Wong, Daniel F. K.; Ip, Priscilla S. Y.; Lee, Kim Man
This pilot study attempted to examine the effectiveness of a brief cognitive behavioural therapy (CBT) psychoeducational group for Chinese people with chronic illness in Hong Kong. It adopted a single group design, and 52 participants joined the group. A questionnaire with three outcome measures, measuring general mental health, quality of life…
Buwalda, Femke M.; Bouman, Theo. K.; van Duijn, Marijtje A. J.; Van der Duin, M.
In this study, two 6-week psychoeducational courses for hypochondriasis are compared, one based on the cognitive-behavioural approach, and the other on the problem-solving approach. Effects of both courses on hypochondriacal complaints, depression, trait anxiety, and number of problems encountered
Lloyd, Samantha; Chalder, Trudie; Rimes, Katharine A
The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group; the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with
Effects of a program of cognitive-behavioural group therapy, vestibular rehabilitation, and psychoeducational explanations on patients with dizziness and no quantified balance deficit, compared to patients with dizziness and a quantified balance deficit.
Schmid, D A; Allum, J H J; Sleptsova, M; Gross, S; Gaab, J; Welge-Lüssen, A; Schaefert, R; Langewitz, W
We examined whether a program combining cognitive-behavioural therapy (CBT), vestibular rehabilitation (VR) and psychoeducation is equally effective in improving psychometric measures in patients with dizziness independent of a balance deficit. Measures of patients with dizziness only (DO) were compared to those of patients also having a quantified balance deficit (QBD). 32 patients (23 female, 9 male) with persistent dizziness were analysed as 2 groups based on stance and gait balance control: those with QBD (pathological balance) or DO (normal balance). Dizziness Handicap Inventory (DHI) and Brief Symptom Inventory (BSI) questionnaires were used pre- and post-therapy to assess psychometric measures. Patients then received the same combination therapy in a group setting. The QBD group mean age was 60.6, SD 8.3, and DO group mean age 44.8, SD 12.1, years. Pre-therapy, questionnaire scores were pathological but not different between groups. Balance improved significantly for the QBD group (p=0.003) but not for the DO group. DHI and BSI scores improved significantly in the DO group (0.001VR, and psychoeducation improves psychological measures in DO patients but not significantly in QBD patients, despite their balance control improving to near normal. Possibly, greater focus on phobic anxiety during the group therapy program would have improved psychological measures of QBD patient. Copyright © 2017 Elsevier Inc. All rights reserved.
Vianna Paulo, Debora Lee; Sanches Yassuda, Monica
The present research examined the effects of a cognitive training program combined with psychoeducational intervention for diabetic elderly patients. Specifically, it aimed at assessing the effects of an eight-session cognitive training and educational program in diabetic elderly individuals and investigating changes in their awareness about…
Péneau, Elie; Franck, Nicolas
Rehabilitation techniques aim to reduce the functional impact of severe psychological disorders. The recent development of techniques aimed at the manifestations of the pathology, such as psychoeducation and cognitive remediation, raise questions about how they differ from standard therapies. Beyond their functional purpose, the consideration of the individual's current or future action potential, seems to constitute one of the key aspects. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Fulton, Mandy L; D'Entremont, Barbara
The Psychoeducational Profile-3's (PEP-3) ability to estimate cognitive and language skills of 136 children (20-75 months) with autism spectrum disorders (ASDs) across a range of functioning, and the association between the PEP-3 and ASD symptomatology was examined using retrospective data. PEP-3 cognitive and language measures were positively correlated with similar measures on the Child Development Inventory, the Merrill-Palmer Revised, and the Vineland Adaptive Behaviour Scale-2. The PEP-3 sometimes provided higher or lower estimates than other measures. Significant differences were found between diagnostic groups on PEP-3 cognitive and language measures. PEP-3 cognitive scores correlated positively with scores on the Autism Diagnostic Observation Schedule. Findings support the use of the PEP-3 to measure cognition and language in children with ASDs.
Reijnders, Jennifer; van Heugten, Caroline; van Boxtel, Martin
A psychoeducational face-to-face training program (Keep Your Brain Fit!) was developed to support the working population in coping with age-related cognitive changes and taking proactive preventive measures to maintain cognitive health. A feasibility study was conducted to test the training program presented in a workshop format. Participants…
Yeh, Mei-Yu; Tung, Tao-Hsin; Horng, Fen-Fang; Sung, Su-Ching
To evaluate the effectiveness of a psychoeducational programme in enhancing motivation to change alcohol-addictive behaviour. The prevalence of alcohol abuse has increased over the past 10 years, and the age of initial alcohol use has decreased gradually in Taiwan. Alcohol dependence is one of the leading causes of disability and has led to increases in the incidence of crime and violence, with alcohol abuse identified as a problem in society. A quasi-experimental design with nonequivalent pre/post-testing was used. Alcohol-dependent inpatients undergoing alcohol treatment were selected from the psychiatric ward of a teaching hospital in northern Taiwan. The effectiveness of the psychoeducational programme in enhancing motivation to change alcohol-addictive behaviour was evaluated with the Severity of Alcohol Dependence Data Questionnaire and the Stages of Change Readiness and Treatment Eagerness Scale. In total, 24 and 51 participants were recruited to the experimental and control groups, respectively, for the baseline survey, and 14 and 17 were in the final survey, respectively. After adjustment for baseline survey scores, the experimental group showed significantly greater increases in recognition and ambivalence relative to those observed in the control group. The results not only showed that the psychoeducational programme was effective in reinforcing addicted inpatients' motivation for changing their drinking behaviour but also provided clinical nurses with practical methods via which to enhance patient motivation. The psychoeducational programme could assist clinical nurses in helping alcohol-dependent patients to recognise the nature of their problematic drinking; increase participants' ambivalence towards their drinking behaviour, leading to the contemplation of change; and strengthen the possibility that they will change their addictive behaviour. © 2017 John Wiley & Sons Ltd.
Spaten, Ole Michael; Hansen, Tia G. B.; Gulbrandsen, Knut Arild
coaching module in the graduate curriculum for students of psychology is a rewarding introduction to cognitive behavioural approaches, since it allows combination of traditional lectures with “action-reflection-learning” workshops, during which students train cognitive behavioural techniques in their own......Coaching is an expanding area of professional work, and recent years have brought forward the notion of cognitive coaching (Costa, 2006; Oestrich, 2005) which adapts theory and techniques from cognitive therapy to serve self-enhancement in non-clinical populations. We suggest that a cognitive...... repertoire. The skills needed for cognitive coaching reflect all therapeutic techniques but at a less advanced psychotherapeutic level, and still prepare for future clinical work and development. In the poster, we summarise a cognitive coaching course syllabus as well as results from data collected...
May 20, 2003 ... Introduction. Cognitive behaviour therapy (CBT) developed out of the work of the early behaviour theorists – Watson1 , Skinner, Mowrer2 ,. Dollard & Miller3 . Watson rejected introspection and this had a significant influence on early theorists who focussed only on the role of external variables and stimuli.
The Effects of a Web-Based Interactive Psycho-Educational Program and a Traditional Psycho-Educational Program Based on Cognitive- Behavioral Approach upon Children’s Cognitive Distortions and Psychological Symptoms
BUĞA, Ahmet; HAMAMCI, Zeynep
The purpose of the present study is to compare the effects of a web-based interactive psycho-educational program and a traditional psycho-educational program based on the cognitive-behavioral approach upon children’s cognitive distortions and psychological symptoms. The study group of the research consisted of a total of 36 8th grade middle school students. Of the participants, 12 students participated in the web-based interactive psycho-educational program, 12 students participated in the tr...
Wong, Samuel Yeung Shan; Yip, Benjamin Hon Kei; Mak, Winnie Wing Sze; Mercer, Stewart; Cheung, Eliza Yee Lai; Ling, Candy Yuet Man; Lui, Wacy Wai Sze; Tang, Wai Kwong; Lo, Herman Hay Ming; Wu, Justin Che Yuen; Lee, Tatia Mei Chun; Gao, Ting; Griffiths, Sian M; Chan, Peter Hoi Sing; Ma, Helen Shuk Wah
Research suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD). To compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive-behavioural therapy-based psychoeducation and usual care. In total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels. Linear mixed models demonstrated significant group × time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only. These results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms. © The Royal College of Psychiatrists 2016.
The Effects of a Web-Based Interactive Psycho-Educational Program and a Traditional Psycho-Educational Program Based on Cognitive- Behavioral Approach upon Children’s Cognitive Distortions and Psychological Symptoms
Full Text Available The purpose of the present study is to compare the effects of a web-based interactive psycho-educational program and a traditional psycho-educational program based on the cognitive-behavioral approach upon children’s cognitive distortions and psychological symptoms. The study group of the research consisted of a total of 36 8th grade middle school students. Of the participants, 12 students participated in the web-based interactive psycho-educational program, 12 students participated in the traditional psycho-educational program, and 12 students were in the control group. Children’s Negative Cognitive Distortions Questionnaire (CNCDQ, which was adapted into Turkish by Aydın (2006, and Brief Symptom Inventory (BSI adapted for adolescents by Şahin, Batıgün and Uğurtaş (2002 were used as data collection tools. The students included in the web-based interactive psycho-educational program participated in an online program which covered 10 modules, one module for each week. The students in the traditional psycho-educational program participated in an 8-week program. The control group did not participate in any programs. A post-test was administered one week after the research was completed, and follow-up measurements were done both one month and three months later. The results of the research indicated that cognitive distortions of children who participated in the web-based interactive psycho-educational program and the traditional psycho-educational program decreased after the intervention, and that the decrease continued in the follow-up periods. Psychological symptoms decreased in the children who participated in the web-based interactive program, and this decrease lasted in follow-up periods. However, there was no statistical difference in psychological symptoms of the children who participated in the traditional psycho-educational program and the control group
Fulton, Mandy L.; D'Entremont, Barbara
The Psychoeducational Profile-3's (PEP-3) ability to estimate cognitive and language skills of 136 children (20-75 months) with autism spectrum disorders (ASDs) across a range of functioning, and the association between the PEP-3 and ASD symptomatology was examined using retrospective data. PEP-3 cognitive and language measures were positively…
Wiskin, L F
Rheumatoid arthritis is a systemic autoimmune disorder affecting nearly 2.1 million Americans. This condition often leads to chronic pain, inflammation, joint destruction, feelings of helplessness, maladaptive coping, depression and activity limitations. For those individuals with rheumatoid arthritis and chronic arthritic pain, the role of the worker has become difficult to maintain. Research suggests that cognitive-behavioral intervention reduces chronic arthritic pain, decreases disease activity and improves coping skills in individuals with rheumatoid arthritis. To be effective, cognitive-behavioral techniques must be practiced on a regular basis. The literature suggests that the American worker with rheumatoid arthritis would greatly benefit from work-site wellness programs that provide cognitive-behavioral intervention as a 'reasonable accommodation'. Occupational therapy practitioners can help to advance the positive effects of this psychoeducational intervention by providing 'booster treatments' to clients after formal treatment sessions have ceased.
Schaub, Annette; Hippius, Hanns; Möller, Hans-Jürgen; Falkai, Peter
Programs that view individuals as capable of taking an active role in managing their illness have gained importance in Europe and the United States. This article describes the implementation and evaluation of group psychoeducational and cognitive behavioral treatment programs at the Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany, over the past 20 years. Implementing psychoeducational programs was the first step to establish cognitive behavioral psychotherapy and dispel the myth of schizophrenia for patients. Programs are also provided for patients with mood disorders, substance use disorders, or both. These groups include topics such as psychoeducation about the illness, establishing rewarding activities, stress management, cognitive therapy, and relapse prevention. More than 1000 patients with schizophrenia or mood disorders (380 schizophrenia, 563 major depression, and 110 bipolar) have participated in illness management groups to learn about their illness and its treatment, and to learn skills to manage their illness. Patients have expressed satisfaction with the programs, and research has supported their effectiveness. Individuals with severe disorders can benefit from psychoeducational and cognitive treatment programs if the programs are adapted to the level of neuropsychological functioning and compensate for cognitive deficits and emotional overload. These findings suggest that providing information about the illness and coping skills for patients and relatives are important for treatment outcome. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Schaub, Annette; Hippius, Hanns; Möller, Hans-Jürgen; Falkai, Peter
Objective: Programs that view individuals as capable of taking an active role in managing their illness have gained importance in Europe and the United States. This article describes the implementation and evaluation of group psychoeducational and cognitive behavioral treatment programs at the Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany, over the past 20 years. Methods: Implementing psychoeducational programs was the first step to establish cognitive behavioral psychotherapy and dispel the myth of schizophrenia for patients. Programs are also provided for patients with mood disorders, substance use disorders, or both. These groups include topics such as psychoeducation about the illness, establishing rewarding activities, stress management, cognitive therapy, and relapse prevention. Results: More than 1000 patients with schizophrenia or mood disorders (380 schizophrenia, 563 major depression, and 110 bipolar) have participated in illness management groups to learn about their illness and its treatment, and to learn skills to manage their illness. Patients have expressed satisfaction with the programs, and research has supported their effectiveness. Conclusions: Individuals with severe disorders can benefit from psychoeducational and cognitive treatment programs if the programs are adapted to the level of neuropsychological functioning and compensate for cognitive deficits and emotional overload. These findings suggest that providing information about the illness and coping skills for patients and relatives are important for treatment outcome. PMID:27460621
Piacentini, John; Bergman, R. Lindsey; Chang, Susanna; Langley, Audra; Peris, Tara; Wood, Jeffrey J.; McCracken, James
Objective: To examine the efficacy of exposure-based cognitive-behavioral therapy (CBT) plus a structured family intervention (FCBT) versus psychoeducation plus relaxation training (PRT) for reducing symptom severity, functional impairment, and family accommodation in youths with obsessive-compulsive disorder (OCD). Method: A total of 71…
De Maricourt, P; Gorwood, P; Hergueta, Th; Galinowski, A; Salamon, R; Diallo, A; Vaugeois, C; Lépine, J. P; Olié, J. P; Dubois, O
.... The aim of this study was to assess the feasibility and the impact of a program including cognitive behavioural therapy, psychoeducation, and balneotherapy in a spa resort to facilitate long-term...
Calderone, Alba; Calabro, Pasquale Fabio; Lippi, Chita; Jaccheri, Roberta; Vitti, Jacopo; Santini, Ferruccio
Obesity is a chronic condition with high prevalence and multifaceted aetiology, accompanied by an increased risk of morbidity and mortality. Obesity has several negative effects on the psychological status, and the severity of psychological disorders correlates with the degree of obesity. Aim of this review is to provide an overview of the literature concerning the psychological distress associated with severe obesity, which contributes to deterioration of the quality of life of affected patients. Dysfunctional eating behaviours and eating disorders, psychiatric comorbidity, cognition and quality of life will be discussed together with the most common drugs that can be employed to treat the various disorders in this peculiar clinical setting. The effects of bariatric surgery will be also reviewed. Obesity is often the result of pathological behaviours implemented in an eating disorder. Inconsistent results have been reported with regard to the effect of severe obesity on cognition, which recognize a multifaceted aetiology. Serotonergic agents play an important role in the management of patients with obesity and binge episodes, fluoxetine being currently a drug approved for this disorder. The efficacy of lorcaserin, a combination of bupropion and naltrexone, or antiepileptic medications (topiramate and zonisamide) has also been proposed. A neuroprotective role of leptin and oestrogen has been hypothesized. Bariatric surgery is a helpful treatment of morbid obese patients, with long-term favourable results on the psychopathological profile. Psychological, psychoeducational and psychopharmacological treatment can facilitate weight loss in morbid obese subjects with psychopathological comorbidities. A precise definition of the mechanisms affecting appetite, satiety and energy balance is expected to foster the development of new effective antiobesity drugs. Copyright© Bentham Science Publishers; For any queries, please email at email@example.com.
Anlı, Gazanfer; Şar, Ali Haydar
The purpose of this study is to examine the impact of the cognitive behavioral psychoeducation program, which aims to reduce the submissive behaviors on the interpersonal sensitivity and hostility. The research was carried out with high school students studying at 12th class of Ümraniye Merkez Anadolu high school, located in Istanbul during 2014/2015 academic year. Submissive Acts Scale and Brief Symptom Inventory were used for selecting the experimental objects. 24 students who met the inclu...
Barriga, Alvaro Q; Hawkins, Mark A; Camelia, Carl R T
Cognitive distortions have long been posited to facilitate antisocial behaviours, but the specificity of such distortions has rarely been studied. To replicate findings of specificity between particular cognitions and externalizing or internalizing behaviours; to test for specificity of relationship between particular cognitions and different types of externalizing behaviours. The participants were 239 male youths aged 10 to 19 years (mean (M) = 14.22, standard deviation (SD) = 1.64) from schools on the island of Curaçao. Their cognitive distortions and problem behaviours were investigated through self-report. Results In controlled analyses, self-serving cognitive distortions were associated with externalizing behaviours whereas self-debasing cognitive distortions were associated with internalizing behaviours. Within the externalizing domain, self-serving distortions with overt behavioural referents were linked to aggressive behaviour while self-serving distortions with covert behavioural referents were linked to delinquent behaviour. Within the aggression domain, distortions with opposition-defiance referents related to verbal aggression whereas distortions with physical aggression referents related to physically aggressive behaviour. The degree of cognitive-behavioural specificity documented by this study was remarkable. The observed pattern suggests that cognitive interventions designed for externalizing versus internalizing behaviours should differ in therapeutic approach.
Buwalda, F.M.; Bouman, T.K.
Both individual cognitive-behavioural therapy and short-term psychoeducational courses have shown to be effective in reducing hypochondriacal complaints. However, it is unknown which patients benefit from treatment. The aim of the present study is to explore which variables predict treatment outcome
Roberts-Collins, Cara; Mahoney-Davies, Gerwyn; Russell, Ailsa; Booth, Anne; Loades, Maria
Young people with autism spectrum disorder experience high levels of emotional problems, including anxiety and depression. Adapted cognitive behavioural therapy is recommended for such difficulties. However, no evidence suggests whether emotion awareness is important in treatment outcome for young people on the autism spectrum. This study aimed to investigate the potential differences in emotion awareness between (1) young people on the autism spectrum and typically developing youth and (2) young people on the autism spectrum with and without experience of cognitive behavioural therapy. Three groups (aged 11-20 years) participated: (1) typically developing young people ( n = 56); (2) young people on the autism spectrum with no experience of cognitive behavioural therapy ( n = 23); and (3) young people on the autism spectrum who had attended cognitive behavioural therapy ( n = 33). All participants completed the Emotion Awareness Questionnaire-30 item version. Young people on the autism spectrum differed significantly from typically developing young people on the emotional awareness measure. Young people on the autism spectrum who had attended cognitive behavioural therapy scored significantly lower on the Differentiating Emotions subscale, and significantly higher on the Attending to Others' Emotions subscale, compared to young people on the autism spectrum who had not attended cognitive behavioural therapy. This study highlights the importance of psycho-educational components of cognitive behavioural therapy when adapting for young people on the autism spectrum.
Manjula, M; Prasadarao, P S D V; Kumaraiah, V; Raguram, R
CBT has been proven to be effective in the treatment of panic disorder; however, attempts to study the process of change are limited. The study evaluated the temporal patterns of change in the panic symptoms, cognitions, behaviours, and anxiety sensitivity in subjects with panic disorder being treated with CBT. Thirty subjects with panic disorder were allocated to two groups: Cognitive Behaviour Therapy (CBT, n = 15) and Behaviour Therapy (BT, n = 15). Assessments were carried out weekly for five consecutive weeks using the Semi-Structured Interview Schedule, the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire, and the Texas Panic Attack Record Form. The CBT group received comprehensive CBT and the BT group received psycho-education and Applied Relaxation. Following intervention the change was continuous and gradual on all the variables in the CBT group and the scores reduced to a functional range after 4-5 weeks of therapy. Such a change was not evident in the BT group. Significant change was evident in cognitive domains following the introduction of the exposure and cognitive restructuring within the CBT group. Both cognitive and behavioural techniques contributed to the overall change. CBT had an impact on the cognitive domains and significant changes were evident corresponding to the addition of cognitive restructuring and exposure techniques in the 3rd to 5th week. Both cognitive and behavioural components are therefore crucial for overall improvement to occur.
Cormier, Abigail; McBride, Dawn Lorraine
This project provides a comprehensive overview of the research literature on problem gambling in adults and includes a detailed mindfulness-based psychoeducational group manual for problem gambling, complete with an extensive group counselling consent form, assessment and screening protocols, 10 user-friendly lesson plans, templates for a…
Reijnders, Jennifer S A M; Geusgens, Chantal A V; Ponds, Rudolf W H M; van Boxtel, Martin P J
A psychoeducational intervention (Keep your brain fit!) was designed for the middle-aged and older working population. The intervention focuses on increasing knowledge and awareness about cognitive ageing and teaching strategies to cope with cognitive changes. The primary aim of this study was to investigate the effectiveness of the e-health intervention in terms of subjective cognitive functioning. As secondary aims, objective cognitive functioning and psychological well-being were also measured. A randomised controlled trial that included people aged 40 to 65 years was conducted. A maximum of 4 weeks was allowed to complete the intervention. The outcome measures were obtained from an online test battery that was administered at baseline, post-test and at 4-week follow-up. A total of 376 participants completed the whole study. After the intervention, the experimental group reported more feelings of stability concerning memory functioning and perceived greater locus of control over memory compared to the control group. These effects were maintained at the 4-week follow-up. Taking into account the relatively low costs and easy accessibility of this e-health intervention, we consider the programme to be a valuable contribution to public healthcare interventions for middle-aged and older adults.
López Gómez, Santiago; García, Consuelo
Autistic disorder refers to a neuropsychological disorder with serious and heterogeneous manifestations that include three main areas of development, namely: social and affective alterations, alterations in the linguistic and communicative behaviour and the presence of behavioural patterns, interests or restricted and stereotyped activities. The failure that affects the maintenance and development of social and affective bonds, characterized by social isolation and the presence of inadequate ...
Full Text Available The objective of the present study is to further elucitate the specifics cognitive behavioural therapy (CBT based on the treatment of 2 patients. The theoretical background of the therapy is based on the idea that the learning processes determine behaviour (behavioural therapy, acquisition and consolidation of beliefs and view of the world (cognitive therapy. The CBT is short-term (usually 12–20 weekly sessions. It assumes close links between the patient’s thoughts (about self, the world and the future and his/her emotions, behaviour and physiology. The patient’s work in between sessions consists in observation of their own thoughts, behaviours, and emotions, and introduction of changes within the scope of their thoughts and behaviours. The goal of cognitive behavioural therapy is autonomy and independence of a patient, attainment of the patient’s objectives, and remedying the most important problems of the patient. The therapist should be active, warm and empathic. Cognitive behavioural therapy is structured and active. Between sessions, the patient receives homework assignments to complete. During therapy, information is collected by experiments and verification of hypotheses. It should be emphasized that for changes to occur in the process of psychotherapy it is necessary to establish a strong therapeutic alliance.
Bouman, T.K.; Visser, S.
Background: This study investigates the feasibility and effectiveness of time-limited treatment protocols based upon cognitive and behavioural interventions. Method: Seventeen patients with DSM-IV diagnoses of hypochondriasis were offered 12 1-hour sessions of either 'pure' cognitive or 'pure'
Full Text Available Suicidal behaviour is a consequence of simultaneous influences of many factors. Basically it can be regarded as a consequence of an interplay of two risk factors, namely genetic and environmental, which express themselves in the form of sociological, biological and psychological factors. It is difficult to find a theory of suicidal behaviour which would cover or consider all factors, and although present theories are overlapping, they emphasize different risk factors. More recent studies are focusing on neuropsychological and cognitive functioning of suicidal persons. The most cited psychological theory of suicidal behaviour is the Cry of Pain model which understands the suicidal behaviour as a consequence of a situation signaling defeat, entrapment and no rescue, which subsequently can lead to feelings of hopelessness. The psychobiological theory of two vulnerability components of sucidal behaviour extends existing psychological theories and helps to understand why some persons with depressive disorder engage in suicidal behaviour and the other don't. Both theories imply impaired cognitive abilities in suicidal persons. It is still not entirely understood if these cognitive impairments can be regarded as a state or a trait feature. What happens with cognitive functions after the initial crisis is over, explains the Theory of differential activation. The purpose of the present paper is to introduce and combine these theories and discuss their practical implications.
Lillo, Patricia; Hodges, John R
Motor neurone disease has traditionally been considered a pure motor syndrome which spares aspects of cognition and behaviour, although in recent years it has been suggested that up to 50% of patients with motor neurone disease may develop frontal dysfunction which, in some cases, is severe enough to reach criteria for frontotemporal dementia. We review the cognitive and behavioural changes in motor neurone disease emphasizing the recent advances. A major advance in pathology has been the recent discovery of TDP-43 and FUS inclusions as the key components in cases of motor neurone disease, frontotemporal dementia-motor neurone disease and some cases with pure frontotemporal dementia. In addition, mutations in TARDBP and FUS genes have been reported in recent years. Longitudinal studies showed that progression of cognitive impairment over the course of motor neurone disease appears to be mild and occurs only in a proportion of motor neurone disease patients. The presence of cognitive impairment seems to be related to a faster disease and a shorter survival. Motor neurone disease is a multi-system disorder which overlaps with frontotemporal dementia. Behavioural and cognitive changes appear to occur in a subset of patients with motor neurone disease, but the cause of this variability remains unclear.
Kootker, Joyce A; Rasquin, Sascha M C; Smits, Peter; Geurts, Alexander C; van Heugten, Caroline M; Fasotti, Luciano
Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. This intervention was based on cognitive behavioural therapy principles and was shown feasible in a pilot study. In order to meet the specific needs of stroke patients (concerning both sensori-motor, cognitive, and behavioural problems), we incorporated motivational interviewing, grief resolution, and psycho-education. We emphasised for each session to take into account the cognitive deficits of the patients (i.e. be concrete, accessible, structured, specific, and repeat information). Moreover, we augmented the psychologist-administered therapy with the contribution of an occupational or movement therapist aimed at facilitating patients' goal-setting and attainment. The intervention consisted of 12 one-hour sessions with a psychologist and three or four one-hour sessions with an occupational or movement therapist. Currently, the effectiveness of the intervention is evaluated in a randomised controlled trial. The proposed psychological treatment protocol is innovative, as it applies cognitive behavioural therapy in a stroke-specific manner; moreover, it supports goal attainment by incorporating occupational or movement therapy sessions. © The Author(s) 2014.
, SD = 4.56; t = 2.17, p < .05). The modified Cognitive Behaviour Therapy employed in the study may be helpful in reversing this trend. Keywords: Eating disorders, Anorexia nervosa, Bulimia nervosa, Obesity, Cognitive Behaviour therapy ...
w h at their symptoms are n o t —. CBT invo l ves a collaborat i ve. e f f o rt to find explanations of. w h at their symptoms a r e. • A l l ow the patient to remain sceptical of altern at i ve explana- tions until they have sound evi- dence to support them. Symptom. Cognition. Emotion. Physical. Behaviour. Fatigue. Effort will make.
Newby, Jill M; Smith, Jessica; Uppal, Shivani; Mason, Elizabeth; Mahoney, Alison E J; Andrews, Gavin
To examine the efficacy of an Internet-delivered cognitive-behavioral therapy (iCBT) program for health anxiety compared to an active psychoeducation control group. Individuals (N = 86, mean age: 30 years, 87% female) with a Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnosis of illness anxiety disorder or somatic symptom disorder with health anxiety were randomized to either a 6-lesson clinician-guided iCBT program for health anxiety (n = 45) or an active control group who received anxiety psychoeducation, clinical support, and monitoring (control, n = 41) over a 12-week period. Both groups experienced significant improvements between baseline and posttreatment on self-report measures of health anxiety, depression, general anxiety, and functional impairment. Intention-to-treat analyses indicated that the iCBT group experienced greater improvements in health anxiety on the Short Health Anxiety Inventory (SHAI) compared to controls (between-groups effect size = 1.39, 95% confidence interval [0.87, 1.93]), and a greater proportion of the iCBT group showed clinically reliable change on the SHAI (84% vs. 34% in the control group). Similarly, the iCBT group outperformed the control group on secondary measures of depression, generalized anxiety, functional impairment, maladaptive cognitions, body hypervigilance, safety behaviors and avoidance, and intolerance of uncertainty. Gains were maintained at 3-month follow-up in the iCBT group. iCBT for health anxiety is more effective than psychoeducation, clinical support, and monitoring, and presents an efficacious and accessible treatment option for people with health anxiety. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Ruttledge, Richard A.; Petrides, K. V.
Cognitive behavioural approaches emphasize the links between thoughts, feelings and behaviour (Greig, 2007). Previous research has indicated that these approaches are efficacious in reducing disruptive behaviour in adolescents. The aim of the current study was to provide further evaluation of cognitive behavioural group work to reduce disruptive…
Gräff, Johannes; Mansuy, Isabelle M
The epigenetic marking of chromatin provides a ubiquitous means for cells to shape and maintain their identity, and to react to environmental stimuli via specific remodeling. Such an epigenetic code of the core components of chromatin, DNA and histone proteins, can thus be stable but is also highly dynamic. In the nervous system, epigenetic codes are critical for basic cellular processes such as synaptic plasticity, and for complex behaviours such as learning and memory. At the same time, epigenetic marks can be stably transmitted through mitosis and meiosis, and thereby underlie non-genomic transgenerational inheritance of behavioural traits. In this review, we describe recent findings on the role and mechanisms of epigenetic codes in the brain, and discuss their implication in synaptic plasticity, cognitive functions and psychiatric disorders. We provide examples of transgenerational inheritance of epigenetic marks that affect simple morphological traits or complex processes such as disease susceptibility, and point to the potential implication of epigenetic codes in medicine and evolution.
Robles Bayón, A; Gude Sampedro, F
Behavioural and psychiatric symptoms (BPS) are frequent in neurological patients, contribute to disability, and decrease quality of life. We recorded BPS prevalence and type, as well as any associations with specific diagnoses, brain regions, and treatments, in consecutive outpatients examined in a cognitive neurology clinic. A retrospective analysis of 843 consecutive patients was performed, including a review of BPS, diagnosis, sensory impairment, lesion topography (neuroimaging), and treatment. The total sample was considered, and the cognitive impairment (CI) group (n=607) was compared to the non-CI group. BPS was present in 59.9% of the patients (61.3% in the CI group, 56.4% in the non-CI group). One BPS was present in 31.1%, two in 17.4%, and three or more in 11.4%. BPS, especially depression and anxiety, are more frequent in women than in men. Psychotic and behavioural symptoms predominate in subjects aged 65 and older, and anxiety in those younger than 65. Psychotic symptoms appear more often in patients with sensory impairment. Psychotic and behavioural symptoms are more prevalent in patients with degenerative dementia; depression and anxiety in those who suffer a psychiatric disease or adverse effects of substances; emotional lability in individuals with a metabolic or hormonal disorder; hypochondria in those with a pain syndrome; and irritability in subjects with chronic hypoxia. Behavioural symptoms are more frequent in patients with anomalies in the frontal or right temporal or parietal lobes, and antipsychotics constitute the first line of treatment. Leaving standard treatments aside, associations were observed between dysthymia and opioid analgesics, betahistine and statins, and between psychotic symptoms and levodopa, piracetam, and vasodilators. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
Kellett, Stephen; Bolton, Jessica V
Compulsive buying (CB) has only relatively recently become a topic of interest for researchers and clinicians alike. This hiatus means that (unlike other impulse control disorders) there is currently little theoretical guidance for clinicians attempting to intervene with CB clients and no established model for researchers to evaluate, distil and refine. The current paper summarizes and organizes the main extant identified factors in the CB literature into four distinct phases: (1) antecedents; (2) internal/external triggers; (3) the act of buying; and finally, (4) post-purchase. The relationships and interactions between the identified phases are then hypothesized, within the proposed cognitive-behavioural model. The model distinguishes the key cognitive, affective and behavioural factors within each phase and identifies how CB can become self-reinforcing over time. The over-arching treatment implication is that CB can be re-conceptualized as chronic and repetitive failure in self-regulation efforts, and that psychological interventions can accommodate this in attempting to facilitate change. A successful case example is provided of a 'co-dependent compulsive buyer' using the model, with psychometric evaluation of key aspects of CB and mental health at assessment, termination and 6-month follow-up. The research and clinical implications of the proposed model are discussed, alongside identified short-comings and the need for psychological services to respond appropriately to CB clients seeking help.
Kellett, Stephen; Purdie, Fiona; Bickerstaffe, Darren; Hopper, Sophie; Scott, Sarah
The aim of this study was to identify predictors of return to work in the short and long term following condition management cognitive-behavioural therapy (CM-CBT). All participants (N=3794) were disability welfare claimants, unemployed due to the presence of a physical or mental health condition. CM-CBT consisted of a seven session group cognitive-behavioural psychoeducational programme, with participants followed-up at 3 and 12-30 months. The primary employment outcome measure was a categorical measure of either returned to work, made progress towards work or remained on welfare. Results index an incremental progress and return to work rate, increasing from 34.41% at short-term follow-up to 53.07% at long-term follow-up. Clinically, 17.40% were classed as recovered following CM-CBT. Reliable psychological change during CM-CBT predicted successful return to work and remaining on welfare was associated with psychological regression over time. The results are discussed in terms of identified methodological weaknesses and the potential of CBT in enabling return to work for the health related unemployed. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.
Paxling, Björn; Lundgren, Susanne; Norman, Anita; Almlöv, Jonas; Carlbring, Per; Cuijpers, Pim; Andersson, Gerhard
Internet-delivered cognitive behaviour therapy (iCBT) has been found to be an effective way to disseminate psychological treatment, and support given by a therapist seems to be important in order to achieve good outcomes. Little is known about what the therapists actually do when they provide support in iCBT and whether their behaviour influences treatment outcome. This study addressed the content of therapist e-mails in guided iCBT for generalized anxiety disorder. We examined 490 e-mails from three therapists providing support to 44 patients who participated in a controlled trial on iCBT for generalized anxiety disorder. Through content analysis of the written correspondence, eight distinguishable therapist behaviours were derived: deadline flexibility, task reinforcement, alliance bolstering, task prompting, psychoeducation, self-disclosure, self-efficacy shaping, and empathetic utterances. We found that task reinforcement, task prompting, self-efficacy shaping and empathetic utterances correlated with module completion. Deadline flexibility was negatively associated with outcome and task reinforcement positively correlated with changes on the Penn State Worry Questionnaire. Different types of therapist behaviours can be identified in iCBT, and though many of these behaviours are correlated to each other, different behaviours have an impact on change in symptoms and module completion.
Schneider, Luke H; Hadjistavropoulos, Heather D; Faller, Y Nichole
A previous study of therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) for generalized anxiety (Paxling et al., 2013) identified eight distinct therapist behaviours in ICBT (task reinforcement, self-efficacy shaping, task prompting, alliance bolstering, psychoeducation, empathetic utterances, deadline flexibility, and self-disclosure). It is unknown how generalizable these behaviours are across ICBT programs. We systematically examined the frequency of these eight therapist behaviours and additional newly identified behaviours in e-mails sent to patients during the course of ICBT for depressive symptoms. We also conducted exploratory analyses to examine relationships between therapist behaviours, symptom improvement, and therapeutic alliance. Data was obtained from a previously published open trial (Hadjistavropoulos et al., 2014). A total of 1013 e-mails sent from therapists (n = 24) to patients (n = 41) during ICBT for depressive symptoms were analyzed. Therapist behaviours were correlated with symptom change scores and ratings of therapeutic alliance at mid- and post-treatment. Therapist behaviours described by Paxling et al. were reliably identified in the e-mails using qualitative content analysis; the frequencies of these behaviours differed, however, from the Paxling et al. study and three additional therapist behaviours were identified (administrative statements, questionnaire feedback, asking clarifying questions). Several therapist behaviours (e.g. administrative statements, task prompting) were associated with lower symptom improvement at post-treatment. Questionnaire feedback and task reinforcement were associated with higher patient ratings of therapeutic alliance. The study provides partial support for the generalizability of therapist-assistance across ICBT programs. Experimental research is needed to examine the impact of varying therapist-assistance on patient outcomes.
