Abstract Shift work is associated with an increased risk of sleep disorders, yet tailored prevention and treatment programs remain rare and understudied. Cognitive behavioral therapy for insomnia is the first-line treatment for insomnia in the general population. We thus developed an anonymous online counselling service based on cognitive behavioral principles, adapted it to shift workers’ needs, and evaluated it in a sample of German shift workers from various industries. This prospective, randomized, controlled superiority trial compares two parallel groups: an intervention group that received four personalized counselling messages and completed four weekly sleep diaries, and a waiting-list control-group that completed sleep diaries only during the four-week waiting period. In the Intention to Treat sample ( n = 66), significant improvements were observed in both groups for the primary outcome, sleep efficiency, and for the secondary outcomes, symptoms of insomnia and depression. Daytime sleepiness did not improve in either group. However, improvements were not significantly greater in the treatment than in the control group. We can thus not demonstrate superiority of the counselling intervention over the control condition, where repeated sleep diary completion and study participation may themselves have had therapeutic effects. Limitations regarding time frame and sample size, as well as implications for research and practice are discussed. Trial registration: The study was registered with the German Clinical Trials Register DRKS under the trial ID DRKS00017777 ( https://drks.de/search/en/trial/DRKS00017777 ). Date of registration: 14.01.2020. This study was registered during the early stages of data collection. Of the 27 participants in the final sample, the first four had initiated data collection at the date of registration. No complete data sets were available at that time.

Opioidabhängigkeit ist im Strafvollzug vergleichsweise verbreitet und wird zunehmend mit Opioidagonisten behandelt. Diese Studie untersucht die langfristige Entwicklung von Haftentlassenen, die unter einer Opioidabhängigkeit leiden und entweder substituiert (n = 139) oder nicht substituiert (n = 108) wurden. Erhebungen fanden zu 4 Zeitpunkten – in Haft, einen Monat nach Haftentlassung, 3 bis 6 Monate nach Haftentlassung, 12 Monate nach Haftentlassung sowie 16 bis 44 Monate nach Haftentlassung – statt. Die Ergebnisse zeigen, dass die substituierten Haftentlassenen weniger illegale Opioide und illegal erworbene Opioidagonisten konsumierten, einen geringeren Suchtdruck erlebten und weniger Überdosen berichteten. Diese Gruppenunterschiede zeigten sich aber primär in den ersten 6 Monaten nach der Haftentlassung. Bezüglich weiterer Outcomes zeigten sich keine günstigeren Ergebnisse bei den Substituierten, und die berufliche Reintegration gelang sogar den abstinenzorientiert behandelten Personen besser. Alarmierend ist, dass unabhängig von der Behandlung nach 3 Jahren 40

INTRODUCTION:Relapse rates in individuals with alcohol use disorder (AUD) are particularly high following inpatient treatment. Innovative strategies should specifically target the transitional gap between completion of inpatient treatment and uptake of standard continuing care. This study aimed to determine whether Appstinence, a digital approach that combines a smartphone app intervention with adjunct telephone coaching, more markedly reduces the risk of relapse for 6 months after inpatient AUD treatment in comparison to a control group with access to standard continuing care. METHODS:In this multicenter clinical trial, 356 participants were randomized to the intervention (n = 175) or control group (n = 181). Eligibility criteria included diagnosis of AUD, smartphone access, no acute suicidality, and no language or neurocognitive impairments. The primary outcome was risk of relapse within 6 months after randomization, as assessed with the Timeline-Follow-Back method. Secondary outcomes included uptake of standard continuing care, hazardous alcohol consumption, craving, depression and anxiety symptom severity, and well-being. RESULTS:The intervention reduced the risk of relapse within 6 months as indicated by a log-rank test (HR: 0.72, 95% CI: 0.53-0.98, p = 0.04) and Cox regression adjusted for baseline characteristics (HR: 0.67, 95% CI: 0.48-0.92, p = 0.01). This effect increased when participants fully adhered to the intervention protocol (log-rank test: HR: 0.61, 95% CI: 0.39-0.94, p = 0.02). No significant differences were observed in secondary outcomes. CONCLUSION:Our findings provide supportive evidence for digital AUD transition treatment. Specifically, we found that, in comparison with access standard continuing care, the novel intervention more effectively reduced risk of relapse within 6 months following inpatient treatment.

