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Hendriks GJ, van Zelst WH, van Balkom AJ, Uphoff E, Robertson L, Keijsers GPJ, Oude Voshaar RC. Cognitive behavioural therapy and third wave approaches for anxiety and related disorders in older people. Hippokratia 2021. [DOI: 10.1002/14651858.cd007674.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gert-Jan Hendriks
- “Overwaal” Centre of Expertise for Anxiety Disorders, OCD and PTSD; Institute for Integrated Mental Health Care “Pro Persona; Nijmegen Netherlands
- Behavioural Science Institute; Radboud University; Nijmegen Netherlands
- Department of Psychiatry; Radboud University Medical Centre; Nijmegen Netherlands
| | - Willeke H van Zelst
- Department of Psychiatry; University Medical Centre Groningen; Groningen Netherlands
| | - Anton J van Balkom
- Department of Psychiatry and EMGO+ Institute; VU-University Medical Centre and GGZ inGeest; Amsterdam Netherlands
| | - Eleonora Uphoff
- Cochrane Common Mental Disorders; University of York; York UK
- Centre for Reviews and Dissemination; University of York; York UK
| | - Lindsay Robertson
- Cochrane Common Mental Disorders; University of York; York UK
- Centre for Reviews and Dissemination; University of York; York UK
| | - Ger PJ Keijsers
- Behavioural Science Institute; Radboud University; Nijmegen Netherlands
- Department of Clinical Psychological Sciences; Maastricht University; Maastricht Netherlands
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102
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Luo F, Ye M, Lv T, Hu B, Chen J, Yan J, Wang A, Chen F, He Z, Ding Z, Zhang J, Qian C, Liu Z. Efficacy of Cognitive Behavioral Therapy on Mood Disorders, Sleep, Fatigue, and Quality of Life in Parkinson's Disease: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:793804. [PMID: 34966313 PMCID: PMC8710613 DOI: 10.3389/fpsyt.2021.793804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/19/2021] [Indexed: 02/06/2023] Open
Abstract
Objective: The aim of this study was to perform a quantitative analysis to evaluate the efficacy of cognitive behavioral therapy (CBT) on mood disorders, sleep, fatigue, and its impact on quality of life (QOL) in Parkinson's Disease (PD). Methods: We searched for randomized controlled trials in three electronic databases. Fourteen studies, including 507 patients with PD, met the inclusion criteria. We determined the pooled efficacy by standard mean differences and 95% confidence intervals, using I 2 to reveal heterogeneity. Results: The result showed CBT had a significant effect on depression [-0.93 (95%CI, -1.19 to -0.67, P < 0.001)] and anxiety [-0.76 (95%CI, -0.97 to -0.55, P < 0.001)]. Moderate effect sizes were noted with sleep disorders [-0.45 (95% CI, -0.70 to -0.20, P = 0.0004)]. There was no evident impact of CBT on fatigue or QOL. We found an intervention period >8 weeks was advantageous compared with <8 weeks, and CBT implemented in non-group was more effective than in group. Between the delivery methods, no significant difference was found. Conclusion: We found that CBT in patients with PD was an efficacious therapy for some non-motor symptoms in PD, but not efficacious for fatigue and QOL. These results suggest that CBT results in significant improvement in PD and should be used as a conventional clinical intervention.
