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Brodsky SL, Lichtenstein B. The Gold Standard and the Pyrite Principle: Toward a Supplemental Frame of Reference. Front Psychol 2020; 11:562. [PMID: 32296372 PMCID: PMC7136847 DOI: 10.3389/fpsyg.2020.00562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/10/2020] [Indexed: 11/13/2022] Open
Abstract
In medicine and social sciences, the phrase "gold standard" is often used to characterize an object or procedure described as unequivocally the best in its genre, against which all others should be compared. Examples of this usage are readily available in rigorously peer-reviewed publications, touted by test publishers, and appear in descriptions of methodologies by social science researchers. The phrase does not accurately describe commonly accepted measures, tests, and instruments. Instead, the descriptor can be ambiguous and misleading. This paper presents an overview of the history of the gold standard and its current applications to medicine and the social sciences. We question the use of the phrase "the gold standard" and suggest the additional operational use of a "pyrite principle" as a less presumptuous frame of reference. In thinking about validity and standards, the pyrite principle permits an understanding of standards as authoritative rather than fixed constructs in behavioral and health sciences.
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Affiliation(s)
- Stanley L. Brodsky
- Psychology Department, The University of Alabama, Tuscaloosa, AL, United States
| | - Bronwen Lichtenstein
- Department of Criminology and Criminal Justice, The University of Alabama, Tuscaloosa, AL, United States
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Kazlauskas E, Eimontas J, Olff M, Zelviene P, Andersson G. Adherence Predictors in Internet-Delivered Self-Help Intervention for Life Stressors-Related Adjustment Disorder. Front Psychiatry 2020; 11:137. [PMID: 32231597 PMCID: PMC7083090 DOI: 10.3389/fpsyt.2020.00137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 02/14/2020] [Indexed: 12/19/2022] Open
Abstract
Background: There is a growing body of evidence to show that low-intensity self-help internet-delivered interventions are effective in the treatment of mental disorders. Despite the promising effectiveness of internet-delivered interventions, there is still a challenge for mental health services to implement internet-delivered interventions in routine health care. The aim of this study was to analyze the predictors of adherence to a self-help internet-delivered intervention for adjustment disorder. Methods: This was a secondary report of data, including unpublished data, from a randomized controlled trial of an internet-delivered self-help intervention for adjustment disorder. The study included 1,077 participants who had completed online baseline assessments. All participants had experienced significant life stressors over the last 2 years and had high levels of adjustment disorder symptoms. We analyzed the role of sociodemographic variables, pre-treatment adjustment disorder symptoms, outcome expectations, and perceived barriers to mental health services on the use of the intervention. Results: We found that usage of internet-delivered self-help intervention and higher adherence was associated with female gender, greater age, higher pre-intervention outcome expectations, exposure to other forms of psychological therapy in addition to the internet-intervention at the time of the study, and reported perceived barriers to mental health services by the study participants. Conclusions: The findings of the study indicated the importance of non-specific therapeutic factors on adherence during internet-delivered intervention. Perceived barriers to mental health services were associated with higher adherence to self-help intervention, which indicated that communities with restricted access to mental health services could benefit from low-intensity internet-delivered interventions.
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Affiliation(s)
- Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Jonas Eimontas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Miranda Olff
- Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Arq Psychotrauma Expert Group, Diemen, Netherlands
| | - Paulina Zelviene
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Shevlin M, Hyland P, Ben-Ezra M, Karatzias T, Cloitre M, Vallières F, Bachem R, Maercker A. Measuring ICD-11 adjustment disorder: the development and initial validation of the International Adjustment Disorder Questionnaire. Acta Psychiatr Scand 2020; 141:265-274. [PMID: 31721147 DOI: 10.1111/acps.13126] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adjustment disorder (AjD) is one of the most frequently used diagnoses in psychiatry but a diagnostic definition for AjD was only introduced in release of the ICD-11. This study sought to develop and validate a new measure operationalizing the ICD-11's narrative description of AjD, and to determine the current rate of people meeting the symptoms indicative of AjD in the general population of the Republic of Ireland. METHODS The International Adjustment Disorder Questionnaire (IADQ) was constructed to measure the core diagnostic criteria of ICD-11 AjD: stressor exposure, preoccupations with, and failure to adapt to, the stressor, timing of symptom onset, and functional impairment. A nationally representative sample (N = 1,020) of adults from Ireland completed the IADQ. RESULTS Confirmatory factor analysis supported construct validity and the reliability estimates were excellent. The IADQ correlated strongly with depression, anxiety, and posttraumatic stress. The criteria were met by 7.0% of the sample, adjusted for other exclusionary disorders. DISCUSSION The IADQ is a measure based on the ICD-11's description and produces reliable scores, however it should not be used for clinical assessment until validated with clinical interviews.
