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Li Z, Xu M. Oxytocin enhances group-based guilt in high moral disengagement individuals through increased moral responsibility. Psychoneuroendocrinology 2024; 168:107131. [PMID: 39059227 DOI: 10.1016/j.psyneuen.2024.107131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 06/27/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024]
Abstract
Group-based guilt (collective guilt) refers to the negative emotions experienced when group members violate moral standards and can motivate prosocial behavior. Individuals exhibiting high levels of moral disengagement are prone to engaging in unethical conduct without experience of guilt, thereby prolonging or exacerbating conflicts and hindering conflict resolution. Oxytocin is believed to play key role in shaping social cognition and behaviors associated with morality and prosociality. So, this study (N = 79) explores oxytocin's potential to enhance group-based guilt and compensation for victims among individuals with high moral disengagement. Employing a randomized placebo-controlled design, participants received either oxytocin or placebo before undertaking a task designed to induce group-based guilt, during which they made decisions regarding the allocation of money to victims. Results revealed that participants with high moral disengagement who received oxytocin perceived higher levels of moral responsibility, experienced increased group-based guilt, and allocated significantly more money to victims compared to those who received the placebo. These findings suggested that oxytocin holds promise as an intervention to mitigate moral disengagement and foster moral behavior in individuals predisposed to avoiding responsibility and guilt feelings.
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Affiliation(s)
- Zhiai Li
- Department of Applied Psychology, College of Public Administration, Guangdong University of Foreign Studies, Guangzhou, China.
| | - Mengsi Xu
- School of Psychology, Shaanxi Normal University, Xi'an, China.
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Nisar A, Xiang H, Perin J, Malik A, Zaidi A, Atif N, Rahman A, Surkan PJ. Impact of an intervention for perinatal anxiety on breastfeeding: findings from the Happy Mother-Healthy Baby randomized controlled trial in Pakistan. Int Breastfeed J 2024; 19:53. [PMID: 39095863 PMCID: PMC11295719 DOI: 10.1186/s13006-024-00655-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/29/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The study examined the effects of Happy Mother-Healthy Baby (HMHB), a cognitive-behavioural therapy (CBT) intervention on breastfeeding outcomes for Pakistani women with prenatal anxiety. METHODS Breastfeeding practices were evaluated in a randomized controlled trial between 2019 and 2022 in a public hospital in Pakistan. The intervention group was randomized to receive six HMHB sessions targeted towards prenatal anxiety (with breastfeeding discussed in the final session), while both groups also received enhanced usual care. Breastfeeding was defined in four categories: early breastfeeding, exclusive early breastfeeding, recent breastfeeding, and exclusive recent breastfeeding. Early breastfeeding referred to the first 24 h after birth and recent breastfeeding referred to the last 24 h before an assessment at six-weeks postpartum. Potential confounders included were mother's age, baseline depression and anxiety levels, stress, social support, if the first pregnancy (or not) and history of stillbirth or miscarriage as well as child's gestational age, gender. Both intent-to-treat and per-protocol analyses were examined. Stratified analyses were also used to compare intervention efficacy for those with mild vs severe anxiety. RESULTS Out of the 1307 eligible women invited to participate, 107 declined to participate and 480 were lost to follow-up, resulting in 720 women who completed the postpartum assessment. Both intervention and control arms were similar on demographic characteristics (e.g. sex, age, income, family structure). In the primary intent-to-treat analysis, there was a marginal impact of the intervention on early breastfeeding (OR 1.38, 95% CI: 0.99-1.92; 75.4% (N = 273) vs. 69.0% (N = 247)) and a non-significant association with other breastfeeding outcomes (OR1.42, 95% CI: 0.89-2.27; (47) 12.9% vs. (34) 9.5%, exclusive early breastfeeding; OR 1.48, 95% CI: 0.94-2.35; 90% (N = 327) vs. 86% (N = 309), recent breastfeeding; OR1.01, 95% CI: 0.76-1.35; 49% (N = 178) vs 49% (N = 175) exclusive recent breastfeeding). Among those who completed the intervention's six core sessions, the intervention increased the odds of early breastfeeding (OR1.69, 95% CI:1.12-2.54; 79% (N = 154) vs. 69% (N = 247)) and recent breastfeeding (OR 2.05, 95% CI:1.10-3.81; 93% (N = 181) vs. 86% (N = 309)). For women with mild anxiety at enrolment, the intervention increased the odds of recent breastfeeding (OR 2.41, 95% CI:1.17-5.00; 92% (N = 137) vs. 83% (N = 123). CONCLUSIONS The study highlights the potential of CBT-based interventions like HMHB to enhance breastfeeding among women with mild perinatal anxiety, contingent upon full participation in the intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT03880032.
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Affiliation(s)
- Anum Nisar
- Institute of Population Health, University of Liverpool, Liverpool, UK
- Human Development Research Foundation, Rawalpindi, Pakistan
| | - Haoxue Xiang
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jamie Perin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Abid Malik
- Health Services Academy, Islamabad, Pakistan
| | - Ahmed Zaidi
- Human Development Research Foundation, Rawalpindi, Pakistan
| | - Najia Atif
- Human Development Research Foundation, Rawalpindi, Pakistan
| | - Atif Rahman
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Pamela J Surkan
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
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Gruszczyńska E, Rzeszutek M. Daily stigma and daily emotional well-being among people living with HIV: Testing a buffering hypothesis of social support during the COVID-19 pandemic. Appl Psychol Health Well Being 2024; 16:477-496. [PMID: 37852623 DOI: 10.1111/aphw.12500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023]
Abstract
This study examined the relationship between daily perceived stigma and daily emotional well-being among people living with HIV/AIDS during the COVID-19 pandemic. Additionally, a buffering effect of perceived emotional support on this relationship was verified. The participants were 133 patients with a medically confirmed diagnosis of HIV infection. Data were collected using online diaries completed every evening for five consecutive weekdays in three bursts separated by 6 months. Dynamic multilevel analyses showed a significant positive autoregressive effect for daily stigma in each burst. Additionally, increased stigma predicts increased negative affect and decreased positive affect the next day. However, these effects differed across bursts. Thus, to some extent, daily HIV/AIDS stigma was found to predict a decrease in affective well-being the next day. The buffering effect of perceived emotional support reduced this decline but was also time-limited, probably because of the later established direction in these relationships at the individual level and/or because of changes in the course of the pandemic. The results provide insights on the role of daily stigma in shaping affective well-being, suggesting that it may be a significant source of short-term negative emotional consequences for PWLH.
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Affiliation(s)
- Ewa Gruszczyńska
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
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Westhoff M, Heshmati S, Siepe B, Vogelbacher C, Ciarrochi J, Hayes SC, Hofmann SG. Psychological flexibility and cognitive-affective processes in young adults' daily lives. Sci Rep 2024; 14:8182. [PMID: 38589553 PMCID: PMC11001944 DOI: 10.1038/s41598-024-58598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/01/2024] [Indexed: 04/10/2024] Open
Abstract
Psychological flexibility plays a crucial role in how young adults adapt to their evolving cognitive and emotional landscapes. Our study investigated a core aspect of psychological flexibility in young adults: adaptive variability and maladaptive rigidity in the capacity for behavior change. We examined the interplay of these elements with cognitive-affective processes within a dynamic network, uncovering their manifestation in everyday life. Through an Ecological Momentary Assessment design, we collected intensive longitudinal data over 3 weeks from 114 young adults ages 19 to 32. Using a dynamic network approach, we assessed the temporal dynamics and individual variability in flexibility in relation to cognitive-affective processes in this sample. Rigidity exhibited the strongest directed association with other variables in the temporal network as well as highest strength centrality, demonstrating particularly strong associations to other variables in the contemporaneous network. In conclusion, the results of this study suggest that rigidity in young adults is associated with negative affect and cognitions at the same time point and the immediate future.
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Affiliation(s)
- Marlon Westhoff
- Department of Psychology, Philipps-University of Marburg, Schulstraße 12, 35032, Marburg, Germany
| | - Saida Heshmati
- Department of Psychology, Claremont Graduate University, Claremont, CA, USA
| | - Björn Siepe
- Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Christoph Vogelbacher
- Department of Psychology, Philipps-University of Marburg, Schulstraße 12, 35032, Marburg, Germany
| | - Joseph Ciarrochi
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Steven C Hayes
- Department of Psychology, University of Nevada Reno, Reno, NV, USA
| | - Stefan G Hofmann
- Department of Psychology, Philipps-University of Marburg, Schulstraße 12, 35032, Marburg, Germany.
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Teriba A, Dawson D. Expanding High School Counseling in a Social Media World: Improving Student and Community Well-Being. Psychol Rep 2024; 127:807-826. [PMID: 36154319 DOI: 10.1177/00332941221129138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Adolescent competence and resilience are indicators of adulthood behavior. High school is a pivotal time for adolescents to foster a stable temperament for adult development. The contemporary state of adolescent depression prevalence and an increase in social media-related risky behavior calls for an update to mental health services. We review the nature of modern social comparison that is fueled by social media, mental health help-seeking stigma that prevents individuals from seeking services, and provide mental health advances to remedy the severity of mental health concerns in a social media society. Social media distortions of normative life promote a standard of expectations that can decrease self-esteem and increase depressive tendencies. Expanding high school counseling such that students see a counselor multiple times a year in a proactive rather than reactive school counseling system can provide transformative changes to community mental health.
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Affiliation(s)
- Akorede Teriba
- Department of Psychological and Quantitative Foundations, The University of Iowa, Iowa City, IA, USA
| | - Devon Dawson
- Department of Psychological and Quantitative Foundations, The University of Iowa, Iowa City, IA, USA
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Miegel F, Rubel J, Dietrichkeit M, Hagemann-Goebel M, Yassari AH, Balzar A, Scheunemann J, Jelinek L. Exploring mechanisms of change in the metacognitive training for depression. Eur Arch Psychiatry Clin Neurosci 2024; 274:739-753. [PMID: 37067579 DOI: 10.1007/s00406-023-01604-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/29/2023] [Indexed: 04/18/2023]
Abstract
The Metacognitive Training for Depression (D-MCT) is a highly structured group therapy that has been shown to be effective in reducing depressive symptoms. First evidence suggests that need for control represents a mechanism of change. However, more research is needed to evaluate the mode of action of each module and identify predictors of treatment response. Two sequential studies (one naturalistic pilot study [study I, N = 45] and one randomized controlled trial [study II, N = 32]) were conducted to evaluate the session-specific effects and predictors of D-MCT in patients with depression. The D-MCT was conducted over eight weeks, and patients answered a questionnaire on dysfunctional beliefs (e.g., negative filter) and depressive symptoms (e.g., lack of energy, self-esteem) before and after each session. Linear mixed-effects models showed that several dysfunctional beliefs and symptoms improved over the course of the treatment; three modules were able to evoke within-session effects, but no between-session effects were found. The improvement in lack of energy in one module was identified as a relevant predictor in study I via lasso regression but was not replicated in study II. Exploratory analyses revealed further predictors that warrant replication in future studies. The identified predictors were inconclusive when the two studies were compared, which may be explained by the different instruments administered. Even so, the results may be used to revise questionnaires and improve the intervention.
