trials, 668 participants; very low-quality evidence).A change of seven points on the Child Health Questionnaire (CHQ; range 0 to 100 points; Landgraf 1998) has been deemed a minimal clinically relevant difference. The change reported in a meta-analysis of three trials corresponds to a MD of 8.0 points (95% CI 5.49 to 10.46) on the CHQ, which suggests that methylphenidate may improve parent-reported quality of life (SMD 0.61, 95% CI 0.42 to 0.80; 3 trials, 514 participants; very low-quality evidence). Authors' conclusions: The results of meta-analyses suggest that methylphenidate may improve teacher-reported ADHD symptoms, teacher-reported general behaviour, and parent-reported quality of life among children and adolescents diagnosed with ADHD. However, the low quality of the underpinning evidence means that we cannot be certain of the magnitude of the effects. Within the short follow-up periods typical of the included trials, there is some evidence that methylphenidate is associated with increased risk of non-serious adverse events, such as sleep problems and decreased appetite, but no evidence that it increases risk of serious adverse events.Better designed trials are needed to assess the benefits of methylphenidate. Given the frequency of non-serious adverse events associated with methylphenidate, the particular difficulties for blinding of participants and outcome assessors point to the advantage of large, 'nocebo tablet' controlled trials. These use a placebo-like substance that causes adverse events in the control arm that are comparable to those associated with methylphenidate. However, for ethical reasons, such trials should first be conducted with adults, who can give their informed consent.Future trials should publish depersonalised individual participant data and report all outcomes, including adverse events. This will enable researchers conducting systematic reviews to assess differences between intervention effects according to age, sex, comorbidity, type of ADHD and dose. Finally, the findings highlight the urgent need for large RCTs of non-pharmacological treatments.
    Full-text · Article · Nov 2015 · Cochrane database of systematic reviews (Online)
  • [Show abstract] [Hide abstract] ABSTRACT: Background: Long duration of untreated psychosis is associated with poor clinical and functional outcomes. However, few systematic attempts have been made to reduce this delay and little is known of service users' experience of early detection efforts. Aim: We explored service users' experience of an early detection service and transition to specialized treatment service, including pathway to care, understanding of illness and barriers to adequate assessment and treatment. Methods: In-depth interviews were conducted with 10 service users (median age 21, range 18-27, five males and five females) who were diagnosed with a first-episode non-affective psychosis and who were seen by an early detection team (TOP) and currently enrolled in a specialized early intervention service for this disorder (OPUS). Results: Stigma and fear of the 'psychiatric system' were reported as significant barriers to help seeking, while family members were seen as a crucial support. Moreover, the impact of traumatic events on the experience and development of psychosis was highlighted. Finally, participants were relieved by the prospect of receiving help and the early detection team seemed to create a trusting relationship by offering a friendly, 'anti-stigmatized' space, where long-term symptomatology could be disclosed through accurate and validating questioning. Conclusions: Early detection services have two important functions. One is to make accurate assessments and referrals. The other is to instil hope and trust, and to facilitate further treatment by forming an early therapeutic alliance. The findings in this study provide important insights into the way in which early detection efforts and pathways to care are experienced by service users, with direct implications for improving psychiatric services.
    No preview · Article · Nov 2015 · Early Intervention in Psychiatry
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    [Show abstract] [Hide abstract] ABSTRACT: Objective: Identifying patients at risk of poor outcome at an early stage of illness can aid in treatment planning. This study sought to create a best-fit statistical model of known baseline and early-course risk factors to predict time in psychosis during a ten-year follow-up period after a first psychotic episode. Methods: Between 1997 and 2000, 301 patients with DSM-IV nonorganic, nonaffective first-episode psychosis were recruited consecutively from catchment area-based sectors in Norway and Denmark. Specialized mental health personnel evaluated patients at baseline, three months, and one, two, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores ≥4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years, patients were also evaluated by their clinicians at least biweekly. Baseline and early-course predictors of long-term course were identified with linear mixed-model analyses. Results: Four variables provided significant, additive predictions of longer time in psychosis during the ten-year follow-up: deterioration in premorbid social functioning, duration of untreated psychosis (DUP) of ≥26 weeks, core schizophrenia spectrum disorder, and no remission within three months. Conclusions: First-episode psychosis patients should be followed carefully after the start of treatment. If symptoms do not remit within three months with adequate treatment, there is a considerable risk of a poor long-term outcome, particularly for patients with a deterioration in premorbid social functioning, a DUP of at least half a year, and a diagnosis within the core schizophrenia spectrum.
    Full-text · Article · Nov 2015 · Psychiatric services (Washington, D.C.)
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    Full-text · Poster · Oct 2015
  • No preview · Poster · Oct 2015
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    Bo Bach · Sune Bo · Erik Simonsen