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Affiliation(s)
- Fangyi Luo
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center, Medical College of Shaoxing University, Shaoxing, China.,Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China
| | - Mengfei Ye
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center, Medical College of Shaoxing University, Shaoxing, China
| | - Tingting Lv
- Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China
| | - Baiqi Hu
- Department of Neurology, Shaoxing Hospital, China Medical University, Shaoxing, China
| | - Jiaqi Chen
- Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China
| | - Junwei Yan
- Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China
| | - Anzhe Wang
- Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China
| | - Feng Chen
- Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China
| | - Ziyi He
- Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China
| | - Zhinan Ding
- Laboratory of Forensic Toxicology, Judicial Identification Center of Shaoxing University, Shaoxing, China
| | - Jian Zhang
- Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China
| | - Chao Qian
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Affiliated Mental Health Center, Medical College of Shaoxing University, Shaoxing, China
| | - Zheng Liu
- Department of Behavioral Neurosciences, Science Research Center of Medical College, Shaoxing University, Shaoxing, China.,Laboratory of Forensic Toxicology, Judicial Identification Center of Shaoxing University, Shaoxing, China
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103
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Papola D, Ostuzzi G, Gastaldon C, Purgato M, Del Giovane C, Pompoli A, Karyotaki E, Sijbrandij M, Furukawa TA, Cuijpers P, Barbui C. Which psychotherapy is effective in panic disorder? And which delivery formats are supported by the evidence? Study protocol for two systematic reviews and network meta-analyses. BMJ Open 2020; 10:e038909. [PMID: 33372071 PMCID: PMC7772327 DOI: 10.1136/bmjopen-2020-038909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Panic disorder is among the most prevalent anxiety diseases. Although psychotherapy is recommended as first-line treatment for panic disorder, little is known about the relative efficacy of different types of psychotherapies. Moreover, there is little evidence concerning the effectiveness of different formats of major psychotherapeutic types, such as cognitive-behavioural therapy (CBT). In this protocol, we present an overarching project consisting of two systematic reviews and network meta-analyses (NMA) to shed light on which psychotherapy (NMA-1), and specifically, which CBT delivery format (NMA-2) should be considered most effective for adults suffering from panic disorder with or without agoraphobia. METHODS AND ANALYSES Starting from a common pool of data, we will conduct two systematic reviews and NMA of randomised controlled trials examining panic disorder. A comprehensive search will be performed in electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Register of Controlled Trials-CENTRAL from database inception to 1 January 2021 to identify relevant studies. A systematic approach to searching, screening, reviewing and data extraction will be applied. Titles, abstract and-whenever necessary-full texts will be examined independently by at least two reviewers. The quality of the included studies will be assessed using the revised Cochrane risk of bias tool V.2. The primary efficacy outcome will be anxiety symptoms at study endpoint. The primary acceptability outcome will be all-cause discontinuation, as measured by the proportion of patients who had discontinued treatment for any reason at endpoint. Data will be pooled using a random-effects model. Pairwise and NMA will be conducted. ETHICS AND DISSEMINATION No ethical approval is necessary for these two studies, as there will be no collection of primary data. The results will be disseminated through peer-reviewed publications and presentations at national and international conferences and meetings.
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Affiliation(s)
- Davide Papola
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences; Section of Psychiatry, University of Verona, Verona, Italy
| | - Giovanni Ostuzzi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences; Section of Psychiatry, University of Verona, Verona, Italy
| | - Chiara Gastaldon
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences; Section of Psychiatry, University of Verona, Verona, Italy
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences; Section of Psychiatry, University of Verona, Verona, Italy
| | - Cinzia Del Giovane
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | | | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marit Sijbrandij
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Toshi A Furukawa
- Departments of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences; Section of Psychiatry, University of Verona, Verona, Italy
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Marks AK, Calzada E, Kiang L, Pabón Gautier MC, Martinez-Fuentes S, Tuitt NR, Ejesi K, Rogers LO, Williams CD, Umaña-Taylor A. APPLYING THE LIFESPAN MODEL OF ETHNIC-RACIAL IDENTITY: EXPLORING AFFECT, BEHAVIOR, AND COGNITION TO PROMOTE WELL-BEING. RESEARCH IN HUMAN DEVELOPMENT 2020; 17:154-176. [PMID: 38282763 PMCID: PMC10817726 DOI: 10.1080/15427609.2020.1854607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This paper presents an application of the Lifespan Model of Ethnic-Racial Identity (ERI) Development (see Williams, et al., in press). Using a tripartite approach, we present the affective, behavioral, and cognitive aspects of ERI in a framework that can be adapted for group and individual psychosocial interventions across the lifespan. These A-B-C anchors are presented in developmental contexts as well as the larger social contexts of systemic oppression and current and historical sociopolitical climates. It is ultimately the aspiration of this identity work that individuals will engage in ERI meaning-making, drawing from the implicit and explicit aspects of their A-B-Cs, to support a healthy and positive sense of themselves and others as members of ethnic-racial social groups.