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Affiliation(s)
- Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Julian Rubel
- Department of Psychology and Sports Science, Justus Liebig University Giessen, Giessen, Germany
| | - Mona Dietrichkeit
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
- Department of Psychiatry and Psychotherapy, Asklepios Clinic North, Hamburg, Germany
| | | | - Amir H Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Alicia Balzar
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Perry AE, Baker H, Aboaja A, Wilson L, Morris S. Co-production and adaptation of a prison-based problem-solving workbook to support the mental health of patients housed within a medium- and low-secure forensic service. Health Expect 2024; 27:e13997. [PMID: 38400622 PMCID: PMC10891435 DOI: 10.1111/hex.13997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/19/2023] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Problem-solving skills (PSS) help to provide a systematic approach to dealing with and managing complex problems. The overall aim of this study was to assess the acceptability and feasibility of developing and adapting a prison-based PSS workbook for adults within a medium- and low-secure hospital. METHOD We used the Medical Research Council framework in our participatory mixed methods study incorporating an adapted survey (to identify what types of problems people experience in secure hospitals), a series of three interactive workshops (to co-produce two case study examples for a workbook) and we gathered feedback from patients and hospital staff on the acceptability and feasibility of the workbook. Data from the survey were used to inform the case study examples, and the feedback from patients and hospital staff was descriptively summarised and the results consolidated. RESULTS In total, 82 (51%) patients took part in the survey; 22 patients and 49 hospital staff provided feedback on the workbook. The survey results indicated that patients regularly experience problems while in the hospital. Patients reported problems relating to restrictions of freedom and boredom. The workshops produced two case studies for the workbooks, with mainly positive patient and staff feedback. More work is required to improve the visual representation of the characters in the case studies, the amount and content of the language and the mechanism of the intervention delivery. CONCLUSION The adaptation process proved acceptable and feasible to both patients and staff. The co-production methodology for the workbook and feedback from patients and staff was an effective way of iteratively refining the materials to ensure that they were both meaningful and acceptable to staff and patients. Subsequent work is required to develop the workbook and evaluate the feasibility of the intervention delivery, recruitment rates, uptake and adherence to the PSS using a randomised controlled trial. PATIENT OR PUBLIC CONTRIBUTION At each stage of the project consultation with patients and/or hospital staff was involved.
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Affiliation(s)
- Amanda E. Perry
- Department of Health SciencesUniversity of YorkYorkFulfordUK
| | - Heather Baker
- Tees Esk and Wear Valleys NHS Foundation TrustDarlingtonWest ParkUK
| | - Anne Aboaja
- Tees Esk and Wear Valleys NHS Foundation TrustDarlingtonWest ParkUK
| | - Lindsey Wilson
- Tees Esk and Wear Valleys NHS Foundation TrustDarlingtonWest ParkUK
| | - Sarah Morris
- Tees Esk and Wear Valleys NHS Foundation TrustDarlingtonWest ParkUK
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Hoffman SN, Rassaby MM, Stein MB, Taylor CT. Positive and negative affect change following psychotherapeutic treatment for anxiety-related disorders: A systematic review and meta-analysis. J Affect Disord 2024; 349:358-369. [PMID: 38211753 DOI: 10.1016/j.jad.2024.01.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/05/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Anxiety-related disorders feature elevated negative affect (NA), and in some cases, diminished positive affect (PA). It remains unclear how well extant psychotherapies for anxiety-related disorders improve PA versus NA. METHODS We systematically searched the Cochrane Central Register of Controlled Trials, PubMed, PsychInfo, and Web of Science databases. Records included studies involving (1) patients with a principal or co-principal diagnosis of at least one anxiety-related disorder (i.e., generalized anxiety, social anxiety, panic, agoraphobia, health anxiety, specific phobia, obsessive-compulsive disorder, or posttraumatic stress disorder), and (2) pre- and post-treatment PA and NA scores or a change index between pre- and post-treatment PA and NA scores. Effect sizes were calculated for meta-analyses. RESULTS Fourteen studies with 1001 adults with an anxiety-related disorder were included. Psychotherapeutic interventions included cognitive behavioral, present-centered, and imagery-based approaches. Treatments reduced NA (g = -0.90; 95%CI [-1.19, -0.61]) to a greater extent than they improved PA (g = 0.27; 95%CI [0.05, 0.59]), Z = -5.26, p < .001. The limited number of studies available precluded analyses of the relationship between changes in affect and symptoms. LIMITATIONS Results should be considered with caution given the small number and heterogeneity of included studies. CONCLUSIONS Current psychotherapeutic interventions for anxiety-related disorders may not improve PA and NA to comparable levels.
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Affiliation(s)
- Samantha N Hoffman
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA.
| | - Madeleine M Rassaby
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 103, San Diego, CA 92120, USA.
| | - Murray B Stein
- University of California San Diego, Department of Psychiatry, 9452 Medical Center Drive, 4E-226, La Jolla, CA 921037, USA.
| | - Charles T Taylor
- University of California San Diego, Department of Psychiatry, 9452 Medical Center Drive, 4E-226, La Jolla, CA 921037, USA.
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Parker PC, Daniels LM, Mosewich AD. Collegiate Athletes' Cognitive Beliefs Related to Setback Anxiety and Rumination in Sport. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-10. [PMID: 38329500 DOI: 10.1080/02701367.2023.2298740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/19/2023] [Indexed: 02/09/2024]
Abstract
Setbacks are common occurrences in sport. Recently, setbacks such as injuries and deselection have been accompanied, and confounded, by setbacks related to COVID-19. How students manage a setback may depend on the interaction of two control beliefs: primary control (PC) to directly influence the setback and secondary control (SC) to adjust to it. Purpose: This study investigates the relationships between athletes' PC and SC and two important sport setback-related outcomes-anxiety and rumination. Method: We employed a cross-sectional design examining collegiate athletes in the USA and Canada (N = 200; Mage = 20.9 years, 143 women, 52 men, 3 non-binary, 2 did not disclose). Using regression tests controlling for setback severity, we examined the interaction effects of athletes' PC and SC beliefs relative to setbacks, on the anxiety and rumination variables. Results: We found SC beliefs were beneficial to setback-related anxiety and rumination. A significant interaction indicated that particularly when PC was low, SC had negative associations with setback-related anxieties about letting others down (β = -.45, p < .001) and experiencing pain (β = -.37, p < .001). Conclusion: The findings suggest SC beliefs are important for managing setbacks-specifically for attenuating harmful rumination, and specific setback anxieties. We discuss the possibility of enhancing SC beliefs for combatting sport setbacks through control-enhancing interventions as a direction for future research.
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Stephenson C, Moghimi E, Shao Y, Kumar A, Yee CS, Miller S, Stefatos A, Gholamzadehmir M, Abbaspour Z, Jagayat J, Shirazi A, Gizzarelli T, Gutierrez G, Khan F, Patel C, Patel A, Yang M, Omrani M, Alavi N. Comparing the efficacy of electronic cognitive behavioral therapy to medication and combination therapy for generalized anxiety disorder: a quasi-experimental clinical trial. Front Psychiatry 2023; 14:1194955. [PMID: 38125282 PMCID: PMC10732166 DOI: 10.3389/fpsyt.2023.1194955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
Background Generalized anxiety disorder (GAD) is a debilitating mental health disorder with first-line treatments include cognitive behavioral therapy (CBT) and pharmacotherapy. CBT is costly, time-consuming, and inaccessible. Electronic delivery (e-CBT) is a promising solution to address these barriers. However, due to the novelty of this intervention, more research testing the e-CBT efficacy independently and in conjunction with other treatments is needed. Objective This study investigated the efficacy of e-CBT compared to and in conjunction with pharmacotherapy for GAD. Methods This study employed a quasi-experimental design where patients selected their preferred treatment modality. Patients with GAD were enrolled in either e-CBT, medication, or combination arms. The 12-week e-CBT program was delivered through a digital platform. The medications followed clinical guidelines. The efficacy of each arm was evaluated using questionnaires measuring depression, anxiety, and stress severity, as well as quality of life. Results There were no significant differences between arms (N e-CBT = 41; N Medication = 41; N Combination = 33) in the number of weeks completed or baseline scores. All arms showed improvements in anxiety scores after treatment. The medication and combination arms improved depression scores. The e-CBT and Combination arms improved quality of life, and the combination arm improved stress scores. There were no differences between the groups in depression, anxiety, or stress scores post-treatment. However, the combination arm had a significantly larger improvement in quality of life. Gender and treatment arm were not predictors of dropout, whereas younger age was. Conclusion Incorporating e-CBT on its own or in combination with pharmaceutical interventions is a viable option for treating GAD. Treating GAD with e-CBT or medication appears to offer significant improvements in symptoms, with no meaningful difference between the two. Combining the treatments also offer significant improvements, while not necessarily superior to either independently. The findings suggest that all options are viable. Taking the patient's preferred treatment route based on their lifestyle, personality, and beliefs into account when deciding on treatment should be a priority for care providers.