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Affiliation(s)
- M Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - P Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - M Ben-Ezra
- School of Social Work, Ariel University, Ariel, Israel
| | - T Karatzias
- NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK.,School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
| | - M Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
| | - F Vallières
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - R Bachem
- School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - A Maercker
- Department of Psychology, Psychopathology and Clinical Intervention, University of Zürich, Zurich, Switzerland
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Greiner T, Haack B, Toto S, Bleich S, Grohmann R, Faltraco F, Heinze M, Schneider M. Pharmacotherapy of psychiatric inpatients with adjustment disorder: current status and changes between 2000 and 2016. Eur Arch Psychiatry Clin Neurosci 2020; 270:107-117. [PMID: 31440829 DOI: 10.1007/s00406-019-01058-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/13/2019] [Indexed: 01/03/2023]
Abstract
Adjustment disorder is a temporary change in behaviour or emotion as a reaction to a stress factor. Therapy consists of psychotherapy, and pharmacotherapy can be advised. However, data on the real-life pharmacological treatment are sparse. Prescription data for 4.235 psychiatric inpatients diagnosed with adjustment disorder in the time period 2000-2016 were analysed. The data were obtained from the Drug Safety Programme in Psychiatry (AMSP). Data were collected on two reference days per year; prescription patterns and changes over time were analysed. Of all patients, 81.2% received some type of psychotropic drug. Mostly antidepressants (59.8%), antipsychotics (35.5%), and tranquilisers (22.6%) were prescribed. Prescription rates for antidepressants decreased slightly over the years, while rates for antipsychotics increased, especially for atypical antipsychotics. It is important to note that the diagnosis "adjustment disorder" is most likely a working diagnosis that is used for patients in immediate need of psychiatric aid. Overall, pharmacotherapy for inpatients with this diagnosis is mostly symptom-oriented and focuses on depressive moods, agitation and anxiety. Therapy regimes changed over time and show an increased use of atypical antipsychotics with sedative properties. However, for most of the medication, there are neither evidence-based studies nor guidelines, and drugs might be contraindicated in some cases.
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Affiliation(s)
- Timo Greiner
- Brandenburg Medical School, Immanuel Klinik Rüdersdorf, University Clinic for Psychiatry and Psychotherapy, 15562, Rüdersdorf, Germany.
| | - Beatrice Haack
- Brandenburg Medical School, Immanuel Klinik Rüdersdorf, University Clinic for Psychiatry and Psychotherapy, 15562, Rüdersdorf, Germany
| | - Sermin Toto
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hannover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625, Hannover, Germany
| | - Renate Grohmann
- Department of Psychiatry, Ludwig-Maximilians-University, 80336, Munich, Germany
| | - Frank Faltraco
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Rostock, 18147, Rostock, Germany
| | - Martin Heinze
- Brandenburg Medical School, Immanuel Klinik Rüdersdorf, University Clinic for Psychiatry and Psychotherapy, 15562, Rüdersdorf, Germany
| | - Michael Schneider
- Brandenburg Medical School, Immanuel Klinik Rüdersdorf, University Clinic for Psychiatry and Psychotherapy, 15562, Rüdersdorf, Germany
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Oldham MA. Personality-Informed Care: Speaking the Language of Personality. PSYCHOSOMATICS 2020; 61:220-230. [PMID: 32093848 DOI: 10.1016/j.psym.2020.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Personality describes an enduring pattern of experiences and behaviors in the interpersonal and social sphere. Several aspects of personality, e.g., defenses, relational dynamics, and reactions, are commonly accentuated in the midst of medical care; therefore, understanding a patient's personality allows the clinician to make informed predictions about how a specific patient may respond to illness and how care interactions might be modified to optimize care engagement and outcomes. OBJECTIVE/METHODS This article provides a brief description of the personalities in the Psychodynamic Diagnostic Manual, Second Edition, and discusses how each one might inform clinical interactions. Two additional personality-like presentations-the traumatized patient and cognitive impairment-are included for clinical utility given their high prevalence in medical settings and their potential for broad impact on clinical relationships. RESULTS Personality-informed care is an approach that incorporates information about the patient's personality into the clinical relationship. It describes what the clinician might say and when, what recommendations to offer and how to frame them, and how to comport oneself while providing care. CONCLUSIONS Personality-informed care operationalizes several aspects of personalized medicine, and it offers a heuristic framework that may facilitate and enhance the implementation of evidence-based care.
