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Winnick JB, Chancey L, Buzenski J, Sukumar K, Focht DR, Kuhn BR, Tabani S, Zahka NE, Williams SE. Telehealth for Pediatric Disorders of Gut-Brain Interaction During the COVID-19 Pandemic. J Pediatr Gastroenterol Nutr 2023; 76:447-450. [PMID: 36580889 PMCID: PMC10012839 DOI: 10.1097/mpg.0000000000003687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/11/2022] [Indexed: 12/31/2022]
Abstract
A retrospective chart review was completed to examine psychological treatment duration and response among pediatric patients with a disorder of gut-brain interaction including functional abdominal pain and irritable bowel syndrome. Cognitive behavioral therapy (CBT) was delivered via telehealth with a licensed psychologist or supervised psychology trainee embedded in a pediatric gastroenterology clinic. Participants were 22 youth (mean age = 14.36 years) who received CBT via telehealth between February and September of 2021, after completing an initial evaluation between February and July of 2021. Patients completed reliable and valid self-report measures of functional disability and pain during treatment. A unique CBT model was employed with an initial focus on psychoeducation and function regardless of level of severity of functional impairment. Consistent with study hypotheses, nonparametric statistical analyses demonstrated statistically significant reductions in functional disability and pain following implementation of the CBT model via telehealth. Contrary to predictions, there was no relation found between severity of functional impairment and duration of treatment.
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Affiliation(s)
- Joel B. Winnick
- From Geisinger Commonwealth School of Medicine, Scranton, PA
- the Department of Psychiatry and Behavioral Health, Geisinger, Danville, PA
| | | | | | - Kritika Sukumar
- From Geisinger Commonwealth School of Medicine, Scranton, PA
| | - Dean R. Focht
- From Geisinger Commonwealth School of Medicine, Scranton, PA
- the Department of Pediatrics, Pediatric Gastroenterology, Geisinger, Danville, PA
| | - Benjamin R. Kuhn
- From Geisinger Commonwealth School of Medicine, Scranton, PA
- the Department of Pediatrics, Pediatric Gastroenterology, Geisinger, Danville, PA
| | - Saniya Tabani
- From Geisinger Commonwealth School of Medicine, Scranton, PA
| | - Nicole E. Zahka
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Sara E. Williams
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
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Mayuga KA, Fedorowski A, Ricci F, Gopinathannair R, Dukes JW, Gibbons C, Hanna P, Sorajja D, Chung M, Benditt D, Sheldon R, Ayache MB, AbouAssi H, Shivkumar K, Grubb BP, Hamdan MH, Stavrakis S, Singh T, Goldberger JJ, Muldowney JAS, Belham M, Kem DC, Akin C, Bruce BK, Zahka NE, Fu Q, Van Iterson EH, Raj SR, Fouad-Tarazi F, Goldstein DS, Stewart J, Olshansky B. Sinus Tachycardia: a Multidisciplinary Expert Focused Review. Circ Arrhythm Electrophysiol 2022; 15:e007960. [PMID: 36074973 PMCID: PMC9523592 DOI: 10.1161/circep.121.007960] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sinus tachycardia (ST) is ubiquitous, but its presence outside of normal physiological triggers in otherwise healthy individuals remains a commonly encountered phenomenon in medical practice. In many cases, ST can be readily explained by a current medical condition that precipitates an increase in the sinus rate, but ST at rest without physiological triggers may also represent a spectrum of normal. In other cases, ST may not have an easily explainable cause but may represent serious underlying pathology and can be associated with intolerable symptoms. The classification of ST, consideration of possible etiologies, as well as the decisions of when and how to intervene can be difficult. ST can be classified as secondary to a specific, usually treatable, medical condition (eg, pulmonary embolism, anemia, infection, or hyperthyroidism) or be related to several incompletely defined conditions (eg, inappropriate ST, postural tachycardia syndrome, mast cell disorder, or post-COVID syndrome). While cardiologists and cardiac electrophysiologists often evaluate patients with symptoms associated with persistent or paroxysmal ST, an optimal approach remains uncertain. Due to the many possible conditions associated with ST, and an overlap in medical specialists who see these patients, the inclusion of experts in different fields is essential for a more comprehensive understanding. This article is unique in that it was composed by international experts in Neurology, Psychology, Autonomic Medicine, Allergy and Immunology, Exercise Physiology, Pulmonology and Critical Care Medicine, Endocrinology, Cardiology, and Cardiac Electrophysiology in the hope that it will facilitate a more complete understanding and thereby result in the better care of patients with ST.