Assessing the credibility of psychological problems in forensic evaluations is crucial. The Inventory of Problems-29 (IOP-29) is becoming a valuable symptom validity test (SVT) worldwide and has been validated in over 15 languages. This study evaluates the German IOP-29 and fills a gap by replicating a study of Akca, Tepedelen, et al. We analysed 384 IOP-29 protocols from 128 German-speaking adults (range = 18-87 years) under three conditions: honest, random and feigned responses (post-traumatic stress disorder, PTSD; depression; schizophrenia). Statistical analyses showed that the False Disorder Probability Score (FDS) effectively discriminated between honest and feigned responses (Hedges g = 3.90), with a sensitivity of .91 and a specificity of .95 at an FDS cut-off value of ≥.50. A new index for detecting careless or random responses also showed promising results. This study confirms the utility of the IOP-29 in the German-speaking population and supports its cross-cultural applicability.

INTRODUCTION:Visual perception is a fundamental skill that plays a central role in sensing the external environment. Deficits can lead to impairments in everyday activities. Visual perception is known to be impaired in Alzheimer's disease (AD). However, the extent to which visual perception is impaired in mild cognitive impairment (MCI), often a prodromal state of AD, has not been sufficiently investigated. This study aims to assess visual perceptual abilities in people with MCI and mild AD compared with healthy controls. It will also investigate whether executive functions, activities of daily living and intelligence are affected in this context, providing new insights into the research of visual perception together with MCI and mild AD. METHODS AND ANALYSIS:People with MCI, mild AD and healthy controls will be assessed for cognitive deficits using the Syndrom-Kurztest (SKT). Visual perceptual performance will be assessed using the German version of the Developmental Test of Visual Perception-Adolescent and Adult: Second Edition (DTVP-A:2; Frostings Entwicklungstest der visuellen Wahrnehmung - Jugendliche und Erwachsene 2. Auflage). Activities of daily living will be assessed through the Erlangen Test of Activities of Daily Living in Persons with Mild Dementia or Mild Cognitive Impairment (ETAM) and the Bayer Activities of Daily Living Scale (B-ADL). Executive functions will be measured using the German adaptation of the Behaviour Rating Inventory of Executive Function - Adult (BRIEF-A) and intelligence will be assessed using the Matrix Reasoning and Vocabulary Test of the Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV). Data analysis will involve descriptive analyses, linear regression analyses, multivariate analysis of variance, mediation analysis and structural equation modelling. ETHICS AND DISSEMINATION:This study has received approval from the Ethics Committee of Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Germany (number: 2023_009). Findings will be disseminated through peer-reviewed publications and presentations at national and international conferences. TRIAL REGISTRATION NUMBER:Registered at OSF https://doi.org/10.17605/OSF.IO/PM5AV.

OBJECTIVE:Cross-sectional and qualitative studies suggest that online peer counseling have potential benefits in addressing suicidality among adolescents and young adults. The present study aims to evaluate the effectiveness of [U25], a low-threshold online peer counseling service provided in Germany. METHOD:A non-randomized, longitudinal study design with control group was conducted to measure outcomes at baseline as well as four weeks, three months and six months after baseline. The control group consists of young adults who inform themselves about the service on the internet but do not register for counseling. Primary outcomes included service utilization, suicidal ideation, psychopathological symptoms and life adversities. The original sample consisted of N = 1250 young adults (treatment group: n = 210, control group: n = 1040). After propensity score matching, the treatment and control group each comprised n = 210 participants. RESULTS:Service utilization increased in the CG but not in the TG. Suicidal ideation and psychopathological symptoms decreased for both groups across all time points. [U25] did not lead to greater symptom reduction compared to the control group. No differences were found in the number of life adversities. CONCLUSIONS:The results indicate that a large number of young adults with suicidal thoughts and other mental health issues feel supported by the U25 platform. However, similar symptom reduction was obtained in the treatment and control group. This result could be explained by the increased support utilization in the control group, which warrants further investigation. This study can serve as a framework for future research with larger sample sizes to further explore and validate these findings.