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Affiliation(s)
- Mark A Oldham
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY.
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56
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Caruso R, Breitbart W. Mental health care in oncology. Contemporary perspective on the psychosocial burden of cancer and evidence-based interventions. Epidemiol Psychiatr Sci 2020; 29:e86. [PMID: 31915100 PMCID: PMC7214708 DOI: 10.1017/s2045796019000866] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 11/30/2019] [Indexed: 12/18/2022] Open
Abstract
With cancer incidence increasing over time worldwide, attention to the burden of psychiatric and psychosocial consequences of the disease is now mandatory for both cancer and mental health care professionals. Psychiatric disorders have been shown to affect at least 30-35% of cancer patients during all phases of the disease trajectory, and differ in nature according to stage and type of cancer. Other clinically relevant distressing psychosocial and existential conditions (e.g. demoralisation, health anxiety, loss of meaning and existential distress) not included as 'disorders' in the usual diagnostic and nosological systems (i.e. meta-diagnostic conditions) have also been shown to be present in another 15-20% of cancer patients. In this editorial, we will present a summary of the extensive literature regarding the epidemiology of the several psychosocial disorders affecting cancer patients as a cause of distress and burden to be taken into consideration and addressed in cancer care through evidence-based intervention.
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Affiliation(s)
- R. Caruso
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - W. Breitbart
- Department of Psychiatry & Behavioral Sciences, Jimmie C. Holland Chair in Psychiatric Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Zelviene P, Kazlauskas E, Maercker A. Risk factors of ICD-11 adjustment disorder in the Lithuanian general population exposed to life stressors. Eur J Psychotraumatol 2020; 11:1708617. [PMID: 32002141 PMCID: PMC6968697 DOI: 10.1080/20008198.2019.1708617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/09/2019] [Accepted: 12/06/2019] [Indexed: 11/16/2022] Open
Abstract
Background: A new definition of adjustment disorder symptoms has been included in the 11th edition of the International Classification of Diseases (ICD-11). However, little is known about risk factors of ICD-11 adjustment disorder. Objective: The study aimed to analyse risk factors of adjustment disorder in a sample of the Lithuanian general population exposed to life-stressors. Method: In total, the study included 649 adult participants from the general population with various recent significant life-stressor experiences. ICD-11 adjustment disorder symptoms were measured using the Adjustment Disorder New Module-8 (ADNM-8) scale. Results: The prevalence of the ICD-11 adjustment disorder diagnosis in the sample was 16.5%. Job-related stressors and health-related stressors were significantly associated with adjustment disorder. Other risk factors for adjustment disorder in this study were female gender, greater age, and university education. Conclusions: We conclude that stressor type and demographic characteristics are associated with the risk of developing an adjustment disorder.
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Affiliation(s)
- Paulina Zelviene
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Andreas Maercker
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
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Ravindran A, Paric A, Ravindran L. Psychological dimensions of COVID-19: Perspectives for the practicing clinician. INTERNATIONAL JOURNAL OF NONCOMMUNICABLE DISEASES 2020. [DOI: 10.4103/jncd.jncd_27_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Quero S, Rachyla I, Molés M, Mor S, Tur C, Cuijpers P, López-Montoyo A, Botella C. Can Between-Session Homework Be Delivered Digitally? A Pilot Randomized Clinical Trial of CBT for Adjustment Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3842. [PMID: 31614596 PMCID: PMC6843437 DOI: 10.3390/ijerph16203842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/28/2019] [Accepted: 10/08/2019] [Indexed: 12/20/2022]
Abstract
Adjustment disorder (AjD) is one of the most common disorders in clinical practice, and its symptoms are severe enough to cause great distress and functional impairment. The AjD CBT protocol specifically developed for this disorder has shown positive results when delivered face to face and through virtual reality. Despite existing evidence supporting the benefits of therapeutic homework as part of a psychological intervention, little is known about how to increase homework engagement in psychotherapy. This study examines the feasibility (doability, initial efficacy and acceptability) of a digital support system to deliver homework via the Internet in the treatment of AjD. Participants were randomly assigned to a traditional homework condition or a digital support system condition. Both interventions resulted in statistically significant improvements, with large effect sizes, in all the outcome measures at post-treatment, with no significant differences between groups. At 12-month follow-up, these therapeutic gains were maintained, and an improvement was even observed in both conditions, with no significant differences between groups. Additionally, treatment satisfaction predicted efficacy in both groups separately and when the whole group was considered. This is the first study to explore the feasibility an initial efficacy of delivering a therapeutic homework component for AjD through the Internet.