    [Show abstract] [Hide abstract] ABSTRACT: BACKGROUND: DSM-5 Section III includes an alternative model of personality and personality disorders. Apart from rating overall functioning, 25 pathological personality trait facets (DSM-5 traits) are measured. All individuals have certain degrees of DSM-5 traits within continua. OBJECTIVE: Based on the hypothesis that pathological traits are more extreme in clinical participants than in non-clinical participants our aim was to examine the patterns of DSM-5 traits in four subsamples. METHOD: The Personality Inventory for DSM-5 (PID-5) was administered to non-psychotic psychiatric patients, inmates from a mental health care prison department, randomly selected community-dwelling participants, and psychiatric staff members from the region of Zealand in Denmark. RESULTS: As expected, we found significant differences (p < .001) between clinical and non-clinical samples. However, this did not apply to certain traits reflecting externalizing problems. The psychiatric staff members that volunteered to participate in this study generally had remarkably low scores in comparison with the community sample. DISCUSSION: Are psychiatric staff members truly less pathological than the remaining community, are their low scores age-related, or is self-disclosure challenging for this group? Are facets such as Risk Taking, Grandiosity, Manipulativeness and Attention Seeking entirely pathological features, or is a certain amount of such features adaptive?
    Full-text · Conference Paper · Oct 2015
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    Bo Bach · Peter Christoffersen · Erik Simonsen
    [Show abstract] [Hide abstract] ABSTRACT: BACKGROUND: Schema therapy is a psychological treatment approach for personality disorders with a growing body of evidence. The key concepts of the schema therapy model are early maladaptive schemas (schemas) and schema modes (modes), which are both considered vital in the conceptualization and treatment of PDs. Schemas are enduring inner representations of attachment figures comprising beliefs about self and others. Modes are sets of activated schemas along with coping responses and include momentary regressions to child-like states. OBJECTIVE: Based on the proposition that schemas and modes are more extreme in clinical participants than in non-clinical participants our aim was to examine patterns of the two constructs in three subsamples. METHOD: Young Schema Questionnaire 3 – short form (YSQ-S3) and Schema Mode Inventory (SMI) were administered to clinical participants composed of psychiatric patients (n = 294; 79% Women; Mean age 29.4 ) and inmates from a mental health care prison facility (n = 18; 100% males; Mean age 29.2), and community-dwelling participants (n = 350; 81% females; Mean age 29.2). RESULTS: As expected, we found significant differences (p ≤ .001) between clinical and non-clinical subsamples. However, for the self-aggrandizer mode this difference was rather weak. Within the clinical sample, the subsample of prisoners stood out from psychiatric out-patients in terms of elevated externalizing features. CONCLUSION: Schemas and modes, as utilized in schema therapy, differentiate between clinical and non-clinical subsamples in accordance with propositions in the schema therapy literature
    Full-text · Conference Paper · Oct 2015
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    Bo Bach · Sune Bo · Erik Simonsen
    [Show abstract] [Hide abstract] ABSTRACT: The DSM-5 trait model, as measured with the PID-5 self report form, has already demonstrated promising psychometric qualities which is an important prerequisite for clinical utility. However, for a considerable number of clinicians, the various “unfamiliar” trait facets may be perceived as a trip in the jungle without any clue of how they should be interpreted or utilized. As with any new approach, it seems reasonable that clinicians must feel that the burden of implementing such an unfamiliar framework is worth the effort. The purpose of this presentation is to demonstrate how clinicians may use the DSM-5 traits in clinical practice in terms of scoring, interpretation, and treatment. First, the reliability and structural validity of the applied Danish PID-5 self-report form will be summarized (N = 1117; Bo, Bach, Mortensen, Simonsen, 2015). Next, a tentative approach to computerized administration, scoring, and interpretation of the PID-5 scales in clinical practice is put forward. This will be demonstrated reviewing examples of specific PID-5 profiles including interpretation and treatment considerations (Bach, Markon, Simonsen, Krueger, 2015). In this context, clinical advantages and disadvantages of DSM-5 traits are considered. Finally, suggestions for future implementation and standardized use in clinical practice will be presented and discussed involving both self-reported, informant-reported, and clinician-rated DSM-5 traits as well as using norms from different populations.
    Full-text · Conference Paper · Oct 2015
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    [Show abstract] [Hide abstract] ABSTRACT: DSM-5 offers an alternative model of personality pathology that includes 25 traits. Although personality disorders are mostly treated with psychotherapy, the correspondence between DSM-5 traits and concepts in evidence-based psychotherapy has not yet been evaluated adequately. Suitably, schema therapy was developed for treating personality disorders, and it has achieved promising evidence. The authors examined associations between DSM-5 traits and schema therapy constructs in a mixed sample of 662 adults, including 312 clinical participants. Associations were investigated in terms of factor loadings and regression coefficients in relation to five domains, followed by specific correlations among all constructs. The results indicated conceptually coherent associations, and 15 of 25 traits were strongly related to relevant schema therapy constructs. Conclusively, DSM-5 traits may be considered expressions of schema therapy constructs, which psychotherapists might take advantage of in terms of case formulation and targets of treatment. In turn, schema therapy constructs add theoretical understanding to DSM-5 traits.
    Full-text · Article · Aug 2015 · Journal of Personality Disorders

Publication Stats

2k Citations
339.78 Total Impact Points

Institutions

  • 2009-2015
    • IT University of Copenhagen
      København, Capital Region, Denmark
  • 2011
    • Copenhagen University Hospital
      København, Capital Region, Denmark
  • 2010-2011
    • Copenhagen Trial Unit
      København, Capital Region, Denmark
    • University of Oslo
      • Department of Behavioural Sciences in Medicine
      Kristiania (historical), Oslo, Norway
  • 2007-2011
    • Roskilde University
      • Department of Psychology and Educational Studies (PAES)
      Roskilde, Zealand, Denmark
  • 2004-2011
    • Roskilde Hospital
      Roskilde, Zealand, Denmark
  • 2006-2010
    • Oslo University Hospital
      • Division of Mental Health and Addiction
      Kristiania (historical), Oslo, Norway