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Affiliation(s)
| | | | | | | | | | | | - Kida Ejesi
- Boston Children's Hospital/Harvard Medical School
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105
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Ruffault A, Bernier M, Fournier J, Hauw N. Anxiety and Motivation to Return to Sport During the French COVID-19 Lockdown. Front Psychol 2020; 11:610882. [PMID: 33391128 PMCID: PMC7773808 DOI: 10.3389/fpsyg.2020.610882] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022] Open
Abstract
Feeling anxious and presenting self-determined motivations about returning to sport after a break may impair sport performance and increase the risk of sustaining an injury. Hence, the aim of this study is to explore differences in anxiety and motivation to return to sport according to gender, expertise, training status before and during the lockdown, and athletes' availability (i.e., injury status) at the time of the lockdown. A total of 759 competitive athletes (49% female; mean age: 27 ± 10 years old) completed the cross-sectional study. Participants were invited to state their expertise, training status before and during the lockdown (did they have a training program), and whether they were injured at the start of the lockdown. Additionally, participants filled out psychometric self-report measures of anxiety (TFAI-return) and motivation (SMS-return) to return to sport. Due to non-normal distributions in the TFAI and SMS scores, non-parametric group comparisons were performed to compare participants for each categorical variable: non-parametric correlation tests were also performed to test the associations between continuous variables. Group comparisons showed higher scores of anxiety for females, younger athletes, athletes practicing and competing at the highest level, and athletes without a training program during the lockdown. Moreover, results suggested lower motivation scores (i.e., autonomous and controlled) for older athletes, experts (practicing for more than 10 years), athletes practicing and competing at a lower level, and athletes without a training program during the lockdown. Additionally, participants who were injured at the start of the lockdown reported higher scores of cognitive anxiety to return to sport than non-injured participants. The results of this study suggest that elite athletes may have suffered from external pressures to return to sport during the lockdown. Additionally, participants with a training program during the lockdown seemed to be less anxious and more self-determined to return to sport after the lockdown. Future studies may focus on the impact of cognitive behavioral interventions on anxiety and motivation to return to sport.
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Affiliation(s)
- Alexis Ruffault
- Laboratory “Sport, Expertise, and Performance” (EA 7370), French Institute of Sport (INSEP), Paris, France
- Unité de Recherche Interfacultaire Santé et Société, Université de Liège, Liège, Belgium
| | | | - Jean Fournier
- Laboratoire Interdisciplinaire en Neurosciences, Physiologie et Psychologie: Activité Physique, Santé et Apprentissages, Université Paris Nanterre, Nanterre, France
| | - Nicolas Hauw
- Institute of Physical Education and Sports Sciences (IFEPSA), West Catholic University of Angers, Angers, France
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Sokol RL, Goldstick J, Zimmerman MA, Muzik M, Rosenblum KL, Miller AL. Transitions into and out of post-traumatic stress among children involved in the child welfare system. CHILDREN AND YOUTH SERVICES REVIEW 2020; 118:105384. [PMID: 32921859 PMCID: PMC7485932 DOI: 10.1016/j.childyouth.2020.105384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE To describe the transition patterns into and out of post-traumatic stress (PTS) for youth and identify social supports preceding these transitions. METHODS We used inhomogeneous, continuous-time, 1Markov Chain models to model transitions in and out of PTS using data from Waves 1, 3, 4, and 5 of the National Survey of Child and Adolescent Wellbeing (NSCAW I)-a longitudinal study of children who first had contact with the child welfare system between 1999 and 2000. Our analytic sample contained 915 individuals aged 11-17 years. We analyzed data in 2020. RESULTS Youth with stronger peer relationships were less likely to transition into PTS (HR: 0.82; 95% CI [0.70-0.96]), and these individuals were also more likely to transition out of PTS (HR: 1.21; 95% CI [1.04, 1.42]). Youth with adult support were less likely to transition into PTS at any given time interval (HR: 0.37; 95% CI [0.17-0.78]), but adult support was not associated with the transition out of PTS. CONCLUSIONS Strengthening peer relationships may help at-risk children both avoid PTS altogether and recover from PTS after its onset. Promoting adult support, however, may only be most effective when attempting to prevent PTS-onset.