P. De Maricourt; Gorwood, P.; Th. Hergueta; Galinowski, A.; Salamon, R; Diallo, A.; Vaugeois, C.; Lépine, J P; J. P. Olié; O. Dubois
Benzodiazepines should be prescribed on a short-term basis, but a significant proportion of patients (%) use them for more than 6 months, constituting a serious public health issue. Indeed, few strategies are effective in helping patients to discontinue long-term benzodiazepine treatments. The aim of this study was to assess the feasibility and the impact of a program including cognitive behavioural therapy, psychoeducation, and balneotherapy in a spa resort to facilitate long-term discontinu...
The evidence base for cognitive behaviour therapy (CBT)1 and other psychotherapeutic interventions in child and adolescent populations in low to middle income countries such as in South Africa is almost non-existent. In this review we explored the transportability of cognitive behaviour therapy interventions into the South ...
Hvenegaard, Morten; Watkins, Ed R; Poulsen, Stig
Scale for Depression) at completion of treatment. Secondary outcomes will be level of rumination, worry, anxiety, quality of life, behavioural activation, experimental measures of cognitive flexibility, and emotional attentional bias. A 6-month follow-up is planned and will include the primary outcome......BACKGROUND: Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients...... present with residual symptoms by the end of treatment. A common residual symptom is rumination, a process of recurrent negative thinking and dwelling on negative affect. Rumination has been demonstrated as a major factor in vulnerability to depression, predicting the onset, severity, and duration...
Carlijn de Roos
Full Text Available Background : Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations. Objective : The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT and Eye Movement Desensitisation and Reprocessing (EMDR. Design : Children (n=52, aged 4–18 were randomly allocated to either CBT (n=26 or EMDR (n=26 in a disaster mental health after-care setting after an explosion of a fireworks factory. All children received up to four individual treatment sessions over a 4–8 week period along with up to four sessions of parent guidance. Blind assessment took place pre- and post-treatment and at 3 months follow-up on a variety of parent-rated and self-report measures of post-traumatic stress disorder symptomatology, depression, anxiety, and behaviour problems. Analyses of variance (general linear model repeated measures were conducted on the intention-to-treat sample and the completers. Results : Both treatment approaches produced significant reductions on all measures and results were maintained at follow-up. Treatment gains of EMDR were reached in fewer sessions. Conclusion : Standardised CBT and EMDR interventions can significantly improve functioning of disaster-exposed children.For the abstract in other languages, please see Supplementary files under Reading Tools online
Griffith-Lendering, Merel Frederique Heleen
During early adolescence, there is no association between internalizing behaviour and cannabis use. There is an association between externalizing behaviour and cannabis use, where externalizing behaviour precedes cannabis use rather than the other way around. Secondly, during adolescence, there is
Poppes, P.; van der Putten, A.; Post, W.; Frans, N.; ten Brug, A.; van Es, A.; Vlaskamp, C.
Background: Prevalence rates of challenging behaviour are high in children and adults with profound intellectual and multiple disabilities (PIMD). Moreover, many of these behaviours are observed daily. Direct support staff report that most challenging behaviour identified has little impact on the person with PIMD and attribute challenging…
Talarska, Dorota; Steinborn, Barbara; Michalak, Michał
Cognitive functioning and behaviour of chronically ill children are affected by many factors, including anxiety due to hospitalization, persistent symptoms of sickness and adverse side effects of medications. The aim of this work was to seek out parents' opinion concerning cognitive functioning and behaviour of children with epilepsy. The study comprised 156 children with epilepsy aged 7-18 and treated in the Department of Developmental Neurology at Karol Marcinkowski Poznan University of Medical Sciences and in an outpatient clinic. The research tool used was the questionnaire Quality of Life in Childhood Epilepsy (QOLCE) completed by parents. Assessment of cognitive functioning and behaviour was based on the analysis of the areas V (cognitive processes) and VII (behaviour). Parents assessed children's functioning in the areas of cognitive processes and behaviour at a similar level - 55 points. In the area of cognitive processes, concentration while performing some tasks and reading was assessed as the worst. A significant difference in caregivers' assessment was found according to age, frequency of seizures and duration of disease. In the area analysing the child's behaviour, parents indicated getting angry easily and not being upset by other people's opinions. The display of aggression towards others got the lowest number of comments. The children's functioning was assessed by parents as rather poor in both analysed areas. Parents of children treated with polytherapy noticed more difficulties in cognitive functioning and behaviour than parents of children treated with one medication.
Bizarre repetitive behaviour may be quite common, with estimates in people and dogs of a prevalence of up to 8%. Whereas these are often considered important indicators of mental health problems in people, in companion animals, many owners view these behaviours as "quirky" or even amusing features of their pet. However, the absence of self-report also means that the array of repetitive behaviour conditions in companion animals is also much more diverse than in humans and there is a danger of ...
Pedestrian behaviour simulation models are being developed with the intention to simulate human behaviour in various environments in both non-emergency and emergency situations. These models are applied with the objective to understand the underlying causes and dynamics of pedestrian behaviour and how the environment or the environment’s intrinsic procedures can be adjusted in order to provide an improvement of human comfort and safety.\\ud \\ud In order to realistically model pedestrian behavi...
Sherry, David F; Strang, Caroline G
Bumblebees and honeybees have been the subjects of a great deal of recent research in animal cognition. Many of the major topics in cognition, including memory, attention, concept learning, numerosity, spatial cognition, timing, social learning, and metacognition have been examined in bumblebees, honeybees, or both. Although bumblebees and honeybees are very closely related, they also differ in important ways, including social organization, development, and foraging behaviour. We examine whether differences between bumblebees and honeybees in cognitive processes are related to differences in their natural history and behaviour. There are differences in some cognitive traits, such as serial reversal learning and matching-to-sample, that appear related to differences between bumblebees and honeybees in foraging and social behaviour. Other cognitive processes, such as numerosity, appear to be very similar. Despite the wealth of information that is available on some aspects of bumblebee and honeybee cognition and behaviour, there are relatively few instances, however, in which adequate data exist to make direct comparisons. We highlight a number of phenomena, including concept learning, spatial cognition, timing, and metacognition, for which targeted comparative research may reveal unexpected adaptive variation in cognitive processes in these complex animals. This article is part of a Special Issue entitled: In Honor of Jerry Hogan. Copyright © 2014 Elsevier B.V. All rights reserved.
The main purpose of this dissertation was to highlight and address seven challenges related to the measurement of youth cognition, understanding the role of cognitive constructs in anxiety and school refusal, and the examination of cognitive mediators of cognitive-behavioural treatment outcomes. The
Full Text Available Research investigating cognition and behaviour in Sotos syndrome has been sporadic and to date, there is no published overview of study findings.A systematic review of all published literature (1964-2015 presenting empirical data on cognition and behaviour in Sotos syndrome. Thirty four journal articles met inclusion criteria. Within this literature, data relating to cognition and/or behaviour in 247 individuals with a diagnosis of Sotos syndrome were reported. Ten papers reported group data on cognition and/or behaviour. The remaining papers employed a case study design.Intelligence quotient (IQ scores were reported in twenty five studies. Intellectual disability (IQ < 70 or borderline intellectual functioning (IQ 70-84 was present in the vast majority of individuals with Sotos syndrome. Seven studies reported performance on subscales of intelligence tests. Data from these studies indicate that verbal IQ scores are consistently higher than performance IQ scores. Fourteen papers provided data on behavioural features of individuals with Sotos syndrome. Key themes that emerged in the behavioural literature were overlap with ASD, ADHD, anxiety and high prevalence of aggression/tantrums.Although a range of studies have provided insight into cognition and behaviour in Sotos syndrome, specific profiles have not yet been fully specified. Recommendations for future research are provided.
Maczka, Grzegorz; Grabski, Bartosz; Gierowski, Józef Krzysztof; Dudek, Dominika
To share our experience in introducing an original, structured group psychoeducational programme entitled "Familiarizing bipolar disorder" into the integrated complex treatment of bipolar disorder (BP). The programme is partially based on the Barcelona Bipolar Disorders Program format and represents our proposal of a short, easily applied group psychoeducation. It consists of 8 meetings, conducted by a psychiatrist and a psychologist who are both trained in cognitive-behavioural therapy. Two groups of patients accomplished the programme so far. We would like to present our conclusions and qualitative observations. The patients noticed a change in a philosophical view on the bipolar disorder treatment (access to information, partnership between a doctor and a patient, appreciation of psychological aspects of bipolar illness), which is embodied by the psychoeducational approach. They welcomed our programme with enthusiasm and interest. Many questions were asked about different aspects of bipolar disorder, especially concerning pharmacotherapy, genetic and legal issues. Our participants assessed the number of sessions as optimal, but some of them insisted on devoting one more meeting to interactively discuss pharmacotherapy of BP. The programme revealed many other relevant issues concerning patients' attitudes toward bipolar disorder like: common presence of dysfunctional beliefs patients hold regarding their illness, unawareness of importance of mood stabilizer serum level examination, insufficient knowledge on hypomania or--in some cases--ignorance of a hypomania phenomenon. Moreover, patients appreciated the fact that the psychoeducational programme helped them to diminish the sense of stigma, shame, and the feeling of being different or worse. Finally we are amazingly impressed by the unsatisfied need existing in bipolar patients to share their fears, emotions and to be fully informed. Our observations support the statement, that the psychoeducational approach to
Hvenegaard, Morten; Watkins, Ed R; Poulsen, Stig; Rosenberg, Nicole K; Gondan, Matthias; Grafton, Ben; Austin, Stephen F; Howard, Henriette; Moeller, Stine B
Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients present with residual symptoms by the end of treatment. A common residual symptom is rumination, a process of recurrent negative thinking and dwelling on negative affect. Rumination has been demonstrated as a major factor in vulnerability to depression, predicting the onset, severity, and duration of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more effective in treating depression and reducing relapse than standard cognitive behavioural therapy. This study is a two-arm pragmatic randomised controlled superiority trial comparing the effectiveness of group-based rumination-focused cognitive behaviour therapy with the effectiveness of group-based cognitive behavioural therapy for treatment of depression. One hundred twenty-eight patients with depression will be recruited from and given treatment in an outpatient service at a psychiatric hospital in Denmark. Our primary outcome will be severity of depressive symptoms (Hamilton Rating Scale for Depression) at completion of treatment. Secondary outcomes will be level of rumination, worry, anxiety, quality of life, behavioural activation, experimental measures of cognitive flexibility, and emotional attentional bias. A 6-month follow-up is planned and will include the primary outcome measure and assessment of relapse. The clinical outcome of this trial may guide clinicians to decide on the merits of including rumination-focused cognitive behavioural therapy in the treatment of depression in
David eSmailes; Ben eAlderson-Day; Charles eFernyhough; Simon eMcCarthy-Jones; Guy eDodgson
Cognitive behavioural therapy (CBT) for voice-hearing (i.e., auditory verbal hallucinations; AVH) has, at best, small-to-moderate effects. One possible reason for this limited efficacy is that current CBT approaches tend to conceptualise voice-hearing as a homogenous experience in terms of the cognitive processes involved in AVH. However, the highly heterogeneous nature of voice-hearing suggests that many different cognitive processes may be involved in the etiology of AVH. These heterogeneou...
Prasko, Jan; Vyskocilová, Jana; Mozny, Petr; Novotny, Miroslav; Slepecky, Milos
For cognitive behavioural therapy, acquisition and maintenance of psychotherapeutic and supervisory competencies is crucial. The PubMed, Web of Science and Scopus databases were searched for articles containing the following keywords: cognitive-behavioural therapy, competencies, therapeutic relationship, intervention, technique, training, supervision, self-reflection, empirically supported, transference, countertransference, scheme of therapy, dialectical behaviour therapy. The search was performed by repeating the words in different combinations with no language or time limitations. The articles were sorted and key articles listed in reference lists were searched. In addition, original texts by A.T. Beck, J. Beck, C. Padesky, M. Linehan, R. Leahy, J. Young, W. Kuyken and others were used. The resources were confronted with our own psychotherapeutic and supervisory experiences and only most relevant information was included in the text. Thus, the article is a review with conclusions concerned with competencies in cognitive behavioural therapy. For cognitive behavioural therapy, four domains of competencies in psychotherapy are crucial - relationship, case assessment and conceptualization, self-reflection and intervention. These may be divided into foundational, specific and supervisory. The foundational competencies include recognition of empirical basis for a clinical approach, good interpersonal skills, ability to establish and maintain the therapeutic relationship, self-reflection, sensitivity to a difference and ethical behaviour. The specific competencies involve the skill of case conceptualization in terms of maladaptive beliefs and patterns of behaviour, ability to think scientifically and teach this to the patient, structure therapy and sessions, assign and check homework, etc. The supervisor's competencies include multiple responsibilities in supporting the supervisee, identification and processing of the therapist's problems with the patient, continuous
Zapata Ospina, Juan Pablo; Rangel Martínez-Villalba, Andrés Mauricio; García Valencia, Jenny
The treatment of schizophrenia includes the use of psychotropic drugs, psychotherapy, and psychosocial interventions that include psychoeducation. This strategy has been defined as the delivery of information about the disorder and its treatment in a systematic and structured way. To review the literature on the efficacy of psychoeducation in schizophrenia. A search in PubMed, SciELO, EMBASE and PsycINFO was made with the terms "psychoeducation", "schizophrenia" and "psychosocial intervention". Articles in Spanish and English language were reviewed. Psychoeducation can be applied to patients, family or both, and individually or in groups. The number of sessions can vary. There have been many studies that seek to determine the efficacy of psychoeducation in the clinical course, family dynamics and stigma, with results that favor its implementation, but so far it has not been possible to determine exactly how best to apply psychoeducation, mainly because of the great variability of designs. The studies on psychoeducation have shown efficacy. However, this might be an overestimation, as there is a high risk of bias. Consequently, there is not enough evidence. At least for now, it is reasonable to complement pharmacotherapy with psycoeducation. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Most evaluations of cognitive behavioural therapy to treat people with chronic fatigue syndrome/myalgic encephalomyelitis rely exclusively on subjective self-report outcomes to evaluate whether treatment is effective. Few studies have used measures appropriate to assessing whether cognitive behavioural therapy changes in more objective measures. A review of studies incorporating objective measures suggests that there is a lack of evidence that cognitive behavioural therapy produces any improvement in a patient's physical capabilities or other objective measures such as return to work. Future studies of chronic fatigue syndrome/myalgic encephalomyelitis should include some objective assessments as primary outcomes. If this is to include activity monitors, we first need a sound baseline dataset.
Reinholt, Nina; Krogh, Jesper
Transdiagnostic approaches to cognitive behaviour therapy (TCBT) of anxiety disorders have drawn increasing interest and empirical testing over the past decade. In this paper, we review evidence of the overall efficacy of TCBT for anxiety disorders, as well as TCBT efficacy compared with wait......-list, treatment-as-usual, and diagnosis-specific cognitive behaviour therapy (CBT) controls. A total of 11 studies reporting 12 trials (n = 1933) were included in the systematic review. Results from the meta-analysis of 11 trials suggest that TCBT was generally associated with positive outcome; TCBT patients did...
Abraham, Charles; Sheeran, Paschal; Henderson, Marion
A cross-sectional study assessed the extent to which indices of social structure, including family socio-economic status (SES), social deprivation, gender and educational/lifestyle aspirations correlated with adolescent condom use and added to the predictive utility of a theory of planned behaviour model. Analyses of survey data from 824 sexually…
Full Text Available The aim of this review paper is to show an overview of the empirical evidence of effectiveness of cognitive behavioral therapy (CBT in reducing suicidal cognitions and suicidal behavior. The topic of suicidal cognition and suicidal behavior is of special importance to clinicians and practitioners. Analyses of empirical findings from the oldest, first systematic review and meta-analysis and the newest one shown that there not enough evidence from clinical trials to suggest that CBT focusing on mental illness reduces suicidal cognitions and behaviors. But, from the other hand, CBT focusing on suicidal cognitions and suicidal behaviors was found to be effective. Taking into consideration the effectiveness of this psychotherapy, we can conclude that it is preferable for clinicians to be trained in working with CBT techniques focused on suicidal cognition and behavior that are independent of treatment of mental disorders. In addition, it is necessary to initiate new research that will make it possible to create preventive and interventional programs dedicated to reducing the risk of suicide.
Vico Chung Lim Chiang
Full Text Available Having a loved one in the intensive care unit (ICU is a stressful event, which may cause a high level of anxiety to the family members. This could threaten their wellbeing and ability to support the patients in, or after discharge from, the ICU. To investigate the outcomes of a brief cognitive-behavioral psycho-education program (B-CBE to manage stress and anxiety of the main family caregivers (MFCs, a pragmatic quasi-experimental study involving 45 participants (treatment group: 24; control group: 21 was conducted in an ICU. The Depression and Anxiety Stress Scale and the Critical Care Family Need Inventory were used to evaluate the primary outcomes on stress and anxiety, and satisfaction with family needs. The treatment group reported significantly better improvement in the information satisfaction score compared to the control group (p < 0.05; η2 = 0.09. Overall main effects were observed on the stress (p < 0.01; η2 = 0.20, anxiety (p < 0.01; η2 = 0.18, depression (p < 0.05; η2 = 0.13, support satisfaction (p < 0.05; η2 = 0.13, and comfort satisfaction (p < 0.05; η2 = 0.11 scores. The experience of this study suggest that MFCs are in great need of additional support like B-CBE to manage their stress and anxiety. Given the brevity of B-CBE, it is practical for critical care nurses to deliver and MFCs to take within the industrious context of an ICU. More studies are needed to investigate these types of brief psychological interventions.
Shirotsuki, Kentaro; Nonaka, Yuji; Abe, Keiichi; Adachi, So-Ichiro; Adachi, Shohei; Kuboki, Tomifusa; Nakao, Mutsuhiro
Computerized cognitive behaviour therapy (CCBT) programs can provide a useful self-help approach to the treatment of psychological problems. Previous studies have shown that CCBT has moderate effects on depression, insomnia, and anxiety. The present study investigated whether a supplement drink that includes L-carnosine enhances the effect of CCBT on psychological well-being. Eighty-seven participants were randomly allocated to a control group, CCBT, or CCBT with supplement drink. The CCBT and CCBT with supplement drink groups received six weekly self-help CCBT program instalments, which consisted of psycho-education about stress management and coping, behaviour activation, and cognitive restructuring. The CCBT group consumed a bottle of the supplement soft drink every morning through the 6 weeks. This program was delivered by an e-learning system on demand and also included a self-help guidebook. Seventy-two participants completed the program or were assess at the end of the study. ANOVA revealed that there were significant interactions (times × groups) for POMS tension-anxiety and fatigue. The CCBT group showed significantly improved tension-anxiety scores, whereas the CCBT with drink group showed significant improvements on fatigue. The self-help CCBT program reduced the subjective experience of tension-anxiety in this group of workers. The addition of a supplement drink enhanced the effect of CCBT on fatigue, providing one possible approach to enhancement of such programs. This study was registered on September 2, 2016 at UMIN. The registration number is UMIN000023903.
The study investigated the effect of Reality Therapy and Cognitive Coping Behaviour Training and their combination in handling psychological adjustment problems of the empty nesters after retirement. The study adopted the pre-test, posttest, control group, quasi experimental design using a 4x2 factorial matrix.
Flynn, Sarah M.
A young woman initiated counselling services at a community agency to address her explosive anger that was a remnant of childhood physical and emotional abuse. Sensorimotor psychotherapy was used to help this client learn how to monitor and regulate her sensorimotor processes. In conjunction with this approach, Cognitive behavioural therapy was…
This thesis describes the outcomes of a randomized controlled trial of a Cognitive Behavioural Therapy (CBT) intervention for patients who engage in Deliberate Self-Harm (DSH). The CBT intervention was designed to supplement usual care following an episode of DSH. The study involved 90 people (95%
This study investigated the effects of Cognitive Behaviour Therapy and Social Learning Therapy on adolescents' aggressiveness among senior secondary students in Lagos Metropolis. It used the quasi-experimental pretest-posttest control group design. The participants were one hundred and fifty-four adolescents ...
This study focused on applying counselling models in managing adolescent psycho-social crisis. A laboratory approach using a simulated problem situation to determine the effectiveness of Cognitive-behavioural counselling model in managing psycho-social crisis and propensity to drug-abuse in adolescents was adopted ...
Jonsson, H.; Kristensen, M.; Arendt, M.
Despite promising results from intensive formats of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) the format is rarely used. The aim of the study was to systematically review the literature within this area of research and provide a meta-analysis of the effectiveness...
Full Text Available Penelitian ini merupakan penelitian pra-eksperimen yang bertujuan menguji pengaruhterapi Cognitive Behaviour Therapy (CBT untuk meningkatkan kesejahteraan psikologis pada remaja gay. Hasil penelitian menunjukkan bahwa ada pengaruh CBTuntuk meningkatkan kesejahteraan psikologis. Kedua subjek mengalami perubahan pada tingkat kesejahteraan psikologis dari rendah menjadi sedang, yang menunjukkan subjek mengalami peningkatan pada kesejahteraan psikologisnya.
Gøtzsche, Peter C; Gøtzsche, Pernille K
is excluded, the risk ratio becomes 0.61 (0.46-0.80) and the heterogeneity in the results disappears (I(2 )= 0%). Conclusions Cognitive behavioural therapy reduces not only repeated self-harm but also repeated suicide attempts. It should be the preferred treatment for all patients with depression....
Buwalda, Femke M.; Bouman, Theo K.
Aims: The present study aims to determine whether cognitive-behavioural minimal contact bibliotherapy is acceptable to participants suffering from DSM-IV-TR hypochondriasis, and whether this intervention is able to reduce hypochondriacal complaints, as well as comorbid depressive complaints and
Conradi, H.J.; de Jonge, P.; Ormel, J.
We examined in a primary care sample whether acute-phase cognitive-behavioural therapy (CBT) would be more effective than usual care for patients with multiple prior episodes of depression. Depression outcome was based on a 3-monthly administered Beck Depression Inventory (BDI) during a 2-year
Dumontheil, Iroise; Burgess, Paul W.; Blakemore, Sarah-Jayne
Information on the development and functions of rostral prefrontal cortex (PFC), or Brodmann area 10, has been gathered from different fields, from anatomical development to functional neuroimaging in adults, and put forward in relation to three particular cognitive and behavioural disorders. Rostral PFC is larger and has a lower cell density in…
Knoop, H.; Kessel, K. van; Moss-Morris, R.
BACKGROUND: Chronic fatigue is a common symptom of multiple sclerosis (MS). A randomized controlled trial (RCT) showed that cognitive behavioural therapy (CBT) was more effective in reducing MS fatigue than relaxation training (RT). The aim of the current study was to analyse additional data from
Auty, Katherine Mary; Cope, A; Liebling, A
Institutional violence presents significant challenges to the accomplishment of legitimate social order in prison. This systematic review examines the effect of psychoeducational programs on violent behaviour in prison. Comprehensive searches of the empirical research literature were conducted to identify randomized and non-randomized studies carried out in the last two decades (1996–2016) that compared psychoeducational programs with treatment as usual (TAU). The content of programs was anal...
Blundell, John; Gumaste, Deepa; Handley, Rowena; Dye, Louise
There is a rapidly growing interest in the scientific study of the effects of foods on psychological processes involved in the control of behaviour (performance) and cognitive functions such as memory, perception, attention and vigilance. This study forms part of innovative research on functional foods, which provides an active arena for collaboration between researchers in universities, institutes and industry. Research outputs will inform legislation currently being drawn up in Europe. This...
Christensen, Hans Peter
Many educationists recommend that learning objectives should be given in a behaviouristic way with directly observable actions. At the same time cognitive constructivism seems to be the preferred theory within the engineering educational community. There is no conflict in using a behavioural...... approach to assess final competences in a constructivist setting, but during an education we should evaluate the progress of the student’s learning. One way could be to look at the student’s errors....
Buwalda, Femke M; Bouman, Theo K
The present study aims to determine whether cognitive-behavioural minimal contact bibliotherapy is acceptable to participants suffering from DSM-IV-TR hypochondriasis, and whether this intervention is able to reduce hypochondriacal complaints, as well as comorbid depressive complaints and trait anxiety. Participants were assigned to either an immediate treatment condition, or subsequently to a waiting list condition. Participants were sent a book, Doctor, I Hope it's Nothing Serious?, containing cognitive behavioural theory and exercises. Measures were taken pre, post and at follow-up (after 3 months). Those in the waiting list group received a second pre-assessment, and were then enrolled in the bibliotherapy. Results showed that participants were accepting of the cognitive-behavioural theory. Furthermore, results showed beneficial effects of the intervention: all effect measures decreased significantly over time, with the largest effect at post-assessment. However, a large amount of questionnaires were not returned. It is concluded that bibliotherapy may be an efficient aid in reducing hypochondriacal and comorbid complaints, but due to data attrition and methodological flaws should first be studied further.
Taylor, Alex H.; Elliffe, Douglas; Hunt, Gavin R.; Gray, Russell D.
Apes, corvids and parrots all show high rates of behavioural innovation in the wild. However, it is unclear whether this innovative behaviour is underpinned by cognition more complex than simple learning mechanisms. To investigate this question we presented New Caledonian crows with a novel three-stage metatool problem. The task involved three distinct stages: (i) obtaining a short stick by pulling up a string, (ii) using the short stick as a metatool to extract a long stick from a toolbox, and finally (iii) using the long stick to extract food from a hole. Crows with previous experience of the behaviours in stages 1–3 linked them into a novel sequence to solve the problem on the first trial. Crows with experience of only using string and tools to access food also successfully solved the problem. This innovative use of established behaviours in novel contexts was not based on resurgence, chaining and conditional reinforcement. Instead, the performance was consistent with the transfer of an abstract, causal rule: ‘out-of-reach objects can be accessed using a tool’. This suggests that high innovation rates in the wild may reflect complex cognitive abilities that supplement basic learning mechanisms. PMID:20410040
Richter, L M; Rose, C; Griesel, R D
The cognitive and behavioural effects of a school breakfast were explored in a study of 55 children in Grade II and Standard 1 at a farm school outside Johannesburg. A previous study had confirmed widespread undernutrition and micronutrient deficiencies among the children. For comparative purposes, 55 children at an inner-city school, among whom no signs of undernutrition were found, were assessed in the same way. Three different types of measures of attention, distractibility, short-term memory and activity level were used: psychometric testing of the children; teacher ratings of children's classroom behaviour, and coded video-recorded classroom behaviour. A pre- and post-test design was employed to assess the effects of a school breakfast, continually in place in the experimental school for a period of 6 weeks. The results indicated significant change from pre- to post-test assessment among the experimental children in respect of the psychometric measures, teacher-rated hyperactivity and video-recorded classroom behaviour. With regard to the latter measure, the children showed a decline in both the occurrence and duration of off-task and out-of-seat behaviour, and an increase in active participation in class and positive peer interaction. While the children in the comparison group also showed some changes from pre- to post-test, probably attributable to the effects of observation, familiarity with the test materials and developmental change, the changes were not generalised or consistent. The findings support the conclusion that a school breakfast programme had a beneficial effect on the cognitive and behavioural performance of socially disadvantaged, undernourished children in their first 2 years of school.
Xia, Jun; Merinder, Lars Bertil; Belgamwar, Madhvi R
Background Schizophrenia can be a severe and chronic illness characterised by lack of insight and poor compliance with treatment. Psychoeducational approaches have been developed to increase patients’ knowledge of, and insight into, their illness and its treatment. It is supposed that this increased knowledge and insight will enable people with schizophrenia to cope in a more effective way with their illness, thereby improving prognosis. Objectives To assess the effects of psychoeducational interventions compared with standard levels of knowledge provision. Search methods We searched the Cochrane Schizophrenia Group Trials Register (February 2010). We updated this search November 2012 and added 27 new trials to the awaiting assessment section. Selection criteria All relevant randomised controlled trials focusing on psychoeducation for schizophrenia and/or related serious mental illnesses involving individuals or groups. We excluded quasi-randomised trials. Data collection and analysis At least two review authors extracted data independently from included papers. We contacted authors of trials for additional and missing data. We calculated risk ratios (RR) and 95% confidence intervals (CI) of homogeneous dichotomous data. We used a fixed-effects model for heterogeneous dichotomous data. Where possible we also calculated the numbers needed to treat (NNT), as well as weighted means for continuous data. Main results This review includes a total of 5142 participants (mostly inpatients) from 44 trials conducted between 1988 and 2009 (median study duration ~ 12 weeks, risk of bias - moderate). We found that incidences of non-compliance were lower in the psychoeducation group in the short term (n = 1400, RR 0.52 CI 0.40 to 0.67, NNT 11 CI 9 to 16). This finding holds for the medium and long term. Relapse appeared to be lower in psychoeducation group (n = 1214, RR 0.70 CI 0.61 to 0.81, NNT 9 CI 7 to 14) and this also applied to readmission (n = 206, RR 0.71 CI 0.56 to 0
P. De Maricourt
Full Text Available Benzodiazepines should be prescribed on a short-term basis, but a significant proportion of patients (% use them for more than 6 months, constituting a serious public health issue. Indeed, few strategies are effective in helping patients to discontinue long-term benzodiazepine treatments. The aim of this study was to assess the feasibility and the impact of a program including cognitive behavioural therapy, psychoeducation, and balneotherapy in a spa resort to facilitate long-term discontinuation of benzodiazepines. We conducted a prospective multicentre cohort study. Patients with long-term benzodiazepine use were recruited with the aim of anxiolytic withdrawal by means of a psychoeducational program and daily balneotherapy during 3 weeks. The primary efficacy outcome measure was benzodiazepine use 6 months after the program, compared to use at baseline. A total of 70 subjects were enrolled. At 6 months, overall benzodiazepine intake had decreased by 75.3%, with 41.4% of patients completely stopping benzodiazepine use. The results also suggest a significantly greater improvement in anxiety and depression symptoms among patients who discontinued benzodiazepines compared to patients who only reduced their use. Our findings suggest that balneotherapy in association with a psychoeducative program is efficient in subjects with benzodiazepine addiction.
De Maricourt, P; Gorwood, P; Hergueta, Th; Galinowski, A; Salamon, R; Diallo, A; Vaugeois, C; Lépine, J P; Olié, J P; Dubois, O
Benzodiazepines should be prescribed on a short-term basis, but a significant proportion of patients (%) use them for more than 6 months, constituting a serious public health issue. Indeed, few strategies are effective in helping patients to discontinue long-term benzodiazepine treatments. The aim of this study was to assess the feasibility and the impact of a program including cognitive behavioural therapy, psychoeducation, and balneotherapy in a spa resort to facilitate long-term discontinuation of benzodiazepines. We conducted a prospective multicentre cohort study. Patients with long-term benzodiazepine use were recruited with the aim of anxiolytic withdrawal by means of a psychoeducational program and daily balneotherapy during 3 weeks. The primary efficacy outcome measure was benzodiazepine use 6 months after the program, compared to use at baseline. A total of 70 subjects were enrolled. At 6 months, overall benzodiazepine intake had decreased by 75.3%, with 41.4% of patients completely stopping benzodiazepine use. The results also suggest a significantly greater improvement in anxiety and depression symptoms among patients who discontinued benzodiazepines compared to patients who only reduced their use. Our findings suggest that balneotherapy in association with a psychoeducative program is efficient in subjects with benzodiazepine addiction.
Psychosocial approaches to the management of behavioural and psychological symptoms of dementia have received much support in the scientific literature. The following paper focuses on cognitive behaviour therapy as a valid framework in assessing and treating people with behavioural and psychological symptoms of dementia. The importance of identifying symptoms of depression and anxiety is emphasized, as cognitive behaviour therapy has been shown to be an effective intervention for these conditions in older adults. Modifications of cognitive behaviour therapy for those with dementia are discussed based on available evidence, with emphasis on incorporating nursing home staff in treatment programs and focusing on behavioural elements of cognitive behaviour therapy such as activity scheduling. The paper concludes with suggestions regarding how to incorporate and promote the use of cognitive behaviour therapy in dementia care settings.
Prasko, Jan; Mozny, Petr; Novotny, Miroslav; Slepecky, Milos; Vyskocilova, Jana
Supervision is a basic part of training and ongoing education in cognitive behavioural therapy. Self-reflection is an important part of supervision. The conscious understanding of one's own emotions, feelings, thoughts, and attitudes at the time of their occurrence, and the ability to continuously follow and recognize them are among the most important abilities of both therapists and supervisors. The objective of this article is to review aspects related to supervision in cognitive behavioural therapy and self-reflection in the literature. This is a narrative review. A literature review was performed using the PubMed, SciVerse Scopus, and Web of Science databases; additional references were found through bibliography reviews of relevant articles published prior to July 2011. The databases were searched for articles containing the following keywords: cognitive behavioural therapy, self-reflection, therapeutic relationship, training, supervision, transference, and countertransference. The review also includes information from monographs referred to by other reviews. We discuss conceptual aspects related to supervision and the role of self-reflection. Self-reflection in therapy is a continuous process which is essential for the establishment of a therapeutic relationship, the professional growth of the therapist, and the ongoing development of therapeutic skills. Recognizing one's own emotions is a basic skill from which other skills necessary for both therapy and emotional self-control stem. Therapists who are skilled in understanding their inner emotions during their encounters with clients are better at making decisions, distinguishing their needs from their clients' needs, understanding transference and countertransference, and considering an optimal response at any time during a session. They know how to handle their feelings so that these correspond with the situation and their response is in the client's best interest. The ability to self-reflect increases the
O'Toole, Mia S; Mennin, Douglas S; Hougaard, Esben; Zachariae, Robert; Rosenberg, Nicole K
The objective of the study was to investigate variables, derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder (SAD), as possible change processes in cognitive behaviour therapy (CBT) for SAD. Several proposed change processes were investigated: estimated probability, estimated cost, safety behaviours, acceptance of emotions, cognitive reappraisal and expressive suppression. Participants were 50 patients with SAD, receiving a standard manualized CBT program, conducted in groups or individually. All variables were measured pre-therapy, mid-therapy and post-therapy. Lower level mediation models revealed that while a change in most process measures significantly predicted clinical improvement, only changes in estimated probability and cost and acceptance of emotions showed significant indirect effects of CBT for SAD. The results are in accordance with previous studies supporting the mediating role of changes in cognitive distortions in CBT for SAD. In addition, acceptance of emotions may also be a critical component to clinical improvement in SAD during CBT, although more research is needed on which elements of acceptance are most helpful for individuals with SAD. The study's lack of a control condition limits any conclusion regarding the specificity of the findings to CBT. Change in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for SAD. Cognitive distortions appear relevant to target with cognitive restructuring techniques. Finding acceptance to have an indirect effect could be interpreted as support for contemporary CBT approaches that include acceptance-based strategies. Copyright © 2014 John Wiley & Sons, Ltd.