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Affiliation(s)
- Soledad Quero
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto Salud Carlos III, 28029 Madrid, Spain.
| | - Iryna Rachyla
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Mar Molés
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Sonia Mor
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Cintia Tur
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Pim Cuijpers
- Department of Clinical, Neuro, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081BT Amsterdam, The Netherlands.
| | - Alba López-Montoyo
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
| | - Cristina Botella
- Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, 12006 Castellón, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERON), Instituto Salud Carlos III, 28029 Madrid, Spain.
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ZIEL: Internet-Based Self-Help for Adjustment Problems: Results of a Randomized Controlled Trial. J Clin Med 2019; 8:jcm8101655. [PMID: 31614528 PMCID: PMC6832125 DOI: 10.3390/jcm8101655] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/30/2019] [Accepted: 10/05/2019] [Indexed: 11/16/2022] Open
Abstract
Adjustment Disorder (AjD) represents a healthcare paradox. On the one hand, it is one of the most diagnosed mental disorders worldwide. On the other hand, AjD and its possible treatment options remain a severely neglected field of research. In this context, we developed a self-guided online intervention for adjustment problems, named ZIEL, and tested its efficacy. It is based on and extends a bibliotherapeutic treatment approach for symptoms of AjD. In our study, a total of 98 individuals who had experienced a life event in the last two years, were randomly assigned to care as usual (CAU) or an online intervention group (CAU + online intervention). The primary endpoint was AjD symptom severity measured by Adjustment Disorder–New Module 20 (ADNM-20). Secondary endpoints were depressive symptoms, quality of life and other variables such as satisfaction and usability. Both the intervention and the control group improved comparably well regarding the severity of adjustment disorder symptoms post-treatment. However, participants in the intervention group showed significantly fewer depressive symptoms and a significantly higher quality of life (Cohen’s d: 0.89 (BDI) and −0.49 (SF-12)). The intervention was well-received by users with an above average usability rating. Overall, the results suggest that the ZIEL intervention has the promise to contribute to the treatment of AjD and reduce symptom burden by means of a scalable low-barrier approach.
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Montero-Marin J, Collado-Navarro C, Navarro-Gil M, Lopez-Montoyo A, Demarzo M, Herrera-Mercadal P, Barcelo-Soler A, Garcia-Campayo J. Attachment-based compassion therapy and adapted mindfulness-based stress reduction for the treatment of depressive, anxious and adjustment disorders in mental health settings: a randomised controlled clinical trial protocol. BMJ Open 2019; 9:e029909. [PMID: 31597650 PMCID: PMC6797287 DOI: 10.1136/bmjopen-2019-029909] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Depressive, anxiety and adjustment disorders are highly prevalent among mental health outpatients. The lack of funding for mental health problems produces inefficient results and a high burden of disease. New cost-effective group interventions aimed at treating these symptoms might be an appropriate solution to reduce the healthcare burden in mental health units. Mindfulness-based interventions (MBIs) have shown significant reductions in anxious, depressive and adjustment symptomatology. Recent research highlights the influence of compassion as a key mechanism of change. However, MBIs only address compassion implicitly, whereas compassion-based protocols consider it a core aspect of psychotherapy. In this randomised controlled trial, we hypothesise that the provision of attachment-based compassion therapy (ABCT), which is a compassion-based protocol, will be more effective than mindfulness-based stress reduction (MBSR), which is a conventional MBI programme, for the treatment of depressive, anxious and adaptive symptoms in patients in mental health settings. METHODS AND ANALYSIS Approximately 90 patients suffering from depressive, anxious or adjustment disorders recruited from Spanish mental health settings will be randomised to receive 8 weekly 2 hours group sessions of ABCT, 8 weekly 2.5 hours group sessions of adapted MBSR (with no full-day silent retreat) or treatment as usual (TAU), with a 1:1:1 allocation rate. Patients in the ABCT and adapted MBSR groups will also receive TAU. The main outcome will be general affective distress measured by means of the 'Depression Anxiety Stress Scales-21' at post-test as primary endpoint. Other outcomes will be quality of life, mindfulness, self-compassion and the use of healthcare services. There will be a 6-month follow-up assessment. Intention-to-treat analysis will be conducted using linear mixed models. Per-protocol and secondary outcome analyses will be performed. A data monitoring committee comprising the trial manager, the ABCT and MBSR teachers and an independent clinical psychologist will monitor for possible negative side effects. ETHICS AND DISSEMINATION Approval was obtained from the Ethics Committee of the General University Hospital of Castellón, Spain. The results will be submitted to peer-reviewed specialised journals, and brief reports will be sent to participants on request. TRIAL REGISTRATION NUMBER NCT03425487.