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Affiliation(s)
- Rebeccah L. Sokol
- School of Social Work, Wayne State University, 5447 Woodward Ave, Detroit, MI 48202, USA
| | - Jason Goldstick
- University of Michigan Injury Prevention Center, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI 48109
- Department of Emergency Medicine, University of Michigan School of Medicine, 1500 East Medical Center Drive, Ann Arbor, MI 48109
- Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
- University of Michigan Injury Prevention Center, 2800 Plymouth Road, NCRC 10-G080, Ann Arbor, MI 48109
- Michigan Youth Violence Prevention Center, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Katherine L. Rosenblum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alison L. Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
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Horigome T, Kurokawa S, Sawada K, Kudo S, Shiga K, Mimura M, Kishimoto T. Virtual reality exposure therapy for social anxiety disorder: a systematic review and meta-analysis. Psychol Med 2020; 50:2487-2497. [PMID: 33070784 DOI: 10.1017/s0033291720003785] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Virtual reality exposure therapy (VRET) is currently being used to treat social anxiety disorder (SAD); however, VRET's magnitude of efficacy, duration of efficacy, and impact on treatment discontinuation are still unclear. METHODS We conducted a meta-analysis of studies that investigated the efficacy of VRET for SAD. The search strategy and analysis method are registered at PROSPERO (#CRD42019121097). Inclusion criteria were: (1) studies that targeted patients with SAD or related phobias; (2) studies where VRET was conducted for at least three sessions; (3) studies that included at least 10 participants. The primary outcome was social anxiety evaluation score change. Hedges' g and its 95% confidence intervals were calculated using random-effect models. The secondary outcome was the risk ratio for treatment discontinuation. RESULTS Twenty-two studies (n = 703) met the inclusion criteria and were analyzed. The efficacy of VRET for SAD was significant and continued over a long-term follow-up period: Hedges' g for effect size at post-intervention, -0.86 (-1.04 to -0.68); three months post-intervention, -1.03 (-1.35 to -0.72); 6 months post-intervention, -1.14 (-1.39 to -0.89); and 12 months post-intervention, -0.74 (-1.05 to -0.43). When compared to in vivo exposure, the efficacy of VRET was similar at post-intervention but became inferior at later follow-up points. Participant dropout rates showed no significant difference compared to in vivo exposure. CONCLUSION VRET is an acceptable treatment for SAD patients that has significant, long-lasting efficacy, although it is possible that during long-term follow-up, VRET efficacy lessens as compared to in vivo exposure.
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Affiliation(s)
- Toshiro Horigome
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shunya Kurokawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Shun Kudo
- Department of Neuropsychiatry, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
| | - Kiko Shiga
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taishiro Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Psychiatry at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA
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108
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Bailey DH, Duncan GJ, Cunha F, Foorman BR, Yeager DS. Persistence and Fade-Out of Educational-Intervention Effects: Mechanisms and Potential Solutions. Psychol Sci Public Interest 2020; 21:55-97. [PMID: 33414687 PMCID: PMC7787577 DOI: 10.1177/1529100620915848] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Some environmental influences, including intentional interventions, have shown persistent effects on psychological characteristics and other socially important outcomes years and even decades later. At the same time, it is common to find that the effects of life events or interventions diminish and even disappear completely, a phenomenon known as fadeout. We review the evidence for persistence and fadeout, drawing primarily on evidence from educational interventions. We conclude that 1) fadeout is widespread, and often co-exists with persistence; 2) fadeout is a substantive phenomenon, not merely a measurement artefact; and 3) persistence depends on the types of skills targeted, the institutional constraints and opportunities within the social context, and complementarities between interventions and subsequent environmental affordances. We discuss the implications of these conclusions for research and policy.
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109
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Gellner AK, Voelter J, Schmidt U, Beins EC, Stein V, Philipsen A, Hurlemann R. Molecular and neurocircuitry mechanisms of social avoidance. Cell Mol Life Sci 2020; 78:1163-1189. [PMID: 32997200 PMCID: PMC7904739 DOI: 10.1007/s00018-020-03649-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/09/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022]
Abstract
Humans and animals live in social relationships shaped by actions of approach and avoidance. Both are crucial for normal physical and mental development, survival, and well-being. Active withdrawal from social interaction is often induced by the perception of threat or unpleasant social experience and relies on adaptive mechanisms within neuronal networks associated with social behavior. In case of confrontation with overly strong or persistent stressors and/or dispositions of the affected individual, maladaptive processes in the neuronal circuitries and its associated transmitters and modulators lead to pathological social avoidance. This review focuses on active, fear-driven social avoidance, affected circuits within the mesocorticolimbic system and associated regions and a selection of molecular modulators that promise translational potential. A comprehensive review of human research in this field is followed by a reflection on animal studies that offer a broader and often more detailed range of analytical methodologies. Finally, we take a critical look at challenges that could be addressed in future translational research on fear-driven social avoidance.