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Affiliation(s)
- Callum Stephenson
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Elnaz Moghimi
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Yijia Shao
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- Department of Psychology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Anchan Kumar
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Caitlin S. Yee
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Shadé Miller
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Anthi Stefatos
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Maedeh Gholamzadehmir
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Zara Abbaspour
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Jasleen Jagayat
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Amirhossein Shirazi
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Digital Media Zone, Ryerson University, Toronto, ON, Canada
| | - Tessa Gizzarelli
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Gilmar Gutierrez
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Ferwa Khan
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Archana Patel
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Digital Media Zone, Ryerson University, Toronto, ON, Canada
| | - Nazanin Alavi
- Department of Psychiatry, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
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Edwards KA, Reed DE, Anderson D, Harding K, Turner AP, Soares B, Suri P, Williams RM. Opening the black box of psychological treatments for chronic pain: A clinical perspective for medical providers. PM R 2023; 15:999-1011. [PMID: 36633497 DOI: 10.1002/pmrj.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Karlyn A Edwards
- Department of Anesthesiology, Perioperative & Pain Medicine, Division of Pain Medicine, Stanford University, Stanford, California, USA
| | - David E Reed
- Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Administration Puget Sound Health Care, Seattle, Washington, USA
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Derek Anderson
- Rehabilitation Care Services, Veterans Administration Puget Sound Health Care System, Seattle, Washington, USA
| | - Kaitlin Harding
- Rehabilitation Care Services, Veterans Administration Puget Sound Health Care System, Seattle, Washington, USA
| | - Aaron P Turner
- Rehabilitation Care Services, Veterans Administration Puget Sound Health Care System, Seattle, Washington, USA
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Bosco Soares
- Rehabilitation Care Services, Veterans Administration Puget Sound Health Care System, Seattle, Washington, USA
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Pradeep Suri
- Rehabilitation Care Services, Veterans Administration Puget Sound Health Care System, Seattle, Washington, USA
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
- Clinical Learning, Evidence, and Research (CLEAR) Center, University of Washington, Seattle, Washington, USA
| | - Rhonda M Williams
- Rehabilitation Care Services, Veterans Administration Puget Sound Health Care System, Seattle, Washington, USA
- Department of Rehabilitation Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
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Mazurek MO, Pappagianopoulos J, Brunt S, Sadikova E, Nevill R, Menezes M, Harkins C. A mixed methods study of autistic adults' mental health therapy experiences. Clin Psychol Psychother 2023; 30:767-779. [PMID: 36708045 PMCID: PMC10372197 DOI: 10.1002/cpp.2835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/11/2023] [Accepted: 01/24/2023] [Indexed: 01/29/2023]
Abstract
Autistic adults are at high risk for co-occurring mental health problems and need access to effective and appropriate mental health treatment. However, the relative effectiveness or acceptability of specific mental health strategies among autistic adults has not been previously examined. The current study sought to gain a deeper understanding of autistic adults' experiences and preferences regarding mental health strategies using a mixed methods approach. Autistic adults (n = 303, ages 21-77) completed online surveys and open-ended questions about their mental health and therapy experiences. Most (88.8%) had participated in therapy, with cognitive approaches being the most common. Regarding overall therapy experiences, qualitative analyses revealed four primary themes and nine subthemes. Therapist acceptance and understanding were seen as critical for therapy success, and many participants felt that therapy was helpful for personal growth. However, many participants found that talking in session was challenging and noted that aspects of the session format affected their ability to engage in therapy. Regarding specific strategies, four cross-cutting themes and eight strategy-specific subthemes were identified. A variety of strategies were seen as helpful for reducing anxiety and improving mood. However, autistic adults reported trouble generalizing strategies to daily life and found some techniques to be difficult to implement due, in part, to their unique autism-related needs. As the first study of its kind, the results underscore the importance of establishing a safe and accepting therapeutic relationship, providing accommodations to support communication needs, and considering individual differences and preferences when selecting mental health strategies for autistic clients.
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Affiliation(s)
- Micah O Mazurek
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
| | | | - Sophie Brunt
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
| | - Eleonora Sadikova
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
| | - Rose Nevill
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
| | - Michelle Menezes
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
| | - Christina Harkins
- Department of Human Services, University of Virginia, Charlottesville, Virginia, USA
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Norbury A, Seeley SH, Perez-Rodriguez MM, Feder A. Functional neuroimaging of resilience to trauma: convergent evidence and challenges for future research. Psychol Med 2023; 53:3293-3305. [PMID: 37264949 DOI: 10.1017/s0033291723001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Resilience is broadly defined as the ability to adapt successfully following stressful life events. Here, we review functional MRI studies that investigated key psychological factors that have been consistently linked to resilience to severe adversity and trauma exposure. These domains include emotion regulation (including cognitive reappraisal), reward responsivity, and cognitive control. Further, we briefly review functional imaging evidence related to emerging areas of study that may potentially facilitate resilience: namely social cognition, active coping, and successful fear extinction. Finally, we also touch upon ongoing issues in neuroimaging study design that will need to be addressed to enable us to harness insight from such studies to improve treatments for - or, ideally, guard against the development of - debilitating post-traumatic stress syndromes.
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Affiliation(s)
- Agnes Norbury
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Queen Square Institute of Neurology and Mental Health Neuroscience Department, Applied Computational Psychiatry Lab, Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
| | - Saren H Seeley
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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14
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Cox WTL. Developing scientifically validated bias and diversity trainings that work: empowering agents of change to reduce bias, create inclusion, and promote equity. MANAGEMENT DECISION 2023; 61:1038-1061. [PMID: 37090785 PMCID: PMC10120861 DOI: 10.1108/md-06-2021-0839] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Purpose – Research consistently shows that non-scientific bias, equity, and diversity trainings do not work, and often make bias and diversity problems worse. Despite these widespread failures, there is considerable reason for hope that effective, meaningful DEI efforts can be developed. One approach in particular, the bias habit-breaking training, has 15 years of experimental evidence demonstrating its widespread effectiveness and efficacy. Design/methodology/approach – This article discusses bias, diversity, equity, and inclusion (DEI) efforts from the author's perspective as a scientist-practitioner - the author draws primarily on the scientific literature, but also integrates insights from practical experiences working in DEI. The author provides a roadmap for adapting effective, evidence-based approaches from other disciplines (e.g. cognitive-behavioral therapy) into the DEI context and reviews evidence related to the bias habit-breaking training as one prominent demonstration of a scientifically-validated approach that effects lasting, meaningful improvements on DEI issues within both individuals and institutions. Findings – DEI trainings fail due to widespread adoption of the information deficit model, which is well-known as a highly ineffective approach. Empowerment-based approaches, in contrast, are highly promising for making meaningful, lasting changes in the DEI realm. Evidence indicates that the bias habit-breaking training is effective at empowering individuals as agents of change to reduce bias, create inclusion, and promote equity, both within themselves and the social contexts they inhabit. Originality/value – In contrast to the considerable despair and pessimism around DEI efforts, the present analysis provides hope and optimism, and an empirically-validated path forward, to develop and test DEI approaches that empower individuals as agents of change.
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Affiliation(s)
- William Taylor Laimaka Cox
- Department of Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Inequity Agents of Change, Madison, Wisconsin, USA
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15
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Allsop DB, Péloquin K, Saxey MT, Rossi MA, Rosen NO. Perceived financial burden is indirectly linked to sexual well-being via quality of life among couples seeking medically assisted reproduction. Front Psychol 2023; 14:1063268. [PMID: 37082570 PMCID: PMC10110993 DOI: 10.3389/fpsyg.2023.1063268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/01/2023] [Indexed: 04/07/2023] Open
Abstract
IntroductionMedically assisted reproduction is a difficult treatment process for couples both financially and sexually. Yet, these two domains have not been examined together among couples seeking treatment, leaving couples and practitioners without guidance on how to address these domains together.MethodsIn line with Couples and Finance Theory, we tested the hypothesis that perceived financial burden and couple income would predict quality of life during medically assisted reproduction, which would then predict four domains of sexual well-being (i.e., sexual satisfaction, desire, distress, and frequency). We also examined if the results differed by treatment status—that is, between partners who were receiving treatment and those who were not. Cross-sectional data from 120 couples who had undergone medically assisted reproduction in the past six months were analyzed via structural equation modeling through an actor-partner interdependence mediation model.ResultsAn individual’s greater perceived financial burden predicted their own lower quality of life during medically assisted reproduction, which in turn predicted their lower sexual satisfaction, desire and distress, as well as their partner’s lower sexual satisfaction. Household income did not indirectly predict any sexual well-being domains, and results regarding treatment status were inconclusive.DiscussionClinicians can discuss with couples how perceived financial strain of medically assisted reproduction affects their quality of life and what ramifications that may have for their sexual well-being.
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Affiliation(s)
- David B. Allsop
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Katherine Péloquin
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Matthew T. Saxey
- School of Family Life, Brigham Young University, Provo, UT, United States
| | - Meghan A. Rossi
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Natalie O. Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
- *Correspondence: Natalie O. Rosen,
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Pauley AM, Leonard KS, Cumbo N, Teti IF, Pauli JM, Satti M, Stephens M, Corr T, Roeser RW, Legro RS, Mackeen AD, Bailey-Davis L, Downs DS. Women's beliefs of pain after childbirth: Critical insight for promoting behavioral strategies to regulate pain and reduce risks for maternal mortality. PATIENT EDUCATION AND COUNSELING 2023; 107:107570. [PMID: 36410313 PMCID: PMC9789185 DOI: 10.1016/j.pec.2022.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/24/2022] [Accepted: 11/11/2022] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Promoting behavioral strategies to better regulate pain and decrease the use of prescription pain medications immediately after childbirth is an attractive approach to reduce risks for adverse outcomes associated with the maternal mortality crisis. This study aimed to understand women's beliefs and experiences about pain management to identify important insights for promoting behavioral strategies to control postpartum pain. METHODS N = 32 postpartum women participated in a semi-structured interview about beliefs/experiences with managing postpartum pain. Higher- and lower-order themes were coded; descriptive statistics were used to summarize results. RESULTS Major trends emerging from the data were: (1) most women used a combination of medications (e.g., oxycodone and acetaminophen) and behavioral strategies (e.g., physical activity) in the hospital (94 %) and at discharge (83 %); (2) some women reported disadvantages like negative side effects of medications and fatigue from physical activity; and (3) some women reported they would have preferred to receive more evidence-based education on behavioral strategies during prenatal visits. CONCLUSION Our findings showed that most women were prescribed medications while in the hospital and at discharge, and used non-prescription, behavioral strategies. PRACTICAL IMPLICATIONS Future research is needed to test behavioral strategies in randomized clinical trials and clinical care settings to identify impact on reducing adverse maternal health outcomes.