The new Chinese version of the SKT (Syndrom-Kurz-Test) Short Cognitive Performance Test aims to detect early cognitive impairment and is a promising addition to neuropsychological test batteries in China and suitable for Chinese speaking patients. This study has three aims: 1. to assess whether the SKT's diagnostic accuracy is comparable to established cognitive impairment tests (e.g. Addenbrooke´s cognitive examination-III (ACE-III) and Montreal Cognitive Assessment-Basic (MoCA-B)); 2. to examine whether the three tests show intra-individual differences according to different types of mild cognitive impairment (single-domain amnestic MCI, semantic MCI and multiple-domain amnestic MCI); 3. to determine whether these tests distinguish between individuals with no cognitive impairment and those with subjective cognitive decline (SCD). The validation sample included 1038 older adults (mean age = 70.04, SD = 6.05) from the Chinese Preclinical Alzheimer's Disease Study (C-PAS). Participants underwent cognitive testing and received consensus diagnoses of normal cognition, MCI, or dementia. Sensitivity and specificity were calculated for each test. ANOVAs examined differences between MCI subtypes, and t-tests assessed group differences between normal cognition and SCD. Results: The SKT showed the highest discrimination between normal cognition and cognitive impairment (MCI or dementia), with a sensitivity of 85.4% and specificity of 69.8%. All three tests demonstrated significant score differences across MCI subtypes. Additionally, all tests significantly distinguished individuals with SCD from those without cognitive impairment (p < 0.01). Conclusions: The new Chinese produced weaker results than the established tests. However, given its strengths, it could be a useful tool for identifying cognitive impairment in certain situations.

ABSTRACTBackgroundThis article is dedicated to David Farrington who was a giant in criminology and, in particular, a pioneer in studying developmental pathways of delinquent and antisocial behaviour. Numerous studies followed his work. Systematic reviews of his and others' research described between two and seven (mainly 3–5) trajectories. The variation is due to the age of individuals, kind and seriousness of problem behaviour, data sources, assessment methods and cultural context. Reviews stated a lack of research on very early starting problem behaviour, broad developmental outcomes, data from multiple informants and (beyond description) on risk and protective factors or potential causes of the different trajectories.AimsThe present study addresses these issues in a prospective longitudinal design and test of the concept of antisocial potential (AP) in Farrington's ICAP theory.MethodsData on more than 600 children and their families were gathered in a prospective longitudinal design over 10 years in Germany. To avoid potentially negative effects of criminal justice interventions, the study concentrates on child development from ages 4–5 to 6–7, 8–9, 10–12 and 13–14 years. Child externalising behaviour problems were assessed using the social behaviour questionnaire by kindergarten educators, mothers, school teachers and youth self‐reports. Developmental trajectories were analysed by general growth curve modelling (GGCM) across five time points. The prediction and explanation of different pathways included family factors (SES, stressful life events, aggressive and inconsistent parenting) and child characteristics (intelligence, resting heart rate, disruptive behaviour, temperament and social adaptability). In accordance with dose–response relationships, we also tested accumulated factors in the Cracow Risk/Needs Instrument.ResultsThe GGCM analysis revealed five developmental trajectories: high‐chronics (2.4%), high‐reducers (7.9%), medium‐reducers (22.4%), late‐starters medium (8.7%) and low‐chronics (continuously unproblematic youngsters; 58.6%). Although the group with high externalising problems across all time points was rather small due to the affluent context of the region, there were significant social and individual differences between this and the other groups that fitted to ICAP theory. Furthermore, the study revealed differences between those youngsters that desisted from behaviour problems or started later. The predictive validity of accumulated factors in the Cracow Risk/Needs Instrument was very good for the comparison of the groups with persistently high versus no serious behaviour problems.ConclusionsOur results showed that different pathways of aggressive, delinquent, impulsive and other externalising behaviour already commence in early childhood. Behavioural stability (high‐ vs. low‐chronic problems) was well predicted by child and family characteristics, but there were also plausible findings on trajectories of behavioural change. Overall, the findings underline the need for early developmental prevention.