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Affiliation(s)
- Anne-Kathrin Gellner
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Jella Voelter
- Department of Psychiatry, School of Medicine and Health Sciences, University of Oldenburg, Hermann-Ehlers-Str. 7, 26160, Bad Zwischenahn, Germany
| | - Ulrike Schmidt
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.,Department of Psychiatry Und Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Eva Carolina Beins
- Institute of Human Genetics, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Valentin Stein
- Institute of Physiology II, University Hospital Bonn, 53115, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - René Hurlemann
- Division of Medical Psychology, Department of Psychiatry, University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany. .,Department of Psychiatry, School of Medicine and Health Sciences, University of Oldenburg, Hermann-Ehlers-Str. 7, 26160, Bad Zwischenahn, Germany. .,Research Center Neurosensory Science, University of Oldenburg, 26129, Oldenburg, Germany.
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110
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Patient-Centered Care in Psoriatic Arthritis-A Perspective on Inflammation, Disease Activity, and Psychosocial Factors. J Clin Med 2020; 9:jcm9103103. [PMID: 32992983 PMCID: PMC7600723 DOI: 10.3390/jcm9103103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/11/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022] Open
Abstract
Psoriatic arthritis (PsA) is a seronegative spondyloarthropathy characterized by skin lesions, dactylitis, and enthesitis. Patients with PsA suffer from a variety of psychosocial difficulties and nonspecific symptoms early on in the disease course and continue to experience progressive disease due to delays in diagnosis and treatment. Symptoms initially viewed as somatization could lead to undertreatment and promote psychological distress, poor coping, and negative patient-provider relationships. Pain and fatigue are important complaints that affect the patient's perception and may need to be addressed with a multidisciplinary approach. Maladaptive cognitive responses can lead to a negative illness perception and impact patient beliefs and concerns over treatment, as well as nonadherence. An underlying inflammatory component in affective disorders has been examined, though whether and how it may interact mechanistically in PsA warrants interest. Cognitive behavioral therapy represents a nonpharmacological treatment modality that can be combined with cytokine-targeted therapy to address both somatic and psychological complaints. Future directions for research include: (1) Elucidating nonspecific manifestations (e.g., subclinical stage, differential with functional syndromes) of PsA and how they impact diagnosis and management; (2) characterizing immune-mediated components of mood disorders in PsA; and (3) whether a bidirectional approach with abrogating inflammation and psychotherapeutic support leads to improved outcomes.
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111
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Lorimer B, Kellett S, Nye A, Delgadillo J. Predictors of relapse and recurrence following cognitive behavioural therapy for anxiety-related disorders: a systematic review. Cogn Behav Ther 2020; 50:1-18. [DOI: 10.1080/16506073.2020.1812709] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Ben Lorimer
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Stephen Kellett
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Arthur Nye
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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112
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Urits I, Callan J, Moore WC, Fuller MC, Renschler JS, Fisher P, Jung JW, Hasoon J, Eskander J, Kaye AD, Viswanath O. Cognitive behavioral therapy for the treatment of chronic pelvic pain. Best Pract Res Clin Anaesthesiol 2020; 34:409-426. [PMID: 33004156 DOI: 10.1016/j.bpa.2020.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 01/18/2023]
Abstract
Chronic pelvic pain (CPP) in women is defined as noncyclical and persistent pain lasting more than six months perceived to be related to the pelvis. There are many etiologies that can cause CPP, including gynecologic, urologic, gastrointestinal, musculoskeletal, neurologic, and psychosocial. There is a strong association between psychological factors and CPP. It has been noted that almost half of women being treated for CPP report a history of sexual, physical, or emotional trauma. Women with CPP have been noted to have higher rates of psychological disorders in comparison to their peers. For men, the most common etiology for CPP is chronic prostatitis and there are also correlations with psychological disorders. There are many different treatment options for CPP: surgical, pharmacological, and non-pharmacological (alternative therapies). Cognitive-behavioral therapy may be another option when treating chronic pelvic pain syndrome and should be considered.
