A Delphi study of late-onset personality disorders

2019 ◽  
Vol 31 (07) ◽  
pp. 1007-1013 ◽  
Author(s):  
Erlene Rosowsky ◽  
Emily Lodish ◽  
James M. Ellison ◽  
S. P. J. van Alphen
Keyword(s):  
Personality Disorders ◽  
Old Age ◽  
Assisted Living ◽  
Delphi Study ◽  
De Novo ◽  
Late Onset ◽  
Late Life ◽  
The Core ◽  
The Usa ◽  
The Uk

ABSTRACTObjectives:The DSM-5 describes personality disorders (PDs) as emerging in early life and remaining continuous throughout the life-span. Yet case studies and expert opinion support the existence of late-onset PDs. Little is known about PDs in late life, and our instruments for assessing them are not well validated. Thus, the focus of this exploratory Delphi study was the late-onset PD, with special attention to the accuracy of the core criteria for the diagnosis.Design:A Delphi study was designed to assess the presentation of PDs in late life. The Delphi consisted of three successive rounds of inquiry. Between rounds, the participants were provided with a summary of the panel’s responses.Participants:A panel of 21 experts included published authors, researchers, and teachers from the USA, the UK, Australia, France, Belgium, and the Netherlands.Measurements:Researchers designed a survey that included an introduction, a demographic questionnaire, and five questions that varied in presentation and response format.Results:Experts reached consensus that a variant of PD appears de novo in old age. The core features of inflexibility and pervasiveness may not pertain to late-onset PD. There was agreement that frequently occurring life events contribute selectively to the expression of late-onset PD, with the major ones being death of a spouse or partner and transition to a nursing or assisted-living facility.Conclusions:Nearly all participants took the position that PD can present for the first time in old age and be clinically identifiable without having been so identified earlier in life.

Treatment of psychoses in the elderly

1996 ◽  
Vol 2 (3) ◽  
pp. 133-139
Author(s):  
A. Phanjoo
Keyword(s):  
Old Age ◽  
Psychotic Disorders ◽  
De Novo ◽  
Late Onset ◽  
Late Life ◽  
The Elderly ◽  
Functional Psychoses ◽  
First Time ◽  
Paranoid Psychosis

Psychotic disorders in the elderly can be divided into three types: disorders that have started in earlier life and persist into old age; disorders that start de novo after the age of 60, and psychoses associated with brain disease, including the dementias. The classification of psychoses in late life has provoked controversy for nearly a century. The debate concerns whether schizophrenia can present at any stage of life or whether functional psychoses, arising for the first time in late life, represent different illnesses. The nomenclature of such disorders consists of numerous terms including late onset schizophrenia, late paraphrenia, paranoid psychosis of late life and schizophreniform psychosis. This plethora of terms has made research difficult to interpret.

Strategie Management in Eleven National Libraries: A Report on a Research Study

1997 ◽  
Vol 9 (2) ◽  
pp. 101-113 ◽  
Author(s):  
Anna Chalmers
Keyword(s):  
New Zealand ◽  
Strategic Management ◽  
Research Study ◽  
Information Environment ◽  
Digital Information ◽  
The Core ◽  
The Usa ◽  
The Uk ◽  
Key Aspects ◽  
National Libraries

In 1996 the national libraries of Australia, Canada, France, Germany, Ireland, Malaysia, the Netherlands, New Zealand, Singapore, the UK and the USA took part in a study of their experiences with strategic management. A literature review had identified 15 key aspects of strategic management. Respondents were asked their views of the importance of each aspect, and how satisfied they were with the library's achievement of it. In every case the importance attached to the aspect was greater than the library's satisfaction with achievement. Each library was also asked to nominate from a checklist the reason or reasons why it had produced its first strategic document. The centrality of the digital information environment to the core functions of national libraries has been highlighted by the study.

The Case for a Psychological Perspective on Late-Onset Psychosis

1997 ◽  
Vol 31 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Anne Hassett
Keyword(s):  
Old Age ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Late Life ◽  
Personality Factors ◽  
Elderly Persons ◽  
Developmental Studies ◽  
Vulnerability Factors ◽  
Future Directions ◽  
Self Image