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Affiliation(s)
- Abigail M Pauley
- Department of Kinesiology, The Pennsylvania State University, 276 Recreation Building, University Park, PA 16802, United States.
| | - Krista S Leonard
- Department of Kinesiology, The Pennsylvania State University, 276 Recreation Building, University Park, PA 16802, United States
| | - Nicole Cumbo
- Department of Obstetrics and Gynecology, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United States
| | - Isabella F Teti
- Department of Kinesiology, The Pennsylvania State University, 276 Recreation Building, University Park, PA 16802, United States
| | - Jaimey M Pauli
- Department of Obstetrics and Gynecology, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United States
| | - Mohamed Satti
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Geisinger, Danville, PA, United States
| | - Mark Stephens
- Department of Family and Community Medicine, Penn State College of Medicine, University Park, PA 16802, United States
| | - Tammy Corr
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA 17033, United States
| | - Robert W Roeser
- Department of Health and Human Development, Pennsylvania State University, University Park, PA 16802, United States
| | - Richard S Legro
- Department of Obstetrics and Gynecology, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United States
| | - A Dhanya Mackeen
- Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Geisinger, Danville, PA, United States
| | - Lisa Bailey-Davis
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, United States
| | - Danielle Symons Downs
- Department of Kinesiology, The Pennsylvania State University, 276 Recreation Building, University Park, PA 16802, United States; Department of Obstetrics and Gynecology, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United States
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Alavi N, Moghimi E, Stephenson C, Gutierrez G, Jagayat J, Kumar A, Shao Y, Miller S, Yee CS, Stefatos A, Gholamzadehmir M, Abbaspour Z, Shirazi A, Gizzarelli T, Khan F, Patel C, Patel A, Yang M, Omrani M. Comparison of online and in-person cognitive behavioral therapy in individuals diagnosed with major depressive disorder: a non-randomized controlled trial. Front Psychiatry 2023; 14:1113956. [PMID: 37187863 PMCID: PMC10175610 DOI: 10.3389/fpsyt.2023.1113956] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Objective The increased prevalence of major depressive disorder (MDD) amid the COVID-19 pandemic has resulted in substantial growth in online mental health care delivery. Compared to its in-person counterpart, online cognitive behavioral therapy (e-CBT) is a time-flexible and cost-effective method of improving MDD symptoms. However, how its efficacy compares to in-person CBT is yet to be explored. Therefore, the current study compared the efficacy of a therapist-supported, electronically delivered e-CBT program to in-person therapy in individuals diagnosed with MDD. Methods Participants (n = 108) diagnosed with MDD selected either a 12 week in-person CBT or an asynchronous therapist-supported e-CBT program. E-CBT participants (n = 55) completed weekly interactive online modules delivered through a secure cloud-based online platform (Online Psychotherapy Tool; OPTT). These modules were followed by homework in which participants received personalized feedback from a trained therapist. Participants in the in-person CBT group (n = 53) discussed sessions and homework with their therapists during one-hour weekly meetings. Program efficacy was evaluated using clinically validated symptomatology and quality of life questionnaires. Results Both treatments yielded significant improvements in depressive symptoms and quality of life from baseline to post-treatment. Participants who opted for in-person therapy presented significantly higher baseline symptomatology scores than the e-CBT group. However, both treatments demonstrated comparable significant improvements in depressive symptoms and quality of life from baseline to post-treatment. e-CBT seems to afford higher participant compliance as dropouts in the e-CBT group completed more sessions on average than those in the in-person CBT group. Conclusion The findings support e-CBT with therapist guidance as a suitable option to treat MDD. Future studies should investigate how treatment accessibility is related to program completion rates in the e-CBT vs. in-person group. Clinical Trial Registration ClinicalTrials.Gov Protocol Registration and Results System (NCT04478058); clinicaltrials.gov/ct2/show/NCT04478058.
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Affiliation(s)
- Nazanin Alavi
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Toronto, ON, Canada
- *Correspondence: Nazanin Alavi,
| | - Elnaz Moghimi
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Gilmar Gutierrez
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Jasleen Jagayat
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Anchan Kumar
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Yijia Shao
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Shadé Miller
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Caitlin S. Yee
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Anthi Stefatos
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Zara Abbaspour
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | | | - Tessa Gizzarelli
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Ferwa Khan
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Charmy Patel
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Archana Patel
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Megan Yang
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
| | - Mohsen Omrani
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- OPTT Inc., Toronto, ON, Canada
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18
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Bhattacharya S, Goicoechea C, Heshmati S, Carpenter JK, Hofmann SG. Efficacy of Cognitive Behavioral Therapy for Anxiety-Related Disorders: A Meta-Analysis of Recent Literature. Curr Psychiatry Rep 2023; 25:19-30. [PMID: 36534317 PMCID: PMC9834105 DOI: 10.1007/s11920-022-01402-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Effective treatment of anxiety-related disorders is crucial, considering the prevalence of such disorders and their association with poor psychosocial functioning. To evaluate the most recent evidence on the efficacy of cognitive behavioral therapy (CBT) for anxiety-related disorders in adults, we conducted a meta-analysis of randomized placebo-controlled trials published since 2017. RECENT FINDINGS Ten studies with a total of 1250 participants met the inclusion criteria. Seven of these studies examined PTSD. The findings demonstrated small placebo-controlled effects of CBT on target disorder symptoms (Hedges' g = 0.24, p < 0.05) and depression (Hedges' g = 0.15, p = n.s). When examining only PTSD studies, effects were reduced (Hedges' g = 0.14, p < 0.05). Heterogeneity in most analyses was very low, and no publication bias was found. Effect sizes from placebo-controlled trials from the past 5 years appear to be smaller than those in prior meta-analyses. The findings are largely driven by research on PTSD, with few placebo-controlled trials of other anxiety-related disorders published since 2017.
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Affiliation(s)
- Shalini Bhattacharya
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Carmen Goicoechea
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Saeideh Heshmati
- Department of Psychology, Claremont Graduate University, Claremont, CA USA
| | - Joseph K. Carpenter
- National Center for PTSD Women’s Health Sciences Division, VA Boston Healthcare System, Boston, MA USA ,Department of Psychiatry, Boston University School of Medicine, Boston, MA USA
| | - Stefan G. Hofmann
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany ,Department of Psychological and Brain Sciences, Boston University, Boston, MA USA
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19
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Li C, Hou W, Ding D, Yang Y, Gu S, Zhu Y. Evidence Mapping Based on Systematic Reviews of Cognitive Behavioral Therapy for Neuropathic Pain. Neural Plast 2023; 2023:2680620. [PMID: 36994240 PMCID: PMC10041341 DOI: 10.1155/2023/2680620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 01/03/2023] [Accepted: 02/18/2023] [Indexed: 03/31/2023] Open
Abstract
Objective This evidence mapping is aimed at identifying, summarizing, and analyzing the available evidence on cognitive behavioral therapy (CBT) for neuropathic pain (NP). Methods This study was conducted following the methodology of Global Evidence Mapping (GEM). Searches were conducted in PubMed, Embase, the Cochrane Library, and PsycINFO to identify systematic reviews (SRs) with or without meta-analysis published before February 15, 2022. The authors independently assessed eligibility, extracted data, and evaluated the methodological quality of the included SRs using AMSTAR-2. The results were presented in the tables and a bubble plot based on the identified population-intervention-comparison-outcome (PICO) questions. Results A total of 34 SRs met the eligibility criteria. According to the AMSTAR-2, 2 SRs were rated "high," 2 SRs were rated "moderate," 6 SRs were rated "low," and 24 SRs were rated "critically low." The most common study design utilized to evaluate the efficacy of CBT for NP was the randomized controlled trial. In total, 24 PICOs were identified. Migraine was the most studied population. CBT for NP usually reaches the "potentially better" result at follow-up. Conclusions Evidence mapping is a useful way to present existing evidence. Currently, the existing evidence on CBT for NP is limited. Overall, the methodological quality of the included SRs was low. Further improvements in the methodological quality of SRs and more research on the most efficient CBT formats for NP are recommended in the future.
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Affiliation(s)
- Conghui Li
- 1The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
- 2Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Weiqian Hou
- 1The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
- 2Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Dongfang Ding
- 1The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
- 2Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Yujie Yang
- 3University of Health and Rehabilitation Sciences, Qingdao, Shandong 266000, China
| | - Shanshan Gu
- 4Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Yi Zhu
- 1The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
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20
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Kindt M, Elsey JWB. A paradigm shift in the treatment of emotional memory disorders: Lessons from basic science. Brain Res Bull 2023; 192:168-174. [PMID: 36442693 DOI: 10.1016/j.brainresbull.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/10/2022] [Accepted: 11/24/2022] [Indexed: 11/26/2022]
Abstract
Experiments demonstrating post-reactivation amnesia for learned fear in animals have generated a novel and influential hypothesis on the plasticity of memory, usually referred to as memory reconsolidation. The clinical potential of pharmacologically disrupting the process of memory reconsolidation has sparked a wave of interest into whether this phenomenon can also be demonstrated in humans, and ultimately harnessed for therapeutic purposes. In this essay we outline how the work of Karim Nader and colleagues has moved the field forward from a focus on extinction learning to the prospect of disrupting memory reconsolidation. We then review some promising findings on the necessary conditions, as well as potential boundary conditions, of pharmacologically disrupting the process of memory reconsolidation obtained in our laboratory. Even though laboratory experiments in animals and humans suggest that we may be at the brink of a breakthrough in fundamentally changing emotional memories, the necessary and sufficient conditions for targeting and disrupting memory reconsolidation in clinical practice are largely unknown. There is likely no universally effective reactivation procedure for triggering the reconsolidation of clinically significant emotional memories, and the impact of subtle boundary conditions observed in basic experiments compounds this issue. Notwithstanding these challenges, the discovery of changing emotional memory through disrupting the process of memory reconsolidation has unquestionably invigorated the field.
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Nook EC, Jaroszewski AC, Finch EF, Choi-Kain LW. A Cognitive-Behavioral Formulation of Narcissistic Self-Esteem Dysregulation. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:378-388. [PMID: 37200882 PMCID: PMC10187391 DOI: 10.1176/appi.focus.20220055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Narcissistic personality disorder (NPD) is a commonly encountered diagnosis, affecting approximately 1%-6% of the population, with no evidence-based treatments. Recent scholarship has focused on self-esteem dysregulation as a key component of NPD: Excessively high expectations for oneself and how one should be treated leads to brittle self-esteem and maladaptive reactions to self-esteem threats. The current article builds on this formulation, introducing a cognitive-behavioral model of narcissistic self-esteem dysregulation that clinicians can use in providing a relatable model of change for their patients. Specifically, symptoms of NPD can be seen as a set of cognitive and behavioral habits that serve to regulate difficult emotions emerging from maladaptive beliefs and interpretations of self-esteem threats. This perspective renders narcissistic dysregulation amenable to cognitive-behavioral therapy (CBT) in which patients learn skills that help them gain awareness around these habitual reactions, reshape cognitive distortions, and engage in behavioral experiments that serve to transform maladaptive belief systems that consequently free them from symptomatic reactions. Here, we provide a precis of this formulation and examples of how CBT skills can be used to treat narcissistic dysregulation. We also discuss future research that could provide empirical support for the model and test the efficacy of CBT approaches to NPD. Conclusions focus on the notion that narcissistic self-esteem dysregulation likely varies continuously in the population and transdiagnostically across disorders. Greater insight into the cognitive-behavioral mechanisms of self-esteem dysregulation could foster tools for ameliorating distress both in people with NPD and the general populace.