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Affiliation(s)
- Jesus Montero-Marin
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | | | - Mayte Navarro-Gil
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Alba Lopez-Montoyo
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Marcelo Demarzo
- Department of Preventive Medicine, Mente Aberta - Brazilian Center for Mindfulness and Health Promotion, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Paola Herrera-Mercadal
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Alberto Barcelo-Soler
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
| | - Javier Garcia-Campayo
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
- Institute of Health Research of Aragon (IIS), Zaragoza, Spain
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Fava GA, McEwen BS, Guidi J, Gostoli S, Offidani E, Sonino N. Clinical characterization of allostatic overload. Psychoneuroendocrinology 2019; 108:94-101. [PMID: 31252304 DOI: 10.1016/j.psyneuen.2019.05.028] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 11/19/2022]
Abstract
Allostatic load reflects the cumulative effects of stressful experiences in daily life and may lead to disease over time. When the cost of chronic exposure to fluctuating or heightened neural and systemic physiologic responses exceeds the coping resources of an individual, this is referred to as "toxic stress" and allostatic overload ensues. Its determination has initially relied on measurements of an interacting network of biomarkers. More recently, clinical criteria for the determination of allostatic overload, that provide information on the underlying individual experiential causes, have been developed and used in a number of investigations. These clinimetric tools can increase the number of people screened, while putting the use of biomarkers in a psychosocial context. The criteria allow the personalization of interventions to prevent or decrease the negative impact of toxic stress on health, with particular reference to lifestyle modifications and cognitive behavioral therapy.
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Affiliation(s)
- Giovanni A Fava
- Department of Psychology, University of Bologna, Bologna, Italy; Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA.
| | - Bruce S McEwen
- Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY, USA
| | - Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Sara Gostoli
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Emanuela Offidani
- Department of Behavioral Science and Education, Pennsylvania State University, Schuylkill Haven, PA, USA
| | - Nicoletta Sonino
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA; Department of Statistical Sciences, University of Padova, Padova, Italy
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Bachem R, Baumann J, Köllner V. ICD-11 Adjustment Disorder among Organ Transplant Patients and Their Relatives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173030. [PMID: 31438589 PMCID: PMC6747135 DOI: 10.3390/ijerph16173030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/14/2019] [Accepted: 08/17/2019] [Indexed: 01/06/2023]
Abstract
Adjustment disorder (AD) is one of the most frequent mental health conditions after stressful life experiences in the medical setting. The diagnosis has been conceptually redefined in International Classification of Diseases (ICD-11) and now includes specific symptoms of preoccupations and failure to adapt. The current study assesses the prevalence of self-reported ICD-11 AD among organ transplantation patients and their relatives, explores the association of patients’ demographic-, transplant-, and health-related characteristics and ICD-11 AD symptoms, and evaluates the role of social support in the post- transplant context. A total of N = 140 patient-relative dyads were examined cross-sectionally. Hierarchical linear regression analyses were conducted to explore potential predictive factors of AD. The results revealed an AD prevalence of 10.7% among patients and 16.4% among relatives at an average of 13.5 years after the transplantation. The time that had passed since the transplantation was unrelated to AD symptom severity. Women tended to be at a higher risk in both groups. Somatic issues were predictive for AD only among patients and social support was predictive mainly among relatives. The results suggest that ICD-11 AD is a relevant diagnosis after organ transplantations for patients and relatives and its specific symptom clusters may provide important information for developing intervention strategies.
