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Dementia
Published in Henry J. Woodford, Essential Geriatrics, 2022
Most studies assessing the effect of cholinesterase inhibitors were not primarily designed to assess non-cognitive symptoms. The AD2000 study did not demonstrate an improvement in behavioural symptoms in people with mild to moderate AD on donepezil.118 A study randomised people with AD and agitation (n = 272; mean age 85; mean Neuropsychiatric Inventory [NPI] score 24 [see Appendix A]) to receive donepezil or placebo over a 12-week period.157 No significant benefit was observed with cholinesterase inhibitor use. A trial recruiting people with DLB (n = 120; mean age 74; mean MMSE score 17/30) compared rivastigmine to placebo for the control of behavioural features over 23 weeks.158 NPI scores were used as the main outcome measure. A benefit was found with rivastigmine in the symptom domains of apathy, anxiety, delusions and hallucinations but overall differences failed to reach statistical significance. Adverse effects occurring more commonly in the treatment group included nausea (37%), vomiting (25%), anorexia (19%) and somnolence (9%). Similarly, rivastigmine has not been found to improve agitation in people with AD.134 In summary, there is little evidence to support the use of cholinesterase inhibitors for the control of non-cognitive symptoms in dementia. Available studies recruited only small numbers of people and over short durations. When a difference has been found, the magnitude has been small and of doubtful clinical significance.159
Leveraging a Unique Nurse Identifier to Improve Outcomes
Published in Connie White Delaney, Charlotte A. Weaver, Joyce Sensmeier, Lisiane Pruinelli, Patrick Weber, Nursing and Informatics for the 21st Century – Embracing a Digital World, 3rd Edition, Book 4, 2022
Whende M. Carroll, Joyce Sensmeier
Both the NPI and NCSBN ID are free, publicly accessible, unique identifiers that are available to all registered nurses. One advantage of the NPI is that its database is interprofessional and nurses are recognized, along with their interprofessional colleagues, as potential recipients of federal payment for services provided. There is no fee for application, nor is there any maintenance required, such as annual renewal (Office of the National Coordinator for Health Information Technology, 2017). However, a potential challenge to the widespread use of an NPI is that nurses must apply for it. Since most nurses do not provide care as sole proprietors, there is no clarity for how or when to apply for the NPI code. In addition, the application process is complex, and combined with the lack of a perceived need for each individual nurse to take action to obtain an NPI together represent important challenges.
The Narcissistic Couple
Published in Len Sperry, Katherine Helm, Jon Carlson, The Disordered Couple, 2019
The Narcissistic Personality Inventory (NPI) is one of the main measures of severity of NPD (Pincus & Lukowitsky, 2010). Another measure is the Psychodynamic Diagnostic Manual (PDM), which divides NPD into two subtypes: Arrogant/Entitled and Depressed/Depleted. More recently, researchers have found the DSM to focus on levels of grandiosity when diagnosing NPD (Pincus & Lukowitsky, 2010). It is important to note that some narcissistic traits are helpful for generation of positive self-esteem, achievement, and adaptive functioning. This lack of a gold standard for what is normal versus abnormal regarding narcissistic traits can make the disorder challenging to diagnose unless in severe cases (Pincus & Lukowitsky, 2010).
A Cross-Cultural Investigation of the Five-Factor Narcissism Inventory Short Form: Narcissism as a Multidimensional Trait in the United Kingdom and Russia
Published in Journal of Personality Assessment, 2022
Kostas A. Papageorgiou, Andrew Denovan, Neil Dagnall, Elena Artamonova
Despite evidence to suggest a multifactorial structure for narcissism (e.g., grandiose and vulnerable narcissism; Crowe et al., 2019) with each factor incorporating several dimensions (e.g., grandiose narcissism is characterized, in part, by antagonism and extraversion), narcissism and the associated Dark Traits of Machiavellianism and psychopathy have been inconsistently assessed with unifactorial measures (Miller et al., 2019). Indeed, many existing measures assess narcissism as a unifactorial trait (e.g., the Short Dark Triad [SD3]; Paulhus & Jones, 2014) focusing on capturing either its grandiose aspects (e.g., Narcissistic Personality Inventory; Raskin & Terry, 1988), or its vulnerable qualities (e.g., Hypersensitive Narcissism Scale; Hendin & Cheek, 1997). Few measures, such as the Pathological Narcissism Inventory (Pincus et al., 2009), capture both grandiose and vulnerable narcissism and have been adapted for use across several countries (e.g., Diguer et al., 2014; Jakšić et al., 2014). Another example of a measure that was developed to account for some of the complexities around assessing narcissism is the Five-Factor Narcissism Inventory (FFNI; Glover et al., 2012).
Narcissistic grandiosity and risky health behaviors in college students
Published in Journal of American College Health, 2022
Sulamunn R. M. Coleman, Michael J. Bernstein, Jacob A. Benfield, Joshua M. Smyth
Grandiosity was assessed with the Narcissistic Personality Inventory-13 (NPI-13).15 The NPI-13 contains 13 forced-choice items (i.e., a “grandiose” response option vs. a “non-grandiose” response option) from its 40-item parent measure, the NPI.14 Participants were instructed to select the response option that best described them, even if not a perfect fit. The NPI-13 also includes three subscales to assess specific grandiose traits: four items assess “leadership/authority” (e.g., “I am a born leader” vs. “Leadership is a quality that takes a long time to develop”), five items assess “grandiose exhibitionism” (e.g., “I will usually show off if I get the chance” vs. “I try not to show off”), and four items assess “entitlement/exploitativeness” (e.g., “I will never be satisfied until I get all that I deserve” vs. “I take my satisfactions as they come”). Grandiose response options were summed across subscales to generate an overall grandiosity score (α = .67) and within subscales to generate scores for leadership/authority (LA; α = .70), grandiose exhibitionism (GE; α = .61), and entitlement/exploitativeness (EE; α = .55). Internal consistencies were low to acceptable in the current sample. However, it has been noted that scales derived from the NPI may exhibit low internal consistencies but tend to correlate in theoretically meaningful ways with criterion variables.48 Importantly, the NPI has been utilized as a measure of grandiosity in college samples for roughly 40 years.51,52
Cross-Cultural Adaptation and Validation of the Arabic Version of the Rating Anxiety in Dementia Scale
Published in Clinical Gerontologist, 2020
Yara Feghali, Hiba Koubaissy, Youssef Fares, Linda Abou Abbas
NPI is a clinician-rated instrument for assessing the presence and severity of twelve neuropsychiatric symptoms including anxiety in patients with dementia. Information for the NPI is obtained from a caregiver familiar with the patient’s behavior. The Arabic version of the NPI has been developed and validated in a previous study among the caregivers of the Lebanese patients with dementia (Karam, Khandakji, Sahakian, Dandan, & Karam, 2018). The NPI-A subscale is assessed by the caregiver in term of screening question that assesses presence (0 no or 1 yes). Each experienced symptom is then assessed in term of frequency on a 4-point Likert scale from 1“occasionally” to 4 “very frequently” and severity on a 3-point Likert scale from 1 “mild” to 3“severe”. A composite score is calculated by multiplying the frequency by the severity (Cummings, 1997). The total NPI-A score ranges from 0 to 12 with higher scores reflecting greater anxiety.