Full Text Available Alopecia areata (also known as spot baldness is a disease with multifactorial aetiology, including genetic, hormonal, autoimmune and psychological factors as well as nervous system disorders. This disorder belongs to the group of dermatological conditions modified by psychological factors. Clinical experience indicates that stress and psychological aspects contribute significantly to the onset and/or exacerbation of alopecia areata. Pharmacological treatment of this dermatosis is often ineffective or insufficient. Therefore, a holistic approach to the disease, including both medical and psychological aspects, is crucial. It is emphasised in the subject literature that some forms of psychotherapy and pharmacotherapy used in patients with alopecia areata improve their psychophysical condition, and, consequently, stimulate the regrowth of their hair. Research has shown that cognitive-behavioural therapy complements dermatological treatment of alopecia areata, improving the quality of life of patients. The aim of cognitive and behavioural techniques is, on the one hand, to change the maladaptive negative convictions about oneself, the world, and the disease, and, on the other hand, to acquire the ability to cope with negative emotional states and difficult situations, such as a disease. The aim of the paper is to present the results of a literature review on the efficiency of pharmacotherapy and the role of cognitive-behavioural therapy in alopecia areata.
Diet can affect cognitive ability and behaviour in children and adolescents. Nutrient composition and meal pattern can exert immediate or long-term, beneficial or adverse effects. Beneficial effects mainly result from the correction of poor nutritional status. For example, thiamin treatment reverses aggressiveness in thiamin-deficient adolescents. Deleterious behavioural effects have been suggested; for example, sucrose and additives were once suspected to induce hyperactivity, but these effects have not been confirmed by rigorous investigations. In spite of potent biological mechanisms that protect brain activity from disruption, some cognitive functions appear sensitive to short-term variations of fuel (glucose) availability in certain brain areas. A glucose load, for example, acutely facilitates mental performance, particularly on demanding, long-duration tasks. The mechanism of this often described effect is not entirely clear. One aspect of diet that has elicited much research in young people is the intake/omission of breakfast. This has obvious relevance to school performance. While effects are inconsistent in well-nourished children, breakfast omission deteriorates mental performance in malnourished children. Even intelligence scores can be improved by micronutrient supplementation in children and adolescents with very poor dietary status. Overall, the literature suggests that good regular dietary habits are the best way to ensure optimal mental and behavioural performance at all times. Then, it remains controversial whether additional benefit can be gained from acute dietary manipulations. In contrast, children and adolescents with poor nutritional status are exposed to alterations of mental and/or behavioural functions that can be corrected, to a certain extent, by dietary measures.
Vassilopoulos, Stephanos P.; Brouzos, Andreas; Damer, Diana E.; Mellou, Angeliki; Mitropoulou, Alexandra
This study investigated the impact of a psychoeducational group for social anxiety aimed at elementary children. An 8-week psychoeducational program based on empirically validated risk factors was designed. Interventions included cognitive restructuring, anxiety management techniques, and social skills training. Pre-and posttest data from 3 groups…
Full Text Available Background. Behavioural and psychological symptoms of dementia (BPSD cause significant patient and caregiver morbidity in vascular cognitive impairment (VCI. Objectives. To study and compare the occurrence and severity of BPSD between multi-infarct dementia (MID, subcortical ischaemic vascular disease (SIVD, and strategic infarct subtypes of poststroke VCI and to evaluate the relationship of these symptoms with the severity of cognitive impairment. Methods. Sixty patients with poststroke VCI were classified into MID, SIVD, and strategic infarct subtypes. BPSD were studied by the neuropsychiatric inventory (NPI. The severity of cognitive impairment was evaluated by the clinical dementia rating scale (CDR. Results. 95% of cases had at least one neuropsychiatric symptom, with depression being the commonest, irrespective of subtype or severity of VCI. Strategic infarct patients had the lowest frequency of all symptoms. SIVD showed a higher frequency and severity of apathy and higher total NPI scores, compared to MID. Apathy and appetite disturbances occurred more commonly with increasing CDR scores. The total NPI score correlated positively with the CDR score. Conclusion. Depression was the commonest neuropsychiatric symptom in VCI. The neuropsychiatric profiles of MID and SIVD were similar. The frequency and severity of apathy and the net burden of BPSD increased with increasing cognitive impairment.
Spano, Giuseppina; O Caffò, Alessandro; Bosco, Andrea
Home accidents are one of the major causes of death, particularly in older people, young children and women. The first aim of this study was to explore the role of subjective memory complaints, cognitive functioning and risky behaviour as predictors of home injuries occurred in a year in a sample of healthy Italian older adults. The second aim was to investigate the role of risky behaviour as a mediator in the relationship between subjective and objective cognitive functioning and home injuries. One hundred thirty-three community-dwelling older people from southern Italy were administered a battery of tests to evaluate cognitive functioning, subjective memory complaints, and risky behaviour during home activities. Risky behaviour was evaluated using the Domestic Behaviour Questionnaire, created specifically for this purpose. The number of home injuries was recorded for a year throughout monthly telephone interviews. A path analysis was performed to test the following model: cognitive functioning and subjective memory complaints directly influence risky behaviour and number of accidents over a year; risky behaviour mediates the impact of cognitive functioning and subjective memory on number of accidents over a year. Path analysis confirmed the model tested except the role of risky behaviour as a mediator between cognitive functioning and home accidents. Risky behaviour could represent a further risk factor in cognitively intact older adults with subjective memory complaints. The assessment of both cognition and behaviour in elderly can make a valuable contribution in preventing home accidents in elderly.
Therapeutic computer games might enhance children's motivation for psychotherapy, facilitate their understanding of important therapeutic concepts, structure therapy sessions, enhance treatment of migrant children and disseminate evidence-based treatment approaches. The game Treasure Hunt was developed to support cognitive behaviour therapy with children who come into treatment for various mental health problems. To evaluate the applicability and appropriateness of the game, 124 therapists answered a questionnaire on their impression of Treasure Hunt three months after download. Of these, 42 consented to participate in the further evaluation and sent questionnaires of 218 children in whose therapy Treasure Hunt had been used. A limitation of these data is an eventual positive bias, as therapists with a positive attitude towards therapeutic computer games may have been more likely to participate. Data show that the vast majority of children were satisfied their therapist had used the game during treatment. Therapists used Treasure Hunt for a broad range of diagnoses. They judged the game as helpful in the explanation of cognitive-behavioural concepts, used it as reinforcement and reported it enhanced child motivation for psychotherapy and strengthened the therapeutic relationship with the child.
Godin, Gaston; Bélanger-Gravel, Ariane; Eccles, Martin; Grimshaw, Jeremy
... interventions targeting healthcare professionals. The aim of this study was to systematically review the published scientific literature about factors influencing health professionals' behaviours based on social cognitive theories...
Joosten-Weyn Banningh, L.W.A.; Kessels, R.P.C.; Olde Rikkert, M.G.M.; Geleijns-Lanting, C.E.
Objective: To evaluate the feasibility and present preliminary results of a cognitive behavioural group therapy for patients with mild cognitive impairment and their significant others. Design: One group pretest-posttest design. Subjects: Twenty-two patients with mild cognitive impairment and their
Joosten-Weyn Banningh, E.W.A.; Kessels, R.P.C.; Olde Rikkert, M.G.M.; Geleijns-Lanting, C.E.; Kraaimaat, F.W.
OBJECTIVE: To evaluate the feasibility and present preliminary results of a cognitive behavioural group therapy for patients with mild cognitive impairment and their significant others. DESIGN: One group pretest-posttest design. SUBJECTS: Twenty-two patients with mild cognitive impairment and their
Oathamshaw, Stephen C.; Haddock, Gillian
Background: Cognitive skills thought to be necessary to undertake cognitive-behavioural therapy (CBT) include the ability to recognize emotions, link events and emotions, and recognize cognitive mediation. These skills have been assessed in people with intellectual disabilities, but not in those who also have psychosis. Materials and methods:…
Santangelo, Gabriella; Piscopo, Fausta; Barone, Paolo; Vitale, Carmine
Affective disorders and personality changes have long been considered pre-motor aspects of Parkinson's disease (PD). Many authors have used the term "premorbid personality" to define distinctive features of PD patients' personality characterized by reduced exploration of new environmental stimuli or potential reward sources ("novelty seeking") and avoidance behaviour ("harm avoidance") present before motor features. The functional correlates underlying the personality changes described in PD, implicate dysfunction of meso-cortico-limbic and striatal circuits. As disease progresses, the imbalance of neurotransmitter systems secondary to degenerative processes, along with dopamine replacement therapy, can produce a reversal of behaviours and an increase in reward seeking, laying the foundations for the emergence of the impulse control disorders. Personality disorders can be interpreted, therefore, as the result of individual susceptibility arising from intrinsic degenerative processes and individual personality features, in combination with extrinsic factors such as lifestyle, PD motor dysfunction and drug treatment. For a better understanding of personality disorders observed in PD and their relationship with the prodromal stage of the disease, prospective clinical studies are needed that correlate different personality profiles with other disease progression markers. Here, we review previous studies investigating the clinical, cognitive and behavioural correlates of personality traits in PD patients. Copyright © 2017 Elsevier B.V. All rights reserved.
Fehm, Lydia; Mrose, Jana
Homework assignments are an indispensable part of cognitive-behavioural therapy. During the past two decades, a growing number of studies have shed light on its characteristics and effects. However, most studies primarily consider the therapists' view, and little is known about the use of supportive strategies to implement homework assignments in psychotherapy and about patients' attitudes towards regular assignments. To fill this gap, we assessed the attitudes towards homework assignments of 80 outpatients. In addition, those who had received a task during the past session (75%) were asked to report characteristics of their task as well as therapists' behaviour strategies during the assignment of the task. One week later, therapists rated the extent of completion of the task. Results showed that the patients generally had a positive attitude towards homework and that they accomplished most of the tasks. With regard to the therapists' behaviour during the assignment of the task, there seems to be room for improvement. Copyright (c) 2008 John Wiley & Sons, Ltd.
Gómez Gallego, M; Gómez García, J
Music therapy is one of the types of active ageing programmes which are offered to elderly people. The usefulness of this programme in the field of dementia is beginning to be recognised by the scientific community, since studies have reported physical, cognitive, and psychological benefits. Further studies detailing the changes resulting from the use of music therapy with Alzheimer patients are needed. Determine the clinical improvement profile of Alzheimer patients who have undergone music therapy. Forty-two patients with mild to moderate Alzheimer disease underwent music therapy for 6 weeks. The changes in results on the Mini-mental State Examination, Neuropsychiatric Inventory, Hospital Anxiety and Depression Scale and Barthel Index scores were studied. We also analysed whether or not these changes were influenced by the degree of dementia severity. Significant improvement was observed in memory, orientation, depression and anxiety (HAD scale) in both mild and moderate cases; in anxiety (NPI scale) in mild cases; and in delirium, hallucinations, agitation, irritability, and language disorders in the group with moderate Alzheimer disease. The effect on cognitive measures was appreciable after only 4 music therapy sessions. In the sample studied, music therapy improved some cognitive, psychological, and behavioural alterations in patients with Alzheimer disease. Combining music therapy with dance therapy to improve motor and functional impairment would be an interesting line of research. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
Full Text Available Cognitive behavioural therapy (CBT for voice-hearing (i.e., auditory verbal hallucinations; AVH has, at best, small-to-moderate effects. One possible reason for this limited efficacy is that current CBT approaches tend to conceptualise voice-hearing as a homogenous experience in terms of the cognitive processes involved in AVH. However, the highly heterogeneous nature of voice-hearing suggests that many different cognitive processes may be involved in the etiology of AVH. These heterogeneous voice-hearing experiences do, however, appear to cluster into a set of subtypes, opening up the possibility of tailoring treatment to the subtype of AVH that a voice-hearer reports. In this paper, we (a outline our rationale for tailoring CBT to subtypes of voice-hearing, (b describe CBT for three putative subtypes of AVH (inner speech-based AVH, memory-based AVH, and hypervigilance AVH, and (c discuss potential limitations and problems with such an approach. We conclude by arguing that tailoring CBT to subtypes of voice-hearing could prove to be a valuable therapeutic development, which may be especially effective when used in early intervention in psychosis services.
De Houwer, Jan; Barnes-Holmes, Yvonne; Barnes-Holmes, Dermot
Different types of therapy explain psychopathology and the effects of psychotherapy differently. Different explanations are, however, not necessarily mutually exclusive. Based on the idea that functional and cognitive explanations are situated at different levels, we argue that functional therapies such as traditional Behaviour Therapy (BT) and Acceptance and Commitment Therapy (ACT) are not necessarily incompatible with Cognitive Behaviour Therapy (CBT). Whether a functional and a cognitive therapy actually align depends on whether they highlight the same type of environmental causes. This functional-cognitive perspective reveals various differences and communalities among BT, CBT and ACT. © 2015 International Union of Psychological Science.
Kiviniemi, Marc T; Ellis, Erin M; Hall, Marissa G; Moss, Jennifer L; Lillie, Sarah E; Brewer, Noel T; Klein, William M P
Researchers have historically treated cognition and affect as separate constructs in motivating health behaviour. We present a framework and empirical evidence for complex relations between cognition and affect in predicting health behaviour. Main Outcome, Design and Results: First, affect and cognition can mediate each other's relation to health behaviour. Second, affect and cognition can moderate the other's impact. Third, context can change the interplay of affect and cognition. Fourth, affect and cognition may be indelibly fused in some psychological constructs (e.g. worry, anticipated regret and reactance). These four propositions in our framework are not mutually exclusive. Examination of the types of complex relations described here can benefit theory development, empirical testing of theories and intervention design. Doing so will advance the understanding of mechanisms involved in regulation of health behaviours and the effectiveness of interventions to change health behaviours.
Mitsi, C; Efthimiou, K
Infertility primarily refers to the biological inability of a man or a woman to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term, however other causes can be found in both sexes. The diagnosis of infertility and the concurrent medical treatment are rather stressful events for the couple and can provoke a number of negative symptoms such as depression, anxiety and psychosomatic symptoms which may interfere with the medical therapeutic procedures especially with the in-vitro fertilisation technique. The relationship between infertility and psychological factors has not been explored fully and are still under research. However current findings can be summarized in three basic hypotheses; namely, the effect of psychological factors on the appearance of infertility, the psychological consequences of infertility at the couple, and the reciprocal relation of psychological factors and infertility. Stress and anxiety activate the hypothalamic-adrenal axis (HPA), and this activation can disturb the hormones of fertility. The presence of depressive/anxiety symptoms seems to have a negative impact on the treatment of infertility and sometimes can be a risk factor for lower pregnancy rate. There is a possibility that psychological complaints could develop, prior, during and after the diagnosis of infertility and may interfere with the fertilisation therapy. Should such psychological complaints develop it is suggested that psychotherapeutic treatment is used in conjunction with the treatment approach of infertility, e.g. IVF. The above mentioned suggestion is supported by a large number of researchers and current research efforts focus on different psychotherapeutic interventions such as Cognitive-Behavioural Therapy. Cognitive-Behavioural Therapy (CBT) has shown during research its superiority compared to other psychotherapeutic interventions and that could be an effective way to decrease the depressive
Ali, Afia; Hall, Ian; Blickwedel, Jessica; Hassiotis, Angela
Outwardly-directed aggressive behaviour is a significant part of problem behaviours presented by people with intellectual disabilities. Prevalence rates of up to 50% have been reported in the literature, depending on the population sampled. Such behaviours often run a long-term course and are a major cause of social exclusion. This is an update of a previously published systematic review (see Hassiotis 2004; Hassiotis 2008). To evaluate the efficacy of behavioural and cognitive-behavioural interventions on outwardly-directed aggressive behaviour in people with intellectual disabilities when compared to standard intervention or wait-list controls. In April 2014 we searched CENTRAL, Ovid MEDLINE, Embase, and eight other databases. We also searched two trials registers, checked reference lists, and handsearched relevant journals to identify any additional trials. We included studies if more than four participants (children or adults) were allocated by random or quasi-random methods to either intervention, standard treatment, or wait-list control groups. Two review authors independently identified studies and extracted and assessed the quality of the data. We deemed six studies (309 participants), based on adult populations with intellectual disabilities, suitable for inclusion in the current version of this review. These studies examined a range of cognitive-behavioural therapy (CBT) approaches: anger management (three studies (n = 235); one individual therapy and two group-based); relaxation (one study; n = 12), mindfulness based on meditation (one study; n = 34), problem solving and assertiveness training (one study; n = 28). We were unable to include any studies using behavioural interventions. There were no studies of children.Only one study reported moderate quality of evidence for outcomes of interest as assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We judged the evidence for the remaining studies to be of
Falck, Ryan S; Davis, Jennifer C; Liu-Ambrose, Teresa
The increasing rate of all-cause dementia worldwide and the lack of effective pharmaceutical treatments emphasise the value of lifestyle approaches as prevention strategies. Emerging evidence suggests sedentary behaviour is associated with impaired cognitive function. A better understanding of this association would significantly add to our knowledge of how to best promote healthy cognitive ageing. Thus, we conducted a systematic review ascertaining the contribution of sedentary behaviour towards associated changes in cognitive function over the adult lifespan. Systematic review of peer-reviewed literature examining the association of sedentary behaviour with cognition. We searched PubMed, PsycINFO, EBSCO and Web of Science, and reference lists of relevant reviews on sedentary behaviour. Two independent reviewers extracted (1) study characteristics and (2) information regarding measurement of sedentary behaviour and cognitive function. We also assessed study quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. We limited search results to adults ≥40 years, observational studies published in English since 1990 and studies investigating associations between sedentary behaviour and cognitive function. 8 studies examined the association of sedentary behaviour with cognitive function. 6 studies reported significant negative associations between sedentary behaviour and cognitive function. 8 different measures of sedentary behaviour and 13 different measures of cognitive function were used across all eight studies. Sedentary behaviour is associated with lower cognitive performance, although the attributable risk of sedentary time to all-cause dementia incidence is unclear. Our systematic review provides evidence that limiting sedentary time and concomitantly engaging in regular moderate-to-vigorous physical activity may best promote healthy cognitive ageing. Published by the BMJ Publishing Group Limited. For
Bazelmans, E.; Prins, J.B.; Hoogveld, S.W.B.; Bleijenberg, G.
Several randomized controlled trials have indicated that cognitive behaviour therapy is an effective treatment for chronic fatigue syndrome. In 1 of these studies 13 therapists applied cognitive behaviour therapy for chronic fatigue syndrome in 83 chronic fatigue syndrome patients. In the present
Berle, David; Moulds, Michelle L; Starcevic, Vladan; Milicevic, Denise; Hannan, Anthony; Dale, Erin; Viswasam, Kirupamani; Brakoulias, Vlasios
Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world. It is a key interpretative bias in cognitive models of anxiety disorders and appears to be especially evident in individuals with anxiety disorders. However, the amenability of emotional reasoning to change during treatment has not yet been investigated. We sought to determine whether emotional reasoning tendencies change during a course of routine cognitive-behavioural therapy (CBT). Emotional reasoning tendencies were assessed in 36 individuals with a primary anxiety disorder who were seeking treatment at an outpatient clinic. Changes in anxiety and depressive symptoms as well as emotional reasoning tendencies after 12 sessions of CBT were examined in 25 individuals for whom there was complete data. Emotional reasoning tendencies were evident at pretreatment assessment. Although anxiety and depressive symptoms decreased during CBT, only one of six emotional reasoning interpretative styles (pertaining to conclusions that one is incompetent) changed significantly during the course of therapy. Attrition rates were high and there was not enough information regarding the extent to which therapy specifically focused on addressing emotional reasoning tendencies. Individuals seeking treatment for anxiety disorders appear to engage in emotional reasoning, however routine individual CBT does not appear to result in changes in emotional reasoning tendencies.
Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.
Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and
Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.
OBJECTIVE: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and
Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.
Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and
Schendelaar, Pamela; La Bastide-Van Gemert, Sacha; Heineman, Maas Jan; Middelburg, Karin J.; Seggers, Jorien; Van den Heuvel, Edwin R.; Hadders-Algra, Mijna
Research on cognitive and behavioural development of children born after assisted conception is inconsistent. This prospective study aimed to explore underlying causal relationships between ovarian stimulation, in-vitro procedures, subfertility components and child cognition and behaviour.
van der Veek, Shelley M. C.; de Haan, Else; Derkx, H. H. F.; Benninga, Marc A.; Boer, Frits
The effectiveness of cognitive behaviour therapy for paediatric functional abdominal pain leaves room for improvement. We studied which factors addressed in cognitive behaviour therapy relate most strongly to the physical and psychological functioning of children with functional abdominal pain and
Dijk, Corine; Buwalda, Femke M; de Jong, Peter J
The clinical impression is that people who fear blushing do not easily seek psychological help for their complaints. Therefore, we designed a low-threshold psychoeducational group intervention to reduce fear of blushing. The intervention followed a cognitive-behavioural approach, but in a course setting, e.g., with 'participants' and 'teachers' instead of 'patients' and 'therapists'. The effectiveness of the course in reducing fear of blushing and social anxiety was tested in a group of blushing-fearful individuals (n = 47) by using an uncontrolled study design. The course consisted of six weekly sessions and one booster session 3 months after the last regular session. Assessments took place upon application, immediately before the intervention, after the sixth session, before the booster session, and at 1-year follow-up. Results showed that the course was effective in reducing fear of blushing as well as symptoms of social anxiety. The positive effect of the course on anxiety measures suggests that it might be a promising approach for treating fear of blushing. The course 'dealing with fear of blushing' is a cognitive-behavioural group intervention in a course setting, e.g., with 'participants' and 'teachers' instead of 'patients' and 'therapists'. The course was effective in reducing anxiety complaints. An effect size of 1.4 and a reduction of approximately 30 points on this Blushing, Trembling and Sweating Questionnaire are comparable with what was reported for individual cognitive-behavioural treatments. Participants evaluated the course positively. Copyright © 2011 John Wiley & Sons, Ltd.
Full Text Available This study examines whether combined cognitive bias modification for interpretative biases (CBM-I and computerised cognitive behaviour therapy (C-CBT can produce enhanced positive effects on interpretation biases and social anxiety. Forty socially anxious students were randomly assigned into two conditions, an intervention group (positive CBM-I + C-CBT or an active control (neutral CBM-I + C-CBT. At pre-test, participants completed measures of social anxiety, interpretative bias, cognitive distortions, and social and work adjustment. They were exposed to 6 × 30 min sessions of web-based interventions including three sessions of either positive or neutral CBM-I and three sessions of C-CBT, one session per day. At post-test and two-week follow-up, participants completed the baseline measures. A combined positive CBM-I + C-CBT produced less negative interpretations of ambiguous situations than neutral CBM-I + C-CBT. The results also showed that both positive CBM-I + C-CBT and neutral CBM-I + C-CBT reduced social anxiety and cognitive distortions as well as improving work and social adjustment. However, greater effect sizes were observed in the positive CBM-I + C-CBT condition than the control. This indicates that adding positive CBM-I to C-CBT enhanced the training effects on social anxiety, cognitive distortions, and social and work adjustment compared to the neutral CBM-I + C-CBT condition.
Ridgway, Nicola; Williams, Chris
The World Health Organisation suggests that 60-80% of those affected by depression can be effectively treated using medication or psychotherapy within primary care. However, less than 50% of those affected actually receive such treatments. In practice, it remains a challenge to provide access to psychotherapy due to limited numbers of therapists combined with a growing number of treatment guidelines recommending the delivery of evidence-based psychological therapies such as cognitive behavioural therapy (CBT). One way to overcome this problem is to offer therapy in different ways - with so-called low-intensity (LI) working. One example of LI working is CBT self-help (CBT-SH). To provide an overview of the current literature surrounding the effectiveness of CBT-SH with a particular focus on depression and discuss the future directions for both research and policy implementation. It is clear that self-help has a place within a healthcare framework but more work is needed to clarify where and how it should be delivered. The paper concludes that there appears to be enough benefits and sufficient evidence to argue for the introduction of LI working as an appropriate first step for most people facing depression and anxiety.
Green, G C; Buckroyd, J
Long-term success in weight loss treatments for obesity is elusive. The most widely used approach after diet books is slimming clubs. A percentage of members achieve dramatic and lasting weight losses. The study aimed to evaluate the prevalence of binge eating and unhealthy eating-related thought patterns among a group of highly successful weight losers. Sixty-five slimming competition winners self reported their weight history and eating habits in a semi-structured questionnaire. The Eating Disorders Examination Questionnaire (EDE-Q) and the Emotional Eating Scale (EES) were also administered. Despite substantial weight loss (mean = 38%, SD = 10%) and widespread maintenance of losses, participants evidenced high levels of dietary restraint and weight, shape and eating overconcern. Emotional eating levels were significantly higher than those seen in noneating disordered populations on two of three subscales. Seventy-one per cent also reported bingeing in the past 3 months. Commercial slimming organizations should engage with broader psychological and behavioural features of obesity, including bingeing and eating-related cognitive patterns.
De Castella, Krista; Goldin, Philippe; Jazaieri, Hooria; Heimberg, Richard G; Dweck, Carol S; Gross, James J
Despite strong support for the efficacy of cognitive behavioural therapy (CBT) for social anxiety disorder (SAD), little is known about mechanisms of change in treatment. Within the context of a randomized controlled trial of CBT, this study examined patients' beliefs about the fixed versus malleable nature of anxiety-their 'implicit theories'-as a key variable in CBT for SAD. Compared to waitlist (n = 29; 58% female), CBT (n = 24; 52% female) led to significantly lower levels of fixed beliefs about anxiety (Mbaseline = 11.70 vs. MPost = 7.08, d = 1.27). These implicit beliefs indirectly explained CBT-related changes in social anxiety symptoms (κ(2) = .28, [95% CI = 0.12, 0.46]). Implicit beliefs also uniquely predicted treatment outcomes when controlling for baseline social anxiety and other kinds of maladaptive beliefs (perceived social costs, perceived social self-efficacy, and maladaptive interpersonal beliefs). Finally, implicit beliefs continued to predict social anxiety symptoms at 12 months post-treatment. These findings suggest that changes in patients' beliefs about their emotions may play an important role in CBT for SAD.
Riccardo Dalle Grave
Full Text Available The aim of this paper is to describe a novel model of intensive outpatient cognitive-behaviour therapy (CBT indicated for eating disorder patients who are having difficulty modifying their eating habits in response to conventional outpatient CBT. Intensive outpatient CBT is a manual based treatment derived by the CBT-Enhanced (CBT-E for eating disorders. The treatment has four features that distinguish it from the conventional outpatient CBT-E: (1 it is designed to be suitable for both adult and adolescent patients, (2 it is delivered by a multidisciplinary non-eclectic team trained in CBT, (3 there is assistance with eating, (4 there is a family therapy module for patients under the age of 18 years. Preliminary outcome of intensive outpatient CBT-E are encouraging. The treatment has been applied to 20 consecutive underweight eating disorder patients (age 18.2 ± 6.5 years; BMI 14.6 ± 1.5 kg/m2. Thirteen patients (65% concluded the treatment, five (25% were admitted at an eating disorder inpatient unit, and two (10% prematurely interrupted the treatment. Completers obtained significant weight regain and improvement of eating disorder and general psychopathology. Most of the improvements were maintained at six-month follow-up.
Jones, Christopher; Hacker, David; Cormac, Irene; Meaden, Alan; Irving, Claire B
Background Cognitive behavioural therapy (CBT) is now a recommended treatment for people with schizophrenia. This approach helps to link the person’s distress and problem behaviours to underlying patterns of thinking. Objectives To review the effects of CBT for people with schizophrenia when compared with other psychological therapies. Search methods We searched the Cochrane Schizophrenia Group Trials Register (March 2010) which is based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO. We inspected all references of the selected articles for further relevant trials, and, where appropriate, contacted authors. Selection criteria All relevant randomised controlled trials (RCTs) of CBT for people with schizophrenia-like illnesses. Data collection and analysis Studies were reliably selected and assessed for methodological quality. Two review authors, working independently, extracted data. We analysed dichotomous data on an intention-to-treat basis and continuous data with 65% completion rate are presented. Where possible, for dichotomous outcomes, we estimated a risk ratio (RR) with the 95% confidence interval (CI) along with the number needed to treat/harm. Main results Thirty one papers described 20 trials. Trials were often small and of limited quality. When CBT was compared with other psychosocial therapies, no difference was found for outcomes relevant to adverse effect/events (2 RCTs, n = 202, RR death 0.57 CI 0.12 to 2.60). Relapse was not reduced over any time period (5 RCTs, n = 183, RR long-term 0.91 CI 0.63 to 1.32) nor was rehospitalisation (5 RCTs, n = 294, RR in longer term 0.86 CI 0.62 to 1.21). Various global mental state measures failed to show difference (4 RCTs, n = 244, RR no important change in mental state 0.84 CI 0.64 to 1.09). More specific measures of mental state failed to show differential effects on positive or negative symptoms of schizophrenia but there may be some longer term effect for affective symptoms (2 RCTs, n = 105
Mourad, Ghassan; Strömberg, Anna; Jonsbu, Egil; Gustafsson, Mikael; Johansson, Peter; Jaarsma, Tiny
Patients with recurrent episodes of non-cardiac chest pain may experience cardiac anxiety and avoidance behavior, leading to increased healthcare utilization. These patients might benefit from help and support to evaluate the perception and management of their chest pain. The purpose of this study was to test the feasibility of a short guided Internet-delivered cognitive behavioural therapy (CBT) program and explore the effects on cardiac anxiety, fear of body sensations, depressive symptoms, and chest pain in patients with non-cardiac chest pain, compared with usual care. A pilot randomized controlled study was conducted. Fifteen patients with non-cardiac chest pain with cardiac anxiety or fear of body sensations, aged 22-76 years, were randomized to intervention (n = 7) or control (n = 8) groups. The four-session CBT program contained psychoeducation, physical activity, and relaxation. The control group received usual care. Data were collected before and after intervention. Five of seven patients in the intervention group completed the program, which was perceived as user-friendly with comprehensible language, adequate and varied content, and manageable homework assignments. Being guided and supported, patients were empowered and motivated to be active and complete the program. Patients in both intervention and control groups improved with regard to cardiac anxiety, fear of body sensations, and depressive symptoms, but no significant differences were found between the groups. The Internet-delivered CBT program seems feasible for patients with non-cardiac chest pain, but needs to be evaluated in larger groups and with a longer follow-up period. Clinicaltrials.gov NCT02336880 . Registered on 8 January 2015.
Lara, Ma Asunción; Navarro, Claudia; Acevedo, Maricarmen; Berenzon, Shoshana; Mondragón, Liliana; Rubí, Norma Angélica
Yalom (1995) has stated that psycho-educational interventions could be made more effective by incorporating a focus on the interpersonal process. A qualitative analysis is proposed to investigate the degree of fidelity with which a psycho-educational intervention for women with depressive symptoms was delivered and to identify Yalom's significant therapeutic mechanisms operating in group therapy. The intervention consisted of six 2 two-hour weekly sessions organized around educational material. Eight groups were conducted with 5-19 participants each. A qualitative analysis was undertaken based on Kvale's (1996) technique of 'categorization of meanings' for the transcribed registers of audiotaped recordings. The analysis led to the definition of five major group process categories: establishment of rules, educational exchange, experiential exchange, reflexive work designed to achieve cognitive and behavioural change, and limitations on the exchange process. It showed that the facilitators largely adhered to the goals of the intervention, its strategies and model, and that the main limitations concerned facilitators' and participants'speaking for over-long periods of time and facilitators' failure to cover all the material due to lack of time. The subsequent analysis identified four of Yalom's categories: installation of hope, didactic instruction, catharsis, and universality. In support of Yalom's assertion, we concluded that this exercise was useful in that it highlighted important therapeutic factors that could be more purposefully manipulated in the future.
Full Text Available The world’s most numerous bird, the domestic chicken, and their wild ancestor, the red junglefowl, have long been used as model species for animal behaviour research. Recently, this research has advanced our understanding of the social behaviour, personality, and cognition of fowl, and demonstrated their sophisticated behaviour and cognitive skills. Here, we overview some of this research, starting with describing research investigating the well-developed senses of fowl, before presenting how socially and cognitively complex they can be. The realisation that domestic chickens, our most abundant production animal, are behaviourally and cognitively sophisticated should encourage an increase in general appraise and fascination towards them. In turn, this should inspire increased use of them as both research and hobby animals, as well as improvements in their unfortunately often poor welfare.
Spillekom-van Koulil, S.; Lankveld, W.G.J.M. van; Kraaimaat, F.W.; Helmond, T. van; Vedder, A.; Hoorn, H. van; Donders, A.R.T.; Wirken, L.; Cats, H.; Riel, P.L.C.M. van; Evers, A.W.M.
OBJECTIVES: Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving
Schreurs, Karlein Maria Gertrudis; Veehof, M.M.; Passade, L.; Vollenbroek-Hutten, Miriam Marie Rosé
Cognitive behavioural therapy (CBT) was combined with graded exercise therapy (GET) for patients with chronic fatigue syndrome (CFS) in an uncontrolled implementation study of an inpatient multidisciplinary group therapy. During the intake procedure, 160 CFS patients completed a questionnaire on
Filges, Trine; Knudsen, Anne-Sofie Due; Svendsen, Majken
BACKGROUND Youth drug use is a severe problem worldwide. This review focuses on Cognitive-Behavioural Therapy (CBT) as a treatment for young people who misuse non-opioid drugs, such as cannabis, amphetamines, ecstasy and cocaine, which are strongly associated with a range of health and social...... problems. CBT is an individualized and multicomponent intervention that combines behavioural and cognitive therapy. While behavioural therapy mainly focuses on external settings and observable behaviour, cognitive therapy is concerned with internal cognitive processes. The primary focus of CBT is to reduce...... literature databases, citations in other reviews and in the included primary studies, hand searches of relevant journals, and Internet searches using Google. We also corresponded with researchers in the CBT field. No language or date restrictions were applied to the searches. SELECTION CRITERIA Studies were...
Schuster, Andrea Claudia
Behavioural traits were assumed to be the most flexible traits in animals (Briffa et al. 2008). However, there is now diverse evidence for constant between-individual behavioural differences in many species, i.e. animal personality (Réale et al. 2007), resulting in less flexible individual behaviour (Evans et al. 2010). Knowledge on animal personality has provided new insights into evolutionary biology and animal ecology, as behavioural types - individuals with a specific combination of two o...
Hronis, Anastasia; Roberts, Lynette; Kneebone, Ian I
Nearly half of children with intellectual disability (ID) have comorbid affective disorders. These problems are chronic if left untreated and can significantly impact upon future vocational, educational, and social opportunities. Despite this, there is a paucity of research into effective treatments for this population. Notably, one of the most supported of psychological therapies, cognitive behaviour therapy (CBT), remains largely uninvestigated in children with ID. The current review considers the neuropsychological profile of children and adolescents with mild to moderate ID, with a view to informing how CBT might best be adapted for children and adolescents with ID. Narrative review of literature considering the neuropsychological profiles of children and adolescents with ID, with specific focus upon attention, memory, learning, executive functioning, and communication. Studies were identified through SCOPUS, PsycINFO, and PubMed databases, using combinations of the key words 'intellectual disability', 'learning disability', 'neuropsychology', 'attention', 'learning', 'memory', 'executive function', 'language', and 'reading'. Children with ID have significant deficits in attention, learning, memory, executive functions, and language. These deficits are likely to have a negative impact upon engagement in CBT. Suggestions for adapting therapy to accommodate these wide ranging deficits are proposed. There are multiple cognitive factors which need to be considered when modifying CBT for children who have ID. Furthermore, research is required to test whether CBT so modified is effective in this population. Clinical implications Effective ways of providing cognitive behavioural therapy (CBT) to children with intellectual disability (ID) is unclear. This study provides a framework of potential adaptations for clinical practice As rates of mental illness for children with intellectual disability are high, and rates of treatment provision low, it is hoped that the
Willner, Paul; Goodey, Rebecca
Aims: This case study describes the formulation and cognitive-behavioural treatment (CBT) of obsessive-compulsive thoughts and behaviours in a woman with an intellectual disability. The report aimed to distinguish the cognitive deficits that reflect her disability from the cognitive distortions integral to her obsessive-compulsive disorder. Case…
Reme, S E; Stahl, D; Kennedy, T; Jones, R; Darnley, S; Chalder, T
Cognitive behaviour therapies (CBTs) have through several trials been demonstrated to reduce symptoms and disability in irritable bowel syndrome (IBS) patients, but the mechanisms responsible for the changes are still unknown. The aim of this study was to test a theoretical model of CBT and investigate if cognitions and/or behaviour mediated the changes seen in CBT for IBS. To assess for possible mediating effects, we applied path analysis to the dataset of 149 diagnosed participants randomized to mebeverine hydrochloride plus CBT or mebeverine hydrochloride alone. Primary outcome was symptom severity, while secondary outcomes were work and social adjustment and anxiety. The path analyses supported mediational paths for all outcomes. Changes in behaviour and cognitions mediated all three outcomes, with models placing behaviour change 'upstream' of cognition change having best fit. The analyses of model fits revealed best fit for the anxiety model and hence provide increased confidence in the causal model of anxiety. Changes in behaviour and cognitions mediate the change in CBT given to IBS patients. The results strengthen the validity of a theoretical model of CBT by confirming the interaction of cognitive, emotional and behavioural factors in IBS.
