A mechanism-based group-psychotherapy approach to aggressive behaviour in borderline personality disorder: findings from a cluster-randomised controlled trial

Background Aggressive behaviour is a prevalent and harmful phenomenon in patients with borderline personality disorder (BPD). However, no short-term, low-cost programme exists that specifically focuses on aggression. Aims Attuning therapy modules to pathogenetic mechanisms that underlie reactive aggression in BPD, we composed a 6 week mechanism-based anti-aggression psychotherapy (MAAP) approach for the group setting, which we tested against a non-specific supportive psychotherapy (NSSP). Method A cluster-randomised two-arm parallel-group phase II trial of N = 59 patients with BPD and overt aggressive behaviour was performed (German Registry for Clinical Trials, DRKS00009445). The primary outcome was the externally directed overt aggression score of the Modified Overt Aggression Scale (M-OAS) post-treatment (adjusted for pre-treatment overt aggression). Secondary outcomes were M-OAS irritability, M-OAS response rate and ecological momentary assessment of anger post-treatment and at 6 month follow-up, as well as M-OAS overt aggression score at follow-up. Results Although no significant difference in M-OAS overt aggression between treatments was found post-treatment (adjusted difference in mean 3.49 (95% CI −5.32 to 12.31, P = 0.22), the MAAP group showed a clinically relevant decrease in aggressive behaviour of 65% on average (versus 33% in the NSSP group), with particularly strong improvement among those with the highest baseline aggression. Most notably, significant differences in reduction in overt aggression between MAAP and NSSP were found at follow-up. Conclusions Patients with BPD and aggressive behaviour benefited from a short group psychotherapy, with improvements particularly visible at 6 month follow-up. Further studies are required to show whether these effects are specific to MAAP.

Prediction of Colon Cancer Stages and Survival Period with Machine Learning Approach

The prediction of tumor in the TNM staging (tumor, node, and metastasis) stage of colon cancer using the most influential histopathology parameters and to predict the five years disease-free survival (DFS) period using machine learning (ML) in clinical research have been studied here. From the colorectal cancer (CRC) registry of Chang Gung Memorial Hospital, Linkou, Taiwan, 4021 patients were selected for the analysis. Various ML algorithms were applied for the tumor stage prediction of the colon cancer by considering the Tumor Aggression Score (TAS) as a prognostic factor. Performances of different ML algorithms were evaluated using five-fold cross-validation, which is an effective way of the model validation. The accuracy achieved by the algorithms taking both cases of standard TNM staging and TNM staging with the Tumor Aggression Score was determined. It was observed that the Random Forest model achieved an F-measure of 0.89, when the Tumor Aggression Score was considered as an attribute along with the standard attributes normally used for the TNM stage prediction. We also found that the Random Forest algorithm outperformed all other algorithms, with an accuracy of approximately 84% and an area under the curve (AUC) of 0.82 ± 0.10 for predicting the five years DFS.

194 Effects of maternal behavior at calving, parity and season on dam behavior during fenceline weaning

The study objective was to assess the effect of maternal behavior at calving, parity and season on dam behavior during the first 24 h of fence-line weaning. Crossbred cattle (n = 58) were fitted with global positioning system collars on the day of weaning their calves and placed in a 10.1-ha pasture adjacent to their calves and separated by a common fence. Dam position was recorded at 5-minute intervals. Dam distance from the fence was analyzed using SAS PROC MIXED. Both maternal aggression score during calf handling within 24 h of calving (MA: 1 = flight response to 5 = fight response) and mothering aptitude score immediately following calf processing at calving (MOM: 1 = calf abandonment, 2 = cow retreats quickly with calf, 3 = cow flees chasing calf, 4 = cow walks away with calf, 5 = cow stays in immediate area with calf) affected mean daily distance to the fence (P < 0.01). Dams assigned a MA of 5 maintained the greatest (P < 0.01) mean daily distance from the fence (274.8 ± 1.0 m), whereas dams assigned a MA of 2 or 1 maintained the least (209.5 ± 0.8 m) (P < 0.01) and second least (220.5 ± 0.8 m) (P < 0.01) mean daily distance from the fence. Daily distance from the fence was in sequential order from greatest to least for dams with MOM scores of 3, 1, 5, 2, and 4 (P < 0.01). Distance from the fence was greater (P < 0.01) during fall than spring and greater (P < 0.01) for multiparous than primiparous dams. This suggests that maternal behavior at calving is related to maternal behavior at weaning and that parity and season also influence weaning behavior of dams.