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Affiliation(s)
- Erik C Nook
- Department of Psychology, Princeton University, Princeton, New Jersey (Nook); Department of Psychiatry, Harvard Medical School, Boston (Jaroszewski, Choi-Kain); Department of Psychiatry, Massachusetts General Hospital, Boston (Jaroszewski); Department of Psychology, Harvard University, Cambridge, Massachusetts (Finch); McLean Hospital, Harvard Medical School, Boston (Choi-Kain)
| | - Adam C Jaroszewski
- Department of Psychology, Princeton University, Princeton, New Jersey (Nook); Department of Psychiatry, Harvard Medical School, Boston (Jaroszewski, Choi-Kain); Department of Psychiatry, Massachusetts General Hospital, Boston (Jaroszewski); Department of Psychology, Harvard University, Cambridge, Massachusetts (Finch); McLean Hospital, Harvard Medical School, Boston (Choi-Kain)
| | - Ellen F Finch
- Department of Psychology, Princeton University, Princeton, New Jersey (Nook); Department of Psychiatry, Harvard Medical School, Boston (Jaroszewski, Choi-Kain); Department of Psychiatry, Massachusetts General Hospital, Boston (Jaroszewski); Department of Psychology, Harvard University, Cambridge, Massachusetts (Finch); McLean Hospital, Harvard Medical School, Boston (Choi-Kain)
| | - Lois W Choi-Kain
- Department of Psychology, Princeton University, Princeton, New Jersey (Nook); Department of Psychiatry, Harvard Medical School, Boston (Jaroszewski, Choi-Kain); Department of Psychiatry, Massachusetts General Hospital, Boston (Jaroszewski); Department of Psychology, Harvard University, Cambridge, Massachusetts (Finch); McLean Hospital, Harvard Medical School, Boston (Choi-Kain)
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22
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Lieberman R, Dick GL. Interdisciplinary healing power of words. JOURNAL OF POETRY THERAPY 2022. [DOI: 10.1080/08893675.2022.2089689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
| | - Gary L. Dick
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
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Pradhan A, Koirala P, Bhandari SS, Dutta S, García-Grau P, Sampath H, Sharma I. Internalized and Perceived Stigma and Depression in Pulmonary Tuberculosis: Do They Explain the Relationship Between Drug Sensitivity Status and Adherence? Front Psychiatry 2022; 13:869647. [PMID: 35664495 PMCID: PMC9161274 DOI: 10.3389/fpsyt.2022.869647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022] Open
Abstract
Background Adherence to medication for tuberculosis (TB) has been found to be deleteriously affected by psychosocial issues, including internalized and perceived stigma (IPS) and depression, usually resulting in the emergence of multidrug-resistant TB (MDR-TB). The objective of the study was to find the prevalence of depression among patients receiving treatment for pulmonary TB, and how stigma and depression affect the relationship between drug sensitivity status (DSS) and treatment adherence. Method It was a cross-sectional observational study conducted between January 2019 and July 2020 in two centers in Sikkim, India. The Patient Health Questionnaire-9 (PHQ-9), Internalized Social Stigma Scale (ISSS), and Tuberculosis Medication Adherence Scale were used to assess depression, IPS, and medication adherence, respectively. A path analysis was performed with DSS, treatment adherence, IPS, and depression. Education in years was included in the model as it was significantly correlated with IPS. Results A total of 71 patients who were on drug-sensitive TB (DS-TB) regimen (n = 26) and MDR-TB regimen (n = 45) participated in the study. Notably, 56.3% (n = 40) of the participants were found to have depression. Among the depressed participants, 32.5% were on the DS-TB regimen and 67.5% were on the MDR-TB regimen. The path analysis indicated that IPS and depression were serially mediating the relationship between DSS and treatment adherence (β = -0.06, p < 0.05, 95% CI = -3.20, -0.02). Finally, years of education had an exogenous predictor role, not only directly affecting IPS (β = -0.38, p < 0.001, 95% CI = -0.99, -0.31) but also affecting treatment adherence through IPS and depression (β = 0.08, p = 0.02, 95% CI = 0.03, 0.47). This indicated that with more years of education, the IPS decreases, which decreases depression and ultimately leads to better adherence. Conclusion We found an important relationship between different psychosocial factors which may affect treatment adherence. Patients who have higher IPS are more likely to develop depression which negatively affect adherence. Patients on the MDR-TB regimen have higher stigma. There is an urgent need to integrate mental health services with TB Control Programs.
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Affiliation(s)
- Anmol Pradhan
- Department of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, India
| | - Prakash Koirala
- Department of Respiratory Medicine, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, India
| | - Samrat Singh Bhandari
- Department of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, India
| | - Sanjiba Dutta
- Department of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, India
| | - Pau García-Grau
- Programa de Maestro de Educación Infantil, Universidad Católica de Valencia, Valencia, Spain
| | - Harshavardhan Sampath
- Department of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, India
| | - Indralal Sharma
- Department of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, India
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BigMove: A Group Intervention for People with Physical and Mental Health Conditions. Int J Integr Care 2022; 22:6. [PMID: 35530431 PMCID: PMC9029679 DOI: 10.5334/ijic.5955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 04/11/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction: This article describes an innovative, integrated care intervention, called BigMove, which aims to improve the functioning, capabilities and quality of life of people with a combination of physical and mental health conditions. Description: Theoretical frameworks reflected in the intervention are the Capability Approach (CA) and Self-Determination Theory (SDT). Essential elements of the intervention included to expand participants’ behavioural repertoire are motivational interviewing; functional goal setting (using the International Classification of Functioning, Disability and Health (ICF); cognitive behavioural therapy; enjoyment; support of the group; and physical activity. The design combines individual sessions and group sessions. Discussion: By integrating the CA and the SDT, the intervention enables participants to make self-directed and value-driven choices in life and change their behaviour accordingly to strengthen their functioning and capabilities. To foster person-centred, integrated care, it is crucial to reform the interaction between professionals and patients and to re-structure the organisation and financing of care to enable the provision of complex integrated care interventions. Conclusion: For people with physical and mental health conditions, the intervention BigMove provides an innovative integrated care approach that addresses aspirations people have regarding their functioning and focuses on individual goal setting and behaviour change.
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Ahrens J, Shao R, Blackport D, Macaluso S, Viana R, Teasell R, Mehta S. Cognitive -behavioral therapy for managing depressive and anxiety symptoms after stroke: a systematic review and meta-analysis. Top Stroke Rehabil 2022; 30:368-383. [PMID: 35352629 DOI: 10.1080/10749357.2022.2049505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Post-stroke anxiety and depression can be disabling and result in impaired recovery. Cognitive-behavioral therapy (CBT) has been demonstrated to be effective for anxiety and depression; however, determining its efficacy among those with stroke is warranted. Our objectives to evaluate CBT for anxiety and depression post-stroke . METHODS This review was registered with PROSPERO (REG# CRD42020186324). Medline, PsycInfo, and EMBR Cochrane were used to locate studies published before May 2020, using keywords such as stroke and CBT. A study was included if: (1) interventions were CBT-based, targeting anxiety and/or depression; (2) participants experienced a stroke at least 3 months previous; (3) participants were at least 18 years old. Standardized mean differences ± standard errors and 95% confidence intervals were calculated, and heterogeneity was determined. The Cochrane Risk of Bias tool was used. RESULTS The search yielded 563 articles, of which 10 (N = 672) were included;6 were randomized controlled trials. Primary reasons for exclusion included: (1) wrong population (2) insufficient data provided for a meta-analysis; (3) wrongoutcomes. CBT showed large effects on reducing overall anxiety (SMD ± SE: 1.01 ± 0.32, p < .001) and depression (SMD ± SE: 0.95 ± 0.22, p < .000) symptoms at the end of the studies. CBT moderately maintained anxiety (SDM ± SE: 0.779 ± 0.348, p ˂.025) and depression (SDM ± SE: 0.622 ± 0.285, p ˂ .029) scores after 3-months. Limitations included small sample size, limited comparators, and lack of follow-up data. CONCLUSION The results of this meta-analysis provide substantial evidence for the use of CBTto manage post-stroke anxiety and depression.
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Affiliation(s)
- Jessica Ahrens
- Lawson Health Research Institute, Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
| | - Richard Shao
- Lawson Health Research Institute, Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
| | - Daymon Blackport
- Lawson Health Research Institute, Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
| | - Steven Macaluso
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
| | - Ricardo Viana
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
| | - Robert Teasell
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
| | - Swati Mehta
- Lawson Health Research Institute, Parkwood Research Institute, Parkwood Institute, London, Ontario, Canada
- St. Joseph’s Health Care, Parkwood Institute, London, Ontario, Canada
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
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Hindradjat J, Livana PH. Effectiveness of Using a Mixed of CBT, CT-R, and Oral Treatment in Reducing Depression and Anxiety. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This qualitative research with case study method aims to determine the effectiveness of the combined use of CBT, CT-R and oral treatment to reduce depression and anxiety. The subject in this study was a 55 years old woman. Data were obtained through observation, interviews, and measurement of depression and anxiety levels using the DASS and MCMI-IV instruments. The results of this study showed that the combined use of CBT, CT-R and oral treatment reduced depression level and anxiety as indicated by a decrease in persistent depression scores 75 to 14, major depression scores 102 to 12 and generalized anxiety scores 115 to 30 on MCMI-IV scale. Measurements using the DASS show a decrease in depression scores 25 as major depression to 3 as normal depression, and a decrease in anxiety 16 as severe anxiety to 4 as normal anxiety. The measurement results supported by physical, psychological and behavioral changes. In addition, there are changes in personalities from borderline, melancholic and dependent to turbulent, histrionic and compulsiveon MCMI-IV scale..
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Taschereau-Dumouchel V, Michel M, Lau H, Hofmann SG, LeDoux JE. Putting the "mental" back in "mental disorders": a perspective from research on fear and anxiety. Mol Psychiatry 2022; 27:1322-1330. [PMID: 35079126 PMCID: PMC9095479 DOI: 10.1038/s41380-021-01395-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 01/08/2023]
Abstract
Mental health problems often involve clusters of symptoms that include subjective (conscious) experiences as well as behavioral and/or physiological responses. Because the bodily responses are readily measured objectively, these have come to be emphasized when developing treatments and assessing their effectiveness. On the other hand, the subjective experience of the patient reported during a clinical interview is often viewed as a weak correlate of psychopathology. To the extent that subjective symptoms are related to the underlying problem, it is often assumed that they will be taken care of if the more objective behavioral and physiological symptoms are properly treated. Decades of research on anxiety disorders, however, show that behavioral and physiological symptoms do not correlate as strongly with subjective experiences as is typically assumed. Further, the treatments developed using more objective symptoms as a marker of psychopathology have mostly been disappointing in effectiveness. Given that "mental" disorders are named for, and defined by, their subjective mental qualities, it is perhaps not surprising, in retrospect, that treatments that have sidelined mental qualities have not been especially effective. These negative attitudes about subjective experience took root in psychiatry and allied fields decades ago when there were few avenues for scientifically studying subjective experience. Today, however, cognitive neuroscience research on consciousness is thriving, and offers a viable and novel scientific approach that could help achieve a deeper understanding of mental disorders and their treatment.