Zalai, Dora; Carney, Colleen E; Sherman, Morris; Shapiro, Colin M; McShane, Kelly
Fatigue is a leading concern of patients with chronic hepatitis C virus (HCV) infection. Despite its clinical significance, fatigue in HCV is poorly understood and therefore invariably under-treated. A cognitive-behavioural approach offers a framework to understand and treat fatigue, but the characteristics of fatigue in chronic HCV infection have not been documented from a cognitive-behavioural perspective. This study captured the common and unique aspects of fatigue from a cognitive-behavioural perspective in individuals with HCV infection and clinically significant fatigue. Cross-sectional, qualitative using a critical realism approach. Fourteen individuals (64% women; age >18 years) participated in semi-structured interviews. The interviews documented the features, course, and perceived antecedents of fatigue; fatigue-specific cognitions; fatigue management behaviours; and the functional impact of fatigue. Participants' descriptions included the aspects of fatigue that have been targets of cognitive-behavioural therapy in other medical conditions, including attributing fatigue to the illness; expectation of chronicity; low control; and fatigue-driven coping. There were also components of fatigue experience that appear to be unique characteristics of fatigue related to HCV, including predominantly physical fatigue; high acceptance of fatigue; and liver-protective diet as a fatigue management behaviour. This was the first study to document the experience of fatigue in chronic HCV infection in a cognitive-behavioural framework. The findings suggest that the cognitive-behavioural approach can be applied to fatigue in chronic HCV infection. This would open an avenue to alleviate fatigue and thus improve the primary patient-reported outcome of the disease. What is already known on this subject? Fatigue is a key patient-reported outcome measure of chronic hepatitis C virus (HCV) infection. Fatigue management is not part of the standard care, because fatigue is poorly
Chi, Sung-Ae; Kim, Seong Hyun; Kim, HyunJin
This study investigated the affects of cognitive ability, creativity, and self-esteem on kindergartners' problem behaviour. Participants were 203 children (mean age = 65.8 months) attending kindergartens in Korea. Data collection used the Korean version of Child Behaviour Checklist, the Kaufman Assessment Battery for Children, the Torrance Test of…
Flanagan, Helen E.; Smith, Isabel M.; Vaillancourt, Tracy; Duku, Eric; Szatmari, Peter; Bryson, Susan; Fombonne, Eric; Mirenda, Pat; Roberts, Wendy; Volden, Joanne; Waddell, Charlotte; Zwaigenbaum, Lonnie; Bennett, Teresa; Elsabbagh, Mayada; Georgiades, Stelios
We examined the stability of cognitive and adaptive behaviour standard scores in children with autism spectrum disorder (ASD) between diagnosis and school entry approximately age 6. IQ increased 18 points in 2-year-olds, 12 points in 3-year-olds, and 9 points in 4-year-olds (N = 281). Adaptive behaviour scores increased 4 points across age groups…
van Balkom, I. D. C.; Shaw, A.; Vuijk, P. J.; Franssens, M.; Hoek, H. W.; Hennekam, R. C. M.
Background: Marshall-Smith syndrome (MSS) is an infrequently described entity characterised by failure to thrive, developmental delay, abnormal bone maturation and a characteristic face. In studying the physical features of a group of patients, we noticed unusual behavioural traits. This urged us to study cognition, behavioural phenotype and…
Bouman, Theo; Visser, S.
This study evaluates a cognitive and a behavioural treatment protocol for hypochondriacal complaints. In a cross-over design, six patients with a primary diagnosis of hypochondriasis were treated. Three of them first received a block of behavioural therapy (exposure in vivo and response prevention),
Johnson, Nikki; McMahon, Catherine
Background: Childhood sleep problems which are prevalent in Western societies are associated with a wide range of emotional, cognitive and behavioural disturbances. Growing evidence suggests that parents play a pivotal role in children's sleep behaviour and that a parenting style which promotes self-regulation is beneficial. This study tested a…
Kreitler, S; Zigler, E; Kagan, S; Olsen, D; Weissler, K; Kreitler, H
While most studies on the determinants of learning deal with either cognition or motivation, there is a growing awareness that both should be considered. Our purpose was to examine the relative roles of cognitive and motivational factors for the scholastic achievement and behaviour of disadvantaged children. Cognition was conceptualised in terms of the psychosemantic theory that assesses cognitive processes by characteristics of the individual's meaning assignment (Kreitler & Kreitler, 1987a). Motivation was conceptualised in terms of the cognitive orientation (CO) theory which assumes that cognitive contents guide behaviour (Kreitler & Kreitler, 1982). Participants were 57 third and fourth graders of both genders, recommended for a remedial summer programme. They were administered the Meaning Test assessing cognitive abilities; the CO Questionnaire of Motivation for Learning assessing the disposition to learn; and the Metropolitan Achievement Test and the IOWA tests assessing verbal, mathematical and working skills. Teachers completed the Teacher-Child Rating Scale assessing six scholastic behaviours. Regression analyses showed that all dependent variables were predicted by the cognitive and motivational variables, better by specific than global predictors. Cognitive variables contributed more to the predictions, especially of academic achievements, and more in the case of verbal than mathematical abilities. In girls, motivational factors played a larger role than cognitive factors, absolutely and relative to boys. Implications for promoting scholastic achievements are discussed.
Alperen M Aydin
Aim/Purpose: The objective of this paper is to review the vast literature of user-centric in-formation science and inform about the emerging themes in information behaviour science. Background: The paradigmatic shift from system-centric to user-centric approach facilitates research on the cognitive and individual information processing. Various information behaviour theories/models emerged. Methodology: Recent information behaviour theories and models are presented. Features, str...
Woodcock, K. A.; Oliver, C.; Humphreys, G. W.
Background: Individuals with Prader-Willi syndrome (PWS) have been shown to demonstrate a particular cognitive deficit in attention switching and high levels of preference for routine and temper outbursts. This study assesses whether a specific pathway between a cognitive deficit and behaviour via environmental interaction can exist in individuals…
Enriquez Geppert, Stefanie; Huster, René J; Herrmann, Christoph
Neurofeedback is attracting renewed interest as a method to self-regulate one’s own brain activity to directly alter the underlying neural mechanisms of cognition and behaviour. It promises new avenues as a method for cognitive enhancement in healthy subjects, but also as a therapeutic tool. In the
Background: There is a considerable body of evidence to suggest that behavioural activation for depression is an equally effective but less complex treatment than cognitive behavioural therapy. It may therefore be more suitable for those who are cognitively impaired (i.e. early-stage dementia or mild cognitive impairment) or have a learning…
S.P.J. Kremers (Stef); T.L.S. Visscher (Tommy); J.C. Seidell (Jaap); W. van Mechelen (Willem); J. Brug (Hans)
textabstractThe burden of disease as a result of overweight and obesity calls for in-depth examination of the main causes of behavioural actions responsible for weight gain. Since weight gain is the result of a positive energy balance, these behavioural actions are referred to as 'energy
... disruptive behaviour and was facing expulsion from a shelter for homeless children and his school. A thorough assessment served as the basis for a case formulation and treatment plan. Intervention included 23 individual sessions focussing on bereavement and the learning of self-control skills and prosocial behaviours, ...
Kremers, Stef P J; Visscher, Tommy L S; Seidell, Jacob C; van Mechelen, Willem; Brug, Johannes
The burden of disease as a result of overweight and obesity calls for in-depth examination of the main causes of behavioural actions responsible for weight gain. Since weight gain is the result of a positive energy balance, these behavioural actions are referred to as 'energy balance-related
Leiva-Bianchi, Marcelo; Cornejo, Felipe; Fresno, Andrés; Rojas, Carolina; Serrano, Camila
This is the first time that the effectiveness of cognitive-behavioural therapy for post-disaster stress (CBT-PD) in symptoms of posttraumatic stress disorder (PTSD) has been tested outside the United States of America. Quasi-experiment with three groups. In the quasi-control group, complete CBT-PD was applied even though its members did not have PTSD; in quasi-experimental conditions, participants received complete treatment because they had this diagnosis; and in the third group, participants with PTSD received an abbreviated treatment (double sessions) due to organisational requirements. Primary health care workers in Constitución (Chile), city exposed to earthquake and tsunami; public department workers in Talca (city exposed only to earthquake) and teachers from a school (Constitución). A total of 13 of the 91 people diagnosed with PTSD participated. In addition, 16 people without diagnosis voluntarily participated. The treatment was completed by 29 participants. There were no dropouts. Only 1 of the 9 participants in the quasi-experimental group did not respond to treatment. CBT-PD is a group therapy (10-12 sessions) that includes psychoeducation, breathing retraining, behavioural activation and cognitive restructuring. CBT-PD (complete and abbreviated) was applied between September and December 2010. Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E) was used to measure PTSD symptoms before and after treatment. The group that received the complete treatment and was diagnosed with PTSD showed a significant decrease in the total symptoms to below dangerous levels (IGA AB : 31.556; p<0.01; 95%CI: 0.21-2.01]; η 2 =0.709). The effectiveness and benefits of incorporating CBT-PD in the health network after events like disasters were discussed. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Full Text Available The studies in expressed emotions allowed establishing a pattern in educational and psychoeducative interventions within the families of schizophrenic patients. In this paper, the author synthesises his research developed in expressed emotions of the chronic patient's relatives. The author refers the importance of the relative's cognitive variables about mental representation of the patient and his disease. These variables are studied through the attributions made about the patient's personality and causes of disease. Other cognitive variables are analysed, relying to the conceptualisation in family psycho educative intervention, such as, transactional games, family conflicts and parental relationship style. The evaluation of the relatives and families is considered as being part of the process of family psycho-educative intervention.
Timmerby, Nina; Austin, Stephen; Bech, Per
The aim of this article was to examine the evidence of family psychoeducation (FPE) for affective disorders. Evidence indicates that FPE can be an effective supplement to the standard treatment of patients with affective disorders. FPE can effectively reduce the patients' risk of relapse and reduce...
There are a number of ways in which food can influence behaviour, including malnutrition, types of diet, eating habits, pharmacological effects, food allergy, fatty acid deficiency and possibly food additives...
Geraghty, Keith; Blease, Charlotte
Cognitive behavioural therapy is increasingly promoted as a treatment for chronic fatigue syndrome. There is limited research on informed consent using cognitive behavioural therapy in chronic fatigue syndrome. We undertook a narrative review to explore efficacy and to identify the salient information that should be disclosed to patients. We found a complex theoretical model underlying the rationale for psychotherapy in chronic fatigue syndrome. Cognitive behavioural therapy may bring about c...
Meyer, Susann; Puppe, Birger; Langbein, Jan
Animals in the wild are facing a wide variety of challenges and ever-changing environmental stimuli. For successful coping, animals use both innate behavioural programs and their cognitive skills. In contrast, zoo- and farm animals have to cope with restricted husbandry conditions, which offer only few opportunities to adequately satisfy their various needs. Consequences could be sensory and cognitive underchallenge that can cause boredom and frustration as well as behavioural disturbances. Initially intended for improvement of management and husbandry, different forms of operant behavioural training have been applied firstly in zoo- and later also in farm animals. It has been suggested that successful coping with appropriate cognitive challenges is a source of positive emotions and may lead to improved welfare. Under the term cognitive enrichment, new approaches have been developed to integrate cognitive challenges into the housing of zoo- and farm animals. The present article reviews actual research in the field. Previous results indicate that, beyond improvement of management and handling routines, such approaches can positively affect animal behaviour and welfare. The combination of explorative and appetitive behaviour with successful learning improves environmental predictability and controllability for the animals, activates reward-related brain systems and can directly affect emotional processes of appraisal. For practical implementation in farm animal husbandry, it sounds promising to link individual access to e.g. automated feeders or milking systems with previously conditioned stimuli and/or discriminatory learning tasks. First experimental approaches in pigs, dwarf goats and cattle are available and will be discussed in the present article.
Arendt, Kristian; Thastum, Mikael; Hougaard, Esben
Homework assignments are considered an essential component for a successful outcome of cognitive behavioural therapy for youths with anxiety disorders. However, only two studies have examined the association between homework adherence and outcome of cognitive behavioural therapy for youths with anxiety disorders. The study examined the association between homework adherence and treatment outcome following a generic group cognitive behaviour treatment program (Cool Kids) for anxiety disordered youths and their parents. The treatment program was completed by 98 children and adolescents (ages 7-16). Homework adherence was measured as time spent doing homework assignments between each session, reported by youths as well as parents. Outcome criteria consisted of youth-reported anxiety symptoms and clinician rated severity of primary anxiety diagnosis at posttreatment and 3-month follow-up. Results did not support an association between homework adherence and treatment outcome when controlling for pretreatment severity. The study found no convincing evidence that homework adherence predicted outcome of cognitive behavioural therapy for youths with anxiety disorders. Reasons for divergent findings on homework adherence in cognitive behavioural therapy for youths compared to adults are discussed.
Rocha, Nuno B F; Fonseca, Duarte A; Marques, Alina B; Rocha, Susana A; Hoaken, Peter N S
There is considerable evidence that aspects of cognitive function, especially executive function, are associated with antisocial behaviour and violence, but most research to date has measured current cognition and previous criminal behaviour. Furthermore, this research has been conducted almost exclusively with male offenders. The aim of this study is to examine relationships between a wide range of cognitive functions and behaviours among women in prison. Our hypotheses were that cognitive functioning would be associated with both more-or-less contemporaneously observed behaviour problems and self-rated adjustment to the environment. Forty-five drug-free imprisoned female offenders were individually assessed on a battery of cognitive measures. Prison staff rated their behaviour on the Prison Behaviour Rating Scale and the women rated their own sense of adjustment to the environment on the Prison Adjustment Questionnaire. Stepwise hierarchical regressions indicated that attention was independently associated with behaviours reflecting tension, depression, isolation, fear, victimisation and worry, whereas processing speed was independently associated with behaviours reflecting lack of energy, mental slowness and lack of awareness of the surrounding environment and total Prison Adjustment Questionnaire score. There was no relationship between cognitive functioning and subjective perception of adjustment to prison. Results indicate that cognition contributes to some of the behavioural problems displayed by inmates in the prison context. Future studies should evaluate the role of programmes to improve cognitive processes in also improving prison behaviour and also test for continuities and discontinuities with post-release integrative success. Copyright © 2014 John Wiley & Sons, Ltd.
Visser, E M; Berger, H J C; Van Schrojenstein Lantman-De Valk, H M J; Prins, J B; Teunisse, J P
Behavioural problems are frequently reported in residential care for people with an intellectual disability (ID) in particular when they are additionally diagnosed with autism spectrum disorder (ASD). There are indications that impairment in cognitive shifting may be associated with problem behaviour. The objectives of this study were (1) to examine the relationship of cognitive shifting and severity of ASD symptoms with externalising problem behaviour in individuals with ID, with and without ASD, and (2) to examine whether a diagnosis based on shifting impairment is more predictive of externalising problem behaviour than an ASD diagnosis. Participants consisted of adolescents and young adults with mild ID, with and without ASD (n = 41). Pearson intercorrelations were computed to explore the relationship between shifting impairment and severity of ASD symptoms on the one hand and ratings of externalising problem behaviour on the other hand. t-Tests were performed to analyse differences in externalising problem behaviour. Unlike ASD symptom severity, shifting scores were found to be associated with externalising problem behaviour, but only if shifting was measured using rating scales and not when using neuropsychological tasks. Externalising problem behaviour scores significantly differed when groups were classified according to shifting impairment (impaired vs. non-impaired) but not when they were classified according to ID and ASD diagnoses. It is proposed to use a cognition-based approach when analysing problem behaviour, thus concentrating not so much on ID and ASD diagnosis and their corresponding symptoms, but rather placing the focus on cognitive symptoms. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Chuang, Jie-Yu; J Whitaker, Kirstie; Murray, Graham K; Elliott, Rebecca; Hagan, Cindy C; Graham, Julia Me; Ooi, Cinly; Tait, Roger; Holt, Rosemary J; van Nieuwenhuizen, Adrienne O; Reynolds, Shirley; Wilkinson, Paul O; Bullmore, Edward T; Lennox, Belinda R; Sahakian, Barbara J; Goodyer, Ian; Suckling, John
.... To examine the interaction between emotion, cognition and treatment, functional brain responses to sad and happy distractors in an affective go/no-go task were explored before and after Cognitive Behavioural Therapy (CBT...
There are a number of ways in which food can influence behaviour, including malnutrition, types of diet, eating habits, pharmacological effects, food allergy, fatty acid deficiency and possibly food additives. The range of behaviour affected is also wide, and includes attention, conduct disorder and mood. A particular focus of interest has been the effects of food on hyperactivity in children. There is some initial evidence that fatty acids may influence hyperactivity in children with specific learning disabilities. The findings also suggest that some food additives (colourings, flavourings and preservatives) may increase hyperactivity in children with behaviour problems. For children showing behaviour problems such as hyperactivity the use of dietary manipulation tends to be a more acceptable approach to treatment than the use of drugs. However, there needs to be awareness of the dangers of the use of unsupervised restriction diets with children, and the use of dietary treatments alone is not likely to be sufficient treatment for many children with attention-deficit hyperactivity disorder. A study is currently underway to investigate the possible effects of additives on behaviour in the general population of children.
Canals, Pascual; Pérez Del Valle, Belén; Lopez, Francisco; Marco, Amparo
It has been a long time since subjective tinnitus cases were described for the first time but they still lack a treatment with proven effectiveness. The main goal of this study was to evaluate the effectiveness of cognitive behavioural therapy in these patients. Between 2012 and 2013, 310 patients that suffered from subjective tinnitus were studied. Of these, 267 were included in treatment based on cognitive behavioural therapy. The monitoring period lasted 18 months for most cases, while it lasted 21 months for 11 patients. Considering patients that interrupted their treatment as failures, the percentage of recovery was 95.7%. Cognitive behavioural therapy should always be included in the treatment of people suffering from tinnitus. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.
Loades, M E; Chalder, T
Approximately one in three children and young people with chronic fatigue syndrome (CFS/ME) also have probable depression. Cognitive behaviour therapy (CBT) has a growing evidence base as an effective treatment approach for CFS/ME and for depression in this population. Given the high degree of co-morbidity, this discussion paper aims to compare and contrast CBT for CFS/ME and CBT for depression in children and young people. The existing literature on CBT for depression and CBT for CFS/ME, in relation to children and young people was reviewed. Whilst there are commonalities to both treatments, the cognitive behavioural model of CFS/ME maintenance includes different factors and has a different emphasis to the cognitive behavioural model of depression, resulting in different intervention targets and strategies in a different sequence. A collaborative, formulation-driven approach to intervention should inform the intervention targets and treatment strategies.
Rouch, Isabelle; Dorey, Jean-Michel; Boublay, Nawèle; Henaff, Marie-Anne; Dibie-Racoupeau, Florence; Makaroff, Zaza; Harston, Sandrine; Benoit, Michel; Barrellon, Marie-Odile; Fédérico, Denis; Laurent, Bernard; Padovan, Catherine; Krolak-Salmon, Pierre
Alzheimer's disease is characterised by a loss of cognitive function and behavioural problems as set out in the term "Behavioural and Psychological Symptoms of Dementia". These behavioural symptoms have heavy consequences for the patients and their families. A greater understanding of behavioural symptoms risk factors would allow better detection of those patients, a better understanding of crisis situations and better management of these patients. Some retrospective studies or simple observations suggested that personality could play a role in the occurrence of behavioural symptoms. Finally, performance in social cognition like facial recognition and perspective taking could be linked to certain personality traits and the subsequent risks of behavioural symptoms. We propose to clarify this through a prospective, multicentre, multidisciplinary study. Main Objective: -To assess the effect of personality and life events on the risk of developing behavioural symptoms. Secondary Objectives: -To evaluate, at the time of inclusion, the connection between personality and performance in social cognition tests; -To evaluate the correlation between performance in social cognition at inclusion and the risks of occurrence of behavioural symptoms; -To evaluate the correlation between regional cerebral atrophy, using brain Magnetic Resonance Imaging at baseline, and the risk of behavioural symptoms. Study type and Population: Prospective multicentre cohort study with 252 patients with Alzheimer's disease at prodromal or mild dementia stage. The inclusion period will be of 18 months and the patients will be followed during 18 months. The initial evaluation will include: a clinical and neuropsychological examination, collection of behavioural symptoms data (Neuropsychiatric-Inventory scale) and their risk factors, a personality study using both a dimensional (personality traits) and categorical approach, an inventory of life events, social cognition tests and an Magnetic Resonance
Full Text Available Abstract Background There is an important gap between the implications of clinical research evidence and the routine clinical practice of healthcare professionals. Because individual decisions are often central to adoption of a clinical-related behaviour, more information about the cognitive mechanisms underlying behaviours is needed to improve behaviour change interventions targeting healthcare professionals. The aim of this study was to systematically review the published scientific literature about factors influencing health professionals' behaviours based on social cognitive theories. These theories refer to theories where individual cognitions/thoughts are viewed as processes intervening between observable stimuli and responses in real world situations. Methods We searched psycINFO, MEDLINE, EMBASE, CIHNAL, Index to theses, PROQUEST dissertations and theses and Current Contents for articles published in English only. We included studies that aimed to predict healthcare professionals' intentions and behaviours with a clear specification of relying on a social cognitive theory. Information on percent of explained variance (R2 was used to compute the overall frequency-weighted mean R2 to evaluate the efficacy of prediction in several contexts and according to different methodological aspects. The cognitive factors most consistently associated with prediction of healthcare professionals' intention and behaviours were documented. Results Seventy eight studies met the inclusion criteria. Among these studies, 72 provided information on the determinants of intention and 16 prospective studies provided information on the determinants of behaviour. The theory most often used as reference was the Theory of Reasoned Action (TRA or its extension the Theory of Planned Behaviour (TPB. An overall frequency-weighted mean R2 of 0.31 was observed for the prediction of behaviour; 0.59 for the prediction of intention. A number of moderators influenced the
Linden, Michael; Baumann, Kai; Lieberei, Barbara; Lorenz, Constanze; Rotter, Max
Posttraumatic embitterment disorder (PTED) is a reaction to unjust or humiliating life events, including embitterment and impairment of mood, somatoform complaints, reduction in drive, withdrawal from social contacts, and even suicide and murder suicide. Patients have been shown to be nonresponders to many treatments. This paper gives an outline of cognitive behaviour therapy based on wisdom psychology and reports first data on treatment effects. In a first pilot study on psychotherapy for PTED, a cohort of 25 PTED inpatients was treated with routine multidimensional cognitive behaviour therapy. A second consecutive cohort of 28 patients was treated with PTED-specific cognitive behaviour therapy, which is based on wisdom psychology (wisdom psychotherapy) and another 29 patients with cognitive behaviour therapy based on wisdom psychology together with additional hedonia strategies (wisdom and hedonia psychotherapy). Treatment integrity was measured with special modules of the Behaviour Therapy Competency Checklist. The outcomes were measured in all 3 groups with the SCL-90 and a global clinical rating of patients and therapists on treatment outcome. There were significant and clinically meaningful reductions in the SCL score after wisdom therapy, as compared to routine treatment. In clinical ratings by therapists and patients, both specific treatments were judged as more effective than treatment as usual. Additional hedonia strategies did not lead to better treatment effects. The results of this pilot study suggest that wisdom psychology offers an approach to treat PTED and justify further randomized controlled outcome studies. Copyright © 2011 S. Karger AG, Basel.
Schendelaar, Pamela; Seggers, Jorien; Heineman, Maas Jan; Hadders-Algra, Mijna
To investigate associations between neurological condition, assessed with the Hempel examination, in terms of minor neurological dysfunction (MND) and neurological optimality, and cognition and behaviour at 4years. Cross-sectional analyses within a prospective, assessor-blinded follow-up study. Four-year-old singletons born to subfertile parents (n=235; 120 boys). Outcome parameters were complex minor neurological dysfunction (complex MND) and the neurological optimality score (NOS). Cognitive outcome was evaluated with the Kaufman Assessment Battery for Children, resulting in a total intelligence quotient (IQ). Behavioural outcome was evaluated with the Child Behavior Checklist, resulting in a total problem T-score. Fifty-seven (24.3%) children had complex MND. None of the children showed fine motor dysfunction, suggesting a ceiling effect of the Hempel assessment. Complex MND was not correlated with IQ or total problem T-score. Nevertheless, a higher NOS was correlated with a higher IQ and a lower total problem T-score (adjusted mean estimate [95% confidence interval]: cognition: 0.445 [0.026; 0.865], p=0.038; behaviour: -0.458 [-0.830; -0.087], p=0.016). At age 4, complex MND assessed with the Hempel assessment was not associated with cognition and behaviour, presumably due to a ceiling effect in the Hempel domain of fine motor function. A more optimal neurological condition was associated with higher IQ and better behaviour. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available Despite decades of research, some of the most basic issues concerning the extraordinarily complex brains and behaviour of birds and mammals, such as the factors responsible for the diversity of brain size and composition, are still unclear. This is partly due to a number of conceptual and methodological issues. Determining species and group differences in brain composition requires accounting for the presence of taxon-cerebrotypes and the use of precise statistical methods. The role of allometry in determining brain variables should be revised. In particular, bird and mammalian brains appear to have evolved in response to a variety of selective pressures influencing both brain size and composition. Brain and cognition are indeed meta-variables, made up of the variables that are ecologically relevant and evolutionarily selected. External indicators of species differences in cognition and behaviour are limited by the complexity of these differences. Indeed, behavioural differences between species and individuals are caused by cognitive and affective components. Although intra-species variability forms the basis of species evolution, some of the mechanisms underlying individual differences in brain and behaviour appear to differ from those between species. While many issues have persisted over the years because of a lack of appropriate data or methods to test them; several fallacies, particularly those related to the human brain, reflect scientists’ preconceptions. The theoretical framework on the evolution of brain, cognition and behaviour in birds and mammals should be reconsidered with these biases in mind.
Austin, S.F.; Sumbundu, A.D.; Lykke, J.
Panic disorder is a common and debilitating disorder that has a prevalence rate of 3-5% in the general population. Cognitive-behavioural interventions have been shown to be an efficacious treatment for panic, although a limited number of studies have examined the effectiveness of such interventions...... of significant clinical change displayed and resources required to carry out the intervention. A small sample of GP-referred patients displaying panic symptoms completed a 2-week intensive cognitive-behavioural intervention. Results collected post-intervention revealed significant clinical reductions in panic...... of implementing effective treatments in everyday clinical practice and developing a stepped care approach to treating panic symptoms Udgivelsesdato: 2008...
Sørensen, Anders Dræby
the lived experience of the learning outcomes of these approaches. The study also clarifies the differences between existential psychotherapy as an art of learning directed at existential learning of authenticity and cognitive- behavioural therapy as a learning-based medical treatment technology directed...... of the outcome of psychotherapy through qualitative research. The precise aim is to draw attention to the special characteristics of this outcome in terms of learning outcome. This regards both existential therapy and cognitive behavioural therapy and to clarify the possible differences and similarities between...
Lawlor, Caroline; Hall, Katherine; Ellett, Lyn
This study explored therapists' and clients' experiences of paranoia about the therapist in cognitive behaviour therapy. Ten therapists and eight clients engaged in cognitive behaviour therapy for psychosis were interviewed using a semi-structured interview. Data were analyzed using thematic analysis. Clients reported experiencing paranoia about their therapist, both within and between therapy sessions. Therapists' accounts highlighted a number of dilemmas that can arise in responding to clients' paranoia about them. The findings highlight helpful ways of working with clients when they become paranoid about their therapist, and emphasize the importance of developing a therapeutic relationship that is radically collaborative, supporting a person-based approach to distressing psychotic experience.
Quemada, José Ignacio; Rusu, Olga; Fonseca, Paola
Social behaviour disorders in traumatic brain injury are caused by the dysfunction of cognitive processes involved in social and interpersonal interaction. The concept of social cognition was introduced by authors studying schizophrenia, autism or mental retardation. The boundaries and the content of the concept have not yet been definitively defined, but theory of mind, empathy and emotional processing are included in all the models proposed. The strategies proposed to improve social behaviour focus on the restoration of cognitive processes such as working memory, emotional recognition and processing, and empathy, as well as social skills. To date, there is very little evidence on the efficacy of the aforementioned social cognition strategies. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Carter, Janet D; McIntosh, Virginia Vw; Jordan, Jennifer; Porter, Richard J; Douglas, Katie; Frampton, Christopher M; Joyce, Peter R
Few studies have examined differential predictors of response to psychotherapy for depression. Greater understanding about the factors associated with therapeutic response may better enable therapists to optimise response by targeting therapy for the individual. The aim of the current exploratory study was to examine patient characteristics associated with response to cognitive behaviour therapy and schema therapy for depression. Participants were 100 outpatients in a clinical trial randomised to either cognitive behaviour therapy or schema therapy. Potential predictors of response examined included demographic, clinical, functioning, cognitive, personality and neuropsychological variables. Individuals with chronic depression and increased levels of pre-treatment negative automatic thoughts had a poorer response to both cognitive behaviour therapy and schema therapy. A treatment type interaction was found for verbal learning and memory. Lower levels of verbal learning and memory impairment markedly impacted on response to schema therapy. This was not the case for cognitive behaviour therapy, which was more impacted if verbal learning and memory was in the moderate range. Study findings are consistent with the Capitalisation Model suggesting that therapy that focuses on the person's strengths is more likely to contribute to a better outcome. Limitations were that participants were outpatients in a randomised controlled trial and may not be representative of other depressed samples. Examination of a variety of potential predictors was exploratory and requires replication.
The target adolescent had a history of severely disruptive behaviour and was facing expulsion from a shelter for homeless children and his school. A thorough assessment served as the basis for a case formulation and treatment plan. Intervention included 23 individual sessions focussing on bereavement and the learning ...
Van Balkom, Ingrid D. C.; Vuijk, Pieter Jelle; Franssens, Marijke; Hoek, Hans W.; Hennekam, Raoul C. M.
Aim The aim of the study was to collect detailed data on behavioural, adaptive, and psychological functioning in 10 individuals with PittHopkins syndrome (PTHS), with specific attention to manifestations of autism spectrum disorder (ASD). Method The participants (four females, six males), residing
Van Balkom, I.D.; Vuijk, P.J.; Franssens, M.; Hoek, H.W.; Hennekam, R.C.
Aim The aim of the study was to collect detailed data on behavioural, adaptive, and psychological functioning in 10 individuals with Pitt-Hopkins syndrome (PTHS), with specific attention to manifestations of autism spectrum disorder (ASD). Method The participants (four females, six males), residing
Lopresti, Adrian L
There is growing evidence confirming increased inflammation in a subset of adults with depression. The impact of this relationship has mostly been considered in biologically based interventions; however, it also has potential implications for psychological therapies. Cognitive behaviour therapy is the most commonly used psychological intervention for the treatment of depression with theories around its efficacy primarily based on psychological mechanisms. However, cognitive behaviour therapy may have an effect on, and its efficacy influenced by, physiological processes associated with depression. Accordingly, the purpose of this systematic review was to examine the relationship between cognitive behaviour therapy and inflammation. Studies examining the anti-inflammatory effects of cognitive behaviour therapy in people with depression and other medical conditions (e.g. cancer, diabetes and heart disease) were examined. In addition, the relationship between change in inflammatory markers and change in depressive symptoms following cognitive behaviour therapy, and the influence of pre-treatment inflammation on cognitive behaviour therapy treatment response were reviewed. A total of 23 studies investigating the anti-inflammatory effects of cognitive behaviour therapy were identified. In 14 of these studies, at least one reduction in an inflammatory marker was reported, increases were identified in three studies and no change was found in six studies. Three studies examined the relationship between change in inflammation and change in depressive symptoms following cognitive behaviour therapy. In two of these studies, change in depressive symptoms was associated with a change in at least one inflammatory marker. Finally, three studies examined the influence of pre-treatment inflammation on treatment outcome from cognitive behaviour therapy, and all indicated a poorer treatment response in people with higher premorbid inflammation. Preliminary evidence suggests
Borragan Pedraz, Guillermo
La fatigue cognitive représente un phénomène auquel nous sommes tous familiers. Nous en faisons quotidiennement l'expérience, celle-ci étant associée à une réduction de productivité, une augmentation de risques professionnels et une diminution de notre qualité de vie. Malgré l’importance sociétale de ces implications, qui ont fait de l'étude de la fatigue cognitive une de plus investiguées dans le domaine des sciences cognitives, il subsiste un manque de vision commune ainsi qu'une théorie un...
Finning, Katie; Richards, David A; Moore, Lucy; Ekers, David; McMillan, Dean; Farrand, Paul A; O'Mahen, Heather A; Watkins, Edward R; Wright, Kim A; Fletcher, Emily; Rhodes, Shelley; Woodhouse, Rebecca; Wray, Faye
To explore participant views on acceptability, mechanisms of change and impact of behavioural activation (BA) delivered by junior mental health workers (MHWs) versus cognitive behavioural therapy (CBT) delivered by professional psychotherapists. Semistructured qualitative interviews analysed using a framework approach. 36 participants with major depressive disorder purposively sampled from a randomised controlled trial of BA versus CBT (the COBRA trial). Primary care psychological therapies services in Devon, Durham and Leeds, UK. Elements of therapy considered to be beneficial included its length and regularity, the opportunity to learn and not dwelling on the past. Homework was an important, although challenging aspect of treatment. Therapists were perceived as experts who played an important role in treatment. For some participants the most important element of therapy was having someone to talk to, but for others the specific factors associated with BA and CBT were crucial, with behavioural change considered important for participants in both treatments, and cognitive change unsurprisingly discussed more by those receiving CBT. Both therapies were considered to have a positive impact on symptoms of depression and other areas of life including feelings about themselves, self-care, work and relationships. Barriers to therapy included work, family life and emotional challenges. A subset (n=2) of BA participants commented that therapy felt too simple, and MHWs could be perceived as inexperienced. Many participants saw therapy as a learning experience, providing them with tools to take away, with work on relapse prevention essential. Despite barriers for some participants, BA and CBT were perceived to have many benefits, to have brought about cognitive and behavioural change and to produce improvements in many domains of participants' lives. To optimise the delivery of BA, inexperienced junior MHWs should be supported through good quality training and ongoing
van Es, Eelco
This book provides a cognitive analysis of the poetry of George Herbert (1593- 1633). From Herbert’s own thinking, recorded in his prose treatises, can be deduced that his poems should serve a specific function: teaching self-knowledge to his readers. Self-knowledge is a necessary skill, to be
... conﬁrmed by rigorous investigations. In spite of potent biological mechanisms that protect brain activity from disruption, some cognitive functions appear sensitive to short-term variations of fuel (glucose) availability in certain brain areas. A glucose load, for example, acutely facilitates mental performance, particularly on demanding, long-duratio...
