Decentering, a central change strategy of Mindfulness-Based Cognitive Therapy, is a process of stepping outside of one’s own mental events leading to an objective and non-judging stance towards the self. The study aimed at investigating associated mechanisms of decentering. The present study investigated the relation of decentering, operationalized by means of the German Version of the Experiences Questionnaire, to severity of depressive symptoms, assessed by the adaptive Rasch-based depression screening, and self-focussed attention, assessed by the Questionnaire of Dysfunctional and Functional Self-Consciousness. Furthermore, the relationship between decentering and a) the ability to shift and allocate attention by means of the Stroop test, and b) metacognitive monitoring, i.e. the absolute difference between judged and real task performance, was investigated. These relationships were examined in 55 healthy students using Pearson’s correlations. In line with our assumptions, higher decentering scores were significantly associated with lower scores on severity of depressive symptoms, with higher functional- and lower dysfunctional self-focussed attention. Contrary to our expectations, results neither indicated a relationship between decentering and attention ability, nor between decentering and metacognitive monitoring. The present results suggest that decentering is associated with concepts of mental health (i.e. less severity of depressive symptoms and higher functional self-focussed attention). Overall, the concept decentering seems to be mainly composed of self-focussed aspects when investigated in a healthy sample without intervention. Further investigations of associated concepts of decentering should consider aspects of self-relevance and emotional valence.

Inflammation-induced thrombosis represents a severe complication in patients with myeloproliferative neoplasms (MPN) and in those with kidney dysfunction. Overlapping disease-specific attributes suggest common mechanisms involved in MPN pathogenesis, kidney dysfunction, and thrombosis. Data from 1420 patients with essential thrombocythemia (ET, 33.7%), polycythemia vera (PV, 38.5%), and myelofibrosis (MF, 27.9%) were extracted from the bioregistry of the German Study Group for MPN. The total cohort was subdivided according to the calculated estimated glomerular filtration rate (eGFR, (mL/min/1.73 m²)) into eGFR1 (≥90, 21%), eGFR2 (60–89, 56%), and eGFR3 (<60, 22%). A total of 29% of the patients had a history of thrombosis. A higher rate of thrombosis and longer MPN duration was observed in eGFR3 than in eGFR2 and eGFR1. Kidney dysfunction occurred earlier in ET than in PV or MF. Multiple logistic regression analysis identified arterial hypertension, MPN treatment, increased uric acid, and lactate dehydrogenase levels as risk factors for kidney dysfunction in MPN patients. Risk factors for thrombosis included arterial hypertension, non-excessive platelet counts, and antithrombotic therapy. The risk factors for kidney dysfunction and thrombosis varied between MPN subtypes. Physicians should be aware of the increased risk for kidney disease in MPN patients, which warrants closer monitoring and, possibly, early thromboprophylaxis.

Social attitudes experienced by people with disabilities can strongly impact upon their health and quality of life. The extent to which social attitude measurement transcends specific cultures is unknown. Thus, the aim of the study was to develop German item banks to assess social attitude barriers and facilitators to participation and compare the construct definition with that developed in the United States. The American version of the two item banks assessing social attitudes that act as barriers and facilitators in persons with disabilities was translated into German and culturally adapted. The sample consisted of 410 in- and outpatients treated for spinal diseases at a German University Hospital. The psychometric properties of the resulting 53 items-item pool were evaluated using Rasch analysis. A special focus was placed on the investigation of unidimensionality, local independence, differential item functioning (DIF) and targeting. To evaluate convergent and divergent validity correlations with perceived social support, depression and pain interference were calculated. Unlike the American version, both the barriers and facilitators item banks had to be divided into two subscales assessing attitudes that individuals with disabilities experience as being directed towards them (individual perception) or attitudes that respondents experience as being directed towards people with disabilities as a social group (societal perception). Four unidimensional scales were constructed. Fit to the Rasch model required item deletion and forming testlets to account for extensive local dependence. There was no evidence of DIF with regard to gender or age. Targeting of the subscales was moderate to good. Results support a distinction between social attitudes at the individual and societal level, allowing a more specific assessment than is possible when this distinction is ignored.

Purpose: Neuroblastoma, a common cancer in children, is characterized by striking clinical heterogeneity, ranging from spontaneous regression to fatal disease. Precise risk classification is therefore essential for appropriate treatment stratification. Given that genotoxic chemotherapy constitutes the mainstay of neuroblastoma treatment, it is particularly important to avoid overtreatment in patients with biologically favorable disease, notably in the heterogeneous group of current non–high-risk patients. Here, we tested the hypothesis that telomere maintenance mechanisms (TMM), which have been proposed as key hallmark of high-risk neuroblastoma, may improve neuroblastoma risk classification over current standard of care. Methods: We examined the prognostic accuracy of TMM in comparison with current standard-of-care prognostic variables in 366 patients with neuroblastoma, including 259 non–high-risk patients (test set, n = 116; validation set, n = 143). Patient event-free survival (EFS) and overall survival (OS) were determined according to TMM and currently used molecular classification by chromosomal copy-number alterations or gene expression profiles. The prognostic impact of the three molecular classifications was compared pairwise and with standard-of-care prognostic variables in multivariable analyses. Results: TMM-based and gene expression-based classification accurately distinguished non–high-risk patients with excellent and adverse EFS and OS in both the test and validation sets. On multivariable analyses of standard-of-care prognostic factors, TMM-based classification remained the only risk factor in the final models (EFS, hazard ratio [HR], 6.4 [95% CI, 3.9 to 10.6], P < .001; OS, HR, 29.4 [95% CI, 9.6 to 90.0], P < .001), in contrast to the two other molecular classifiers. In pairwise comparisons, TMM-based classification outperformed the two other molecular classifications in models built on both EFS and OS ( P < .001 each). Conclusion: TMM-based classification improves risk assessment in neuroblastoma, providing a rationale for clinical implementation as a new standard for risk stratification of patients with neuroblastoma.