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Affiliation(s)
- Ivan Urits
- Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA; Louisiana State University Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA.
| | - Jessica Callan
- University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ, USA
| | - Warner C Moore
- Louisiana State University Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
| | | | - Jordan S Renschler
- Louisiana State University Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
| | - Paul Fisher
- Louisiana State University Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
| | - Jai Won Jung
- Georgetown University School of Medicine, Washington, DC, USA
| | - Jamal Hasoon
- Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA
| | - Jonathan Eskander
- Portsmouth Anesthesia Associates, Anesthesiology and Pain Medicine, Portsmouth, VA, USA
| | - Alan D Kaye
- Louisiana State University Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA
| | - Omar Viswanath
- University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ, USA; Louisiana State University Health Shreveport, Department of Anesthesiology, Shreveport, LA, USA; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, USA; Valley Pain Consultants - Envision Physician Services, Phoenix, AZ, USA
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113
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Nelson HD, Cantor A, Pappas M, Weeks C. Screening for Anxiety in Adolescent and Adult Women: A Systematic Review for the Women's Preventive Services Initiative. Ann Intern Med 2020; 173:29-41. [PMID: 32510989 DOI: 10.7326/m20-0579] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Anxiety disorders are infrequently recognized during routine health care even though they are common in adolescent girls and adult women. PURPOSE To evaluate evidence on the effectiveness of screening for anxiety disorders in primary care in improving symptoms, function, and quality of life; harms of screening; accuracy of screening instruments; and effectiveness and harms of treatments. DATA SOURCES English-language searches of Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Health and Psychosocial Instruments (1 January 1996 to 4 November 2019); ClinicalTrials.gov (November 2019); and reference lists of studies and reviews. STUDY SELECTION Studies that enrolled adolescent girls and adult women not currently diagnosed with anxiety disorders, including pregnant or postpartum women, and compared clinical outcomes and harms between women who were and were not screened; diagnostic accuracy studies of screening instruments; and systematic reviews of randomized trials of behavioral and pharmacologic treatments. DATA EXTRACTION Dual extraction and quality assessment of individual studies. DATA SYNTHESIS No studies evaluated the overall effectiveness or harms of screening. Thirty-three studies and 2 systematic reviews (171 studies; 112 574 participants) evaluated the diagnostic accuracy of 27 screening instruments and their variations against a clinical diagnosis or other instruments. Most demonstrated moderate to high accuracy for adults (Generalized Anxiety Disorder scale: sensitivity, 70% to 97%; specificity, 50% to 89%), pregnant and postpartum women (Edinburgh Postnatal Depression Scale: sensitivity, 74%; specificity, 64%), and adolescents (Screen for Child Anxiety Related Emotional Disorders: sensitivity, 64% to 74%; specificity, 64% to 73%). Anxiety symptoms improved with cognitive behavioral therapy (246 randomized controlled trials; 17 209 participants) and antianxiety medications (126 randomized controlled trials; 8225 participants). LIMITATION Limited data on long-term harms of treatment and no treatment trials in pregnant or postpartum women. CONCLUSION Evidence on the overall effectiveness and harms of screening for anxiety is insufficient. Most screening instruments are moderately to highly accurate. Behavioral therapies and antianxiety medications effectively improve anxiety symptoms. PRIMARY FUNDING SOURCE Health Resources and Services Administration.
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Affiliation(s)
- Heidi D Nelson
- Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon (H.D.N., A.C., M.P., C.W.)
| | - Amy Cantor
- Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon (H.D.N., A.C., M.P., C.W.)
| | - Miranda Pappas
- Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon (H.D.N., A.C., M.P., C.W.)
| | - Chandler Weeks
- Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon (H.D.N., A.C., M.P., C.W.)
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Gregory KD, Chelmow D, Nelson HD, Van Niel MS, Conry JA, Garcia F, Kendig SM, O'Reilly N, Qaseem A, Ramos D, Salganicoff A, Son S, Wood JK, Zahn C. Screening for Anxiety in Adolescent and Adult Women: A Recommendation From the Women's Preventive Services Initiative. Ann Intern Med 2020; 173:48-56. [PMID: 32510990 DOI: 10.7326/m20-0580] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
DESCRIPTION The Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives, developed a recommendation on screening for anxiety in adolescent and adult women to improve detection; achieve earlier diagnosis and treatment; and improve health, function, and well-being. The WPSI's recommendations are intended to guide clinical practice and coverage of services for the Health Resources and Services Administration and other stakeholders. The target audience for this recommendation includes all clinicians providing preventive health care to women, particularly in primary care settings. This recommendation applies to women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women. METHODS The WPSI developed this recommendation after evaluating results of a systematic review of the effectiveness of screening, accuracy of screening instruments, and benefits and harms of treatments in adolescent girls and adult women. No studies directly evaluated the overall effectiveness or harms of screening for anxiety. Twenty-seven screening instruments and their variations were moderately to highly accurate in identifying anxiety (33 individual studies and 2 systematic reviews; 171 studies total). Symptoms improved and relapse rates decreased with psychological therapies (246 randomized controlled trials [RCTs] in 5 systematic reviews) and with selective serotonin reuptake inhibitors or selective serotonin and norepinephrine reuptake inhibitors (126 RCTs in 3 systematic reviews). The WPSI also considered the effect of screening on symptom progression and identification of associated and underlying conditions, as well as implementation factors. RECOMMENDATION The WPSI recommends screening for anxiety in women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women. Optimal screening intervals are unknown, and clinical judgment should be used to determine frequency. When screening suggests the presence of anxiety, further evaluation is necessary to establish the diagnosis and determine appropriate treatment and follow-up.