Opioid addiction is relatively common in the prison system and is frequently treated with opioid agonists. This study examines the long-term development of persons suffering from opioid addiction who were either receiving (n = 139) or not receiving (n = 108) opioid maintenance treatment while in prison. Interviews were conducted with each participant at four time points: in prison, 1 month after release, 3-6 months after release, 12 months after release and 16-44 months after release. The results show that persons who received opioid maintenance treatment during prison consumed fewer illicit opioids and illegally acquired opioid agonists, experienced less craving and reported fewer overdoses after release from custody; however, these group differences were primarily evident in the first 6 months after release. Regarding other outcomes, more favorable results were not found for those receiving opioid maintenance treatment and occupational reintegration was even lower. Re-incarceration rate was 40% after 3 years (independent of treatment) which is alarming. Furthermore, treatment continuity is a relevant factor. Overall, opioid maintenance treatment is an effective intervention for opioid addicts in prison but it needs to be supplemented by additional support services and intensive transition management.

The study explores the utilization of psychosocial support by young adults facing suicidal ideation or impulses, considering a comprehensive spectrum of psychosocial services. The study sheds light on help utilization and gaps in service use among different groups. The data is derived from the baseline assessment of the research project "Outcome Evaluation [U25]". The sample includes 888 young adults who reported suicidal thoughts and behaviors. Among the participants, 55% accessed at least one psychosocial service. Medical/psychotherapy services were the most utilized (54%), followed by professional counseling (34%) and non-professional self-help services (22%). Gender differences were observed, with males using help less frequently than females and individuals with diverse gender identities. Participants in relationships were less likely to seek help than singles. A migrant background showed no consistent impact on service utilization. Psychological distress and suicide literacy were associated with increased service utilization. Regression analysis revealed that gender and relationship status remained predictors of service utilization even when considering mental distress, suicidal thoughts and behaviors, and suicide literacy.

Zusammenfassung Die Studie untersucht die Inanspruchnahme von psychosozialen Diensten bei jungen Menschen, die unter suizidalem Erleben und Verhalten leiden. Dadurch werden Versorgungslücken deutlich gemacht und besondere Zielgruppen herausgearbeitet. Die Daten stammen aus der Baselinebefragung des Forschungsprojekts „Outcome Evaluation [U25]“. Die Stichprobe umfasst n=888 Personen im jungen Erwachsenenalter, die unter suizidalem Erleben und Verhalten leiden. Unter den Teilnehmenden griffen 55% auf mindestens ein psychosoziales Hilfsangebot zu. Heilkundliche Angebote wurden am häufigsten genutzt (54%), gefolgt von weiteren professionellen Beratungsangeboten (34%) und nichtprofessionellen Selbsthilfeangeboten (22%). Männer nahmen seltener Hilfe in Anspruch als Frauen und Personen diversen Geschlechts. Teilnehmende in Beziehungen suchten seltener Hilfe als Singles. Der Migrationshintergrund zeigte keinen konsistenten Zusammenhang mit der Inanspruchnahme von psychosozialen Diensten. Psychische Belastungen und „suicide literacy“ hingen mit einer erhöhten Inanspruchnahme zusammen. Geschlecht und Beziehungsstatus waren auch dann signifikante Prädiktoren für die Inanspruchnahme von psychosozialen Angeboten, wenn psychische Belastungen, suizidales Erleben und Verhalten sowie „suicide literacy“ berücksichtigt wurden.

The aim of this study was to examine the long-term effects of medication-assisted treatment after release from prison. We compared prisoners receiving medications for opioid use disorder (MOUD) to prisoners receiving no MOUD, on a number of outcome variables. Self-reported drug use was confirmed with laboratory tests. A sample of 247 prisoners in German prisons completed the European Addiction Severity Index shortly before release. Subjects were contacted again at 1, 3–6, and 12 months after release for telephone interviews. Compared to no-MOUD subjects, MOUD subjects reported fewer illegal opioids and significantly fewer non-prescribed substitution medications. MOUD participants showed high treatment continuity through 12 months. Benefits of MOUD peaked at 3–6 months; effects were reduced at 12 months. Convergent validity of the self-report measure of drug use with laboratory drug screenings was satisfactorily high ( 71