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Affiliation(s)
- Vincent Taschereau-Dumouchel
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada.
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.
| | - Matthias Michel
- Department of Philosophy, New York University, New York, NY, 1003, USA
| | - Hakwan Lau
- RIKEN Center for Brain Science, Wako, Japan
| | - Stefan G Hofmann
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Joseph E LeDoux
- Center for Neural Science and Department of Psychology, New York University, New York, NY, 1003, USA
- Department of Psychiatry, and Department of Child and Adolescent Psychiatry, New York University Langone Medical School, New York, NY, 1003, USA
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Alejandre-Lara AL, Canby NK, Wesbecher KD, Eichel K, Britton WB, Lindahl JR. How do Mindfulness-Based Programs Improve Depression Symptoms: Selflessness, Valence, or Valenced Self? COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-021-10287-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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A thalamo-centric neural signature for restructuring negative self-beliefs. Mol Psychiatry 2022; 27:1611-1617. [PMID: 34974523 PMCID: PMC9095461 DOI: 10.1038/s41380-021-01402-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/13/2021] [Accepted: 11/24/2021] [Indexed: 11/08/2022]
Abstract
Negative self-beliefs are a core feature of psychopathology. Despite this, we have a limited understanding of the brain mechanisms by which negative self-beliefs are cognitively restructured. Using a novel paradigm, we had participants use Socratic questioning techniques to restructure negative beliefs during ultra-high resolution 7-Tesla functional magnetic resonance imaging (UHF 7 T fMRI) scanning. Cognitive restructuring elicited prominent activation in a fronto-striato-thalamic circuit, including the mediodorsal thalamus (MD), a group of deep subcortical nuclei believed to synchronize and integrate prefrontal cortex activity, but which has seldom been directly examined with fMRI due to its small size. Increased activity was also identified in the medial prefrontal cortex (MPFC), a region consistently activated by internally focused mental processing, as well as in lateral prefrontal regions associated with regulating emotional reactivity. Using Dynamic Causal Modelling (DCM), evidence was found to support the MD as having a strong excitatory effect on the activity of regions within the broader network mediating cognitive restructuring. Moreover, the degree to which participants modulated MPFC-to-MD effective connectivity during cognitive restructuring predicted their individual tendency to engage in repetitive negative thinking. Our findings represent a major shift from a cortico-centric framework of cognition and provide important mechanistic insights into how the MD facilitates key processes in cognitive interventions for common psychiatric disorders. In addition to relaying integrative information across basal ganglia and the cortex, we propose a multifaceted role for the MD whose broad excitatory pathways act to increase synchrony between cortical regions to sustain complex mental representations, including the self.
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Matsumoto K, Hamatani S, Shimizu E. Effectiveness of Videoconference-Delivered Cognitive Behavioral Therapy for Adults With Psychiatric Disorders: Systematic and Meta-Analytic Review. J Med Internet Res 2021; 23:e31293. [PMID: 34898445 PMCID: PMC8713091 DOI: 10.2196/31293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/14/2021] [Accepted: 10/29/2021] [Indexed: 12/23/2022] Open
Abstract
Background Cognitive behavioral therapy (CBT) is the gold standard of psychotherapy for psychiatric disorders. However, the format of delivering CBT in person limits access to the intervention. The advancements in information and communication technology, especially the internet, present an opportunity for cognitive behavioral therapists to service patients or clients in remote areas through videoconferencing. Although many randomized controlled trials of videoconference-delivered cognitive behavioral therapy (VCBT) have already been conducted, the overall estimated effect size of VCBT for psychiatric disorders has not been examined by systematic reviews and meta-analyses. Objective This study attempts to evaluate the effectiveness of VCBT for psychiatric disorders through a systematic and meta-analytic review. Methods A systematic review and meta-analysis of studies in which VCBT was directly compared to control groups (such as treatment as usual, attention control, wait-list control, and other minimal supports) was carried out. To identify previous studies that meet our study objective, 2 independent reviewers undertook a systematic search through seven databases: MEDLINE (via PubMed), Web of Science, Science Direct, PsycINFO, CINAHL, LILACS, and SciELO. Other databases (ClinicalTrials.gov and Cochrane Central Resister of Controlled Trials) were also checked. All studies included in the review were assessed using the quality criteria of the Cochrane Collaboration. Statistical analysis was performed by using Cochrane Review Manager (RevMan, version 5.4.0). Standardized mean difference was used in major meta-analyses where a P value of .05 or less was the threshold for statistical significance. A heterogeneity test and the chi-square test were performed to assess the presence and extent of statistical heterogeneity with significance set at P<.10. Funnel plots were visually inspected to assess the risk of bias. Subgroup analyses were conducted for each disorder to estimate intervention effects. Results The systematic search resulted in 16 studies (total N=1745) that met the criteria for this study and were included in the review. There were 10 studies on depressive symptoms, 3 on chronic pain, 1 on generalized anxiety disorder, 1 on obsessive-compulsive disorder, and 1 on hypochondriasis. The quality and risk of bias was also assessed. Results showed a pooled effect size (Hedge g) post treatment of −0.49 (95% CI –0.68 to –0.29), indicating that VCBT is effective for clients with psychiatric disorders. Study quality did not affect outcomes. Conclusions While the overall results indicate the effectiveness of VCBT, there are still only a limited number of studies on specific psychiatric and somatic conditions. Therefore, more randomized controlled trials are needed to establish the effectiveness of VCBT for different disorders. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42021224832; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=224832
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Affiliation(s)
- Kazuki Matsumoto
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Laboratory of Neuropsychology, Institute of Liberal Arts and Science, Kanazawa University, Kanazawa, Japan
| | - Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Cognitive Behavioral Therapy Center, Chiba University Hospital, Chiba, Japan
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Eklund K, Kilgus SP, Izumi J, DeMarchena SL, McCollom EM. The Resilience Education Program: Examining the efficacy of a Tier 2 internalizing intervention. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Katie Eklund
- Department of Educational Psychology University of Wisconsin‐Madison Madison Wisconsin USA
| | - Stephen P. Kilgus
- Department of Educational Psychology University of Wisconsin‐Madison Madison Wisconsin USA
| | - Jared Izumi
- Department of Educational School, and Counseling Psychology University of Missouri Columbia Missouri USA
| | - Sarah L. DeMarchena
- Department of Educational School, and Counseling Psychology University of Missouri Columbia Missouri USA
| | - Elizabeth M. McCollom
- Department of Educational School, and Counseling Psychology University of Missouri Columbia Missouri USA
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Applebaum A, Walsh LE, Polacek LC, Benvengo S, Levin T. Acute Cancer Cognitive Therapy Online Training Program: Feasibility and Impact on Clinician Knowledge Uptake. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1081-1085. [PMID: 32253724 PMCID: PMC7541394 DOI: 10.1007/s13187-020-01738-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The delivery of psychosocial support to patients and families is challenging in the acute cancer setting. To meet their needs, we developed Acute Cancer Cognitive Therapy (ACCT), an approach that applies traditional cognitive therapy (CT) techniques to this setting. We assessed the feasibility and impact of a six-hour web-based ACCT training for professionals working in psychosocial oncology. Learners were recruited in person at psycho-oncology lectures, workshops, and conferences and through social media channels. One hundred and thirty professionals completed the application, and 46 learners completed all training requirements. Descriptive statistics were used to characterize the sample of applicants and learners, and a paired-samples t-test compared learners' scores on pre-and-post assessments of ACCT knowledge. Learners were predominantly female (n = 40, 86.9%), white (n = 42, 91.3%), and trained in the disciplines of social work (n = 17, 36.9%) or psychology (n = 17, 36.9%). Post-training scores were significantly higher than baseline, averaging a 19.78-point increase. These results support the feasibility and positive impact of using this web-based training to teach ACCT. Future studies will evaluate alternative approaches to retention, multi-cultural applicability, broader dissemination and the extent and durability of skill acquisition using multimodal longitudinal models of assessment.
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Affiliation(s)
- Allison Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Fl., New York, NY, 10022, USA.
| | - Leah E Walsh
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Fl., New York, NY, 10022, USA
- Department of Psychology, Fordham University, 441 East Fordham Road, 226 Dealy Hall, Bronx, NY, 10458, USA
| | - Laura C Polacek
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Fl., New York, NY, 10022, USA
- Department of Psychology, Fordham University, 441 East Fordham Road, 226 Dealy Hall, Bronx, NY, 10458, USA
| | - Stephanie Benvengo
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave., 7th Fl., New York, NY, 10022, USA
| | - Tomer Levin
- Collaborative Care Psychiatry, One Penn Plaza, Suite 3652, New York, NY, 10119, USA
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Bertuzzi V, Fratini G, Tarquinio C, Cannistrà F, Granese V, Giusti EM, Castelnuovo G, Pietrabissa G. Single-Session Therapy by Appointment for the Treatment of Anxiety Disorders in Youth and Adults: A Systematic Review of the Literature. Front Psychol 2021; 12:721382. [PMID: 34539523 PMCID: PMC8440994 DOI: 10.3389/fpsyg.2021.721382] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/31/2021] [Indexed: 12/29/2022] Open
Abstract
Purpose: This systematic review provides a summary of the available evidence of the efficacy of single-session therapy (SST) on anxiety disorders in both youth and adults. Methods: PubMed, Scopus, Medline, and Google Scholar databases were search for relevant articles, and the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials was used for transparent reporting of the methodological quality of each selected study. Results: The search of electronic databases identified 18 reports based on rigorous inclusion criteria. Single-session therapy was found superior to no treatment in reducing anxiety symptoms, and similar results were observed while comparing SST to multi-treatment sessions. Discussion: The findings support the benefits of SST in enhancing cognitive, behavioral, and psychological outcomes in both youth and adults suffering from anxiety disorders across treatment conditions and approaches, SST thus appears to be a promising way of providing access to both private and public therapeutic services efficiently and cost-effectively. Conclusions: Single-session therapy is effective in treating anxiety disorders. Further research is required to quantify its cost-effectiveness and deepen the knowledge of effective treatment ingredients for both young people and the adult population suffering from diverse anxiety disorders. Systematic Review Registration: PROSPERO, identifier [CRD42021232024].