John Chandy C
Full Text Available Abstract Background Infection with severe malaria in African children is associated with not only a high mortality but also a high risk of cognitive deficits. There is evidence that interventions done a few years after the illness are effective but nothing is known about those done immediately after the illness. We designed a study in which children who had suffered from severe malaria three months earlier were enrolled into a cognitive intervention program and assessed for the immediate benefit in cognitive, academic and behavioral outcomes. Methods This parallel group randomised study was carried out in Kampala City, Uganda between February 2008 and October 2010. Sixty-one Ugandan children aged 5 to 12 years with severe malaria were assessed for cognition (using the Kaufman Assessment Battery for Children, second edition and the Test of Variables of Attention, academic skills (Wide Range Achievement Test, third edition and psychopathologic behaviour (Child Behaviour Checklist three months after an episode of severe malaria. Twenty-eight were randomised to sixteen sessions of computerised cognitive rehabilitation training lasting eight weeks and 33 to a non-treatment group. Post-intervention assessments were done a month after conclusion of the intervention. Analysis of covariance was used to detect any differences between the two groups after post-intervention assessment, adjusting for age, sex, weight for age z score, quality of the home environment, time between admission and post-intervention testing and pre-intervention score. The primary outcome was improvement in attention scores for the intervention group. This trial is registered with Current Controlled Trials, number ISRCTN53183087. Results Significant intervention effects were observed in the intervention group for learning mean score (SE, [93.89 (4.00 vs 106.38 (4.32, P = 0.04] but for working memory the intervention group performed poorly [27.42 (0.66 vs 25.34 (0.73, P = 0.04]. No
Park, Emma C; Waller, Glenn; Gannon, Kenneth
The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.
Full Text Available Objective. Identification of the factors that influence sedentary behaviour in older adults is important for the design of appropriate intervention strategies. In this study, we determined the prevalence of sedentary behaviour and its association with physical, cognitive, and psychosocial status among older adults residing in Assisted Living (AL. Methods. Participants (n=114, mean age = 86.7 from AL sites in British Columbia wore waist-mounted activity monitors for 7 consecutive days, after being assessed with the Timed Up and Go (TUG, Montreal Cognitive Assessment (MoCA, Short Geriatric Depression Scale (GDS, and Modified Fall Efficacy Scale (MFES. Results. On average, participants spent 87% of their waking hours in sedentary behaviour, which accumulated in 52 bouts per day with each bout lasting an average of 13 minutes. Increased sedentary behaviour associated significantly with scores on the TUG (r=0.373, p<0.001 and MFES (r=-0.261, p=0.005, but not with the MoCA or GDS. Sedentary behaviour also associated with male gender, use of mobility aid, and multiple regression with increased age. Conclusion. We found that sedentary behaviour among older adults in AL associated with TUG scores and falls-related self-efficacy, which are modifiable targets for interventions to decrease sedentary behaviour in this population.
Douglass, Sarah; Palmer, Katherine; O'Connor, Chris
An anxiety management group utilizing a cognitive behavioural intervention, of 12 weeks duration, for six people with mild to moderate learning disabilities is described. A number of techniques to assist in developing clients' understanding of their anxiety, cognitive and behavioural coping strategies and maximizing generalizability of skills…
Zonneveld, L.N.; Duivenvoorden, H.J.; Passchier, J.; van 't Spijker, A
The prevalence of unexplained physical symptoms (UPS) in primary care is at least 33%. Cognitive behavioural therapy has shown to be effective. Within cognitive behavioural therapy, three models can be distinguished: reattribution model, coping model and consequences model. The consequences model,
Romijn, Geke; Riper, Heleen; Kok, Robin
.e. panic disorder, social phobia or generalized anxiety disorder, in specialized mental health care settings compared to face-to-face cognitive behavioural therapy. In this paper, we present the study protocol. It is hypothesized that blended cognitive behavioural therapy for anxiety disorders...
L.N.L. Zonneveld (Lyonne); H.J. Duivenvoorden (Hugo); J. Passchier (Jan); A. van 't Spijker (Adriaan)
textabstractThe prevalence of unexplained physical symptoms (UPS) in primary care is at least 33%. Cognitive behavioural therapy has shown to be effective. Within cognitive behavioural therapy, three models can be distinguished: reattribution model, coping model and consequences model. The
Cooney, Patricia; Tunney, Conall; O'Reilly, Gary
Background: Cognitive behavioural therapy (CBT) is being increasingly adapted for use with people who have an intellectual disability. However, it remains unclear whether inherent cognitive deficits that are present in adults who have an intellectual disability preclude the use of cognitive-based therapies. This review aims to systematically…
Full Text Available Behavioural tests to assess affective states are widely used in human research and have recently been extended to animals. These tests assume that affective state influences cognitive processing, and that animals in a negative affective state interpret ambiguous information as expecting a negative outcome (displaying a negative cognitive bias. Most of these tests however, require long discrimination training. The aim of the study was to validate an exploration based cognitive bias test, using two different handling methods, as previous studies have shown that standard tail handling of mice increases physiological and behavioural measures of anxiety compared to cupped handling. Therefore, we hypothesised that tail handled mice would display a negative cognitive bias. We handled 28 female CD-1 mice for 16 weeks using either tail handling or cupped handling. The mice were then trained in an eight arm radial maze, where two adjacent arms predicted a positive outcome (darkness and food, while the two opposite arms predicted a negative outcome (no food, white noise and light. After six days of training, the mice were also given access to the four previously unavailable intermediate ambiguous arms of the radial maze and tested for cognitive bias. We were unable to validate this test, as mice from both handling groups displayed a similar pattern of exploration. Furthermore, we examined whether maze exploration is affected by the expression of stereotypic behaviour in the home cage. Mice with higher levels of stereotypic behaviour spent more time in positive arms and avoided ambiguous arms, displaying a negative cognitive bias. While this test needs further validation, our results indicate that it may allow the assessment of affective state in mice with minimal training-a major confound in current cognitive bias paradigms.
Romijn, Geke; Riper, Heleen; Kok, Robin
BACKGROUND: Anxiety disorders are among the most prevalent psychiatric conditions, and are associated with poor quality of life and substantial economic burden. Cognitive behavioural therapy is an effective treatment to reduce anxiety symptoms, but is also costly and labour intensive. Cost......-effectiveness could possibly be improved by delivering cognitive behavioural therapy in a blended format, where face-to-face sessions are partially replaced by online sessions. The aim of this trial is to determine the cost-effectiveness of blended cognitive behavioural therapy for adults with anxiety disorders, i.......e. panic disorder, social phobia or generalized anxiety disorder, in specialized mental health care settings compared to face-to-face cognitive behavioural therapy. In this paper, we present the study protocol. It is hypothesized that blended cognitive behavioural therapy for anxiety disorders...
Rossi, N. F.; Giacheti, C. M.
Background: Williams syndrome (WS) phenotype is described as unique and intriguing. The aim of this study was to investigate the associations between speech-language abilities, general cognitive functioning and behavioural problems in individuals with WS, considering age effects and speech-language characteristics of WS sub-groups. Methods: The…
de Lange, Floris P.; Koers, Anda; Kalkman, Joke S.; Bleijenberg, Gijs; Hagoort, Peter; van der Meer, Jos W. M.; Toni, Ivan
Chronic fatigue syndrome (CFS) is a disabling disorder, characterized by persistent or relapsing fatigue. Recent studies have detected a decrease in cortical grey matter volume in patients with CFS, but it is unclear whether this cerebral atrophy constitutes a cause or a consequence of the disease. Cognitive behavioural therapy (CBT) is an…
Burns, Emma; Martin, Andrew J.
Adaptability has been recently proposed as cognitive, behavioural, and emotional regulation assisting individuals to effectively respond to change, uncertainty and novelty. Given students with attention-deficit/hyperactivity disorder (ADHD) have known impairments with regulatory functions, they may be at particular disadvantage as they seek to…
Emmelkamp, Paul M. G.; Benner, Ank; Kuipers, Antoinette; Feiertag, Guus A.; Koster, Harrie C.; van Apeldoorn, Franske J.
Background There is a paucity of controlled trials examining the effectiveness of individual psychotherapy in personality disorders, especially in patients with cluster C disorders. Aims To compare the effectiveness of brief dynamic therapy and cognitive-behavioural therapy as out-patient treatment
Squires, Garry; Dunsmuir, Sandra
At the national level there has been a call for more therapeutic interventions and Cognitive Behavioural Therapy (CBT) has been identified as one approach that can be used. The training of educational psychologists (EPs) has been extended to three years and this provides an opportunity to increase the depth of knowledge of particular therapeutic…
Feeney, Farah; Egan, Sarah; Gasson, Natalie
Depression and anxiety affect up to 50% of people with Parkinson's Disease (PD) (Marsh, 2000; Murray, 1996), however, few studies have examined the effectiveness of psychological treatment. This study examined the effectiveness of group cognitive behaviour therapy (CBT) in treating depression and anxiety in PD. Four participants, aged between 56…
Chen, Yu-Han; Rodgers, Jacqui; McConachie, Helen
Many individuals with autism tend to focus on details. It has been suggested that this cognitive style may underlie the presence of stereotyped routines, repetitive interests and behaviours, and both relate in some way to sensory abnormalities. Twenty-nine children with diagnosis of high functioning autism or Asperger syndrome completed the…
Almlov, J.; Carlbring, P.; Berger, T.; Cuijpers, P.; Andersson, G.
Internet-delivered cognitive behavioural therapy (CBT) can be an effective method for treating major depression, but it often works best when therapist support is provided in the form of e-mail support or telephone calls. The authors investigated whether there were any intraclass correlations within
Ruwaard, Jeroen; Lange, Alfred; Bouwman, Manon; Broeksteeg, Janneke; Schrieken, Bart
The aim of this study was to assess the effects of a 7-week standardized cognitive behavioural treatment of work-related stress conducted via e-mail. A total of 342 people applied for treatment in reaction to a newspaper article. Initial screening reduced the sample to a heterogeneous (sub)clinical
Sivan, Atara; Chan, Dennis W. K.
This study validated the Chinese version of the Questionnaire on Teacher Interaction (QTI) in the Hong Kong context as well as examined the relationship between students' perceptions of interpersonal teacher behaviour and their cognitive, affective and moral learning outcomes. Data were collected with the QTI and four other measures of student…
Recent developments in digital technology have resulted in the unprecedented uptake of digital technology engagement as a leisure-time pursuit across the age span. This has resulted in the speculation that such use of digital technology is responsible for changes in cognition and learning behaviour. This study investigated two groups of…
Henselmans, Inge; Fleer, Joke; de Vries, J; Baas, Peter C; Sanderman, Robbert; Ranchor, Adelita V
This prospective study examines the cognitive and behavioural mediators of the relation between personal control and the initial response to a breast cancer diagnosis as well as subsequent psychological adjustment. A total of 143 patients participated immediately after diagnosis (T1), after surgery
Boelen, Paul A.; de Keijser, Jos; van den Hout, Marcel A.; van den Bout, Jan
Complicated grief (CG), also called prolonged grief disorder, is a debilitating condition that can develop following a loss. There is growing evidence that cognitive-behavioural interventions are efficacious in the treatment of CG. The present preliminary study used data from 43 patients with CG who
Schröder, Andreas; Ørnbøl, Eva; Jensen, Jens Søndergaard
Objective: Functional somatic syndromes (FSS) such as fibromyalgia, irritable bowel and chronic fatigue syndrome often disrupt employment and may lead to long-term dependence on social benefits and permanently reduced work ability. Cognitive-behavioural treatments (CBT) relief symptoms and improve...
Lammers, M.W.; Vroling, M.S.; Ouwens, M.A.; Engels, R.C.M.E.; van Strien, T.
The aim of this naturalistic study was to identify pretreatment predictors of response to cognitive behaviour therapy in treatment-seeking patients with binge eating disorder (BED; N = 304). Furthermore, we examined end-of-treatment factors that predict treatment outcome 6 months later (N = 190). We
Scherder, E.J A; van Someren, E.W J; Bouma, J.M.; van der Berg, M
In previous studies, transcutaneous electrical nerve stimulation (TENS) improved cognition and behaviour in patients with Alzheimer's disease (AD). The rationale underlying these studies was that TENS could activate, e.g. the septo-hippocampal region and the hypothalamus through direct and indirect
van Straten, A.; Emmelkamp, J.; de Wit, J.; Lancee, J.; Andersson, G.; van Someren, E.J.W.; Cuijpers, P.
Background: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT
van Straten, A.; Emmelkamp, J.; de Wit, J.; Lancee, J.; Andersson, G.; van Someren, E.J.W.; Cuijpers, P.
Background Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT
van Straten, A; Emmelkamp, J; de Wit, J; Lancee, J; Andersson, G; van Someren, E J W; Cuijpers, P
BACKGROUND: Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT
Dissanayake, Cheryl; Bui, Quang; Bulhak-Paterson, Danuta; Huggins, Richard; Loesch, Danuta Z.
Background: In order to better understand the underlying biological mechanism/s involved in autism, it is important to investigate the cognitive and behavioural phenotypes associated with idiopathic autism (autism without a known cause) and comorbid autism (autism associated with known genetic/biological disorders such as fragile X syndrome).…
Mantione, M.; Nieman, D. H.; Figee, M.; Denys, D.
Deep brain stimulation (DBS) is a promising new treatment for patients with treatment-refractory obsessive-compulsive disorder (OCD). However, since most DBS patients only show a partial response, the treatment still needs to be improved. In this study we hypothesized that cognitive-behavioural
Heins, M.J.; Knoop, H.; Bleijenberg, G.
Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) can reduce fatigue and impairment. Recently, it was found that changes in fatigue-perpetuating factors, i.e. focusing on symptoms, control over fatigue, perceived activity and physical functioning, are associated with and explain
Heins, M.J.; Knoop, H.; Bleijenberg, G.
Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) can reduce fatigue and impairment. Recently, it was found that changes in fatigue-perpetuating factors, i.e. focusing on symptoms, control over fatigue, perceived activity and physical functioning, are associated with and explain
Lammers, M.W.; Vroling, M.S.; Ouwens, M.A.; Engels, R.C.M.E.; Strien, T. van
The aim of this naturalistic study was to identify pretreatment predictors of response to cognitive behaviour therapy in treatment-seeking patients with binge eating disorder (BED; N=304). Furthermore, we examined end-of-treatment factors that predict treatment outcome 6months later (N=190). We
Schene, A. H.; Baas, K. D.; Koeter, M.; Lucassen, P.; Bockting, C. L. H.|info:eu-repo/dai/nl/258267992; Wittkampf, K. F.; van Weert, H. C.; Huyser, J.
Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and
Schene, A.H.; Baas, K.D.; Koeter, M.W.J.; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K.A.; Huyser, J.; van Weert, H.C.
Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and
Bennett, Emily; Heaton, Pamela
Parents of 125 children, adolescents and young adults with autism spectrum disorders completed a newly developed questionnaire aimed at identifying cognitive and behavioural characteristics associated with savant skills in this group. Factors distinguishing skilled individuals were then further investigated in case studies of three individuals…
Westra, Henny A
While cognitive behavioural therapy is highly effective in the treatment of anxiety and depression, a substantive number of individuals either refuse treatment, fail to respond to treatment or respond only partially. Arguably, ambivalence about change or about engaging in treatment tasks may in part be related to incomplete recovery rates in cognitive behavioural therapy. Motivational interviewing is a client-centred, directive treatment originally developed in the addictions domain whose goal is to enhance motivation for change by understanding and resolving ambivalence. This method has consistently received support for enhancing outcomes in the addictions domain, particularly when used as an adjunct to further treatment. As yet, motivational methods have not been generalized to the treatment of prevalent mental health problems, such as anxiety and depression. The present paper presents the application of a treatment targeting motivation (motivational interviewing adapted for anxiety and depression) to the management of resistance in cognitive behavioural therapy for 3 clients with mixed anxiety and depression. Motivational interviewing is conceived as an adjunct to highly effective traditional cognitive behavioural therapy methods, which is indicated for use with clients resistant to and significantly ambivalent about change-based techniques for managing anxiety or alleviating depression.
Schendelaar, Pamela; Seggers, Jorien; Heineman, Maas Jan; Hadders-Algra, Mijna
Aim: To investigate associations between neurological condition, assessed with the Hempel examination, in terms of minor neurological dysfunction (MND) and neurological optimality, and cognition and behaviour at 4 years. Study design: Cross-sectional analyses within a prospective, assessor-blinded
Huyser, Chaim; van den Heuvel, Odile A.; Wolters, Lidewij H.; de Haan, Else; Boer, Frits; Veltman, Dick J.
Identify differences in regional brain volume between medication-free pediatric OCD patients and controls and examine changes after cognitive behavioural therapy. We assessed 29 medication-free paediatric OCD patients (Age: M = 13.78 years; SD = 2.58; range 8.2-19.0) and 29 controls, matched on age
Huyser, C.; van den Heuvel, O.A.; Wolters, L.H.; Haan, E.; de Boer, F.; Veltman, D.J.
Objectives. Identify differences in regional brain volume between medication-free pediatric OCD patients and controls and examine changes after cognitive behavioural therapy. Methods. We assessed 29 medication-free paediatric OCD patients (Age: M =13.78 years; SD =2.58; range 8.2-19.0) and 29
Marwood, Hayley; Chinn, Deborah; Gannon, Kenneth; Scior, Katrina
Background: People with intellectual disabilities (ID) should be able to access the Improving Access to Psychological Therapies (IAPT) programme, currently a main provider of mainstream mental health services in England. IAPT offer cognitive behavioural therapy (CBT) to individuals experiencing mental health problems, although its effectiveness…
Rait, Shami; Monsen, Jeremy J.; Squires, Garry
This paper critically considers the growing interest in the use of Cognitive Behaviour Therapies to support children and young people presenting with a wide range of social-emotional difficulties. This focus has emerged since the prevalence of such difficulties in children and young people has increased over the past four decades, and the…
Ruwaard, Jeroen; Lange, Alfred; Broeksteeg, Janneke; Renteria-Agirre, Aitziber; Schrieken, Bart; Dolan, Conor V; Emmelkamp, Paul
BACKGROUND: Manualized cognitive-behavioural treatment (CBT) is underutilized in the treatment of bulimic symptoms. Internet-delivered treatment may reduce current barriers. OBJECTIVE: This study aimed to assess the efficacy of a new online CBT of bulimic symptoms. METHOD: Participants with bulimic
Essau, Cecilia A; Olaya, Beatriz; Sasagawa, Satoko; Pithia, Jayshree; Bray, Diane; Ollendick, Thomas H
The present study examined the effectiveness of a transdiagnostic prevention programme, Super Skills for Life (SSL), in children with anxiety problems. SSL is based on the principles of cognitive-behaviour therapy (CBT), behavioural activation, social skills training, and uses video-feedback and cognitive preparation as part of the treatment. Participants were 61 primary school children, aged 8-10 years, who were referred by their teachers as having significant anxiety problems. Children were video-recorded during a 2-min speech task in sessions 1 and 8, and during a social interaction task. All the children completed measures of anxiety symptoms, social skills, and self-esteem before and after participating in the 8-week SSL and at the 6-months follow-up assessment. Anxiety symptoms were significantly reduced at post-test and follow-up assessments. SSL also had a positive effect on hyperactivity, conduct, and peer problems although it took longer for these effects to occur. Behavioural indicators of anxiety during the 2-min speech task decreased, indicating that the independent raters observed behavioural change in the children from pre-treatment to follow-up. Boys had higher overall behavioural anxiety during the 2-min speech task at all three assessment periods, specifically showing higher lip contortions and leg movement than girls. The present study used an open clinical trial design, had small sample size, and did not use structured diagnostic interview schedules to assess anxiety disorders. This study provides preliminary empirical support for the effectiveness of SSL in children with anxiety problems. Copyright © 2014 Elsevier B.V. All rights reserved.
Prasad, Rajniti; Shambhavi; Mishra, Om P; Upadhyay, Shashi K; Singh, Tej B; Singh, Utpal Kant
Eighty-three confirmed cases of neurocysticercosis diagnosed as per modified delBrutto criteria were enrolled in the study (Group-I) to observe cognitive and behavioural changes. Controls consisted of two groups: children with idiopathic generalized tonic-clonic seizure (Group-II) and normal children with non-specific cough (Group-III). Cases and controls were subjected to cognitive and behaviour assessment. There was significant difference in the intelligence quotient (IQ) of cases in domains of visual perception, immediate recall, analysis synthesis and reasoning, verbal ability, memory and spatial ability. In the age group of 6-18 years, cases had significantly more behaviour problems than control without seizure, in domains of anxious depressed, withdrawn depressed, somatic problems, social problems and rule-breaking behaviour. Neurocysticercosis causes decline in cognitive function and behaviours in older children, which should be recognized early for appropriate management and to avoid undue parental anxiety. © The Author . Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Mansor Abu Talib, Rojanah BT Kahar, Vahid Momtaz, Mariani BTE Mansor
Internalizing/externalizing behavioural problems among adolescents are the most important issue in adolescents' mental health. Cognitive-emotional regulation strategies are the important protective and risk factor for internalizing/externalizing behavioural problems. In the present study the moderating role of gender in the relationship between cognitive-emotional regulation strategies and internalizing/externalizing behavioural problems among adolescents was investigated. The respondents wer...
Journal of Applied Research in Intellectual Disabilities, 2010
Background: For non-disabled men, group cognitive-behaviour therapy is a successful form of treatment when men have committed sexual offences. However, men with intellectual disabilities and sexually abusive behaviour are rarely offered treatment for their sexual behaviour and little research data on the effectiveness of such treatment has been…
Spoelstra, Sandra L; Schueller, Monica; Hilton, Melissa; Ridenour, Kimberly
This article presents an integrative review of the evidence for combined motivational interviewing and cognitive behavioural interventions that promote medication adherence. We undertook this review to establish a scientific foundation for development of interventions to promote medication adherence and to guide clinical practice. The World Health Organization has designated medication adherence as a global problem. Motivational interviewing and cognitive behaviour interventions have been found to individually promote medication adherence. However, there is a gap in the literature on the effect of combined motivational interviewing and cognitive behavioural approaches to promote medication adherence. Integrative review. COCHRANE, PubMed and CINAHL were searched to access relevant studies between 2004-2014. Inclusion criteria were interventions combining motivational interviewing and cognitive behavioural therapy with medication adherence as the outcome. Articles were assessed for measures of adherence and methodological rigour. Analysis was performed using an integrative review process. Six articles met the inclusion criteria. A randomised controlled trial reported pretreatment missed doses of 5·58 and post-treatment of 0·92 and trended towards significance. Four cohort studies had effect sizes of 0·19-0·35 (p adherence rate of 25% and post-treatment 77% (p medication adherence. Future studies with large rigorous randomised trials are needed. This review provides clinicians with the state of the science in relation to combined motivational interviewing and cognitive behavioural therapy interventions that promote medication adherence. A summary of intervention components and talking points are provided to aid nurses in informing decision-making and translating evidence into practice. © 2014 John Wiley & Sons Ltd.
Ding, Yan-hua; Xu, Xiu; Wang, Zheng-yan; Li, Hui-rong; Wang, Wei-ping
In China, research on the relation of mother-infant attachment to children's development is scarce. This study sought to investigate the relation of mother-infant attachment to attachment, cognitive and behavioural development in young children. This study used a longitudinal study design. The subjects included healthy infants (n=160) aged 12 to 18 months. Ainsworth's "Strange Situation Procedure" was used to evaluate mother-infant attachment types. The attachment Q-set (AQS) was used to evaluate the attachment between young children and their mothers. The Bayley scale of infant development-second edition (BSID-II) was used to evaluate cognitive developmental level in early childhood. Achenbach's child behaviour checklist (CBCL) for 2- to 3-year-olds was used to investigate behavioural problems. In total, 118 young children (73.8%) completed the follow-up; 89.7% of infants with secure attachment and 85.0% of infants with insecure attachment still demonstrated this type of attachment in early childhood (κ=0.738, pdevelopment index (MDI) in early childhood than did infants with secure attachment, especially the resistant type. In addition, resistant infants were reported to have greater social withdrawal, sleep problems and aggressive behaviour in early childhood. There is a high consistency in attachment development from infancy to early childhood. Secure mother-infant attachment predicts a better cognitive and behavioural outcome; whereas insecure attachment, especially the resistant attachment, may lead to a lower cognitive level and greater behavioural problems in early childhood. Copyright © 2014 Elsevier Ltd. All rights reserved.
Johan WS Vlaeyen
Full Text Available Although cognitive-behavioural treatments of patients with chronic pain generally are reported to be effective, customization might increase their effectiveness. One possible way to customize treatment is to focus the intervention on the supposed mechanism underlying the transition from acute to chronic pain disability. Evidence is accumulating in support of the conjecture that pain-related fear and associated avoidance behaviours are crucial in the development and maintenance of chronic pain disability. It seems timely to apply this knowledge to the cognitive-behavioural management of chronic pain. Two studies are presented here. Study 1 concerns a secondary analysis of data gathered in a clinical trial that was aimed at the examination of the supplementary value of coping skills training when added to an operant-behavioural treatment in patients with chronic back pain. The results show that, compared with a waiting list control, an operant-behavioural treatment with or without pain-coping skills training produced very modest and clinically negligible decreases in pain-related fear. Study 2 presents the effects of more systematic exposure in vivo treatment with behavioural experiments in two single patients reporting substantial pain-related fear. Randomization tests for AB designs revealed dramatic changes in pain-related fear and pain catastrophizing. In both cases, pain intensity also decreased significantly, but at a slower pace. Differences before and after treatment revealed clinically significant improvements in pain vigilance and pain disability.
Heins, Marianne J; Knoop, Hans; Burk, William J; Bleijenberg, Gijs
Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and behaviour are related to the decrease in fatigue. We included 183 patients meeting the US Centers for Disease Control criteria for CFS, aged 18 to 65 years, starting CBT. We measured fatigue and possible process variables before treatment; after 6, 12 and 18 weeks; and after treatment. Possible process variables were sense of control over fatigue, focusing on symptoms, self-reported physical functioning, perceived physical activity and objective (actigraphic) physical activity. We built multiple regression models, explaining levels of fatigue during therapy by (changes in) proposed process variables. We observed large individual variation in the patterns of change in fatigue and process variables during CBT for CFS. Increases in the sense of control over fatigue, perceived activity and self-reported physical functioning, and decreases in focusing on symptoms explained 20 to 46% of the variance in fatigue. An increase in objective activity was not a process variable. A change in cognitive factors seems to be related to the decrease in fatigue during CBT for CFS. The pattern of change varies considerably between patients, but changes in process variables and fatigue occur mostly in the same period. © 2013.
Giovagnoli, Anna Rita; Oliveri, Serena; Schifano, Letizia; Raglio, Alfredo
This study describes the effects of active music therapy (AMT) on cognition and behaviour in chronic vascular encephalopathy. A single case study investigated different cognitive and psycho-behavioural changes after AMT. An adult patient with memory, attention, and verbal fluency deficits associated with Vascular Cognitive Impairment-No Dementia (VCI-ND) was treated. A four-months AMT course was based on creative and interactive music playing. Sixteen sessions were conducted simultaneously to the pharmacological therapy. Cognitive performances, mood, interpersonal interactions, and perceived abilities were assessed using standardized neuropsychological and psycho-behavioural measurements. At baseline, the patient reported a tendency to feel tense, nervous, and angry and difficulties in memory and visuospatial performances, frequently accompanied by attention drops. The social network was a habitual component of the patient's life, but not a source of sharing of personal experiences, safety or comfort. Neuropsychological tests showed deficits in object and figure naming, verbal fluency, short and long-term verbal memory, short-term spatial memory, selective attention, and visuomotor coordination. After AMT, the cognitive profile significantly improved in attention, visuomotor coordination, and verbal and spatial memory. Such positive changes were confirmed at the three-months follow-up. An increase of the interpersonal interactions and consistent reduction of anxiety were also observed. In selected patients with VCI-ND, a well-structured AMT intervention added to standard therapy may contribute in determining a stable improvement of cognitive and psycho-behavioural aspects. Controlled studies are needed to confirm these promising results. Copyright © 2013 Elsevier Ltd. All rights reserved.
Bonifacci, Paola; Montuschi, Martina; Lami, Laura; Snowling, Margaret J
Within a dimensional view of reading disorders, it is important to understand the role of environmental factors in determining individual differences in literacy outcome. In the present study, we compared a group of 40 parents of children with dyslexia (PDys) with a group of 40 parents of typically developing children. The two parent groups did not differ in socioeconomic status or nonverbal IQ. Participants were assessed on cognitive (IQ, digit span) and literacy (reading fluency and accuracy) tasks, phonological awareness and verbal fluency measures. Questionnaires addressed reading history, parental distress, family functioning, anxiety and depression. The PDys group performed worse in all literacy measures and more frequently reported a history of poor reading; they also showed more parental distress. There were no differences between the two groups in depression or family functioning and no differences between mothers and fathers. Findings indicate that PDys show a cognitive profile consistent with the broader phenotype of dyslexia (i.e. reading impairment and poor phonological awareness), whereas, considering the emotional profile, the impact of dyslexia on the family system is limited to parental distress associated with the perception of having a child with specific needs. Copyright © 2013 John Wiley & Sons, Ltd.
Nergård-Nilssen, Trude; Hulme, Charles
This paper explores the nature of residual literacy and cognitive deficits in self-reported dyslexic Norwegian adults. The performance of 26 self-reported dyslexic adults was compared with that of a comparison group of 47 adults with no history of reading or spelling difficulties. Participants completed standardized and experimental measures tapping literacy skills, working memory, phonological awareness and rapid naming. Spelling problems were the most prominent marker of dyslexia in adults, followed by text reading fluency and nonword decoding. Working memory and phoneme awareness explained unique variance in spelling, whereas rapid automatized naming explained unique variance in reading fluency and nonword reading. The moderate to strong correlations between self-reported history, self-rating of current literacy skills and outcomes on literacy tests indicate that adults estimated their literacy skills fairly well. Results suggest that spelling impairments, more strongly than reading impairments, make adults perceive themselves as being dyslexic. A combination of three literacy and three cognitive tests predicted group membership with 90.4% accuracy. It appears that weaknesses in phoneme awareness, rapid automatized naming and working memory are strong and persistent correlates of literacy problems even in adults learning a relatively transparent orthography. Copyright © 2014 John Wiley & Sons, Ltd.
van der Hulst, Egberdina-Józefa; Bak, Thomas H; Abrahams, Sharon
Executive and behavioural changes are well-recognised in classical amyotrophic lateral sclerosis (ALS), indicating a subclinical behavioural-variant frontotemporal dementia (bvFTD) in some patients. Social cognitive deficits in ALS have been recently described and an impairment was identified on a simple Theory of Mind (ToM) test, which assesses the judgement of the preference of another through direction of eye gaze. The present study further delineated this deficit, by distinguishing between Affective and Cognitive subcomponents, and determining the relationship to behavioural change, levels of empathy and self-awareness. The Cognitive-Affective Judgement of Preference Test was administered to 33 patients with ALS and 26 controls. Furthermore, a comprehensive neuropsychological battery and detailed behavioural assessment, with measures of empathy and awareness, were included. Patients with ALS showed a significant impairment in Affective ToM only when compared with healthy controls, with a deficit in 36% of patients; 12% showed an isolated Affective ToM deficit while 24% showed more generic ToM dysfunction. A Cognitive ToM deficit was found in 27% of patients, with 3% showing an isolated Cognitive ToM deficit. The patients with ALS showed reduced empathy (Fantasy scale) and increased behavioural dysfunction with high levels of apathy. In addition, patients with either an Affective and/or Cognitive ToM deficit exhibited poor self-awareness of their performance and abnormalities on verbal fluency, while those with an Affective ToM deficit also displayed higher levels of apathy and a naming deficit. Dysfunctional ToM is a prominent feature of the cognitive profile of ALS. This specific difficulty in identifying and distinguishing the feelings and thoughts of another from a self-perspective may underpin the social behavioural abnormalities present in some patients with ALS, manifest as apathy and loss of awareness. Published by the BMJ Publishing Group Limited. For
Kovac, Velibor Bobo; Cameron, David Lansing; Høigaard, Rune
Understanding the underlying processes influencing college students' academic achievement represents an important goal of educational research. The aim of the present study was to examine the utility of the extended Theory of Planned Behaviour (TPB) and the relative influence of cognitive processes and measures of past behaviour in the prediction…
The purposes of this article are (1) to introduce the outline of the outcomes model and substruction, and (2) to introduce the example of synthesis and critique of literature about psychoeducational therapy for schizophrenic patients. Recently, psychiatrists or psychologists are providing patients with education for medication using cognitive therapy, social skills training and psychoeducational therapy in Japan. Psychiatrists and psychologists are doing evaluation research of these structure...
Hall, Pauline L; Tarrier, Nicholas
Low self esteem in individuals with a psychotic disorder is common and may be related to poorer clinical outcomes. However, there has been little research on devising treatment methods to improve self-esteem either generally or in psychotic patients in particular. The aims of this study were to evaluate the efficacy of a simple cognitive behavioural intervention to improve self esteem in psychotic patients who scored poorly on a self-esteem measure. This pilot study was a randomised control trial with a convenience sample of chronic psychotic inpatients. The cognitive behavioural self-esteem intervention, as an adjunct to treatment as usual (TAU), was compared to TAU alone in patients with psychosis. The individual self-esteem intervention as described by Tarrier (The use of coping strategies and self-regulation in the treatment of psychosis. (2001)) consisted of working with participants to elicit positive self-attributes and then identify specific behavioural examples to provide evidence of this attribute. Emphasis was given to any consequential change in the patient's belief that they had the attribute. The results indicated that this cognitive behavioural treatment for self-esteem used as an adjunct treatment in psychosis, resulted in clinical benefits in terms of increased self-esteem, decreased psychotic symptomatology and improved social functioning. These benefits were largely maintained at 3-month follow-up.
Dixon, Martin; Turner, Martin J; Gillman, Jamie
Previous research demonstrates that sports coaching is a stressful activity. This article investigates coaches' challenge and threat cognitive appraisals of stressful situations and their impact on coaching behaviour, using Blascovich and Mendes' (2000) biopsychosocial model as a theoretical framework. A cross-sectional correlational design was utilised to examine the relationships between irrational beliefs (Shortened general attitude and belief scale), challenge and threat appraisals (Appraisal of life events scale), and coaching behaviours (Leadership scale for sports) of 105 professional football academy coaches. Findings reveal significant positive associations between challenge appraisals and social support, and between threat appraisals and autocratic behaviour, and a significant negative association between threat appraisals and positive feedback. Results also show that higher irrational beliefs are associated with greater threat, and lesser challenge cognitive appraisals. However, no associations were revealed between irrational beliefs and challenge cognitive appraisals. Additionally, findings demonstrate a positive relationship between age and training and instruction. Results suggest that practitioners should help coaches to appraise stressful situations as a challenge to promote positive coaching behaviours.
Full Text Available This paper addresses the impact of language on cognitive behavioural therapy. Language is emotive and studies carried out in the linguistic field have shown second language is less emotive when describing events occuring in the first language. This paper has been written based on the experiences of a cognitive behavior therapy (CBT service providing therapy to patients from a diverse cultural and ethnic population. Patients whose first language is not English often receive therapy in their second language. Global migration is a common phenomenon and mainly occurs for economic reasons or threat of violence. This paper has been drawn from the results of a literature review on first and second languages and therapy. Despite being an area that is extremely relevant to therapy, there is an apparent lack of literature in relation to cognitive behavioural therapy for depression and other disorders. CBT is one of the recommended therapies by National Institute of Health and Clinical Excellence (NICE for the treatment of depression and anxiety disorders. Findings from the linguistic field highlight the potential short comings providing therapy in a patient’s second language. The aim of this paper is to highlight the importance that therapists working in this field have an understanding of how first and second languages function and the role they play in maintaining patients’ psychological problems. This practice paper discusses measures that can be used in cognitive behavioural therapy to deal with this using a case example.