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Affiliation(s)
- Kenneth A. Mayuga
- Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH
| | - Artur Fedorowski
- Karolinska Institutet & Karolinska University Hospital, Stockholm, Sweden
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, “G.d’Annunzio” University of Chieti-Pescara, Chieti Scalo, Italy
| | | | | | | | | | | | - Mina Chung
- Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, Phoenix, AZ
| | - David Benditt
- University of Minnesota Medical School, Minneapolis, MN
| | | | - Mirna B. Ayache
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Hiba AbouAssi
- Division of Endocrinology, Metabolism, and Nutrition, Duke University Medical Center, Durham, NC
| | | | | | | | | | - Tamanna Singh
- Department of Cardiovascular Medicine, Cleveland Clinic, OH
| | | | - James A. S. Muldowney
- Vanderbilt University Medical Center &Tennessee Valley Healthcare System, Nashville Campus, Department of Veterans Affairs, Nashville, TN
| | - Mark Belham
- Cambridge University Hospitals NHS FT, Cambridge, UK
| | - David C. Kem
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Cem Akin
- University of Michigan, Ann Arbor, MI
| | | | - Nicole E. Zahka
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Qi Fu
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas & University of Texas Southwestern Medical Center, Dallas, TX
| | - Erik H. Van Iterson
- Section of Preventive Cardiology & Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic Cleveland, OH
| | - Satish R Raj
- Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Henderson HA, Zahka NE, Kojkowski NM, Inge AP, Schwartz CB, Hileman CM, Coman DC, Mundy PC. Self-referenced memory, social cognition, and symptom presentation in autism. J Child Psychol Psychiatry 2009; 50:853-61. [PMID: 19298471 PMCID: PMC2697280 DOI: 10.1111/j.1469-7610.2008.02059.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND We examined performance on a self-referenced memory (SRM) task for higher-functioning children with autism (HFA) and a matched comparison group. SRM performance was examined in relation to symptom severity and social cognitive tests of mentalizing. METHOD Sixty-two children (31 HFA, 31 comparison; 8-16 years) completed a SRM task in which they read a list of words and decided whether the word described something about them, something about Harry Potter, or contained a certain number of letters. They then identified words that were familiar from a longer list. Dependent measures were memory performance (d') in each of the three encoding conditions as well as a self-memory bias score (d' self-d' other). Children completed The Strange Stories Task and The Children's Eyes Test as measures of social cognition. Parents completed the SCQ and ASSQ as measures of symptom severity. RESULTS Children in the comparison sample showed the standard SRM effect in which they recognized significantly more self-referenced words relative to words in the other-referenced and letter conditions. In contrast, HFA children showed comparable rates of recognition for self- and other-referenced words. For all children, SRM performance improved with age and enhanced SRM performance was related to lower levels of social problems. These associations were not accounted for by performance on the mentalizing tasks. CONCLUSIONS Children with HFA did not show the standard enhanced processing of self- vs. other-relevant information. Individual differences in the tendency to preferentially process self-relevant information may be associated with social cognitive processes that serve to modify the expression of social symptoms in children with autism.
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Affiliation(s)
| | | | | | | | | | | | | | - Peter C. Mundy
- School of Education and the M.I.N.D. Institute, UC Davis
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Schwartz CB, Henderson HA, Inge AP, Zahka NE, Coman DC, Kojkowski NM, Hileman CM, Mundy PC. Temperament as a predictor of symptomotology and adaptive functioning in adolescents with high-functioning autism. J Autism Dev Disord 2009; 39:842-55. [PMID: 19165586 PMCID: PMC2683187 DOI: 10.1007/s10803-009-0690-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 01/05/2009] [Indexed: 12/27/2022]
Abstract
Variation in temperament is characteristic of all people but is rarely studied as a predictor of individual differences among individuals with autism. Relative to a matched comparison sample, adolescents with High-Functioning Autism (HFA) reported lower levels of Surgency and higher levels of Negative Affectivity. Variability in temperament predicted symptomotology, social skills, and social-emotional outcomes differently for individuals with HFA than for the comparison sample. This study is unique in that temperament was measured by self-report, while all outcome measures were reported by parents. The broader implications of this study suggest that by identifying individual variability in constructs, such as temperament, that may influence adaptive functioning, interventions may be developed to target these constructs and increase the likelihood that individuals with HFA will achieve more adaptive life outcomes.
