The effects of cognitive and behavioural therapies for anxiety disorders on depression: a meta-analysis

BACKGROUND

The effects of cognitive behavioural therapy of anxiety disorders on depression has been examined in previous meta-analyses, suggesting that these treatments have considerable effects on depression. In the current meta-analysis we examined whether the effects of treatments of anxiety disorders on depression differ across generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder (PD). We also compared the effects of these treatments with the effects of cognitive and behavioural therapies of major depression (MDD).

METHOD

We searched PubMed, PsycINFO, EMBASE and the Cochrane database, and included 47 trials on anxiety disorders and 34 trials on MDD.

RESULTS

Baseline depression severity was somewhat lower in anxiety disorders than in MDD, but still mild to moderate in most studies. Baseline severity differed across the three anxiety disorders. The effect sizes found for treatment of the anxiety disorders ranged from g = 0.47 for PD, g = 0.68 for GAD and g = 0.69 for SAD. Differences between these effect sizes and those found in the treatment of MDD (g = 0.81) were not significant in most analyses and we found few indications that the effects differed across anxiety disorders. We did find that within-group effect sizes resulted in significantly (p < 0.001) larger effect sizes for depression (g = 1.50) than anxiety disorders (g = 0.73-0.91). Risk of bias was considerable in the majority of studies.

CONCLUSIONS

Patients participating in trials of cognitive behavioural therapy for anxiety disorders have high levels of depression. These treatments have considerable effects on depression, and these effects are comparable to those of treatment of primary MDD.

Multisensor Knowledge Systems

We describe an approach which facilitates and makes explicit the organization of the knowledge necessary to map multi sensor system requirements onto an appropriate assembly of algorithms, processors, sensors, and actuators. We have previously introduced the multisensor kernel system and logi cal sensor specifications as a means for high-level specifi cation of multisensor systems. The main goals of such a characterization are to develop a coherent treatment of multi sensor information, to allow system reconfiguration for both fault tolerance and dynamic response to environmental con ditions, and to permit the explicit description of control.

In this paper we show how logical sensors can be incorpo rated into an object-based approach for the interpretation of 3D structure. Considering the inherent difficulties in inter preting general configurations of lines in space, and consider ing the ubiquitousness of special line configurations in manu factured environments and objects, we advocate the use of computational units tuned to the occurrence of special config urations. The organized use of these units circumvents the inherent difficulties in interpreting general configurations of lines. After a brief examination of the problem of interpreting general configurations of lines in space, a number of compu tational units are proposed which are naturally derived from angular relations. The process of propagation (which allows interpretation to spread over the image) is also advocated. Such computational units and processes, which are simple and efficient, can be conveniently organized in a rule-based framework where the occurrence of the various special config urations can be tested. The multisensor knowledge system provides such a framework.

Mechanistic studies of pyridinium electrochemistry: alternative chemical pathways in the presence of CO2

Pyridinium has been described as a catalyst for CO₂ reduction, however with low faradaic efficiency. This article discusses a series of electrochemistry experiments to study other chemical processes occurring during pyridinium electrochemistry which might provide insight into the low faradaic efficiency.

Experimental determination of the Cr-C(2)Cl(4) bond dissociation enthalpy in Cr(CO)(5)(C(2)Cl(4)): quantifying metal-olefin bonding interactions

The bond dissociation enthalpy for the Cr-C(2)Cl(4) bond in gas-phase Cr(CO)(5)(C(2)Cl(4)) has been determined to be 12.8 +/- 1.6 kcal/mol using transient infrared spectroscopy. The results of a density functional theory-based energy decomposition analysis are used to quantify the metal-olefin bonding interactions in terms of the bonding description provided by the Dewar-Chatt-Duncanson model (sigma donation and back-bonding). The bond energy decomposition analysis reveals that metal-olefin bond strengths can be strongly influenced by the Pauli repulsion energy and by the energy necessary to deform the olefin and the metal-centered moiety from their equilibrium geometries to their geometry in the final complex. Further, a comparison between the metal-olefin bond strengths and the magnitude of the electronic interactions demonstrates that the energy associated with these deformations is the determining factor in the trends in bond enthalpies in the series of complexes Cr(CO)(5)(C(2)X(4)) (X = H, F, Cl). Though deformation of the Cr(CO)(5) moiety contributes to the overall deformation energy, the major contribution involves deformation of the olefin. This occurs as a consequence of rehybridization of the olefin as a result of metal-olefin back-bonding. The results are discussed in terms of the Dewar-Chatt-Duncanson model, which provides the accepted qualitative description of bonding in organometallic olefin complexes.

Isokinetic trunk strength and lifting strength measures. Differences and similarities between low-back-injured and noninjured workers

Fifty-eight back pain patients and 21 entry-level Postal Service workers without low-back pain were evaluated using a variety of lumbar function measures. Isolated trunk strength and full lifting strength were gauged with isokinetic and isometric methods. Lumbar range-of-motion was computed using toe-touch and goniometers. Conventional clinical techniques such as toe touch and straight leg raise were effective in distinguishing back-injured from normal subjects. Isometric and isokinetic peak force and torque tests failed to show significant differences between low-back pain and job applicant groups. When compared with published norms, our job applicant group was significantly deconditioned. Our data suggest that asymptomatic, deconditioned subjects could be mistaken for back-impaired patients or symptom magnifiers.