Kousaie, Shanna; Phillips, Natalie A
Given previous, but inconsistent, findings of language group differences on cognitive control tasks the current investigation examined whether such differences could be demonstrated in a sample of older bilingual adults. Monolingual and bilingual older adults performed three cognitive control tasks that have previously been used in the literature (i.e., Stroop, Simon and flanker tasks) while brain electrophysiological recordings took place. Both behavioural (response time and accuracy) and event-related brain potentials (ERPs; N2 and P3 amplitude and latency) were compared across the two language groups. Processing differences between monolinguals and bilinguals were identified for each task, although the locus differed across the tasks. Language group differences were most clear in the Stroop task, with bilinguals showing superior performance both behaviourally and electrophysiologically. In contrast, for the Simon and flanker tasks there were electrophysiological differences indicating language group processing differences at the level of conflict monitoring (Simon task only) and stimulus categorization (Simon and flanker tasks), but no behavioural differences. These findings support suggestions that these three tasks that are often used to examine executive control processes show little convergent validity; however, there are clear language group differences for each task that are suggestive of superior performance for bilinguals, with behavioural differences emerging only in the linguistic Stroop task. Furthermore, it is clear that behavioural measures alone do not capture the language group effects in their entirety, and perhaps processing differences between language groups are more marked in a sample of older adults who are experiencing age-related cognitive changes than in younger adults who are at the peak of their cognitive capacity. Copyright © 2016 Elsevier Ltd. All rights reserved.
Bravo-Mehmedbasic, Alma; Salcic, Dubravka; Kucukalic, Abdulah; Fadilpasic, S.; Cakovic, L.; Mehmedika-Suljic, Enra; Masic, Izet
CONFLICT OF INTEREST: NONE DECLARED Introduction Through psychological support for prison guard’s awareness about professional stress and burn-out, cognitive assessment of stress consequences, insight in coping strategies, as well as prevention of stress consequences is achieved. Aim Evaluation of psychoeducation effects on professional stress consequences within prison guards. Method In the research were included 122 prison guards from three prisons in Bosnia and Herzegovina. All of them have been tested before and after psychoeducation was finished using following instruments: Index of reaction, STAI questionnaire, SAMAČA questionnaire. Results Differences between first and second measuring of subjects included in this study in Sarajevo prison indicated statistically significant reduction of stress reactions, improvement of coping strategies and communication skills. In prisons Zenica and Kula there are differences between first and second measurement in stress reactions reduction, improvement of coping strategies and overcoming of stress and improvement of communication skills as well, which are not statistically significant. In Kula prison, significant differences between two measurements in attitudes of prison guards toward detainees were observed. Conclusions Results of this study show that prison guards within prisons where are detained persons with long period of imprisonment are more exposed to professional stress, comparing to prison guards who are employed in investigation prison. Psychoeducation resulted in positive effects and it should be obligatory included in prison guards training with the aim of decreasing of psychological consequences of prolonged professional stress to which they are exposed to. Psychoeducation should be on continuous basis and led by educated mental health professionals. PMID:24133378
Schendelaar, Pamela; La Bastide-Van Gemert, Sacha; Heineman, Maas Jan; Middelburg, Karin J; Seggers, Jorien; Van den Heuvel, Edwin R; Hadders-Algra, Mijna
Research on cognitive and behavioural development of children born after assisted conception is inconsistent. This prospective study aimed to explore underlying causal relationships between ovarian stimulation, in-vitro procedures, subfertility components and child cognition and behaviour. Participants were singletons born to subfertile couples after ovarian stimulation IVF (n = 63), modified natural cycle IVF (n = 53), natural conception (n = 79) and singletons born to fertile couples (reference group) (n = 98). At 4 years, cognition (Kaufmann-ABC-II; total IQ) and behaviour (Child Behavior Checklist; total problem T-score) were assessed. Causal inference search algorithms and structural equation modelling was applied to unravel causal mechanisms. Most children had typical cognitive and behavioural scores. No underlying causal effect was found between ovarian stimulation and the in-vitro procedure and outcome. Direct negative causal effects were found between severity of subfertility (time to pregnancy) and cognition and presence of subfertility and behaviour. Maternal age and maternal education acted as confounders. The study concludes that no causal effects were found between ovarian stimulation or in-vitro procedures and cognition and behaviour in childrenaged 4 years born to subfertile couples. Subfertility, especially severe subfertility, however, was associated with worse cognition and behaviour. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Montero-Marin, Jesus; Garcia-Campayo, Javier; López-Montoyo, Alba; Zabaleta-Del-Olmo, Edurne; Cuijpers, Pim
It is not clear whether relaxation therapies are more or less effective than cognitive and behavioural therapies in the treatment of anxiety. The aims of the present study were to examine the effects of relaxation techniques compared to cognitive and behavioural therapies in reducing anxiety symptoms, and whether they have comparable efficacy across disorders. We conducted a meta-analysis of 50 studies (2801 patients) comparing relaxation training with cognitive and behavioural treatments of anxiety. The overall effect size (ES) across all anxiety outcomes, with only one combined ES in each study, was g = -0.27 [95% confidence interval (CI) = -0.41 to -0.13], favouring cognitive and behavioural therapies (number needed to treat = 6.61). However, no significant difference between relaxation and cognitive and behavioural therapies was found for generalized anxiety disorder, panic disorder, social anxiety disorder and specific phobias (considering social anxiety and specific phobias separately). Heterogeneity was moderate (I 2 = 52; 95% CI = 33-65). The ES was significantly associated with age (p cognitive and/or behavioural therapy (p = 0.015), quality of intervention (p = 0.007), relaxation treatment format (p cognitive and behavioural therapies in the treatment of post-traumatic stress disorder, and obsessive-compulsive disorder and it might also be less effective at 1-year follow-up for panic, but there is no evidence that it is less effective for other anxiety disorders.
Full Text Available Huntington's disease (HD is characterised by motor symptoms which are often preceded by cognitive and behavioural changes, that can significantly contribute to disease burden for people living with HD. Numerous knock-in mouse models of HD are currently available for scientific research. However, before their use, they must be behaviourally characterised to determine their suitability in recapitulating the symptoms of the human condition. Thus, we sought to longitudinally characterise the nature, severity and time course of cognitive and behavioural changes observed in HdhQ111 heterozygous knock-in mice.To determine changes in cognition and behaviour an extensive battery of operant tests including: fixed ratio, progressive ratio, the five choice serial reaction time task and the serial implicit learning task, were applied longitudinally to HdhQ111 and wild type mice. The operant test battery was conducted at 6, 12 and 18 months of age. Significant deficits were observed in HdhQ111 animals in comparison to wild type animals in all operant tests indicating altered cognition (attentional and executive function and motivation. However, the cognitive and behavioural deficits observed were not shown to be progressive over time in the longitudinal testing paradigm that was utilised. The results therefore demonstrate that the HdhQ111 mouse model of HD reflects some features of the cognitive and behavioural changes shown in the human condition of HD. Although, the cognitive and behavioural deficits demonstrated were not shown to be progressive over time.
Drawing on illustrative examples of the functional and cognitive psychology in contemporary research, the present article emphasizes the primacy of functional relationships, which provide the fundament for all attempts to uncover invisible cognitive processes. Cognitive research is not only inherently more difficult and much more ambitious than functional research. It also suffers from several home-made problems, such as unwarranted inferences from model fitting, the mediation-analysis cult and the failure to take environmental influences into account. However, despite the primacy of functional psychology and the problems associated with the ambitious goals of cognitive research, the two partners in this unequal pair are firmly connected and jointly responsible for the most impressive examples of progress in behavioural science. © 2015 International Union of Psychological Science.
Ye, Shan; Ji, Ying; Li, Chengyu; He, Ji; Liu, Xiaolu; Fan, Dongsheng
The existing screening batteries assessing multiple neuropsychological functions are not specific to amyotrophic lateral sclerosis (ALS) patients and are limited to their physical dysfunctions, whereas category cognitive tests are too time-consuming to assess all the domains. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was recently developed as a fast and easy cognitive screening tool specifically designed for patients. The purpose of the study was to validate the effectiveness of the Chinese version in Chinese ALS populations. Eighty-four ALS patients and 84 age-, gender- and education-matched healthy controls were included in this cross-sectional study. All the participants took the ECAS, Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Primary caregivers of patients were interviewed for behavioural and psychiatric changes. Significant differences were noted in language (p = 0.01), fluency, executive function, ALS-specific functions, and ECAS total score (pALS patients and controls. The cut-off value of the total ECAS score was 81.92. Cognitive impairment was observed in 35.71% of patients, and 27.38% exhibited behavioural abnormalities. The ECAS total score had a medium correlation with education year. Memory was more easily impaired in the lower education group, whereas verbal fluency and language function tended to be preserved in the higher education group. The average time of ECAS was only 18 minutes. The Chinese version of the ECAS is the first screening battery assessing multiple neuropsychological functions specially designed for the ALS population in China, which provides an effective and rapid tool to screen cognitive and behavioural impairments.
Full Text Available The existing screening batteries assessing multiple neuropsychological functions are not specific to amyotrophic lateral sclerosis (ALS patients and are limited to their physical dysfunctions, whereas category cognitive tests are too time-consuming to assess all the domains. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS was recently developed as a fast and easy cognitive screening tool specifically designed for patients. The purpose of the study was to validate the effectiveness of the Chinese version in Chinese ALS populations.Eighty-four ALS patients and 84 age-, gender- and education-matched healthy controls were included in this cross-sectional study. All the participants took the ECAS, Mini-Mental State Examination (MMSE and Frontal Assessment Battery (FAB. Primary caregivers of patients were interviewed for behavioural and psychiatric changes.Significant differences were noted in language (p = 0.01, fluency, executive function, ALS-specific functions, and ECAS total score (p<0.01 between ALS patients and controls. The cut-off value of the total ECAS score was 81.92. Cognitive impairment was observed in 35.71% of patients, and 27.38% exhibited behavioural abnormalities. The ECAS total score had a medium correlation with education year. Memory was more easily impaired in the lower education group, whereas verbal fluency and language function tended to be preserved in the higher education group. The average time of ECAS was only 18 minutes.The Chinese version of the ECAS is the first screening battery assessing multiple neuropsychological functions specially designed for the ALS population in China, which provides an effective and rapid tool to screen cognitive and behavioural impairments.
The development of video games promoting health related behaviour is increasing. This holds not only for chronic diseases like asthma and diabetes, but also for the field of child psychotherapy. At the Department of Child and Adolescent Psychiatry of Zürich University, the video game Treasure Hunt was developed to support psychotherapeutic treatment of children between eight and thirteen years of age. Treasure Hunt does not replace the therapist but supports treatment by offering attractive electronic work assignments. The scope of this article is an overview on health games for children and a description of Treasure Hunt. After the explanation of its therapeutic potentials, an evaluation based on questionnaires for therapists and children will be presented. 124 therapists answered a questionnaire on their impression of the game three months after download. 41 therapists were willing to participate in the further evaluation and sent questionnaires of 200 children with whom Treasure Hunt had been used. A limitation of these data is that a positive bias can not be excluded, as therapists with a positive attitude towards psychotherapeutic computer games were more likely to answer the questionnaire. 118 therapists (95.2%) considered Treasure Hunt a useful tool in child psychotherapy. 197 children (98.5%) report being satisfied with the use of the game during treatment. Treasure Hunt was predominantly used for the age group it is designed for and both, by very experienced and by young therapists. Eleven diagnostic categories reflect a broader range of indications than expected.
Huang, Cheng; Martorell, Reynaldo; Ren, Aiguo; Li, Zhiwen
We evaluate the relative importance of birth weight and postnatal growth for cognition and behavioural development in 8389 Chinese children, 4-7 years of age. Method Weight was the only size measure available at birth. Weight, height, head circumference and intelligence quotient (IQ) were measured between 4 and 7 years of age. Z-scores of birth weight and postnatal conditional weight gain to 4-7 years, as well as height and head circumference at 4-7 years of age, were the exposure variables. Z-scores of weight at 4-7 years were regressed on birth weight Z-scores, and the residual was used as the measure of postnatal conditional weight gain. The outcomes were child's IQ, measured by the Chinese Wechsler Young Children Scale of Intelligence, as well as internalizing behavioural problems, externalizing behavioural problems and other behavioural problems, evaluated by the Child Behavior Checklist 4-18. Multivariate regressions were conducted to investigate the relationship of birth weight and postnatal growth variables with the outcomes, separately for preterm children and term children. Both birth weight and postnatal weight gain were associated with IQ among term children; 1 unit increment in Z-score of birth weight (∼450 g) was associated with an increase of 1.60 [Confidence interval (CI): 1.18-2.02; P cognition or behavioural outcomes was observed among preterm children aged 4-7 years.
Jaehne, Emily J; Klarić, Thomas S; Koblar, Simon A; Baune, Bernhard T; Lewis, Martin D
The transcription factor neuronal PAS domain-containing protein 4 (Npas4), which regulates the formation of inhibitory synapses on excitatory neurons, has been suggested as a candidate gene for neurological and psychiatric conditions such as bipolar depression, autism spectrum and cognitive disorders. A mouse model of Npas4 deficiency has been developed to investigate any role in these disorders. Behavioural characterisation of Npas4(-/-), Npas4(+/-) and Npas4(+/+) mice has been conducted using the open field, elevated zero maze (EZM), Y-maze, sociability test and forced swim test (FST) to investigate a range of behaviours. Npas4(-/-) mice spent more time in the open arm of the EZM than other genotypes, suggesting decreased anxiety-like behaviour. Npas4(+/-) mice, however, were more immobile in the FST than other genotypes, suggesting increased depression-like behaviour, and also showed impaired spatial recognition memory in the Y-maze. There were no differences between genotype in social behaviour. These results suggest that differential levels of Npas4 expression in the brain may regulate anxiety, depression and cognition related disorders. Copyright © 2014 Elsevier B.V. All rights reserved.
Cuijpers, P.; Munoz, R.F.; Clarke, G.N.; Lewinsohn, P.M.
The "Coping with Depression" course (CWD) is by the far the best studied psychoeducational intervention for the treatment and prevention of depression, and is used in routine practice in several countries. The CWD is a highly structured cognitive-behavioral intervention, which has been adapted for
Fieke S. Koopman
Full Text Available Background: Cognitive behavioural therapy does not reduce fatigue in post-polio syndrome, but is effective in facioscapulohumeral dystrophy. This difference in efficacy might be explained by a different role of cognitions in these conditions. Objective: To compare fatigue-related cognitions between patients with post-polio syndrome and facio-scapulohumeral dystrophy. Subjects: Patients with post-polio syndrome (n = 21 and facioscapulohumeral dystrophy (n = 24 allocated to a cognitive behavioural therapy intervention in 2 identical trials. Methods: Assessed cognitions included: sense of control over fatigue; catastrophizing; acceptance; focusing on fatigue; and perceived social support. Group differences in cognitions (independent t-tests or Mann–Whitney U tests and group differences in the association of cognitions with fatigue (linear regression models were studied. Results: No differences in cognitions were found between the 2 groups (p > 0.18. Furthermore, there were no cognition-by-group interaction effects, except for “perceived social support”, for which a different association with fatigue was found between the 2 groups (p = 0.01. However, univariate models revealed no associations per group. Conclusion: Fatigue-related cognitions in severely fatigued patients with post-polio syndrome are not clearly different from that in facioscapulohumeral dystrophy. Thus, the lack of efficacy of cognitive behavioural therapy in post-polio syndrome cannot be attributed to unique cognitive characteristics of this population.
Full Text Available In this paper, we explore how persuasive ambient displays could induce cognitive dissonance to promote positive behaviour change among graduate students. We developed iFlit –an interactive and collective ambient display that enables a group of students to reflect on their burnout level, and sleeping and activity habits. iFlit shows a garden with birds representing students monitored behaviour. Birds move according to users’ activity level, and the garden’s background changes according to each user’s sleeping habits. Users match peers perceived burnout, and sleep and activity habits to induce cognitive dissonance. We argue such displays are more efficient than personal devices to empower individuals’ self-reflection due their capabilities for enabling a playful interaction with their personal data.
Lloyd, Samantha; Fleming, Caroline; Schmidt, Ulrike; Tchanturia, Kate
This study aimed to explore whether a six session cognitive behavioural group intervention targeting perfectionism is efficacious in reducing perfectionism in adults with anorexia nervosa in an inpatient setting. Adults with anorexia nervosa received a group perfectionism intervention in an inpatient setting. Self-report and patient satisfaction questionnaires were completed at the beginning of the first session and end of the last session. Significant changes of moderate effect size were observed for overall perfectionism, concern over mistakes and personal standards dimensions of perfectionism following participation in the group. These changes were found to be independent of change in body mass index. A group cognitive behavioural approach appears to be efficacious in reducing perfectionism in adults with anorexia nervosa. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
Christensen, Sara Sletten; Frostholm, Lisbeth; Ørnbøl, Eva
. Methods We analysed additional data from a randomised controlled trial comparing completers of cognitive behavioural group therapy (46 patients) to an enhanced usual care group (66 patients). Proposed mediators (illness perceptions) and primary (physical health) and secondary (somatic symptoms and illness...... (primary analysis), and (2) whether changes in illness perceptions during the whole trial period were associated with improved outcome (secondary analysis). Results Improvements in illness perceptions during treatment partially mediated the effect of cognitive behavioural therapy on physical health one...... year after treatment (sum of indirect effects 1.556, BCa 95% CI (0.006; 3.620)). Improving perceived control was particularly important. Changes in illness perceptions from baseline to 16 months after randomisation were associated with clinically meaningful improvements in physical health, somatic...
Conclusions: Notwithstanding limitations due to the small sample size, the findings indicate that guided ICBT is an effective treatment for students with SAD. Adding an initial face-to-face PE session to the guided ICBT did not lead to enhanced outcomes in the present study.
Miler, Krzysztof; Kuszewska, Karolina; Woyciechowski, Michał
Brain lateralization is hypothesized to improve the efficiency of information processing. Here, we found that some Myrmeleon bore antlion larvae showed individual asymmetry in righting from a supine to normal position over one side of their body, which can be considered a reflection of greater brain lateralization. We demonstrated that these behaviourally asymmetrical individuals showed improved learning abilities, providing novel evidence that brain lateralization leads to beneficial effects on cognitive functions. © 2017 The Author(s).
Millings, Abigail; Carnelley, Katherine B.
BACKGROUND: Computerised cognitive behavioural therapy provides a unique opportunity to collect and analyse data regarding the idiosyncratic content of people's core beliefs about the self, others and the world. \\ud \\ud METHODS: 'Beating the Blues' users recorded a core belief derived through the downward arrow technique. Core beliefs from 1813 mental health patients were coded into 10 categories. \\ud \\ud RESULTS: The most common were global self-evaluation, attachment, and competence. Women ...
Tinnitus is common, and some individuals with tinnitus display high levels of distress. Cognitive behavioural therapy (CBT) is effective in reducing tinnitus distress, but is rarely available. CBT-based self-help, with or without guidance, has yielded positive results in other problem areas, and one initial randomized controlled trial (RCT) has shown promising results for tinnitus. This thesis is based on four studies; Study I showed that Internet-based self-help treatment with e-mail guidanc...
French, Lydia R.M.; Thomas, Laura; Campbell, John; Kuyken, Willem; Lewis, Glyn; Williams, Chris; Wiles, Nicola J.; Turner, Katrina M.
Background: Cognitive Behavioural Therapy (CBT) aims to teach people skills to help them self-manage their depression. Trial evidence shows that CBT is an effective treatment for depression and individuals may experience benefits long-term. However, there is little research about individuals’ continued use of CBT skills once treatment has finished. Aims: To explore whether individuals who had attended at least 12 sessions of CBT continued to use and value the CBT skills they had learnt during...
Stott, Joshua; Charlesworth, Georgina; Scior, Katrina
Cognitive behavioural therapy (CBT) is a promising treatment for mental health problems in people with intellectual disabilities but some may not be suited or ready. This review critically evaluates the quality and utility of measures of CBT readiness in people with intellectual disabilities. Twelve studies of six measures based on three aspects of CBT readiness were identified through systematic review. Across measures, measurement quality was largely poor or un-assessed. Only one study evaluated measurement change over the course of CBT. Not all participants with intellectual disabilities could 'pass' readiness measures and performance may be affected by levels of language and cognitive functioning. There was some evidence that CBT readiness is trainable with brief interventions. Before using readiness measures in a clinical context, further work is needed to extend initial evidence on recognising cognitive mediation as a CBT readiness ability. Given the lack of consensus as to the definition of CBT readiness and the heterogeneity of CBT interventions, future research could also focus on developing readiness measures using a bottom up approach, developing measures within the context of CBT interventions themselves, before further refining and establishing their psychometric properties. This paper is the first to systematically review measures of skills thought necessary to be ready for cognitive behavioural therapy in intellectual disabilities. The findings suggest that while readiness skills may be trainable with brief interventions, the available measures of these skills have not been fully evaluated for quality. Levels of functioning on these measures have yet to be established relative to those without intellectual disabilities and critically, there is very little evidence as to whether these skills are important in cognitive behavioural therapy process and outcome. We suggest that future research could focus on those constructs where there is preliminary
Full Text Available A terapia cognitivo-comportamental é uma intervenção breve, semi-estruturada e orientada para metas, que tem sido amplamente utilizada nos centros de pesquisa e tratamento de transtornos alimentares. O presente artigo tem por objetivo descrever as principais estratégias cognitivas e comportamentais utilizadas no tratamento ambulatorial dos transtornos alimentares. Vários ensaios clínicos avaliaram a eficácia da terapia cognitivo-comportamental, indicando que ela favorece a remissão ou diminuição da freqüência de episódios de compulsão alimentar, dos comportamentos purgativos e da restrição alimentar. Tem sido relatada também melhora do humor, do funcionamento social, e diminuição da preocupação com peso e formato corporal.The cognitive-behavioural therapy is a brief, semi-structured and goal oriented intervention, which has been largely used in research and treatment centers specialized on eating disorders. The present article describes the main cognitive and behavioral strategies used in the outpatient treatment of eating disorders. Several clinical studies assessed the effectiveness of cognitive-behavioural therapy, indicating the remission or the reduction of the frequency of binge eating episodes, purgative behaviours and food restriction. Social and mood improvement, as well as reduction of weight and body shape concerns, have also been reported.
Ek, Ulla; Fernell, Elisabeth; Jacobson, Lena
To describe cognitive and behavioural characteristics in a group of blind children with bilateral optic nerve hypoplasia (ONH). Data from records, parents, teachers, and repeated developmental assessments of 13 blind children with ONH born in 1988-1998 were analysed. All children had neuroimaging and/or hormonal evidence of midline malformations. They were all blind and able to communicate with speech. Severe mood swings and temper tantrums were common, especially during the first years of life. Later in life, sluggish tempo, low frustration tolerance and a narrow range of interests were common. Autism had been diagnosed in 6/13 children, autistic-like condition (ALC) was found in another three. The behaviour of the remaining four children was not within the autism spectrum. Eight children had cognitive capacities within the normal or near-normal range; five had mental retardation. Autism/ALC was found in all cognitive subgroups. All children exhibited fluent speech and, of these, 12 had started to talk at the expected age, but had clear deficiencies in communicative ability. These children had a common pattern of behavioural characteristics including autism spectrum disorders independent of intellectual capacities.
Prins, R G; Beenackers, M A; Boog, M C; Van Lenthe, F J; Brug, J; Oenema, A
This study aimed to explore whether individual cognitions and neighbourhood social capital strengthen each other in their relation with engaging in sports at least three times per week. Cross-sectional analyses on data from the last wave of the YouRAction trial (2009-2010, Rotterdam, the Netherlands; baseline response: 98%) were conducted. In total 1129 had data on the last wave questionnaire (93%) and 832 of them had complete data on a self-administered questionnaire on frequency of sports participation, perceived neighbourhood social capital, cognitions (attitude, subjective norm, perceived behavioural control and intention toward sport participation) and demographics. Ecometric methods were used to aggregate perceived neighbourhood social capital to the neighbourhood level. Multilevel logistic regression analyses (neighbourhood and individual as levels) were conducted to examine associations of cognitions, neighbourhood social capital and the social capital by individual cognition interaction with fit norm compliance. If the interaction was significant, simple slopes analyses were conducted to decompose interaction effects. It was found that neighbourhood social capital was significantly associated with fit norm compliance (OR: 5.40; 95% CI: 1.13-25.74). Moreover, neighbourhood social capital moderated the association of attitude, perceived behavioural control and intention with fit norm compliance. The simple slope analyses visualized that the associations of cognitions with fit norm compliance were stronger in case of more neighbourhood social capital. Hence, higher levels of neighbourhood social capital strengthen the associations of attitude, perceived behavioural control and intention in their association with fit norm compliance. Copyright © 2014 Elsevier Ltd. All rights reserved.
Full Text Available This study investigated the affects of cognitive ability, creativity, and self-esteem on kindergartners' problem behaviour. Participants were 203 children (mean age = 65.8 months attending kindergartens in Korea. Data collection used the Korean version of Child Behaviour Checklist, the Kaufman Assessment Battery for Children, the Torrance Test of Creative Thinking, and the Children's Sense of Self-Esteem Inventory. Pearson's correlations and stepwise multiple regression analysis were used to analyse the data. There were four primary outcomes. First, there were negative correlations between children's problem behaviour (internalising and externalising problems and cognitive ability. Second, there was a negative correlation between internalising problems and fluency in creativity. No correlation was found between children's externalising problems and creativity. Third, there were negative correlations between children's problem behaviour (internalising and externalising problems and self-esteem. Fourth, sequential processing, emotional competence, and fluency were revealed to be predictors of children's internalising problems. Social competency and sequential processing were found to be predictors of children's externalising problems.
Wilson, Rea; Collerton, Daniel; Freeston, Mark; Christodoulides, Thomas; Dudley, Robert
People with psychosis often report distressing visual hallucinations (VH). In contrast to auditory hallucinations, there is little empirical evidence on effective interventions. The effectiveness of a novel-focused cognitive-behavioural therapy (CBT) intervention for VH was explored using a multiple baseline single case design with four participants. Change to individual appraisals, emotional and behavioural responses to VH were measured with daily diaries kept throughout the baseline and intervention phase lasting up to 16 sessions. Maintenance of change was tracked during a follow-up period of one month. Changes in appraisals, distress and response in accordance with the theory was evident in two out of four of the cases. However, change occurred within the baseline phase that limited the conclusions that change could be attributed to CBT alone. There was some evidence of clinically significant change and reliable change for two out of four of the cases at follow-up on one of the standardized psychiatric assessments. The research reported here has theoretical and clinical implications for refinement of the model and interventions for distressing VH. Copyright © 2015 John Wiley & Sons, Ltd. Distressing visual hallucinations (VH) are a relatively common symptom of psychosis. Visual hallucinations seem to be associated with greater impairment and disability. We have no specific treatment for VH. The appraisal of the visual experience and the behavioural response is important in maintaining the distress. Cognitive-behavioural therapy for VH at present has limited value. Copyright © 2015 John Wiley & Sons, Ltd.
Geraghty, Keith J; Blease, Charlotte
Cognitive behavioural therapy is increasingly promoted as a treatment for chronic fatigue syndrome. There is limited research on informed consent using cognitive behavioural therapy in chronic fatigue syndrome. We undertook a narrative review to explore efficacy and to identify the salient information that should be disclosed to patients. We found a complex theoretical model underlying the rationale for psychotherapy in chronic fatigue syndrome. Cognitive behavioural therapy may bring about changes in self-reported fatigue for some patients in the short term, however there is a lack of evidence for long-term benefit or for improving physical function and cognitive behavioural therapy may cause distress if inappropriately prescribed. Therapist effects and placebo effects are important outcome factors.
Full Text Available Objective: Present research examined children’s behavioural and cognitive functioning by using data from a screening study based on reports given by parents and teachers, and investigated the strongest predictors of children’s fluid intelligence.
Full Text Available Several treatment evaluations have highlighted the effectiveness of cognitive-behavioural programmes with both youth and adult offenders. This paper describes the application and assessment of a cognitive-behavioural treatment (adapted to Spanish from Ross and Fabiano’s Reasoning & Rehabilitation Programme with juvenile offenders serving community orders in an educational measure called in Spanish ‘libertad vigilada’ (similar to parole. The intervention comprised six different therapeutic components: self-control, cognitive restructuring, problem solving, social skills/assertiveness, values/empathy, and relapse prevention. Treatment effectiveness was tested using a quasi-experimental design involving two groups and pre/post evaluation. The results show that the programme was effective (with low to moderate effect sizes in improving participants’ social skills and self-esteem, as well as in reducing their aggressiveness. However, the intervention had no positive influence on empathy, cognitive distortions or impulsiveness. These results are in line with those of many other correctional studies, in which the treatment applied had a significant but partial effect on participants.
Van de Winckel, Ann; Feys, Hilde; De Weerdt, Willy; Dom, René
To evaluate the effect of a musical exercise programme on mood state and cognitive function in women with dementia. Randomized controlled trial. Public Psychiatric Hospital Rekem, Belgium. Twenty-five patients with dementia. Fifteen patients attended exercise training for three months, which consisted of daily physical exercises supported by music for 30 min/session. They were compared with a group of 10 control patients, who received an equal amount of attention through daily conversation. The effect on cognition was measured by the Mini-Mental State Examination (MMSE) and the Amsterdam Dementia Screening Test 6 (ADS 6). Behaviour was evaluated with the abbreviated Stockton Geriatric Rating Scale (BOP scale). The assessments were made before, after six weeks of intervention and immediately after the three-month experimental period. The exercise group showed a significant improvement in cognition. This was documented by an increased MMSE mean score of 12.87-15.53, and by a higher median score, rising from 10 to 14 points, on the subset 'fluency' (ADS 6 test). The control group showed no significant improvement, either on the MMSE (mean score of 10.80-11.00) or on the fluency subtest of the ADS 6 (median scores were 6.5-7 points). The effects on behavioural changes were not significant. The present study suggests a beneficial effect of cognition using a music-based exercise programme in a group of patients with moderate to severe dementia. Further studies are needed to confirm these findings.
Terzaghi, Michele; Sinforiani, Elena; Zucchella, Chiara; Zambrelli, Elena; Pasotti, Chiara; Rustioni, Valter; Manni, Raffaele
Rapid eye movement [REM] sleep behaviour disorder (RBD) may herald neurodegenerative diseases. Neurobiological deficits similar to those identified in neurodegenerative diseases have been reported in idiopathic RBD. Researchers are looking for early markers supporting a possible role of RBD as a harbinger of impending neurodegenerative disease. To examine the neuropsychological functions in idiopathic RBD subjects. Should they be found to present a neuropsychological dysfunction that overlaps that reported in neurodegenerative diseases, it would be possible to consider cognitive deficits as possible early markers of an underlying degenerative process. Twenty-three subjects with idiopathic RBD (21 males, mean age 67.0+/-7.0 years) and a group of healthy controls matched for sex, age and education underwent a neuropsychological battery evaluating different cognitive domains. Considering mean values, poorer performances were observed in the Word Span (pneurodegenerative disease, but until more prolonged long-term follow-up data are available, the true neurobiological significance of cognitive deficits in RBD will remain unknown.
Schuster, Andrea C; Zimmermann, Uwe; Hauer, Carina; Foerster, Katharina
Animals show consistent individual behavioural differences in many species. Further, behavioural traits (personality traits) form behavioural syndromes, characterised by correlations between different behaviours. Mechanisms maintaining these correlations could be constrained due to underlying relationships with cognitive traits. There is growing evidence for the non-independence of animal personality and general cognitive abilities in animals, but so far, studies on the direction of the relationship between them revealed contradictory results. Still, it is hypothesised that individuals may exhibit consistent learning and decision styles. Fast behavioural types (consistently bolder and more active individuals) are expected to show faster learning styles. Slow behavioural types in contrast are assumed to learn slower but more accurately. This can be caused by a speed-accuracy trade-off that individuals face during decision making. We measured the repeatability of three personality and four spatial cognitive traits in adult Eurasian harvest mice (Micromys minutus). We analysed correlations among personality traits (behavioural syndrome). We further investigated the relationships between personality and spatial cognitive traits as a first step exploring the potential connection between personality and cognition in this species. Our results showed that exploration, activity and boldness were repeatable in adult mice. Spatial recognition measured in a Y Maze was also significantly repeatable, as well as spatial learning performance and decision speed. We found no repeatability of decision accuracy. Harvest mice showed a behavioural syndrome as we observed strong positive correlations between personality traits. The speed-accuracy trade-off was not apparent within, nor between individuals. Nevertheless, we found weak evidence for a relationship between personality and spatial cognitive traits as fast behavioural types learned a spatial orientation task faster than slow
Stallard, Paul; Sayal, Kapil; Phillips, Rhiannon; Taylor, John A; Spears, Melissa; Anderson, Rob; Araya, Ricardo; Lewis, Glyn; Millings, Abigail; Montgomery, Alan A
To compare the effectiveness of classroom based cognitive behavioural therapy with attention control and usual school provision for adolescents at high risk of depression. Three arm parallel cluster randomised controlled trial. Eight UK secondary schools. Adolescents (n=5030) aged 12-16 years in school year groups 8-11. Year groups were randomly assigned on a 1:1:1 ratio to cognitive behavioural therapy, attention control, or usual school provision. Allocation was balanced by school, year, number of students and classes, frequency of lessons, and timetabling. Participants were not blinded to treatment allocation. Cognitive behavioural therapy, attention control, and usual school provision provided in classes to all eligible participants. Outcomes were collected by self completed questionnaire administered by researchers. The primary outcome was symptoms of depression assessed at 12 months by the short mood and feelings questionnaire among those identified at baseline as being at high risk of depression. Secondary outcomes included negative thinking, self worth, and anxiety. Analyses were undertaken on an intention to treat basis and accounted for the clustered nature of the design. 1064 (21.2%) adolescents were identified at high risk of depression: 392 in the classroom based cognitive behavioural therapy arm, 374 in the attention control arm, and 298 in the usual school provision arm. At 12 months adjusted mean scores on the short mood and feelings questionnaire did not differ for cognitive behavioural therapy versus attention control (-0.63, 95% confidence interval -1.85 to 0.58, P=0.41) or for cognitive behavioural therapy versus usual school provision (0.97, -0.20 to 2.15, P=0.12). In adolescents with depressive symptoms, outcomes were similar for attention control, usual school provision, and cognitive behavioural therapy. Classroom based cognitive behavioural therapy programmes may result in increased self awareness and reporting of depressive symptoms but
Landstedt, Evelina; Gillander Gådin, Katja; Zetterström Dahlqvist, Heléne
Background. Adolescents are a vulnerable group when it comes to the risk of developing depression. Preventing the onset of depressive episodes in this group is therefore a major public health priority. In the last decades, school-based cognitive-behavioural interventions have been a common primary prevention approach. However, evidence on what girls actually are allocated to such interventions when no researchers are involved is scarce.Objective. To explore how a selective cognitive-behaviour...