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Affiliation(s)
- Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Giulia Fratini
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Claudia Tarquinio
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | - Valentina Granese
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Emanuele Maria Giusti
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
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Clauss K, Bardeen JR. The interactive effect of mental contamination and cognitive fusion on anxiety. J Clin Psychol 2021; 78:517-525. [PMID: 34269414 DOI: 10.1002/jclp.23224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 06/08/2021] [Accepted: 06/30/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Mental contamination and cognitive fusion have been identified as risk factors for anxiety. The purpose of this study was to examine the moderating effect of cognitive fusion on the relationship between mental contamination and anxiety. METHOD Participants (N = 504 community adults), recruited via Amazon's Mechanical Turk (MTurk), completed measures of mental contamination, cognitive fusion, and anxiety. RESULTS Results from a regression analysis showed that the interaction between mental contamination and cognitive fusion predicted anxiety (β = 0.15, p < 0.001). Simple slopes analysis revealed a positive association between mental contamination and anxiety that was significant at higher (β = 0.25, p < 0.001), but not lower (β = 0.01, p = 0.88), levels of cognitive fusion. CONCLUSION The development of risk profiles that incorporate mental contamination and cognitive fusion may be beneficial for early identification of individuals at high risk for anxiety.
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Affiliation(s)
- Kate Clauss
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Joseph R Bardeen
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
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Curtiss JE, Levine DS, Ander I, Baker AW. Cognitive-Behavioral Treatments for Anxiety and Stress-Related Disorders. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2021; 19:184-189. [PMID: 34690581 PMCID: PMC8475916 DOI: 10.1176/appi.focus.20200045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cognitive-behavioral therapy (CBT) is a first-line, empirically supported intervention for anxiety disorders. CBT refers to a family of techniques that are designed to target maladaptive thoughts and behaviors that maintain anxiety over time. Several individual CBT protocols have been developed for individual presentations of anxiety. The article describes common and unique components of CBT interventions for the treatment of patients with anxiety and related disorders (i.e., panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, prolonged grief). Recent strategies for enhancing the efficacy of CBT protocols are highlighted as well.
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Affiliation(s)
- Joshua E Curtiss
- Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Department of Psychiatry, Harvard Medical School, Boston (Curtiss, Baker)
| | - Daniella S Levine
- Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Department of Psychiatry, Harvard Medical School, Boston (Curtiss, Baker)
| | - Ilana Ander
- Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Department of Psychiatry, Harvard Medical School, Boston (Curtiss, Baker)
| | - Amanda W Baker
- Department of Psychiatry, Massachusetts General Hospital, Boston (all authors); Department of Psychiatry, Harvard Medical School, Boston (Curtiss, Baker)
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Cognitive Bias and Medication Use Moderate the Relation of Socratic Questioning and Symptom Change in Cognitive Behavioral Therapy of Depression. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10224-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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A-Tjak JGL, Morina N, Topper M, Emmelkamp PMG. One year follow-up and mediation in cognitive behavioral therapy and acceptance and commitment therapy for adult depression. BMC Psychiatry 2021; 21:41. [PMID: 33446152 PMCID: PMC7807695 DOI: 10.1186/s12888-020-03020-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/22/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change. METHODS We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering, and experiential avoidance. RESULTS Patients in both conditions reported significant and large reductions of depressive symptoms (d = - 1.26 to - 1.60) and improvement in quality of life (d = 0.91 to - 1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. CONCLUSIONS Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression. TRIAL REGISTRATION clinicaltrials.gov; NCT01517503 . Registered 25 January 2012 - Retrospectively registered.
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Affiliation(s)
| | - Nexhmedin Morina
- Institute of Psychology, University of Münster, Fliednerstr. 21, 48149, Münster, Germany.
| | - Maurice Topper
- grid.491220.c0000 0004 1771 2151GGZ-Noord-Holland-Noord, Stationsplein 138, 1703 WC Heerhugowaard, The Netherlands
| | - Paul M. G. Emmelkamp
- grid.7177.60000000084992262Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129 B, 1018 WS Amsterdam, The Netherlands
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Utilizing placebos to leverage effects of cognitive-behavioral therapy in patients with depression. J Affect Disord 2020; 277:779-784. [PMID: 33065817 DOI: 10.1016/j.jad.2020.08.087] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/06/2020] [Accepted: 08/24/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients with depression often experience difficulties with completing homework assignments during cognitive-behavioral therapy (CBT). In the present study, we investigated the effects of a specific placebo which aimed at improving the practice of a daily relaxation exercise during a four-week outpatient program. METHODS A total of 126 patients diagnosed with major depressive disorder were randomly assigned to one of three groups: 'Coping with Depression' course, 'Coping with Depression' course with additional daily placebo treatment, and waiting-list group. The placebo (sunflower oil) was introduced as a natural medicine to help the patients focus on their inner strengths and to mobilize their bodies' natural healing powers. The placebo was taken orally before the daily relaxation exercise. RESULTS The placebo improved homework quantity and quality (both p < .001). The placebo group practiced more often and experienced greater relaxation effects than the no-placebo group. Additionally, the placebo group showed a greater reduction of depression symptoms (p < .001). LIMITATIONS The primary limitation of the study is the lack of a psychophysiological measure of relaxation. CONCLUSIONS Placebos can be used to leverage CBT effects in patients with depression.
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Afshari B, Hasani J. Study of Dialectical Behavior Therapy Versus Cognitive Behavior Therapy on Emotion Regulation and Mindfulness in Patients with Generalized Anxiety Disorder. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2020. [DOI: 10.1007/s10879-020-09461-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Domhardt M, Steubl L, Boettcher J, Buntrock C, Karyotaki E, Ebert DD, Cuijpers P, Baumeister H. Mediators and mechanisms of change in internet- and mobile-based interventions for depression: A systematic review. Clin Psychol Rev 2020; 83:101953. [PMID: 33422841 DOI: 10.1016/j.cpr.2020.101953] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/09/2020] [Accepted: 11/23/2020] [Indexed: 01/05/2023]
Abstract
The efficacy of Internet- and mobile-based interventions (IMIs) for depression in adults is well established. Yet, comprehensive knowledge on the mediators responsible for therapeutic change in these interventions is pending. Therefore, we conducted the first systematic review on mediators in IMIs for depression, investigating mechanisms of change in interventions with different theoretical backgrounds and delivery modes (PROSPERO CRD42019130301). Two independent reviewers screened references from five databases (i.e., Cochrane Library, Embase, MEDLINE/PubMed, PsycINFO and ICTRP), selected studies for inclusion and extracted data from eligible studies. We included 26 RCTs on mediators in IMIs for depression (6820 participants), rated their risk of bias and adherence to methodological quality criteria for psychotherapy process research. Primary studies examined 64 mediators, with cognitive variables (e.g., perceived control, rumination or interpretation bias) being the largest group of both examined (m = 28) and significant mediators (m = 22); followed by a range of other mediators, including mindfulness, acceptance and behavioral activation. Our findings might contribute to the empirically-informed advancement of interventions and mental health care practices, enabling optimized treatment outcomes for patients with depression. Furthermore, we discuss implications for future research and provide methodological recommendations for forthcoming mediation studies with more pertinent designs, allowing for inferences with higher causal specificity.
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Affiliation(s)
- Matthias Domhardt
- Department of Clinical Psychology and Psychotherapy, Ulm University, Germany.
| | - Lena Steubl
- Department of Clinical Psychology and Psychotherapy, Ulm University, Germany
| | - Johanna Boettcher
- Department of Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Germany
| | - Claudia Buntrock
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Germany
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands; Department of Global Health and Social Medicine, Harvard Medical School, United States
| | - David D Ebert
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands; Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Germany
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Gonze BDB, Padovani RDC, Simoes MDS, Lauria V, Proença NL, Sperandio EF, Ostolin TLVDP, Gomes GADO, Castro PC, Romiti M, Gagliardi A, Arantes RL, Dourado VZ. Use of a Smartphone App to Increase Physical Activity Levels in Insufficiently Active Adults: Feasibility Sequential Multiple Assignment Randomized Trial (SMART). JMIR Res Protoc 2020; 9:e14322. [PMID: 33094733 PMCID: PMC7647811 DOI: 10.2196/14322] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/30/2019] [Accepted: 04/06/2020] [Indexed: 01/05/2023] Open
Abstract
Background The sequential multiple assignment randomized trial (SMART) design allows for changes in the intervention during the trial period. Despite its potential and feasibility for defining the best sequence of interventions, so far, it has not been utilized in a smartphone/gamified intervention for physical activity. Objective We aimed to investigate the feasibility of the SMART design for assessing the effects of a smartphone app intervention to improve physical activity in adults. We also aimed to describe the participants’ perception regarding the protocol and the use of the app for physical activity qualitatively. Methods We conducted a feasibility 24-week/two-stage SMART in which 18 insufficiently active participants (<10,000 steps/day) were first randomized to group 1 (smartphone app only), group 2 (smartphone app + tailored messages), and a control group (usual routine during the protocol). Participants were motivated to increase their step count by at least 2000 steps/day each week. Based on the 12-week intermediate outcome, responders continued the intervention and nonresponders were rerandomized to subsequent treatment, including a new group 3 (smartphone app + tailored messages + gamification) in which they were instructed to form groups to use several game elements available in the chosen app (Pacer). We considered responders as those with any positive slope in the linear relationship between weeks and steps per day at the end of the first stage of the intervention. We compared the accelerometer-based steps per day before and after the intervention, as well as the slopes of the app-based steps per day between the first and second stages of the intervention. Results Twelve participants, including five controls, finished the intervention. We identified two responders in group 1. We did not observe relevant changes in the steps per day either throughout the intervention or compared with the control group. However, the rerandomization of five nonresponders led to a change in the slope of the steps per day (median −198 steps/day [IQR −279 to −103] to 20 steps/day [IQR −204 to 145]; P=.08). Finally, in three participants from group 2, we observed an increase in the number of steps per day up to the sixth week, followed by an inflection to baseline values or even lower (ie, a quadratic relationship). The qualitative analysis showed that participants’ reports could be classified into the following: (1) difficulty in managing the app and technology or problems with the device, (2) suitable response to the app, and (3) difficulties to achieve the goals. Conclusions The SMART design was feasible and changed the behavior of steps per day after rerandomization. Rerandomization should be implemented earlier to take advantage of tailored messages. Additionally, difficulties with technology and realistic and individualized goals should be considered in interventions for physical activity using smartphones. Trial Registration Brazilian Registry of Clinical Trials RBR-8xtc9c; http://www.ensaiosclinicos.gov.br/rg/RBR-8xtc9c/.