Objective:A conceptual framework is proposed for studying late-onset psychotic disorders. This incorporates developmental and psychological perspectives to complement the biological focus of most recent studies in this area. Method:Studies of late-onset psychosis that focus on the specificity of neuroimaging abnormalities, family history and sensory deficits were reviewed. Aspects of the developmental and personality literature were then examined with the goal of ascertaining their relevance for the emergence of psychosis in late life. Possible future directions incorporating biological and psychological approaches are proposed. Results:The biological abnormalities identified in studies of late-onset psychosis lack the specificity to stand alone as aetiological factors. Neuroimaging changes and sensory impairment are commonly found in study subjects; however, they also occur in elderly persons without psychiatric illness as well as in those with other late-onset psychiatric disorders. Perhaps it is more appropriate to regard these changes as conferring a vulnerability to psychosis in old age, but symptoms do not develop unless other risk factors, either longstanding or ageing-related, are also present. Developmental studies of late life that have used Erikson's concept of a final lifestage crisis of achieving ‘ego-integrity’, suggest that personality style may be influential in determining the negotiation of this last maturational task. Failure to do so results in ‘despair’, fragmentation of self-image and paranoid fears. To date, there has been little investigation of the relevance of these developmental and personality factors for the emergence of psychosis in old age. Conclusions:If we are to advance our understanding of late-onset psychotic disorders, research in this area needs to move beyond the elusive search for specific biological markers. A model of causation that integrates the longitudinal perspective of lifestage tasks with personality and biological vulnerability factors provides a broad framework which protects against premature foreclosure on aetiological determinants.

scholarly journals Urban Uprisings: The Troubled Relationship Between Citizens and Police in France, the UK, and the USA

2019 ◽  
Author(s):  
Luuk Slooter
Keyword(s):  
Collective Violence ◽  
Police Reform ◽  
The West ◽  
Academic Literature ◽  
The Core ◽  
Political Debates ◽  
Political Perspective ◽  
Political Protests ◽  
The Usa ◽  
The Uk

Abstract Violent outbursts in Paris (2005), London (2011), and Ferguson (2014) illustrate the problematic and disturbing relationship between citizens and police in the ‘West’. While these episodes are often portrayed as ‘apolitical’ and ‘criminal’ in media and political debates, they are in the academic literature predominantly seen as (unarticulated) forms of political protests against structural inequalities. Building on this political perspective, I will first argue that the interplay between structural, police, and ‘private’ violence is at the core of these urban uprisings. Subsequently, I will identify four common factors that contributed to the onset and legitimization of collective violence in Paris, London, and Ferguson: an emotive and symbolically significant incident, often with a young inhabitant of a marginalized neighbourhood as protagonist; police involvement; unclarity and pre-violence rumours; and pre-existing us-them divides. In the conclusion, I will emphasize the importance and need of a systemic approach towards police reform.

In defiance of an ageing culture

1999 ◽  
Vol 19 (1) ◽  
pp. 139-148 ◽  
Author(s):  
MIKE HEPWORTH
Keyword(s):  
Social Construction ◽  
Old Age ◽  
Social Constructionism ◽  
Review Article ◽  
Recent Book ◽  
Middle Years ◽  
The Social ◽  
The Usa ◽  
The Uk

Margaret Morganroth Gullette, Declining to Decline: Cultural Combat and the Politics of the Midlife. Charlottesville and London: University Press of Virginia 1997, 276pp, $29.95 cloth ISBN 0-8139-1721-2.Margaret Morganroth Gullette is one of America's foremost critics of the concept of ageing as a universal and comprehensive process of decline which begins in the middle years. She is a formidable critic of biological essentialism, defender of social constructionism, and opponent of ‘middle ageism’. Her most recent book, published in 1997 and not yet available in the UK, has been widely acclaimed in the USA. This review article describes Gullette's analysis of the social construction of decline in the context of her previous writings on midlife and outlines her strategy for combatting the decline model of ageing into old age.

scholarly journals Democracy in the prison of political science

2020 ◽  
pp. 019251212093243
Author(s):  
Felipe Antunes de Oliveira
Keyword(s):  
Political Science ◽  
Review Article ◽  
Science Literature ◽  
Donald Trump ◽  
Disciplinary Boundaries ◽  
The Core ◽  
Individual Traits ◽  
The Usa ◽  
The Uk ◽  
Societal Dynamics

After the Brexit vote and the election of Donald Trump, a widespread perception emerged that the world was witnessing a crisis of liberal democracy. Not surprisingly, said crisis is at the core of a new batch of political science literature. This review article takes stock of some key contributions to the literature, namely Albright (2018), Levitsky and Ziblatt (2018), Norris and Inglehart (2018), Runciman (2018a) and Eatwell and Goodwin (2018). My key argument is that the reviewed books are fundamentally limited by problematic ontological assumptions stemming from artificial disciplinary boundaries. Privileging either individual traits of authoritarian leaders or the very specific experience of the USA or the UK, they fail to capture varied, yet deeply interconnected international expressions of contemporary authoritarianism. Following Justin Rosenberg’s open invitation to place the concept of multiplicity at the centre of a renewed research agenda, I suggest that a more holistic take on the crisis of democracy requires a renewed attention to inter-societal dynamics.

scholarly journals COVID19, mental wellbeing and work engagement

2020 ◽  
Vol 9 (4) ◽  
pp. 356-365
Author(s):  
Syed Mudasser Abbas ◽  
Professor Liu Zhiqiang
Keyword(s):  
Mental Health ◽  
Old Age ◽  
Work Engagement ◽  
Positive Impact ◽  
Mental Wellbeing ◽  
Psychological Resilience ◽  
Structured Interviews ◽  
Core Theme ◽  
The Core ◽  
The Uk