Tyrer, Peter; Cooper, Sylvia; Tyrer, Helen; Salkovskis, Paul; Crawford, Mike; Green, John; Smith, Georgina; Reid, Steven; Dupont, Simon; Murphy, David; Byford, Sarah; Wang, Duolao; Barrett, Barbara
Abnormal health anxiety, also called hypochondriasis, has been successfully treated by cognitive behaviour therapy (CBT) in patients recruited from primary care, but only one pilot trial has been carried out among those attending secondary medical clinics where health anxiety is likely to be more common and have a greater impact on services. The CHAMP study extends this work to examine both the clinical and cost effectiveness of CBT in this population. The study is a randomized controlled trial with two parallel arms and equal randomization of 466 eligible patients (assuming a 20% drop-out) to an active treatment group of 5-10 sessions of cognitive behaviour therapy and to a control group. The aim at baseline, after completion of all assessments but before randomization, was to give a standard simple explanation of the nature of health anxiety for all participants. Subsequently the control group was to receive whatever care might usually be available in the clinics, which is normally a combination of clinical assessment, appropriate tests and reassurance. Those allocated to the active treatment group were planned to receive between 5 and 10 sessions of an adapted form of cognitive behaviour therapy based on the Salkovskis/Warwick model, in which a set of treatment strategies are chosen aimed at helping patients understand the factors that drive and maintain health anxiety. The therapy was planned to be given by graduate research workers, nurses or other health professionals trained for this intervention whom would also have their competence assessed independently during the course of treatment. The primary outcome is reduction in health anxiety symptoms after one year and the main secondary outcome is the cost of care after two years. This represents the first trial of adapted cognitive behaviour therapy in health anxiety that is large enough to test not only the clinical benefits of treatment but also whether the cost of treatment is offset by savings from reduced
Full Text Available Abstract Background Abnormal health anxiety, also called hypochondriasis, has been successfully treated by cognitive behaviour therapy (CBT in patients recruited from primary care, but only one pilot trial has been carried out among those attending secondary medical clinics where health anxiety is likely to be more common and have a greater impact on services. The CHAMP study extends this work to examine both the clinical and cost effectiveness of CBT in this population. Method/Design The study is a randomized controlled trial with two parallel arms and equal randomization of 466 eligible patients (assuming a 20% drop-out to an active treatment group of 5-10 sessions of cognitive behaviour therapy and to a control group. The aim at baseline, after completion of all assessments but before randomization, was to give a standard simple explanation of the nature of health anxiety for all participants. Subsequently the control group was to receive whatever care might usually be available in the clinics, which is normally a combination of clinical assessment, appropriate tests and reassurance. Those allocated to the active treatment group were planned to receive between 5 and 10 sessions of an adapted form of cognitive behaviour therapy based on the Salkovskis/Warwick model, in which a set of treatment strategies are chosen aimed at helping patients understand the factors that drive and maintain health anxiety. The therapy was planned to be given by graduate research workers, nurses or other health professionals trained for this intervention whom would also have their competence assessed independently during the course of treatment. The primary outcome is reduction in health anxiety symptoms after one year and the main secondary outcome is the cost of care after two years. Discussion This represents the first trial of adapted cognitive behaviour therapy in health anxiety that is large enough to test not only the clinical benefits of treatment but also
Bangirana, Paul; Musisi, Seggane; Boivin, Michael J; Ehnvall, Anna; John, Chandy C; Bergemann, Tracy L; Allebeck, Peter
Malaria is a leading cause of ill health and neuro-disability in children in sub-Saharan Africa. Impaired cognition is a common outcome of malaria with neurological involvement. There is also a possibility that academic achievement may be affected by malaria with neurological involvement given the association between cognitive ability and academic achievement. This study investigated the effect of malaria with neurological involvement on cognitive ability, behaviour and academic achievement. This prospective case-control study was carried out in Kampala City, Uganda between February 2008 and October 2010. Sixty-two children with a history of malaria with neurological involvement were followed up and given assessments for cognitive ability (working memory, reasoning, learning, visual spatial skills and attention), behaviour (internalizing and externalizing problems) and academic achievement (arithmetic, spelling and reading) three months after the illness. Sixty-one community controls recruited from the homes or neighbouring families of the cases were also given the same assessments. Tests scores of the two groups were compared using analysis of covariance with age, sex, level of education, nutritional status and quality of the home environment as covariates. This study was approved by the relevant ethical bodies and informed consent sought from the caregivers. Children in the malaria group had more behavioural problems than the community controls for internalizing problems (estimated mean difference = -3.71, 95% confidence interval (CI), = -6.34 to -1.08, p = 0.007). There was marginal evidence of lower attention scores (0.40, CI = -0.05 to 0.86, p = 0.09). However, excluding one child from the analyses who was unable to perform the tests affected the attention scores to borderline significance (0.32, CI, = 0.01 to 0.62, p = 0.05). No significant differences were observed in other cognitive abilities or in academic achievement scores. Malaria with neurological
Full Text Available Abstract Background Malaria is a leading cause of ill health and neuro-disability in children in sub-Saharan Africa. Impaired cognition is a common outcome of malaria with neurological involvement. There is also a possibility that academic achievement may be affected by malaria with neurological involvement given the association between cognitive ability and academic achievement. This study investigated the effect of malaria with neurological involvement on cognitive ability, behaviour and academic achievement. Methods This prospective case-control study was carried out in Kampala City, Uganda between February 2008 and October 2010. Sixty-two children with a history of malaria with neurological involvement were followed up and given assessments for cognitive ability (working memory, reasoning, learning, visual spatial skills and attention, behaviour (internalizing and externalizing problems and academic achievement (arithmetic, spelling and reading three months after the illness. Sixty-one community controls recruited from the homes or neighbouring families of the cases were also given the same assessments. Tests scores of the two groups were compared using analysis of covariance with age, sex, level of education, nutritional status and quality of the home environment as covariates. This study was approved by the relevant ethical bodies and informed consent sought from the caregivers. Results Children in the malaria group had more behavioural problems than the community controls for internalizing problems (estimated mean difference = -3.71, 95% confidence interval (CI, = -6.34 to -1.08, p = 0.007. There was marginal evidence of lower attention scores (0.40, CI = -0.05 to 0.86, p = 0.09. However, excluding one child from the analyses who was unable to perform the tests affected the attention scores to borderline significance (0.32, CI, = 0.01 to 0.62, p = 0.05. No significant differences were observed in other cognitive abilities or in academic
Aagaard, Jørgen; Foldager, Leslie; Makki, Ahmad
Background: The efficacy of psychoeducation is well documented in the treatment of relapse prevention of schizophrenia, and recently also in bipolar disorder; however, for recurrent depression only few controlled studies focusing on the efficacy of psychoeducation have been conducted. Aims......: This randomized study tests the efficacy of treatment-as-usual supplemented with a psychoeducative programme for patients with recurrent depression, treated at Community Mental Health Centres (CMHC) in Denmark. The primary outcome measurements concern was decline in consumption of psychiatric inpatient services...... and decline in Beck’s Depression Inventory (BDI). Methods: Eighty patients were randomized, either to the psychoeducative programme (consisting of eight sessions, each of 2 hours duration) and 2-year outpatient follow-up (42 cases), or only to 2-year outpatient follow-up (38 controls). The patients were...
Kennedy, Tom; Jones, Roger; Darnley, Simon; Seed, Paul; Wessely, Simon; Chalder, Trudie
To assess the efficacy of cognitive behaviour therapy delivered in primary care for treating irritable bowel syndrome. Randomised controlled trial. 10 general practices in London. 149 patients with moderate or severe irritable bowel syndrome resistant to the antispasmodic mebeverine. Cognitive behaviour therapy delivered by trained primary care nurses plus 270 mg mebeverine taken thrice daily compared with mebeverine treatment alone. Primary measures were patients' scores on the irritable bowel syndrome symptom severity scale. Secondary measures were scores on the work and social adjustment scale and the hospital anxiety and depression scale. Of 334 referred patients, 72 were randomised to mebeverine plus cognitive behaviour therapy and 77 to mebeverine alone. Cognitive behaviour therapy had considerable initial benefit on symptom severity compared with mebeverine alone, with a mean reduction in score of 68 points (95% confidence interval 103 to 33), with the benefit persisting at three months and six months after therapy (mean reductions 71 points (109 to 32) and 11 points (20 to 3)) but not later. Cognitive behaviour therapy also showed significant benefit on the work and social adjustment scale that was still present 12 months after therapy (mean reduction 2.8 points (5.2 to 0.4)), but had an inconsistent effect on the hospital anxiety and depression scale. Cognitive behaviour therapy delivered by primary care nurses offered additional benefit over mebeverine alone up to six months, although the effect had waned by 12 months. Such therapy may be useful for certain patients with irritable bowel syndrome in primary care.
Luk, Edwin K; Gorelik, Alexandra; Irving, Louis; Khan, Fary
To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes. Prospective controlled clinical trial. A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation. Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation. A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group. The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.
Engman, Maria; Wijma, Klaas; Wijma, Barbro
The purpose of the present study was to investigate long-term coital behaviour in women treated with cognitive behaviour therapy (CBT) for superficial coital pain and vaginismus. Data were taken from a questionnaire concerning long-term coital behaviour sent to 59 women who presented to Linköping University Hospital because of superficial coital pain, had been diagnosed with vaginismus, and had been treated with CBT. Data were also traced from therapy records: mean follow-up time was 39 months, the women had suffered for an average of almost 4 years, and required a mean of 14 treatment sessions. Forty-four of the 59 women returned the questionnaire, for a response rate of 74.6%. At follow-up, 81% of the treated women had had intercourse. A majority (61%) rated their ability to have intercourse without pain as 6 or higher (on a scale from 0-10), and 61% rated their ability to enjoy intercourse as 6 or higher (on a scale from 0-10). The proportion of women with positive treatment outcome at follow-up ranged from 81% (able to have intercourse) to 6% (able to have pain-free intercourse). An ability to have intercourse at end of therapy was maintained at follow-up. Two-thirds of the women reported high fulfillment of individual treatment goals. At follow-up, the women estimated a significantly higher self-worth as sex partners, and as women and human beings, than before treatment. Twelve per cent of the original sample had healed after a few assessment sessions and without treatment.
Wilson, Lynere; Crowe, Marie; Scott, Anne; Lacey, Cameron
Psychoeducation has become a common intervention within mental health settings. It aims to increase people's ability to manage a life with a long-term illness. For people with bipolar disorder, psychoeducation is one of a range of psychosocial interventions now considered part of contemporary mental health practice. It has taken on a 'common sense' status that results in little critique of psychoeducation practices. Using a published manual on psychoeducation and bipolar disorder as its data, Foucauldian discourse analysis was used in the present study for a critical perspective on psychoeducation in order to explore the taken-for-granted assumptions on which it is based. It identifies that the text produces three key subject positions for people with bipolar disorder. To practice self-management, a person must: (i) accept and recognize the authority of psychiatry to know them; (ii) come to see that they can moderate themselves; and (iii) see themselves as able to undertake a reflexive process of self-examination and change. These findings highlight the circular and discursive quality to the construct of insight that is central to how psychoeducation is practiced. Using Foucault's construct of pastoral power, it also draws attention to the asymmetrical nature of power relations between the clinician and the person with bipolar disorder. An effect of the use of medical discourse in psychoeducation is to limit its ability to work with ambivalence and contradiction. A critical approach to psychotherapy and education offers an alternate paradigm on which to basis psychoeducation practices. © 2017 Australian College of Mental Health Nurses Inc.
International best-practice guidelines for the management of first-episode psychosis have recommended the provision of psychoeducation for multifamily groups. While there is ample evidence of their efficacy in multiepisode psychosis, there is a paucity of evidence supporting this approach specifically for first-episode psychosis. We sought to determine whether a six-week caregiver psychoeducation programme geared specifically at first-episode psychosis improves caregiver knowledge and attitudes.
Buunk, Anne; Spikman, Jacoba M.; Veenstra, Wencke S.; van Laar, Peter Jan; Metzemaekers, Jan D.M.; van Dijk, J. Marc C.; Meiners, Linda C.; Groen, Rob J.M.
Behavioural disturbances are frequently found after aneurysmal subarachnoid haemorrhage (aSAH). Social cognition impairments have been suggested as a possible underlying mechanism for behavioural problems. Also, aSAH is likely to result in damage affecting frontal-subcortical circuits underlying
Buunk, Anne M.; Spikrnan, Jacoba M.; Veenstra, Wencke S.; van Laar, Peter Jan; Metzemaekers, Jan D. M.; van Dijk, J. Marc C.; Meiners, Linda C.; Groen, Rob J. M.
Behavioural disturbances are frequently found after aneurysmal subarachnoid haemorrhage (aSAH). Social cognition impairments have been suggested as a possible underlying mechanism for behavioural problems. Also, aSAH is likely to result in damage affecting frontal-subcortical circuits underlying
Cima, Rilana F F; van Breukelen, Gerard; Vlaeyen, Johan W S
Cognitive behavioural treatments (CBT) for the reduction of tinnitus complaints have been shown to be effective; however the specific mechanisms of change are yet to be unveiled. Reductions in tinnitus-related fear have been indicated to be an important factor in alleviating tinnitus suffering. The role of tinnitus-related fear has been proposed as a mediator explaining the cognitive behavioural treatment effects on tinnitus severity, tinnitus-related impairment and general quality of life of tinnitus patients. A two-group, single-centre RCT was carried out with adult tinnitus patients (n = 492), with 3 follow-up assessments up to 12 months after randomization. Patients were randomly assigned to Usual Care (UC) or Specialised cognitive behavioral stepped Care (SC). A repeated-measures design, with group as a between subjects factor, and time as the within-subject factor, was used in an intention-to-treat analysis. Mixed regressions for assessing mediation effects were performed with general health, tinnitus distress, tinnitus related impairment as the dependent variables and tinnitus related fear as the mediator variable. Tinnitus-related fear appears to mediate part of the treatment benefits of specialized CBT for Tinnitus, as compared to usual care, with respect to increased quality of life ratings, and decreased tinnitus severity and tinnitus related impairments. The effectiveness of specialized cognitive behavioural treatment approaches for tinnitus might be partly explained by significant reductions in tinnitus-related fear. These results are relevant in that currently, though CBT approaches in tinnitus management have been proven to lead to decreased suffering of tinnitus patients, the psychological mechanisms causing these benefits are still to be discovered. Copyright © 2017 Elsevier B.V. All rights reserved.
Mayo-Wilson, Evan; Montgomery, Paul
Anxiety disorders are the most common mental health problems. They are chronic and unremitting. Effective treatments are available, but access to services is limited. Media-delivered behavioural and cognitive behavioural interventions (self-help) aim to deliver treatment with less input from professionals compared with traditional therapies. To assess the effects of media-delivered behavioural and cognitive behavioural therapies for anxiety disorders in adults. Published and unpublished studies were considered without restriction by language or date. The Cochrane Depression, Anxiety and Neurosis Review Group's Specialized Register (CCDANCTR) was searched all years to 1 January 2013. The CCDANCTR includes relevant randomised controlled trials from the following bibliographic databases: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). Complementary searches were carried out on Ovid MEDLINE (1950 to 23 February 2013) and PsycINFO (1987 to February, Week 2, 2013), together with International trial registries (the trials portal of the World Health Organization (ICTRP) and ClinicalTrials.gov). Reference lists from previous meta-analyses and reports of randomised controlled trials were checked, and authors were contacted for unpublished data. Randomised controlled trials of media-delivered behavioural or cognitive behavioural therapy in adults with anxiety disorders (other than post-traumatic stress disorder) compared with no intervention (including attention/relaxation controls) or compared with face-to-face therapy. Both review authors independently screened titles and abstracts. Study characteristics and outcomes were extracted in duplicate. Outcomes were combined using random-effects models, and tests for heterogeneity and for small study bias were conducted. We examined subgroup differences by type of disorder, type of intervention provided, type of media, and recruitment methods used. One hundred and
Full Text Available BACKGROUND: A relevant fraction of patients with amyotrophic lateral sclerosis (ALS exhibit a fronto-temporal pattern of cognitive and behavioural disturbances with pronounced deficits in executive functioning and cognitive control of behaviour. Structural imaging shows a decline in fronto-temporal brain areas, but most brain imaging studies did not evaluate cognitive status. We investigated microstructural white matter changes underlying cognitive impairment using diffusion tensor imaging (DTI in a large cohort of ALS patients. METHODS: We assessed 72 non-demented ALS patients and 65 matched healthy control subjects using a comprehensive neuropsychological test battery and DTI. We compared DTI measures of fiber tract integrity using tract-based spatial statistics among ALS patients with and without cognitive impairment and healthy controls. Neuropsychological performance and behavioural measures were correlated with DTI measures. RESULTS: Patients without cognitive impairment demonstrated white matter changes predominantly in motor tracts, including the corticospinal tract and the body of corpus callosum. Those with impairments (ca. 30% additionally presented significant white matter alterations in extra-motor regions, particularly the frontal lobe. Executive and memory performance and behavioural measures were correlated with fiber tract integrity in large association tracts. CONCLUSION: In non-demented cognitively impaired ALS patients, white matter changes measured by DTI are related to disturbances of executive and memory functions, including prefrontal and temporal regions. In a group comparison, DTI is able to observe differences between cognitively unimpaired and impaired ALS patients.
McGillivray, J. A.; Kershaw, M.
Background: A growing literature suggests that people with mild intellectual disability (ID) who have depressed mood may benefit from cognitive--behavioural interventions. There has been some speculation regarding the relative merit of the components of this approach. The aim of this study was to compare (i) cognitive strategies; (ii) behavioural…
Landa, Y.; Mueser, K.T.; Wyka, K.E.; Shreck, E.; Jespersen, R.; Jacobs, M.A.; Griffin, K.W.; van der Gaag, M.; Reyna, V.F.; Beck, A.T.; Silbersweig, D.A.; Walkup, J.T.
Objective: The onset of psychosis typically occurs during adolescence or early adulthood and can have a detrimental impact on social and cognitive development. Cognitive behavioural therapy (CBT) shows promise in reducing the risk of psychosis. Teaching families to apply CBT with their offspring may
Campbell, Martin; Hogg, James
Background: Cognitive representations of challenging behaviour among staff may influence therapeutic outcomes. This study looked at how cognitive dimensions of Identity, Cause, Consequences, Emotional Reaction and Treatment/Control are affected by training. Materials and Methods: A theoretically derived questionnaire was used to measure the impact…
McIntosh, Virginia V W; Jordan, Jennifer; Carter, Janet D; Frampton, Christopher M A; McKenzie, Janice M; Latner, Janet D; Joyce, Peter R
Cognitive-behavioural therapy (CBT) is the recommended treatment for binge eating, yet many individuals do not recover, and innovative new treatments have been called for. The current study compares traditional CBT with two augmented versions of CBT; schema therapy, which focuses on early life experiences as pivotal in the history of the eating disorder; and appetite-focused CBT, which emphasises the role of recognising and responding to appetite in binge eating. 112 women with transdiagnostic DSM-IV binge eating were randomized to the three therapies. Therapy consisted of weekly sessions for six months, followed by monthly sessions for six months. Primary outcome was the frequency of binge eating. Secondary and tertiary outcomes were other behavioural and psychological aspects of the eating disorder, and other areas of functioning. No differences among the three therapy groups were found on primary or other outcomes. Across groups, large effect sizes were found for improvement in binge eating, other eating disorder symptoms and overall functioning. Schema therapy and appetite-focused CBT are likely to be suitable alternative treatments to traditional CBT for binge eating. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Shuttlewood, Emma; De Zoysa, Nicole; Rankin, David; Amiel, Stephanie
Impaired awareness of hypoglycaemia (IAH) in people with type 1 diabetes is a dangerous condition that is associated with a six-fold greater risk of severe hypoglycaemia than for people with awareness. A new psychoeducational programme, DAFNE-HART, has been specifically designed to address persistent IAH. The initial pilot showed promising outcomes including fewer hypoglycaemic episodes and improved hypoglycaemia awareness. This aim of this paper is to report the development and qualitative evaluation of DAFNE-HART from participant interviews. DAFNE-HART incorporates diabetes education with two psychological approaches that have demonstrated efficacy in long-term health conditions: motivational interviewing and cognitive behaviour therapy. The course, delivered across two UK locations included both group and individual support over a 6-week period facilitated by DAFNE educators, trained and supervised by a clinical psychologist. Semi-structured interviews were conducted with 19 participants immediately after their courses and the interviews were analysed using grounded theory. Five main themes emerged which describe the behavioural changes people made to their diabetes management, the development of new attitudes and beliefs, their experiences of regaining hypoglycaemia cues, reactions to the course format and the significance of the relationship with their care provider. Participants provide insights into how the course changed their view of IAH and led to practical changes in minimising hypoglycaemia. Integration of psychological techniques into diabetes education can address the cognitive and motivational barriers to restoring awareness and optimal diabetes management. It is suggested that further research is needed to evaluate this programme in a larger sample, over a longer time frame. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Abstract Background Behavioural and psychological symptoms are associated with dementia, but are also present in a significant number of the older population without dementia. Here we explore the distribution of behavioural and psychological symptoms in the population without dementia, and their relationship with domains and severity of health and cognitive impairment. Methods The Medical Research Council Cognitive Function and Ageing Study is a two-phase longitudinal study of ageing representative of the population aged 65 and over of England and Wales. A subsample of 1781 participants without a study diagnosis of dementia was included in this study. Information on symptoms including depression, apathy, anxiety, feelings of persecution, hallucination, agitated behaviour, elation, irritability, sleep problems, wandering, confabulation and misidentification, cognitive function, health related factors and socio-demographic information was extracted from interviews with participants and knowledgeable informants. Participants were classified according to the Mini-Mental State Examination and by criteria for subtypes of mild cognitive impairment (MCI. The prevalence of behavioural and psychological symptoms and associations with cognitive function, health and socio-demographics was examined. Co-occurrence of symptoms was tested using factor analysis. Results Most symptoms were reported more frequently in those with more severe cognitive impairment. Subjective memory complaints were the strongest independent predictor of reported symptoms, and most were reported more often in those classified as having MCI than in those with cognitive impairments that did not meet the MCI criteria. The pattern of co-occurrence of symptoms is similar to that seen in dementia. Conclusions Our results highlight that behavioural and psychological symptoms are prevalent in the cognitively impaired older population, and partly explain the variation observed in previous
Full Text Available Apathy has a high prevalence and a significant contribution to treatment and rehabilitation outcomes in acquired brain damage. Research on the disorder’s neuropsychological correlates has produced mixed results. While the mixed picture may be due to the use of varied assessment tools on different patient populations, it’s also the case that most studies treat apathy as a unitary syndrome. This is in spite of evidence that apathy is a multifaceted and multidimensional syndrome. This study investigates the neuropsychological correlates of apathy in 49 patients with acquired brain damage. It further fractionates apathy symptoms into affective, cognitive and behavioural sub-domains, and investigates their individual relations with standard measures of affective, cognitive and behavioural functioning. Global apathy scores were not related to any of these measures. Affective apathy was associated with emotion perception deficits, and cognitive apathy was associated with executive deficits on the Brixton test. These results demonstrate that treating apathy as a single entity may hide important correlates to apathy symptoms that become visible when the disorder is fractionated into its sub-domains. The study highlights the research and clinical importance of treating apathy as a multidimensional syndrome.
Lim, Matthew S M; Bowden-Jones, Henrietta; Rogers, Robert D
Cognitive perspectives on gambling propose that biased thinking plays a significant role in sustaining gambling participation and, in vulnerable individuals, gambling problems. One prominent set of cognitive biases include illusions of control involving beliefs that it is possible to influence random gaming events. Sociologists have reported that (some) gamblers believe that it is possible to throw dice in different ways to achieve gaming outcomes (e.g., 'dice-setting' in craps). However, experimental demonstrations of these phenomena are lacking. Here, we asked regular gamblers to roll a computer-simulated, but fair, 6 sided die for monetary prizes. Gamblers allowed the die to roll for longer when attempting to win higher value bets, and when attempting to hit high winning numbers. This behaviour was exaggerated in gamblers motivated to keep gambling following the experience of almost-winning in gambling games. These results suggest that gambling cognitive biases find expression in the motor behaviour of rolling dice for monetary prizes, possibly reflecting embodied substrates.
Henkel, V; Bussfeld, P; Möller, H-J; Hegerl, U
Helplessness and hopelessness are central aspects of cognitive-behavioural explanations for the development and persistence of depression. In this article a general overview concerning the evolution of those approaches to depression is provided. Included is a critical examination of the theories. The review of the literature suggests that those cognitive models describing helplessness/hopelessness as trait factors mediating depression do not really have a strong empirical base. The majority of those studies had been conducted in healthy or only mildly depressed subjects. Thus, there seems to be little justification for broad generalisations beyond the populations studied. It seems that some of the reported studies have not tested the underlying theories adequately (e. g. correlation had sometimes been interpreted as causation; adequate prospective longitudinal study designs had seldom been applied). Moreover, the theoretical models are not generally prepared to explain all depressive features (e. g. the possibility of a spontaneous shift in a manic episode). Despite those limitations, there is a relevant impact of the learned helplessness paradigm on preclinical research in neurobiological correlates of depressive states. Last but not least, the models are of high interest with respect to the theoretical background of important modules of cognitive-behavioural therapy and its acute and prophylactic effects.
Dolbeault, S; Cayrou, S; Brédart, A; Viala, A L; Desclaux, B; Saltel, P; Gauvain-Piquard, A; Hardy, P; Dickes, P
Many women with breast cancer need psychological help to cope more effectively after treatment. Cognitive and behavioural techniques are not yet well established in France. A multi-site randomized study was conducted to evaluate the effects of a psycho-educational group intervention in this population. Two hundred and three patients, recruited after primary treatment, were randomly assigned either to a treatment group (psycho-educational intervention) or to a waiting-list control group. The 8-week programme of 2 h sessions comprised of thematic discussions, information and training in stress management techniques. Evaluation at baseline, after 8 sessions, and 1 month after programme completion, included evaluations using the STAI, POMS, MAC, EORTC QLQ-C30 and EORTC QLQ-BR23 breast module scales. We observed a significant reduction in anxiety (STAI, POMS) among group participants, a reduction in anger, depression and fatigue (POMS), a significant improvement in vigor and interpersonal relationships (POMS), in emotional and role functioning, in health status and fatigue level (EORTC QLQ-C30). In contrast, coping strategies (MAC) were not significantly different between groups. No group-related negative effects were observed and the global satisfaction levels were very high. This study demonstrates the feasibility and effectiveness of a psycho-educational intervention, which can accelerate the reduction of those negative affects which are present at the end of treatment. It represents an excellent complement or an alternative to individual psycho-oncologic therapeutic support, widely proposed in France, and should now be tested in groups with other types of cancer and at other disease phases.
Bevington, J; Wishart, J G
Identifying factors linked to underachievement is fundamental to understanding the associated academic difficulties and crucial to the development of effective intervention strategies. Underachievement in a number of academic domains has been shown to be associated with behavioural problems in the classroom but the nature of the association and direction of any causal link has yet to be clarified. This study explored the association between poor academic achievement and behavioural problems by examining the direct effects of peer presence on classroom performance in children with identified behavioural difficulties. Specifically, it was hypothesised that independent performance on a cognitive task would decrease as number of classroom peers present increased. A total of 24 children attending two special schools for children with emotional and behavioural difficulties participated in the study. Age range was 9-14 years. A within-subjects design was used in which performance on a set of perceptual/conceptual matching tasks was assessed under three conditions: the child working alone, alongside one other peer, or within a group of six. Measures of non-verbal intelligence and academic attainment were collected, along with teacher ratings of the severity of each child's problem behaviour. Performance was found to be significantly influenced by peer presence, both in terms of number of correct responses and time taken to complete the matching tasks. Direction of effects on these two performance indicators differed according to number of peers present. Findings highlight the importance of contextual factors in determining classroom performance in children with behavioural difficulties. Given the current pressure to educate all children in mainstream classes, findings have implications for classroom management.
Pierobon, Antonia; Giardini, Anna; Callegari, Simona; Majani, Giuseppina
Patients with a chronic illness must continuously revise their lifestyle, adapting it to the behavioural limitations imposed by their state of health. These incessant adjustments of behaviour dictated by the patients' need to adapt to their clinical condition also cause profound psychological changes. The experience of a patient with a chronic illness often leads to a reformulation of self, which the patient may or may not be aware of, but which helps to facilitate successful behavioural adaptation. During the course of their disease, which spans from diagnosis to treatment, some patients have the opportunity to meet a psychologist, who has various tasks: understanding what stage of adaptation the chronically ill patients have reached, evaluating the patients' emotional state, facilitating their acceptance of their clinical condition, stimulating them to redefine their aims, if there are the presuppositions, and supporting their coping capacities and internal and external resources. This article is neither a review nor original research, but rather a "clinical exposition" with educational suggestions. The purpose of this article is to give a voice to the patients' internal dialogue, to what they say to themselves, to their narration of the illness, but also to explain the typical components of cognitive behavioural treatment in the setting of cardiological, respiratory and neuromotor rehabilitation.
Cuijpers, P; Cristea, I A; Weitz, E; Gentili, C; Berking, M
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). We searched PubMed, PsycINFO, EMBASE and the Cochrane database, and included 47 trials on anxiety disorders and 34 trials on MDD. 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 anxiety disorders (g = 0.73-0.91). Risk of bias was considerable in the majority of studies. 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.
Rhodes, Shelley; Richards, David A; Ekers, David; McMillan, Dean; Byford, Sarah; Farrand, Paul A; Gilbody, Simon; Hollon, Steven D; Kuyken, Willem; Martell, Christopher; O'Mahen, Heather A; O'Neill, Emer; Reed, Nigel; Taylor, Rod S; Watkins, Ed R; Wright, Kim A
Cognitive behaviour therapy (CBT) is an effective treatment for depression. However, CBT is a complex therapy that requires highly trained and qualified practitioners, and its scalability is therefore limited by the costs of training and employing sufficient therapists to meet demand. Behavioural activation (BA) is a psychological treatment for depression that may be an effective alternative to CBT and, because it is simpler, might also be delivered by less highly trained and specialised mental health workers. COBRA is a two-arm, non-inferiority, patient-level randomised controlled trial, including clinical, economic, and process evaluations comparing CBT delivered by highly trained professional therapists to BA delivered by junior professional or para-professional mental health workers to establish whether the clinical effectiveness of BA is non-inferior to CBT and if BA is cost effective compared to CBT. Four hundred and forty patients with major depressive disorder will be recruited through screening in primary care. We will analyse for non-inferiority in per-protocol and intention-to-treat populations. Our primary outcome will be severity of depression symptoms (Patient Health Questionnaire-9) at 12 months follow-up. Secondary outcomes will be clinically significant change and severity of depression at 18 months, and anxiety (General Anxiety Disorder-7 questionnaire) and health-related quality of life (Short-Form Health Survey-36) at 12 and 18 months. Our economic evaluation will take the United Kingdom National Health Service/Personal Social Services perspective to include costs of the interventions, health and social care services used, plus productivity losses. Cost-effectiveness will explored in terms of quality-adjusted life years using the EuroQol-5D measure of health-related quality of life. The clinical and economic outcomes of this trial will provide the evidence to help policy makers, clinicians and guideline developers decide on the merits of
Sørensen, Anders Dræby
This is a presentation of a research project, which explores lived experience of psychotherapy in terms of learning outcomes. This includes both Existential therapy (ET) and Cognitive-Behavioural Therapy (CBT) and their possible differences and similarities. I can describe learning as any...... experiential change that occurs in the participants understanding as result of the therapy in which they participate. Learning outcomes are concerned with the achievements of the learner rather than the intentions of the educator, as expressed in the objectives of an educational effort. This research points...
Herman, Yarissa; Shireen, Huma; Bromley, Sarah; Yiu, Natalie; Granholm, Eric
To conduct a preliminary feasibility examination of cognitive-behavioural social skills training (CBSST) in a first-episode psychosis population. Twenty two first-episode psychosis clients participated in an 18-week CBSST group adapted for a younger population. Adaptive functioning significantly improved following group participation and was maintained at 3-month follow-up. The CBSST group was feasible and well accepted in the first episode programme. These preliminary findings warrant further testing in a larger trial to determine efficacy. © 2016 John Wiley & Sons Australia, Ltd.
Kjeldgaard, Dorte; Forchhammer, Hysse B; Teasdale, Thomas William
BACKGROUND: Chronic post-traumatic headache (CPTH) after mild head injury can be difficult to manage. Research is scarce and successful interventions are lacking.To evaluate the effect of a group-based Cognitive Behavioural Therapy (CBT) intervention in relation to headache, pain perception...... distress, and the overall experience of symptoms. The waiting-list group experienced no change in headache but, opposed to the treatment group, a significant decrease in somatic and cognitive symptoms indicating a spontaneous remission over time. CONCLUSIONS: Our primarily negative findings confirm...... that management of patients with CPTH still remains a considerable challenge. Psychological group therapy with CBT might be effective in an earlier stage of CPTH and in less severely affected patients but our findings strongly underline the need for randomized controlled studies to test the efficacy...
Full Text Available Hildegard D Löhr1,2, Jan H Rosenvinge1,3, Rolf Wynn2,41Division of General Psychiatry, University Hospital of North Norway, 2Telemedicine Research Group, Department of Clinical Medicine, Faculty of Health Sciences, 3Department of Psychology, Faculty of Health Sciences, University of Tromsø, 4Division of Addiction and Specialized Psychiatry, University Hospital of North Norway, Tromsø, NorwayAbstract: We describe a psychoeducational program integrated in a basic computer skills course for participants suffering from social anxiety. The two main aims of the course were: that the participants learn basic computer skills, and that the participants learn to cope better with social anxiety. Computer skills were taught by a qualified teacher. Psychoeducation and cognitive therapy skills, including topics such as anxiety coping, self-accept, and self-regulation, were taught by a clinical psychologist. Thirteen of 16 participants completed the course, which lasted 11 weeks. A qualitative analysis was performed, drawing on observations during the course and on interviews with the participants. The participants were positive about the integration of psychoeducation sessions in the computer course, and described positive outcomes for both elements, including improved computer skills, improved self-esteem, and reduced social anxiety. Most participants were motivated to undertake further occupational rehabilitation after the course.Keywords: cognitive therapy, information technology, occupational rehabilitation, psychoeducation, self-help, social anxiety
Siciliano, Mattia; Trojano, Luigi; Trojsi, Francesca; Greco, Roberta; Santoro, Manuela; Basile, Giuseppe; Piscopo, Fausta; D'Iorio, Alfonsina; Patrone, Manila; Femiano, Cinzia; Monsurrò, Mariarosaria; Tedeschi, Gioacchino; Santangelo, Gabriella
Cognitive assessment for individuals with Amyotrophic Lateral Sclerosis (ALS) can be difficult because of frequent occurrence of difficulties with speech, writing, and drawing. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) is a recent multi-domain neuropsychological screening tool specifically devised for this purpose, and it assesses the following domains: executive functions, social cognition, verbal fluency and language (ALS-specific), but also memory and visuospatial abilities (Non-ALS specific). ECAS total score ranges from 0 (worst performance) to 136 (best performance). Moreover, a brief caregiver interview provides an assessment of behaviour changes and psychotic symptoms usually associated with ALS patients. The aim of the present study was to provide normative values for ECAS total score and sub-scores in a sample of Italian healthy subjects. Two hundred and seventy-seven Italian healthy subjects (151 women and 126 men; age range 30-79 years; educational level from primary school to university) underwent ECAS and Montreal Cognitive Assessment (MoCA). Multiple linear regression analysis revealed that age and education significantly influenced performance on ECAS total score and sub-scale scores. From the derived linear equation, a correction grid for raw scores was built. Inferential cut-off scores were estimated using a non-parametric technique and equivalent scores (ES) were computed. Correlation analysis showed a good significant correlation between adjusted ECAS total scores with adjusted MoCA total scores (r rho = 0.669, p study provided normative data for the ECAS in an Italian population useful for both clinical and research purposes.