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Affiliation(s)
- Bárbara De Barros Gonze
- Laboratory of Epidemiology and Human Movement (EPIMOV), Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
| | | | - Maria Do Socorro Simoes
- Laboratory of Epidemiology and Human Movement (EPIMOV), Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
| | - Vinicius Lauria
- Laboratory of Epidemiology and Human Movement (EPIMOV), Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
| | - Neli Leite Proença
- Laboratory of Epidemiology and Human Movement (EPIMOV), Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
| | - Evandro Fornias Sperandio
- Laboratory of Epidemiology and Human Movement (EPIMOV), Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
| | | | | | - Paula Costa Castro
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
| | - Marcello Romiti
- Angiocorpore Institute of Cardiovascular Medicine, Santos, Brazil
| | | | | | - Victor Zuniga Dourado
- Laboratory of Epidemiology and Human Movement (EPIMOV), Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil.,Lown Scholars in Cardiovascular Health Program, Harvard TH Chan School of Public Health, Boston, MA, United States
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López PL, Ciapponi A, Compte EJ, Comandé D, Murray S, Ailan D, Torrente FM. Transdiagnostic versus specific cognitive-behavioral treatments for adults with anxiety disorders. Hippokratia 2020. [DOI: 10.1002/14651858.cd013735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Pablo Luis López
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT); CONICET, INECO Foundation, Favaloro University; Buenos Aires Argentina
| | - Agustín Ciapponi
- Argentine Cochrane Centre; Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET); Buenos Aires Argentina
| | | | - Daniel Comandé
- Argentine Cochrane Centre; Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET); Buenos Aires Argentina
| | - Stuart Murray
- Department of Psychiatry & Behavioral Sciences; University of Southern California; Los Angeles California USA
| | - Delfina Ailan
- Psychiatry and Cognitive Psychotherapy; Institute of Cognitive Neurology (INECO); Buenos Aires Argentina
| | - Fernando Manuel Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT); CONICET, INECO Foundation, Favaloro University; Buenos Aires Argentina
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Moumne S, Hall N, Böke BN, Bastien L, Heath N. Implicit Theories of Emotion, Goals for Emotion Regulation, and Cognitive Responses to Negative Life Events. Psychol Rep 2020; 124:1588-1620. [PMID: 32674669 DOI: 10.1177/0033294120942110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Why do some people routinely respond to emotional difficulty in ways that foster resilience, while others habitually engage in responses associated with deleterious consequences over time? This study examined relations between emotion controllability beliefs and goals for emotion regulation (ER) with peoples' multivariate profile of cognitive ER strategy use. Cluster analysis classified 481 university students (81% female) as adaptive, maladaptive, or low regulators based on their multivariate profile of engagement in five adaptive and four maladaptive cognitive ER strategies. A discriminant function analysis predicting the multivariate profiles supported that lower emotion controllability beliefs and lower performance-avoidance goals for ER significantly distinguished maladaptive regulators from adaptive regulators. Moreover, lower learning, performance-avoidance, and performance-approach goals for ER significantly distinguished low regulators from maladaptive and low regulators. Taken together, findings support that emotion-related beliefs and goals may help to clarify why some people habitually engage in more adaptive patterns of cognitive ER in response to negative life events than others.
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Affiliation(s)
- Samira Moumne
- Faculty of Education, 5620McGill University, Montreal, Quebec, Canada
| | - Nathan Hall
- Faculty of Education, 5620McGill University, Montreal, Quebec, Canada
| | - Bilun Naz Böke
- Faculty of Education, 5620McGill University, Montreal, Quebec, Canada
| | - Laurianne Bastien
- Faculty of Education, 5620McGill University, Montreal, Quebec, Canada
| | - Nancy Heath
- Faculty of Education, 5620McGill University, Montreal, Quebec, Canada
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McBride E, Tatar O, Rosberger Z, Rockliffe L, Marlow LAV, Moss-Morris R, Kaur N, Wade K, Waller J. Emotional response to testing positive for human papillomavirus at cervical cancer screening: a mixed method systematic review with meta-analysis. Health Psychol Rev 2020; 15:395-429. [PMID: 32449477 DOI: 10.1080/17437199.2020.1762106] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Tens-of-millions of women every year test positive for human papillomavirus (HPV) at routine cervical screening. We performed a mixed-methods systematic review using a results-based convergent design to provide the first comprehensive overview of emotional response to testing positive for HPV (HPV+). We mapped our findings using the cognitive behavioural framework. Six electronic databases were searched from inception to 09-Nov-2019 and 33 papers were included. Random-effects meta-analyses revealed that HPV+ women with abnormal or normal cytology displayed higher short-term anxiety than those with normal results (MD on State-Trait Anxiety Inventory = 7.6, 95% CI: 4.59-10.60 and MD = 6.33, CI: 1.31-11.35, respectively); there were no long-term differences. Psychological distress (general/sexual/test-specific) was higher in HPV+ women with abnormal cytology in the short-term and long-term (SMD = 0.68, CI: 0.32-1.03 and SMD = 0.42, CI: 0.05-0.80, respectively). Testing HPV+ was also related to disgust/shame, surprise and fear about cancer. Broadly, adverse response related to eight cognitive constructs (low control, confusion, cancer-related concerns, relationship concerns, sexual concerns, uncertainty, stigma, low trust) and six behavioural constructs (relationship problems, social impact, non-disclosure of results, idiosyncratic prevention, indirect clinical interaction, changes to sexual practice). Almost exclusive use of observational and qualitative designs limited inferences of causality and conclusions regarding clinical significance.
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Affiliation(s)
- Emily McBride
- Department of Behavioural Science and Health, University College London (UCL), London, UK
| | - Ovidiu Tatar
- Research Center-Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, QC, Canada
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychology, Psychiatry and Oncology, McGill University, Montreal, Canada
| | - Lauren Rockliffe
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Laura A V Marlow
- School of Cancer and Pharmaceutical Sciences, King's College London (KCL), London, UK
| | - Rona Moss-Morris
- Department of Psychology, King's College London (KCL), London, UK
| | - Navdeep Kaur
- Research Center-Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Kristina Wade
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Faculty of Medicine, McGill University, Montreal, Canada
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, King's College London (KCL), London, UK
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McInnes JA. Cognitive Model for Processing Trauma in Non-PTSD Sequelae. COGNITIVE AND BEHAVIORAL PRACTICE 2020. [DOI: 10.1016/j.cbpra.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bar‐Tal D, Hameiri B. Interventions to change well‐anchored attitudes in the context of intergroup conflict. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2020. [DOI: 10.1111/spc3.12534] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Boaz Hameiri
- Annenberg School for CommunicationUniversity of Pennsylvania Philadelphia Pennsylvania USA
- The Evens Program in Conflict Resolution and MediationTel Aviv University Tel Aviv Israel
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Nesset MB, Lara-Cabrera ML, Bjørngaard JH, Whittington R, Palmstierna T. Cognitive behavioural group therapy versus mindfulness-based stress reduction group therapy for intimate partner violence: a randomized controlled trial. BMC Psychiatry 2020; 20:178. [PMID: 32306935 PMCID: PMC7169006 DOI: 10.1186/s12888-020-02582-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 04/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Violence in close relationships is a global public health problem and there is a need to implement therapeutic programs designed to help individuals who voluntarily seek help to reduce recurrent intimate partner violence. The effectiveness of such interventions in this population remains inconclusive. The aim of the present study was to compare the effectiveness of cognitive-behavioural group therapy (CBGT) vs mindfulness-based stress reduction (MBSR) group therapy in reducing violent behavior amongst individuals who are violent in intimate partnerships and who voluntarily seek help. METHODS One hundred forty four participants were randomized using an internet-based computer system. Nineteen withdrew after randomization and 125 participants were randomly assigned to the intervention condition (CBGT, n = 67) or the comparator condition (MBSR, n = 58). The intervention condition involved two individual sessions followed by 15 cognitive-behavioural group therapy sessions. The comparator condition included one individual session before and after 8 mindfulness-based group sessions. Participants (N = 125) and their relationship partners (n = 56) completed assessments at baseline, and at three, six, nine and twelve months' follow-up. The pre-defined primary outcome was reported physical, psychological or sexual violence and physical injury as measured by the revised Conflict Tactics Scale (CTS2). RESULTS The intent-to-treat analyses were based on 125 male participants (intervention group n = 67; comparator group n = 58). Fifty-six female partners provided collateral information. Baseline risk estimate in the CBGT-group was .85 (.74-.92), and .88 (.76-.94) in the MBSR-group for physical violence. At 12-months' follow-up a substantial reduction was found in both groups (CBGT: .08 (.03-.18); MBSR: .19 (.11-.32)). CONCLUSION Results provide support for the efficacy of both the cognitive-behavioural group therapy and the mindfulness-based stress reduction group therapy in reducing intimate partner violent behavior in men voluntarily seeking treatment. TRIAL REGISTRATION NCT01653860, registered July 2012.
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Affiliation(s)
- Merete Berg Nesset
- Forensic Department and Research Centre Brøset, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway. .,Faculty of medicine and health sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Mariela Loreto Lara-Cabrera
- grid.5947.f0000 0001 1516 2393Faculty of medicine and health sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway ,grid.52522.320000 0004 0627 3560Tiller Community Mental Health Centre, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Research and Development, St Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Johan Håkon Bjørngaard
- grid.5947.f0000 0001 1516 2393Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Richard Whittington
- grid.52522.320000 0004 0627 3560Forensic Department and Research Centre Brøset, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Faculty of medicine and health sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tom Palmstierna
- grid.52522.320000 0004 0627 3560Forensic Department and Research Centre Brøset, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Faculty of medicine and health sciences, Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
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Podina IR, Cosmoiu A, Rusu P, Chivu A. Positive Thinking is Not Adaptive Thinking: A Cognitive-Behavioral Take on Interpretation Bias Modification for Social Anxiety. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00344-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Emotional distress, brain functioning, and biobehavioral processes in cancer patients: a neuroimaging review and future directions. CNS Spectr 2020; 25:79-100. [PMID: 31010446 DOI: 10.1017/s1092852918001621] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Despite emerging evidence that distress and adversity can contribute to negative health outcomes in cancer, little is known about the brain networks, regions, or circuits that can contribute to individual differences in affect/distress states and health outcomes in treated cancer patients. To understand the state-of-the-science in this regard, we reviewed neuroimaging studies with cancer patients that examined the associations between negative affect (distress) and changes in the metabolism or structure of brain regions. Cancer patients showed changes in function and/or structure of key brain regions such as the prefrontal cortex, thalamus, amygdala, hippocampus, cingulate cortex (mainly subgenual area), hypothalamus, basal ganglia (striatum and caudate), and insula, which are associated with greater anxiety, depression, posttraumatic stress disorder (PTSD) symptoms, and distress. These results provide insights for understanding the effects of these psychological and emotional factors on peripheral stress-related biobehavioral pathways known to contribute to cancer progression and long-term health outcomes. This line of work provides leads for understanding the brain-mediated mechanisms that may explain the health effects of psychosocial interventions in cancer patients and survivors. A multilevel and integrated model for distress management intervention effects on psychological adaptation, biobehavioral processes, cancer pathogenesis, and clinical outcomes is proposed for future research.
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