Dietary intake of carotenoids and fiber is inversely associated with aggression score in adolescent girls

Background: Violence and aggression are considered to be important public health issues. There is limited data on the association between dietary intake and aggression score. Aim: We aimed to examine the relationship between the dietary intake and aggressive behavior in Iranian adolescent girls. Methods: The study was carried out among 670 girls aged 12–18 years. A valid and reliable food frequency questionnaire (FFQ) containing 147 food items was used to estimate dietary intake of the study participants. Aggression score was determined using a validated Persian version of the Buss–Perry questionnaire. We analyzed our data using crude and adjusted models. Results: Participants in the fourth quartile of aggression score had significantly higher energy intake compared with those in the first quartile (2808±949 vs 2629±819, p-trend = 0.01). Dietary intakes of soluble fiber (0.42±0.37 vs 0.35±0.29, p = 0.03) and insoluble fiber (2.17±1.65 vs 1.82±1.36, p = 0.02) were significantly higher in the first quartile than in the fourth quartile. In addition, the strongest negative correlations were found between aggression score and dietary soluble fiber ( p = 0.003) and insoluble fiber intake ( p = 0.001). Moreover, aggression score was negatively correlated with dietary α-carotene ( p = 0.02) and β-carotene ( p = 0.04) intake. These associations remained significant even after adjustment for potential confounders. Conclusions: Our results indicated that dietary intakes of fiber, α-carotene, and β-carotene were inversely associated with aggression score. Moreover, a significant positive association was observed between energy intake and aggression score in adolescent girls.

Evaluation of the efficacy of an appeasing pheromone diffuser product vs placebo for management of feline aggression in multi-cat households: a pilot study

Objectives Aggression and social tension among housemate cats is common and puts cats at risk of injury or relinquishment. The aim of this study was to evaluate the effectiveness of a new pheromone product in reducing aggression between housemate cats. Methods A new pheromone product (Feliway Friends) containing a proprietary cat-appeasing pheromone was evaluated for efficacy in reducing aggression between housemate cats via a randomized, double-blind, placebo-controlled pilot trial of 45 multi-cat households (pheromone [n = 20], placebo [n = 25]) reporting aggression for at least 2 weeks. Each household had 2–5 cats. Participants attended an educational training meeting on day (D) –7 and the veterinary behaviorist described behaviors to be monitored for 7 weeks using the Oakland Feline Social Interaction Scale (OFSIS), which assessed the frequency and intensity of 12 representative aggressive interactions. Participants were also provided with instructions for handling aggressive events, including classical conditioning, redirection by positive reinforcement and not punishing or startling the cat for aggressive displays. Punishment techniques were strongly discouraged. Plug-in diffusers with the pheromone product or placebo were utilized from D0–D28. Participants completed a daily diary of aggressive events and weekly OFSIS assessments through to D42. Results Evolution of the OFSIS–Aggression score according to treatment group in the full analysis set population revealed a significant effect on time and treatment group. The OFSIS–Aggression score decreased over time from D0–D28 in both groups (time factor P = 0.0001) with a significant difference in favor of the verum P = 0.06); similar results were found considering the D0–D42 period (time factor P = 0.0001 [D0] and P = 0.04 [D42]). Conclusions and relevance The OFSIS provided a quantifiable measure of the frequency and intensity of 12 intercat interactions reflecting conflict between cats. The cat-appeasing pheromone is a promising treatment for the management of aggression between housemate cats in multi-cat households.