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Affiliation(s)
- Rahel Bachem
- I-Core Research Center for Mass Trauma, Tel Aviv University, Chaim Levanon 30, Tel Aviv 6997801, Israel.
- Bob Shapell School of Social Work, Tel-Aviv University, Chaim Levanon 30, Tel Aviv 6997801, Israel.
| | - Jan Baumann
- Saarland University Medical Center, Faculty of Medicine, University of Saarland, 66421 Homburg/Saar, Germany
| | - Volker Köllner
- Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, 14513 Teltow, Germany
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology Charité-Universitätsmedizin Berlin, 10098 Berlin, Germany
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O'Donnell ML, Agathos JA, Metcalf O, Gibson K, Lau W. Adjustment Disorder: Current Developments and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142537. [PMID: 31315203 PMCID: PMC6678970 DOI: 10.3390/ijerph16142537] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 12/20/2022]
Abstract
Despite its high prevalence in clinical and consultant liaison psychiatry populations, adjustment disorder research has traditionally been hindered by its lack of clear diagnostic criteria. However, with the greater diagnostic clarity provided in the Diagnostic and Statistical Manual of Mental Disorders – fifth edition (DSM-5) and the International Statistical Classification of Diseases and Related Health Problems, 11th edition (ICD-11), adjustment disorder has been increasingly recognised as an area of research interest. This paper evaluates the commonalities and differences between the ICD-11 and DSM-5 concepts of adjustment disorder and reviews the current state of knowledge regarding its symptom profile, course, assessment, and treatment. In doing so, it identifies the gaps in our understanding of adjustment disorder and discusses future directions for research.
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Affiliation(s)
- Meaghan L O'Donnell
- Phoenix Australia Centre for Posttraumatic Mental Health, 161 Barry Street, Carlton VIC, Melbourne 3053, Australia.
- Department of Psychiatry, University of Melbourne, Melbourne 3053, Australia.
| | - James A Agathos
- Phoenix Australia Centre for Posttraumatic Mental Health, 161 Barry Street, Carlton VIC, Melbourne 3053, Australia
- Department of Psychiatry, University of Melbourne, Melbourne 3053, Australia
| | - Olivia Metcalf
- Phoenix Australia Centre for Posttraumatic Mental Health, 161 Barry Street, Carlton VIC, Melbourne 3053, Australia
- Department of Psychiatry, University of Melbourne, Melbourne 3053, Australia
| | - Kari Gibson
- Phoenix Australia Centre for Posttraumatic Mental Health, 161 Barry Street, Carlton VIC, Melbourne 3053, Australia
- Department of Psychiatry, University of Melbourne, Melbourne 3053, Australia
| | - Winnie Lau
- Phoenix Australia Centre for Posttraumatic Mental Health, 161 Barry Street, Carlton VIC, Melbourne 3053, Australia
- Department of Psychiatry, University of Melbourne, Melbourne 3053, Australia
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Sánchez-González R, Rodríguez-Urrutia A, Monteagudo-Gimeno E, Vieta E, Pérez-Solá V, Herranz-Villanueva S, Pintor-Pérez L. Clinical features of a sample of inpatients with adjustment disorder referred to a consultation-liaison psychiatry service over 10 years. Gen Hosp Psychiatry 2018; 55:98-99. [PMID: 30107936 DOI: 10.1016/j.genhosppsych.2018.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/03/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Roberto Sánchez-González
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - Amanda Rodríguez-Urrutia
- Consultation-Liaison Psychiatry Unit, Department of Psychiatry, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Eila Monteagudo-Gimeno
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eduard Vieta
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, CERCA Programme/Generalitat de Catalunya, Barcelona, Spain; Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Víctor Pérez-Solá
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Sandra Herranz-Villanueva
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, CERCA Programme/Generalitat de Catalunya, Barcelona, Spain
| | - Luis Pintor-Pérez
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, CERCA Programme/Generalitat de Catalunya, Barcelona, Spain
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Grass L, de Figueiredo J. Advances in the Understanding of Demoralization in Oncology and Palliative Care. PSYCHO-ONCOLOGIE 2018. [DOI: 10.3166/pson-2018-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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67
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Latent class analysis differentiation of adjustment disorder and demoralization, more severe depressive and anxiety disorders, and somatic symptoms in patients with cancer. Psychooncology 2018; 27:2623-2630. [DOI: 10.1002/pon.4761] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/13/2018] [Accepted: 05/03/2018] [Indexed: 12/21/2022]
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