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Affiliation(s)
- Caley B Schwartz
- Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL 33146, USA
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Henderson HA, Zahka NE, Kojkowski NM, Inge AP, Schwartz CB, Hileman CM, Coman DC, Mundy PC. Self-referenced memory, social cognition, and symptom presentation in autism. J Child Psychol Psychiatry 2009. [PMID: 19298471 DOI: 10.1111/j.1469‐7610.2008.02059.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND We examined performance on a self-referenced memory (SRM) task for higher-functioning children with autism (HFA) and a matched comparison group. SRM performance was examined in relation to symptom severity and social cognitive tests of mentalizing. METHOD Sixty-two children (31 HFA, 31 comparison; 8-16 years) completed a SRM task in which they read a list of words and decided whether the word described something about them, something about Harry Potter, or contained a certain number of letters. They then identified words that were familiar from a longer list. Dependent measures were memory performance (d') in each of the three encoding conditions as well as a self-memory bias score (d' self-d' other). Children completed The Strange Stories Task and The Children's Eyes Test as measures of social cognition. Parents completed the SCQ and ASSQ as measures of symptom severity. RESULTS Children in the comparison sample showed the standard SRM effect in which they recognized significantly more self-referenced words relative to words in the other-referenced and letter conditions. In contrast, HFA children showed comparable rates of recognition for self- and other-referenced words. For all children, SRM performance improved with age and enhanced SRM performance was related to lower levels of social problems. These associations were not accounted for by performance on the mentalizing tasks. CONCLUSIONS Children with HFA did not show the standard enhanced processing of self- vs. other-relevant information. Individual differences in the tendency to preferentially process self-relevant information may be associated with social cognitive processes that serve to modify the expression of social symptoms in children with autism.
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Affiliation(s)
- Heather A Henderson
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., 33146 Miami, USA.
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Abstract
The present study was designed to begin to explore the perceptual and visuospatial organization required to respond to the Rorschach task. Previous research has shown a relative independence of Rorschach scores from other measures of neurocognitive functioning (e.g., Zillmer & Perry, 1996). However, many of the neuropsychological measures used in previous studies did not require the patient to organize a complex visuospatial stimulus in the same way that the Rorschach does. In this study, data from 27 children and adolescents administered the Rorschach and the Rey-Osterreith Complex Figure Test (ROCF) were examined. Results of analyses indicated that, accounting for age and Full Scale IQ, there were a number of significant relationships between accuracy of ROCF renditions and Rorschach measures of developmental quality and perceptual accuracy. Implications for the understanding the nature of the Rorschach response process and its utility in clinical neuropsychology are discussed.
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Affiliation(s)
- Steven R Smith
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA 93106, USA.
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Smith SR, Zahka NE. Relationship Between Accuracy and Organizational Approach on the Rey-Osterrieth Complex Figure and the Differential Ability Scales: A Pilot Investigation. Child Neuropsychol 2006; 12:383-90. [PMID: 16952885 DOI: 10.1080/09297040500350953] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The present study was designed as an initial exploration of the relationship between global cognitive functioning and organizational and accuracy scores on the Rey-Osterrieth Complex Figure (ROCF) in a sample of children and adolescents. The relationship between ROCF accuracy scores at Copy and Delay as well as Organization and the Differential Ability Scales (DAS) was examined. Results indicate moderate correlations between Copy and Delay ROCF scores and various DAS indicators of nonverbal problem solving and visuospatial processing. Contrary to expectations, organizational scores were not significantly correlated with any of the DAS subscales or composite scales. Although further research is needed to explore the validity of this organizational scoring scheme with younger patients, these findings suggest that organization of the ROCF may be generally unrelated to global measures of cognitive ability or may assess processes associated with executive functioning untapped by the DAS.
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Affiliation(s)
- Steven R Smith
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA 93106, USA.
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