The aim of this study is to explore how COVID-19 influences the mental health of old age employees by posing challenges to psychological resilience thus affecting their work engagement. The data was collected from three countries, China, Pakistan, and the UK, through eighteen semi-structured interviews. Three sub-themes emerged under the core theme of “psychological challenges”: “cognitive challenges”, “physical challenges”, and “behavioral challenges”. Similarly, “individual resilience” and “group resilience” emerged under the core theme of “psychological resilience”. The results showed that the mental health of old age employees without having any medical complications was also affected during the pandemic thus resulting in low work engagement. The data was collected from three countries namely China, Pakistan, and the UK. Furthermore, data were collected through telephonic interviews so some aspects of the study might be left unexplored which can only be possible through face to face interaction. This study, in line with the previous literature, indicate that challenges explored related to COVID-19 can significantly influence the mental wellbeing of aging employees. The study also encourages employers to understand the limitations of aging employees and develop flexible policies that can have a positive impact on work engagement. The study presents a novel approach contributing to the knowledge gap of COVID-19 impact on wellbeing and work engagement of healthy but senescent employees.

scholarly journals Methodological approaches for conducting follow-up research with clinical trial participants: a scoping review and expert interviews

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Aita Signorell ◽  
Jasmina Saric ◽  
Christian Appenzeller-Herzog ◽  
Hannah Ewald ◽  
Christian Burri ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Scoping Review ◽  
De Novo ◽  
Trial Participant ◽  
Expert Interviews ◽  
The Usa ◽  
Methodological Approaches ◽  
Research Frameworks ◽  
The Uk ◽  
Trial Participants

Abstract Background Evidence-based establishment and implementation of best principles, laws and ordinances that regulate clinical research depend on the consultation and involvement of trial participants. Yet, guidance on methodological approaches to obtain trial participants’ perspectives is currently missing. This scoping review therefore aimed at identifying, describing and evaluating research approaches to obtain trial participants’ feedback on their views and experiences. Methods We searched the electronic databases Medline and PsycInfo via Ovid and the Web of Science Core Collection. Clinical trials were included that involved adult participants that were conducted in selected high-income countries and that were published in peer-reviewed journals between 1985 and 2018. In addition, 29 expert interviews were conducted between March and May 2019. Results Out of 5994 identified records, 23 articles were included in this review. Twelve studies used a qualitative approach, 10 were quantitative and one study used a mixed-method design. More than 75% of all work was conducted in the USA and the UK. The scoping review and the expert interviews highlighted that recruitment of participants was generally done through direct contact by principal investigators and/or study nurses or through searches in de-identified patient databases. Authors used surveys, interviews or focus group discussions. The tools used were either based on existing validated ones or developed and verified de novo with the support of experts and/or patient representatives. Conclusions To our knowledge, this is the first methodological literature review of approaches to researching experiences of clinical trial participants where findings were triangulated with expert interviews. Covering a range of indications, trial phases and study settings, it demonstrates that clinical trial participant perspectives and experience is heavily under-researched. This casts doubt on the overall robustness of available insight into trial participants’ views and experiences. Our results demonstrate that the methodology for studying participant opinion, perception and experience should be adapted to the measure of interest and conform to the study population. Using valid patient experience data is the basis to evaluate existing legal and regulatory human subject research frameworks for their appropriateness from a patient perspective. Such an evaluation will be critical to empower research participants.

An early mainstream economist from Hungary: István Varga (1897–1962)

2003 ◽  
Vol 53 (2) ◽  
pp. 195-213 ◽  
Author(s):  
K. Majoros
Keyword(s):  
Austrian Economic ◽  
National Income ◽  
Anglo Saxon ◽  
Turbulent Times ◽  
The Usa ◽  
New Ideas ◽  
Modern Economic ◽  
The Uk ◽  
Economic Thinking ◽  
Lasting Influence

The study introduces a Hungarian economic thinker, István Varga*, whose valuable activity has remained unexplored up to now. He became an economic thinker during the 1920s, in a country that had not long before become independent of Austria. The role played by Austria in the modern economic thinking of that time was a form of competition with the thought adhered to by the UK and the USA. Hungarian economists mainly interpreted and commented on German and Austrian theories, reasons for this being that, for example, the majority of Hungarian economists had studied at German and Austrian universities, while at Hungarian universities principally German and Austrian economic theories were taught. István Varga was familiar not only with contemporary German economics but with the new ideas of Anglo-Saxon economics as well — and he introduced these ideas into Hungarian economic thinking. He lived and worked in turbulent times, and historians have only been able to appreciate his activity in a limited manner. The work of this excellent economist has all but been forgotten, although he was of international stature. After a brief summary of Varga’s profile the study will demonstrate the lasting influence he has had in four areas — namely, business cycle research and national income estimations, the 1946 Hungarian stabilisation program, corporate profit, and consumption economics — and will go on to summarise his most important achievements.

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