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Affiliation(s)
| | - David Chelmow
- Virginia Commonwealth University School of Medicine, Richmond, Virginia (D.C.)
| | - Heidi D Nelson
- Oregon Health & Science University, Portland, Oregon (H.D.N.)
| | | | - Jeanne A Conry
- American College of Obstetricians and Gynecologists, Washington, DC (J.A.C., N.O., S.S., C.Z.)
| | | | - Susan M Kendig
- National Association of Nurse Practitioners in Women's Health, Washington, DC (S.M.K.)
| | - Nancy O'Reilly
- American College of Obstetricians and Gynecologists, Washington, DC (J.A.C., N.O., S.S., C.Z.)
| | - Amir Qaseem
- American College of Physicians, Philadelphia, Pennsylvania (A.Q.)
| | - Diana Ramos
- California Department of Public Health, Sacramento, California (D.R.)
| | | | - Sarah Son
- American College of Obstetricians and Gynecologists, Washington, DC (J.A.C., N.O., S.S., C.Z.)
| | - Julie K Wood
- American Academy of Family Physicians, Leawood, Kansas (J.K.W.)
| | - Christopher Zahn
- American College of Obstetricians and Gynecologists, Washington, DC (J.A.C., N.O., S.S., C.Z.)
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Error in Abstract, Text, Table, and Supplemental Content. JAMA Psychiatry 2020; 77:768. [PMID: 32401280 PMCID: PMC7221853 DOI: 10.1001/jamapsychiatry.2020.1242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Bilet T, Olsen T, Andersen JR, Martinsen EW. Cognitive behavioral group therapy for panic disorder in a general clinical setting: a prospective cohort study with 12 to 31-years follow-up. BMC Psychiatry 2020; 20:259. [PMID: 32448206 PMCID: PMC7247216 DOI: 10.1186/s12888-020-02679-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/18/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The long-term prognosis after cognitive behavioral therapy (CBT) in outpatient groups for panic disorder and agoraphobia is not well known. The purpose of this study was to assess long-term outcomes in terms of psychological health, health-related quality of life (HRQoL), quality of life (QoL) and treatment satisfaction after CBT for panic disorder and agoraphobia. METHODS The sample consisted of 68 patients (61% response rate), who were assessed at pretreatment; at the start and end of treatment; and after 3 months, after 1 year, and over the long term (M = 24 years; SD = 5.3; range: 12 to 31 years). The main outcome was the total score on the Phobic Avoidance Rating Scale (PARS-total). At long-term follow-up, HRQoL was measured with the RAND-12 questionnaire, and QoL was measured with two questions from the "Study on European Union Statistics on Income and Living Conditions". Patient experiences and treatment satisfaction were assessed by the Generic Short Patient Experiences Questionnaire. A marginal longitudinal model was applied to study the main outcome. RESULTS The effect size of the long-term change (mean change/ pooled SD) in the PARS-total score was (- 1.6, p < 0.001) and was stable over time. A PARS-total score reduction of 50% was found in 98% of patients at the long-term follow-up. The patients' HRQoL and QoL were similar to the expected scores for the general Norwegian population. Of the patients, 95% reported high to very high satisfaction with the CBT, and 93% reported large treatment benefits. CONCLUSIONS To the best of our knowledge, this study has the longest follow-up after group CBT for panic disorder and agoraphobia, showing a good prognosis in ≥93% of the participating patients.
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Affiliation(s)
- Truls Bilet
- Division of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Torbjørn Olsen
- Division of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - John Roger Andersen
- Centre of Health Research, Førde Hospital Trust, Førde, Norway. .,Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway.
| | - Egil W. Martinsen
- grid.55325.340000 0004 0389 8485Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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