Aims: Opioid addiction is a common problem among prisoners. The aim of this study was to examine differences between people who are incarcerated receiving opioid substitution treatment (OST) and those not receiving OST on addiction-related outcome variables during incarceration and after release from prison. Variables covered illicit use of opioids, non-prescribed substitution medication and other substances, opioid withdrawal symptoms, opioid craving, non-fatal overdoses and post-release substitution treatment. Design: Interviews (European Addiction Severity Index, EuropASI) were conducted with 247 participants in German prisons before release. Participants were interviewed again 1 month and 3-6 months after release from prison. Results: During incarceration, participants who received OST used less illicit opioids and non-prescribed substitution medication than those who did not receive OST. After release from prison, participants in the OST group reported less illicit opioid use and less non-prescribed substitution medication use, as well as less opioid craving. Participants who received OST in prison were more likely to be in OST at post-release follow-up than those who had not received in-prison OST. Conclusion: OST appears to have a positive effect on illicit opioid use and craving both in prison and after release, as well as on treatment at follow-up, which can be considered a protective factor.

Background: The SKT is a short cognitive performance test designed to assess impairments in memory and cognitive abilities such as attention and speed of information processing. In 2019, new regression-based norms for the English version of the SKT were calculated. This study has two aims: to establish valid cut-offs for distinguishing between no cognitive impairment, mild cognitive impairment (MCI), and dementia (1) and to cross-validate the new norms for detecting MCI and dementia in a community sample of older adults with clinical diagnoses (2). Methods: The validation sample included 143 older adults (mean age = 87.7, SD = 3.55) from the Sydney Memory and Aging Study (MAS Study). Participants were classified as having normal cognition, MCI, or dementia solely based on a consensus diagnosis; in addition, three tests (SKT, Mini-Mental State Examination (MMSE), and Addenbrooke’s Cognitive Examination III (ACE-III)) to measure cognitive impairment were applied. Sensitivity and specificity for all three tests, as well as bivariate correlations, were calculated. Results: The sensitivity of the SKT for the differentiation of cognitive impairment (MCI or dementia) from normal cognition was 80.6%. The convergence between the SKT and the consensus diagnoses was 70.3% for all three diagnostic groups. All correlations between the three tests and the consensus diagnosis were significant (p < 0.01). Conclusions: In sum, it can be stated that the SKT is a valid tool for detecting early stages of cognitive impairment, performing very well in discriminating between no cognitive impairment and cognitive impairment (MCI or dementia).

Background:Major depressive disorder (MDD) is linked to reduced heart rate variability, an index of cardiovascular autonomic modulation (CAM). However, treatment effects on CAM are poorly known. Our objective was to assess if initiation of inpatient treatment has a beneficial effect on CAM in MDD patients. Methods:In 30 MDD inpatients, we recorded RR-intervals (RRI), continuous blood pressure (BPsys, BPdia), skin conductance levels (SCL), respiration frequency (RESP) and current medication within 24 h (T1) and 3 weeks after hospital admission (T2) during resting state and metronomic breathing. The same parameters were recorded once at baseline in 30 controls without mental disorders. We computed indices of sympathetic modulation, parasympathetic modulation and parameters reflecting total CAM. Physiological parameters were compared using MANCOVAS. Symptoms of depression were assessed using Hamilton rating scale for depression (HAM-D) and Beck Depression Inventory (BDI), we used rmANOVAs to compare t1 and t2 questionnaire data. Results:BDI and HAM-D scores were lower at T2 than T1 (both p < 0.01). RRI was lower in T1 patients than in controls (p = 0.021), while BPdia (p = 0.038) and RESP (p = 0.014) were higher in T1 patients than controls. MDD patients showed lower parameters of parasympathetic modulation and total CAM than controls during resting state (parasympathetic p = 0.003; total CAM p = 0.017) and metronomic breathing (parasympathetic p = 0.040; total CAM p = 0.007). Analysis unveiled lower parameters of parasympathetic modulation in T1 patients compared to T2 patients during baseline (p = 0.046). No differences between T1 and T2 patients during metronomic breathing were found. Conclusion:MDD patients showed lower CAM than controls. Contrary to our assumption, we found a decline of parasympathetic modulation in MDD patients over the observation span despite symptomatic improvement. The decline is presumably due to the initiation of psychopharmacotherapy and changes in premedication.