Full Text Available Executive processes, such as coding for sequential order, are of extreme importance for higher-order cognitive tasks. One of the significant questions is, how order information is coded in working memory and what cognitive mechanisms and processes mediate it. The aim of this review paper is to summarize results of studies that explore whether order and item memory are two separable processes. Furthermore, we reviewed evidence for each of the proposed cognitive mechanism that might mediate order processing. Previous behavioural and neuroimaging data suggest different representation and processing of item and order information in working memory. Both information are maintained and recalled separately and this separation seems to hold for recognition as well as for recall. To explain the result of studies of order coding, numerous cognitive mechanisms were proposed. We focused on four different mechanisms by which order information might be coded and retrieved, namely inter-item associations, direct coding, hierarchical coding and magnitude coding. Each of the mechanisms can explain some of the aspect of order information coding, however none of them is able to explain all of the empirical findings. Due to its complex nature it is not surprising that a single mechanism has difficulties accounting for all the behavioral data and order memory may be more accurately characterized as the result of a set of mechanisms rather than a single one. Moreover, the findings beget a question of whether different types of memory for order information might exist.
Paxling, B.; Lundgren, S.; Norman, A.; Almlov, J.; Carlbring, P.; Cuijpers, P.; Andersson, G.
Background: Internet-delivered cognitive behaviour therapy (iCBT) has been found to be an effective way to disseminate psychological treatment, and support given by a therapist seems to be important in order to achieve good outcomes. Little is known about what the therapists actually do when they
The effect of flexible cognitive-behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees: pragmatic randomised controlled clinical trial.
Buhmann, Caecilie Böck; Nordentoft, Merete; Ekstroem, Morten; Carlsson, Jessica; Mortensen, Erik Lykke
Little evidence exists on the treatment of traumatised refugees. To estimate treatment effects of flexible cognitive-behavioural therapy (CBT) and antidepressants (sertraline and mianserin) in traumatised refugees. Randomised controlled clinical trial with 2 × 2 factorial design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months. A total of 217 of 280 patients completed treatment (78%). There was no effect on PTSD symptoms, no effect of psychotherapy and no interaction between psychotherapy and medicine. A small but significant effect of treatment with antidepressants was found on depression. In a pragmatic clinical setting, there was no effect of flexible CBT and antidepressants on PTSD, and there was a small-to-moderate effect of antidepressants and psychoeducation on depression in traumatised refugees. © The Royal College of Psychiatrists 2016.
Cameron, David S; Bertenshaw, Emma J; Sheeran, Paschal
Several reviews suggest that positive affect is associated with improved longevity, fewer physical symptoms, and biological indicators of good health. It is possible that positive affect could influence these outcomes by promoting healthful cognitions and behaviours. The present review identified conceptual pathways from positive affect to health cognitions and behaviour, and used random effects meta-analysis to quantify the impact of positive affect inductions (versus neutral affect conditions) on these outcomes. Literature searches located 54 independent tests that could be included in the review. Across all studies, the findings revealed no reliable effects on intentions (d+ = -.12, 95% CI = -.32 to .08, k = 15) or behaviour (d+ = .15, 95% CI = -.03 to .33, k = 23). There were four reliable effects involving specific cognitions and behaviours, but little clear evidence for generalised benefits or adverse effects of positive emotions on health-related cognitions or actions. Conclusions must be cautious given the paucity of tests available for analysis. The review offers suggestions about research designs that might profitably be deployed in future studies, and calls for additional tests of the impact of discrete positive emotions on health cognitions and behaviour.
Full Text Available Cognitive behavioural psychotherapy is, just like other psychotherapeutic systems, of an eclectic nature. Should a therapist be successful across a wide range of issues, he/she needs to be adaptable, flexible and eclectic in terms of the techniques applied. Eclectically oriented therapists use a wide range of interventions; however, they adhere to individual theoretical structures. The aim of the paper is to point out the application of a combination of artistic activities within the system of the Cognitive behavioural therapy. For this purpose the paper presents a qualitative analysis of two case studies. We formulated the following research questions. Can the methods of combining the cognitive behavioural therapy and art accelerate the course of therapy? Can the methods of combining the cognitive behavioural therapy and art be perceived by the client as effective? The phenomenon investigated in the case study is a functional analysis of a client’s case and subsequent application of therapeutic and educational techniques of the Cognitive behavioural therapy and art. In both case studies it was demonstrated that the involvement of therapeutic elements accelerated the course of therapy. The clients in the research sample assessed the therapy as beneficial.
Warschburger, P; Fromme, C; Petermann, F; Wojtalla, N; Oepen, J
Obesity is common in children and adolescents with incidence rates increasing both nationally and internationally. Its causes are complex and multifaceted, and obesity is associated with high morbidity and mortality as well as psychological distress. Multidimensional programmes are necessary in the treatment of this chronic disease in order to change eating and physical activity habits. A cognitive-behavioural training programme was developed and evaluated. In combination with diet and exercise, this special group programme that includes well established behavioural methods, was expected to result in long-term weight reduction and decrease of psychological distress in connection with obesity. As part of the six week in-patient rehabilitation for children and adolescents at Viktoriastift in Bad Kreuznach, the three-part programme (experimental group, EG) was compared with a programme that differed only in the psychological intervention component (instead of the specific training programme they undertook muscle relaxation training, comparison group, CG). In total, 197 children and adolescents between 9 and 19 y-of-age were recruited into the study. Somatic (eg weight status), behavioural (eg eating behaviour) and psychological (eg quality of life) outcomes were assessed at five points in time: two weeks before the intervention, at the beginning and end of the programme, as well as six months and one year post-intervention. The study started in spring 1997. Main outcomes will be presented. Pre- vs post-intervention-tests showed significant improvements in self-reported eating behaviours for the EG compared with the CG (F=6.38, Phabits and to reduce somatic and psychosocial consequences. Long-term effects after two years are expected to underscore these results.
Hoiles, Kimberley J; Egan, Sarah J; Kane, Robert T
The study examined the validity of the transdiagnostic cognitive behavioural theory of eating disorders. The aim was to determine if the maintaining mechanisms of clinical perfectionism, core low self esteem, mood intolerance and interpersonal difficulties have a direct impact on dietary restraint or an indirect impact via eating, shape and weight concerns. The model was tested in a community sample of 224 females recruited via the internet. The structural equation model provided a good fit for the data. The relationship between maintaining mechanisms and dietary restraint was due to maintaining mechanisms impacting indirectly on dietary restraint via eating disorder psychopathology. The results lend support for the validity of the transdiagnostic model of eating disorders as the maintaining mechanisms lead to restraint via the core psychopathology of eating concerns, weight concerns and shape concerns. The findings suggest the four maintaining mechanisms alone are not enough to lead to dietary restraint, the core psychopathology of eating disorders needs to be present, which supports the predictions of the theory. These results help establish the validity of the transdiagnostic cognitive behavioural theory of eating disorders. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
Full Text Available In any given field, the psychological examination represents a prerequisite for ensuring that the work process is properly and appropriately directed towards increasing its efficiency. An important aspect of the psychological examination is to identify risk and protective factors associated with developing and maintaining emotional and behavioural problems. Special conditions resulting from emergency situations are likely to lead to physical and emotional tensions. In some intervention and rescue personnel these are accompanied by mobilization of internal resource, while in others they can generate inadequacy phenomena and symptoms of mental distress. From this perspective, stress is regarded as a result of the marked disparity between environmental requirements and the individual’s response possibilities. To highlight both cognitive and behavioural coping strategies most often used by rescuers trained in NRDI INSEMEX we used two instruments, namely Strategic Approach to Coping Scale SACS and Cognitive Emotion Regulation Questionnaire CERQ. This paper displays the results of the project no. PN 16 43 01 12, study conducted through Nucleu program, implemented with the support of NASR.
Dalle Grave, Riccardo; Calugi, Simona; Conti, Maddalena; Doll, Helen; Fairburn, Christopher G.
Background The aim of this study was to compare the immediate and longer-term effects of two cognitive behaviour therapy programmes for hospitalized patients with anorexia nervosa, one focused exclusively on the patients' eating disorder features and the other focused also on mood intolerance, clinical perfectionism, core low self-esteem or interpersonal difficulties. Both programmes were derived from enhanced cognitive behaviour therapy (CBT-E) for eating disorders. Methods Eighty consecutive patients with severe anorexia nervosa were randomized to the two inpatient CBT-E programmes, both of which involved 20 weeks of treatment (13 weeks as an inpatient and 7 as a day patient). The patients were then followed up over 12 months. The assessments were made blind to treatment condition. Results Eighty-one percent of the eligible patients accepted inpatient CBT-E, of whom 90% completed the 20 weeks of treatment. The patients in both programmes showed significant improvements in weight, eating disorder and general psychopathology. Deterioration after discharge did occur but it was not marked and it was restricted to the first 6 months. There were no statistically significant differences between the effects of the two programmes. Conclusions These findings suggest that both versions of inpatient CBT-E are well accepted by these severely ill patients and might be a viable and promising treatment for severe anorexia nervosa. There appears to be no benefit from using the more complex form of the treatment. PMID:24060628
Violato, Mara; Petrou, Stavros; Gray, Ron; Redshaw, Maggie
This study investigates the extent to which family income is associated with an extensive range of child cognitive and behavioural outcomes in a cohort of almost 19 000 British children born between 2000 and 2001. Merging the economists' and developmental psychologists' approaches, it also attempts to identify the main mechanisms through which family economic resources translate into better developmental outcomes for children. The relative and joint relevance of three groups of mediating factors (parental stress, parental investment and other family-related pathways), identified from the recent economic and psychological literature, are examined both in a cross-sectional ('mopping-up' approach) and in a panel data (fixed effects models) context. Results indicate a weak or absent direct effect of family economic resources on child development after controlling for potential mediating mechanisms. The study also identifies key mediating factors (e.g. maternal depression, a cognitively stimulating home environment, parenting practices and length of breastfeeding) that could be targeted by government initiatives in order to effectively improve children's intellectual development and behaviour beyond what income redistribution can achieve. Copyright © 2010 John Wiley & Sons, Ltd.
Schreurs, K M G; Veehof, M M; Passade, L; Vollenbroek-Hutten, M M R
Cognitive behavioural therapy (CBT) was combined with graded exercise therapy (GET) for patients with chronic fatigue syndrome (CFS) in an uncontrolled implementation study of an inpatient multidisciplinary group therapy. During the intake procedure, 160 CFS patients completed a questionnaire on fatigue related measurements, physical impairment, depression, somatic and psychological attributions, somatic focus, and sense of control over symptoms. Pre-treatment physical activity level was measured with an actometer. At baseline, post-treatment and 6-month follow-up individual strength, subjective fatigue and physical impairment, were reassessed. Large effect sizes were found on subjective fatigue (1.2 post-treatment; 1.2 follow-up) and physical impairment (-.9 post-treatment; -.9 follow-up), Clinically significant improvement was found in 33.8% of the participants at post-treatment and 30.6% at follow-up. Individual strength at post-treatment was predicted by level of physical activity before treatment, and by sense of control over symptoms and physical activity at follow-up. Clinically significant improvement in subjective fatigue was predicted by not receiving a disablement insurance benefit, shorter duration of fatigue, higher sense of control over symptoms and, at follow-up by more pre-treatment physical activity. In conclusion, the intervention was effective for CFS patients. Cognitive behavioural factors that perpetuate fatigue symptoms are also predictors of treatment outcome. Copyright Â© 2011 Elsevier Ltd. All rights reserved.
El Ansari, W; Dunne, J
This paper examined the opportunities as well as challenges in relation to the use of cognitive behavioural therapy (CBT). The opportunities include the increased range of mental health conditions and other disorders where CBT (in isolation or with other interventions) could be effective to address them, as well as policies around workforce education and training that support the expansion of psychological therapies, particularly CBT services. The challenges include the urgent need of heightened awareness among the wider platform of health and social care workers about CBT principles, structure, framework, methods of delivery, wider applications, evaluation and appropriate referral of clients, and stepped model of care. In response to such needs, the paper described CBT awareness educational award at the University of Gloucestershire, UK: the Certificate of Professional Studies in Awareness of Cognitive and Behavioural Therapies Practice delivered at Level III and M level. The challenges associated with the initiation and running of such educational programmes are highlighted, as well as suggestions for the way forward considering the learners', employers' and educational providers' perspectives. © 2012 Blackwell Publishing.
Gordon, Olivia M; Salkovskis, Paul M; Bream, Victoria
It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders. The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD. 92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders. At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD. The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.
Meta-analyses consistently demonstrate that cognitive behaviour therapy (CBT) provides effective evidence-based treatment for children and adolescents with emotional and behaviour problems. Also consistent across meta-analyses is the observation that CBT treatment effects are often medium in size. This observation has instigated a search for factors that could help explain the limited treatment effects and that could be focused upon to enhance CBT treatment outcomes. The current qualitative review focuses on the parent-child attachment relationship as one factor that could be relevant to enhance CBT treatment effects. This review first acknowledges reasons why CBT has historically not been attracted to attachment theory and its postulates. Second, recent evidence is examined to evaluate whether attachment can be approached from a cognitive schema perspective. Subsequently, research is described showing how restoring attachment relationships could result in large treatment effects. Finally, this evidence is integrated in a model of attachment assessment and intervention that might be compatible with CBT. In sum, this review suggests that restoring trust in insecure parent-child attachment relationships can be integrated within CBT and could contribute to its treatment outcomes.
van Koulil, S; van Lankveld, W; Kraaimaat, F W; van Helmond, T; Vedder, A; van Hoorn, H; Donders, A R T; Wirken, L; Cats, H; van Riel, P L C M; Evers, A W M
Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving physical fitness. However, due to the high drop-out rates and large variability in patients' functioning, it was proposed that a tailored treatment approach might yield more promising treatment outcomes. High-risk fibromyalgia patients were randomly assigned to a waiting list control group (WLC) or a treatment condition (TC), with the treatment consisting of 16 twice-weekly sessions of CBT and exercise training tailored to the patient's cognitive-behavioural pattern. Physical fitness was assessed with two physical tests before and 3 months after treatment and at corresponding intervals in the WLC. Treatment effects were evaluated using linear mixed models. The level of physical fitness had improved significantly in the TC compared with the WLC. Attrition rates were low, effect sizes large and reliable change indices indicated a clinically relevant improvement among the TC. A tailored multidisciplinary treatment approach for fibromyalgia consisting of CBT and exercise training is well tolerated, yields clinically relevant changes, and appears a promising approach to improve patients' physical fitness. ClinicalTrials.gov ID NCT00268606.
Rosado, B; González-Martínez, A; Pesini, P; García-Belenguer, S; Palacio, J; Villegas, A; Suárez, M-L; Santamarina, G; Sarasa, M
Age-related cognitive dysfunction syndrome (CDS) has been reported in dogs and it is considered a natural model for Alzheimer's disease in humans. Changes in spontaneous activity (including locomotor and exploratory behaviour) and social responsiveness have been related to the age and cognitive status of kennel-reared Beagle dogs. The aim of this study was to assess the influence of age and severity of CDS on locomotor and exploratory behaviour of privately owned dogs. This is the first part of a two-part report on spontaneous activity in pet dogs. An open-field (OF) test and a curiosity test were administered at baseline and 6 months later to young (1-4 years, n=9), middle-aged (5-8 years, n=9), cognitively unimpaired aged (≥ 9 years, n=31), and cognitively impaired aged ( ≥ 9 years, n=36) animals. Classification of cognitive status was carried out using an owner-based observational questionnaire, and in the cognitively impaired group, the dogs were categorised as having either mild or severe cognitive impairment. Dogs were recorded during sessions in the testing room and the video-recordings were subsequently analysed. The severity of CDS (but not age) influenced locomotion and exploratory behaviour so that the more severe the impairment, the higher the locomotor activity and frequency of corner-directed (aimless) behaviours, and the lower the frequency of door-aimed activities. Curiosity directed toward novel stimuli exhibited an age-dependent decline although severely affected animals displayed more sniffing episodes directed towards the objects. OF activity did not change after 6 months. Testing aged pet dogs for spontaneous behaviour might help to better characterise cognitively affected individuals. Copyright © 2012 Elsevier Ltd. All rights reserved.
Liau, Albert K.; Shively, Randy; Horn, Mary; Landau, Jennifer; Barriga, Alvaro; Gibbs, John C.
The present study provided a randomized outcome evaluation of the psychoeducational component of the EQUIP program. The psychoeducational curriculum was implemented in a community correctional facility for adult felony offenders. The psychoeducational curriculum is designed to remedy offenders' delays in moral judgment maturity, social cognitive…
O'Driscoll, Ciarán; Mason, Oliver; Brady, Francesca; Smith, Ben; Steel, Craig
Therapeutic alliance, modality, and ability to engage with the process of therapy have been the main focus of research into what makes psychotherapy successful. Individuals with complex trauma histories or schizophrenia are suggested to be more difficult to engage and may be less likely to benefit from therapy. This study aimed to track the in-session 'process' of working alliance and emotional processing of trauma memories for individuals with schizophrenia. The study utilized session recordings from the treatment arm of an open randomized clinical trial investigating trauma-focused cognitive behavioural therapy (TF-CBT) for individuals with schizophrenia (N = 26). Observer measures of working alliance, emotional processing, and affect arousal were rated at early and late phases of therapy. Correlation analysis was undertaken for process measures. Temporal analysis of expressed emotions was also reported. Working alliance was established and maintained throughout the therapy; however, agreement on goals reduced at the late phase. The participants appeared to be able to engage in emotional processing, but not to the required level for successful cognitive restructuring. This study undertook novel exploration of process variables not usually explored in CBT. It is also the first study of process for TF-CBT with individuals with schizophrenia. This complex clinical sample showed no difficulty in engagement; however, they may not be able to fully undertake the cognitive-emotional demands of this type of therapy. Clinical and research implications and potential limitations of these methods are considered. This sample showed no difficulties engaging with TF-CBT and forming a working alliance. However, the participants may not have achieved a level of active involvement required for successful cognitive restructuring of trauma memories. This discrepancy may relate to the mediating role of both working alliance and cognitive-emotional processing. The results underscore
Kebriaee, F; Sarraf Shirazi, A; Fani, K; Moharreri, F; Soltanifar, A; Khaksar, Y; Mazhari, F
To compare the effectiveness of inhalation sedation with nitrous oxide/oxygen (N2O/O2) and cognitive behavioural therapy (CBT) in reducing dental anxiety in preschool children. Randomised controlled clinical trial. This study was conducted on 45 preschoolers with moderate to severe dental anxiety (determined by the Children's Fear Survey Schedule Dental Subscale), who required pulp treatment of at least one primary mandibular molar. Baseline anxiety and cooperation levels were determined using Venham Clinical Anxiety and Cooperation Scales (VCAS and VCCS) and Venham Picture Test (VPT) at the first dental visit (dental prophylaxis and fluoride treatment). Before the second dental visit (pulp treatment), the children were randomly assigned to one of three groups--1: control, 2: N(2)O/O(2) and 3: CBT. In group 1, the usual behaviour management techniques were used, in group 2, nitrous oxide/oxygen gas was used and in group 3, unrelated play, Benson's breathing and positive self-talk and modelling were used. Anxiety and cooperation levels were determined at three periods: injection, rubber dam placement and the application of a high-speed handpiece with VCAS and VCCS and VPT. Finally, anxiety and cooperation differences between the two dental visits were compared within the three groups. Chi square, ANOVA and Kruskal-Wallis and Mann-Whitney U tests were used. N(2)O/O(2) and CBT significantly resulted in lower anxiety and higher cooperation in the second visit (at all three periods) compared to the control, although there was no significant difference between these two treatment methods. Both test methods were effective in reducing dental anxiety in preschoolers. Considering the adverse effects and necessity of equipment and trained personnel when using nitrous oxide and oxygen inhalation sedation, cognitive behavioural therapy is preferable because of its better applicability.
Ramke, S; Sharpe, L; Newton-John, T
Data have consistently shown that patient coping with chronic pain can be affected by various factors associated with the primary relationship, and hence efforts to include the patient's partner in the treatment process have merit. This study evaluated the benefit of adding an adjunctive, couples-based, cognitive behavioural treatment (CBT) for chronic pain to a standard cognitive behavioural pain management programme. Forty-five couples were randomly assigned to either an adjunctive couples intervention (n = 19) or the pain programme only (n = 26). All patient participants completed a 3-week multi-disciplinary pain management programme, to which their partners were invited to attend one full day. In addition, partners in the adjunctive condition received four, one hour treatment sessions focusing on pain education, patient-partner communication, operant behavioural principles and relapse prevention strategies. Partner sessions for the adjunctive intervention were provided over the telephone. By the completion of the pain programme the adjunctive couples intervention demonstrated significant improvements in marital satisfaction for the spouses over and above attendance at the pain management programme alone (p = 0.003). However, spouse involvement did not facilitate any additional response to treatment for pain patients on marital satisfaction, pain, disability or any indices of distress. All treatment gains were maintained at 1 month follow-up. These data demonstrate that a brief CBT intervention can significantly improve marital satisfaction for spouses of chronic pain patients, but the treatment does not translate to improvements in function on any outcomes, including marital satisfaction, for patients of chronic pain. WHAT DOES THIS STUDY ADD?: A brief, telephone-based intervention for couples living with chronic pain is an acceptable format for intervention. This intervention can significantly improve marital satisfaction for partners of chronic pain
Raykos, Bronwyn C; McEvoy, Peter M; Erceg-Hurn, David; Byrne, Susan M; Fursland, Anthea; Nathan, Paula
The present paper assessed therapeutic alliance over the course of Enhanced Cognitive Behavioural Therapy (CBT-E) in a community-based sample of 112 patients with a diagnosis of bulimia nervosa (BN) or atypical BN. Temporal assessment of alliance was conducted at three time points (the start, middle and end of treatment) and the relationship between alliance and treatment retention and outcome was explored. Results indicated that the alliance between patient and therapist was strong at all stages of CBT-E, and even improved in the early stages of treatment when behaviour change was initiated (weekly in-session weighing, establishing regular eating, and ceasing binge-eating and compensatory behaviours). The present study found no evidence that alliance was related to treatment retention or outcomes, or that symptom severity or problematic interpersonal styles interacted with alliance to influence outcomes. Alliance was also unrelated to baseline emotional or interpersonal difficulties. The study provides no evidence that alliance has clinical utility for the prediction of treatment retention or outcome in CBT-E for BN, even for individuals with severe symptoms or problematic interpersonal styles. Early symptom change was the best predictor of outcome in CBT-E. Further research is needed to determine whether these results are generalizable to patients with anorexia nervosa. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
Thirlwall, Kerstin; Creswell, Cathy
Controlling parenting is associated with child anxiety however the direction of effects remains unclear. The present study implemented a Latin-square experimental design to assess the impact of parental control on children's anxious affect, cognitions and behaviour. A non-clinical sample of 24 mothers of children aged 4-5 years were trained to engage in (a) controlling and (b) autonomy-granting behaviours in interaction with their child during the preparation of a speech. When mothers engaged in controlling parenting behaviours, children made more negative predictions about their performance prior to delivering their speech and reported feeling less happy about the task, and this was moderated by child trait anxiety. In addition, children with higher trait anxiety displayed a significant increase in observed child anxiety in the controlling condition. The pattern of results was maintained when differences in mothers' levels of negativity and habitual levels of control were accounted for. These findings are consistent with theories that suggest that controlling parenting is a risk factor in the development of childhood anxiety. Copyright 2010 Elsevier Ltd. All rights reserved.
Full Text Available Chronic Fatigue Syndrome (CFS is a relatively common clinical condition that can cause sufferers to experience significant disability and distress, which may be further exacerbated by a lack of understanding from others, including health professionals. Cognitive behaviour therapy (CBT has been widely researched and reported to be an evidencebased effective treatment approach for CSF. Cognitive-behavioural theory of CFS aims to describe how certain cognitions and behaviours could account for the symptoms, distress, and disability that maintain the illness. In this case study, a successful application of CBT in a 15-year-old young person with a twelve-month-history of disabling CFS is presented. We argue that for a clinical success, a non-judgemental approach to address the parental role in maintenance of the sick role is necessary.
Full Text Available Abstract: Chronic Fatigue Syndrome (CFS is a relatively common clinical condition that can cause sufferers to experience significant disability and distress, which may be further exacerbated by a lack of understanding from others, including health professionals. Cognitive behaviour therapy (CBT has been widely researched and reported to be an evidence-based effective treatment approach for CSF. Cognitive-behavioural theory of CFS aims to describe how certain cognitions and behaviours could account for the symptoms, distress, and disability that maintain the illness. In this case study, a successful application of CBT in a 15-year-old young person with a twelve-month-history of disabling CFS is presented. We argue that for a clinical success, a non-judgemental approach to address the parental role in maintenance of the sick role is necessary. [JCBPR 2015; 4(2.000: 97-103
Hedman, Erik; Andersson, Erik; Ljótsson, Brjánn; Axelsson, Erland; Lekander, Mats
Internet-delivered exposure-based cognitive behaviour therapy (ICBT) has been shown to be effective in the treatment of severe health anxiety. The health economic effects of the treatment have, however, been insufficiently studied and no prior study has investigated the effect of ICBT compared with an active psychological treatment. The aim of the present study was to investigate the cost effectiveness of ICBT compared with internet-delivered behavioural stress management (IBSM) for adults with severe health anxiety defined as Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) hypochondriasis. ICBT was hypothesised to be the more cost-effective treatment. This was a cost-effectiveness study within the context of a randomised controlled trial conducted in a primary care/university setting. Participants from all of Sweden could apply to participate. Self-referred adults (N=158) with a principal diagnosis of DSM-IV hypochondriasis, of whom 151 (96%) provided baseline and post-treatment data. ICBT or IBSM for 12 weeks. The primary outcome was the Health Anxiety Inventory. The secondary outcome was the EQ-5D. Other secondary measures were used in the main outcome study but were not relevant for the present health economic analysis. Both treatments led to significant reductions in gross total costs, costs of healthcare visits, direct non-medical costs and costs of domestic work cutback (p=0.000-0.035). The incremental cost-effectiveness ratio (ICER) indicated that the cost of one additional case of clinically significant improvement in ICBT compared with IBSM was $2214. The cost-utility ICER, that is, the cost of one additional quality-adjusted life year, was estimated to be $10,000. ICBT is a cost-effective treatment compared with IBSM and treatment costs are offset by societal net cost reductions in a short time. A cost-benefit analysis speaks for ICBT to play an important role in increasing access to effective treatment for severe health
Wong, Agatha W S; Chen, Eric Y H
Growing evidence supporting the use of Cognitive Behavioural Therapy (CBT) to improve outcomes in patients with psychosis has largely originated from American and European countries, its applicability and effectiveness in Chinese patients with psychosis is still under-explored. However, the lack of stable and reliable outcome measures to evaluate the effectiveness of CBT for patients with psychosis hinders further development of psychological intervention in patients with psychosis in the Chinese context. The present study therefore aims to translate selected outcomes measures developed in American and European countries to measure the effectiveness of CBT for psychosis into Chinese and evaluate their psychometric properties. Thirty-three patients with residual psychotic symptoms were recruited in the Department of Psychiatry, Kowloon Hospital, Hong Kong. Participants were asked to complete a set of self-reported questionnaires twice with an interval of a week, including Beliefs About Voices Questionnaire-Revised (BAVQ-R), Beck Cognitive Insight Scale (BCIS) and Southampton Mindfulness Questionnaire (SMQ). The results found that the Chinese versions of BAVQ-R, BCIS and SMQ had excellent test-retest reliability with good to acceptable internal reliability. Generally, all three translated outcome measures were found to be stable and reliable, and were ready for evaluating the effectiveness of cognitive therapy for psychosis in the Chinese population. Further discussions on scoring and interpretations of the Chinese version of SMQ were made. Copyright © 2014 Elsevier B.V. All rights reserved.
Chien, Hui-Ching; Chung, Yu-Chu; Yeh, Mei-Ling; Lee, Jia-Fu
The aim of this study was to investigate the effects of a cognitive behavioural intervention combined with a breathing relaxation exercise on sleep quality and heart rate variability in patients with major depression. Depression is a long-lasting illness with significant effects not only in individuals themselves, but on their family, work and social relationships as well. Cognitive behavioural therapy is considered to be an effective treatment for major depression. Breathing relaxation may improve heart rate variability, but few studies have comprehensively examined the effect of a cognitive behavioural intervention combined with relaxing breathing on patients with major depression. An experimental research design with a repeated measure was used. Eighty-nine participants completed this study and entered data analysed. The experimental group (n = 43) received the cognitive behavioural intervention combined with a breathing relaxation exercise for four weeks, whereas the control group (n = 46) did not. Sleep quality and heart rate variability were measured at baseline, posttest1, posttest2 and follow-up. Data were examined by chi-square tests, t-tests and generalised estimating equations. After adjusting for age, socioeconomic status, severity of disease and psychiatric history, the quality of sleep of the experimental group improved, with the results at posttest achieving significance. Heart rate variability parameters were also significantly improved. This study supported the hypothesis that the cognitive behavioural intervention combined with a breathing relaxation exercise could improve sleep quality and heart rate variability in patients with major depression, and the effectiveness was lasting. The cognitive behavioural intervention combined with a breathing relaxation exercise that included muscle relaxation, deep breathing and sleep hygiene could be provided with major depression during hospitalisation. Through group practice and experience sharing
Richmond, Rebecca C; Oleg Skugarevsky; Seungmi Yang; Kramer, Michael S; Wade, Kaitlin H.; Rita Patel; Natalia Bogdanovich; Konstantin Vilchuck; Natalia Sergeichick; George Davey Smith; Emily Oken; Martin, Richard M.
Objectives: Few studies have prospectively investigated associations of child cognitive ability and behavioural difficulties with later eating attitudes. We investigated associations of intelligence quotient (IQ), academic performance and behavioural difficulties at 6.5 years with eating attitudes five years later. Methods: We conducted an observational cohort study nested within the Promotion of Breastfeeding Intervention Trial, Belarus. Of 17,046 infants enrolled at birth, 13,751 (80.7%) co...
Micali, N.; De Stavola, B; Ploubidis, G; Simonoff, E; Treasure, J; Field, AE
BACKGROUND: Eating disorder behaviours begin in adolescence. Few longitudinal studies have investigated childhood risk and protective FACTORS. AIMS: To investigate the prevalence of eating disorder behaviours and cognitions and associated childhood psychological, physical and parental risk factors among a cohort of 14-year-old children. METHOD: Data were collected from 6140 boys and girls aged 14 years. Gender-stratified models were used to estimate prospective associations between childhood ...
Richards, David A; Ekers, David; McMillan, Dean; Taylor, Rod S; Byford, Sarah; Warren, Fiona C; Barrett, Barbara; Farrand, Paul A; Gilbody, Simon; Kuyken, Willem; O'Mahen, Heather; Watkins, Ed R; Wright, Kim A; Hollon, Steven D; Reed, Nigel; Rhodes, Shelley; Fletcher, Emily; Finning, Katie
Depression is a common, debilitating, and costly disorder. Many patients request psychological therapy, but the best-evidenced therapy-cognitive behavioural therapy (CBT)-is complex and costly. A simpler therapy-behavioural activation (BA)-might be as effective and cheaper than is CBT. We aimed to establish the clinical efficacy and cost-effectiveness of BA compared with CBT for adults with depression. In this randomised, controlled, non-inferiority trial, we recruited adults aged 18 years or older meeting Diagnostic and Statistical Manual of Mental Disorders IV criteria for major depressive disorder from primary care and psychological therapy services in Devon, Durham, and Leeds (UK). We excluded people who were receiving psychological therapy, were alcohol or drug dependent, were acutely suicidal or had attempted suicide in the previous 2 months, or were cognitively impaired, or who had bipolar disorder or psychosis or psychotic symptoms. We randomly assigned participants (1:1) remotely using computer-generated allocation (minimisation used; stratified by depression severity [Patient Health Questionnaire 9 (PHQ-9) score of depression symptoms according to the PHQ-9 at 12 months. We analysed all those who were randomly allocated and had complete data (modified intention to treat [mITT]) and also all those who were randomly allocated, had complete data, and received at least eight treatment sessions (per protocol [PP]). We analysed safety in the mITT population. The non-inferiority margin was 1·9 PHQ-9 points. This trial is registered with the ISCRTN registry, number ISRCTN27473954. Between Sept 26, 2012, and April 3, 2014, we randomly allocated 221 (50%) participants to BA and 219 (50%) to CBT. 175 (79%) participants were assessable for the primary outcome in the mITT population in the BA group compared with 189 (86%) in the CBT group, whereas 135 (61%) were assessable in the PP population in the BA group compared with 151 (69%) in the CBT group. BA was non
Fazilah Idris; Wendy Yee Mei Tien; Ezhar Tamam; Azimi Hamzah
This study examined the relationship and contribution of exposure to public affairs news vis-à-vis the cognitive, and attitudinal components and the behavioural component of ethnic tolerance among Malaysian youths aged between 15 to 25 years. The survey data were collected using self-administered questionnaires. A total of 2,906 youths voluntarily participated in a survey. The results of regression analyses showed that when exposed to public affairs news, the cognitive and attitudinal compone...
Flouri, Eirini; Panourgia, Constantina
The aim of this study was to test for gender differences in how negative cognitive errors (overgeneralizing, catastrophizing, selective abstraction, and personalizing) mediate the association between adverse life events and adolescents' emotional and behavioural problems (measured with the Strengths and Difficulties Questionnaire). The sample consisted of 202 boys and 227 girls (aged 11-15 years) from three state secondary schools in disadvantaged areas in one county in the South East of England. Control variables were age, ethnicity, special educational needs, exclusion history, family structure, family socio-economic disadvantage, and verbal cognitive ability. Adverse life events were measured with Tiet et al.'s (1998) Adverse Life Events Scale. For both genders, we assumed a pathway from adverse life events to emotional and behavioural problems via cognitive errors. We found no gender differences in life adversity, cognitive errors, total difficulties, peer problems, or hyperactivity. In both boys and girls, even after adjustment for controls, cognitive errors were related to total difficulties and emotional symptoms, and life adversity was related to total difficulties and conduct problems. The life adversity/conduct problems association was not explained by negative cognitive errors in either gender. However, we found gender differences in how adversity and cognitive errors produced hyperactivity and internalizing problems. In particular, life adversity was not related, after adjustment for controls, to hyperactivity in girls and to peer problems and emotional symptoms in boys. Cognitive errors fully mediated the effect of life adversity on hyperactivity in boys and on peer and emotional problems in girls.
Hodges, Julie; Oei, Tian P S
The purpose of the present paper is to explore the conceptual compatibility between cognitive behaviour therapy (CBT) and the common values of Chinese Culture. In order to address such a question, the distinctive processes attributed to CBT (e.g., teaching of skills, emphasis on homework, cognitive processes, present/future focus), as summarized in the meta-analysis by Blagys and Hilsenroth [(2002). Distinctive activities of cognitive-behavioral therapy: A review of the comparative psychotherapy process literature. Clinical Psychology Review, 22, 671-706], and the core values of Chinese Culture, determined through an integration of The Hofstede Project, [Hofstede, G.H. (1980). Culture's consequences: International differences in work related values. Beverly Hills: Sage]. The Chinese Value Survey [Chinese Culture Connection (1987). Chinese values and the search for culture-free dimensions of culture. Journal of Cross-Cultural Psychology, 18, 143-164]. The Schwartz Value Survey [Schwartz, S.H. (1994). Cultural dimensions of values: Towards an understanding of national differences. In Kim, U., Trandis, H.C., Katiticibasi, C., Choi, S.C., & Yoon, G. (eds.), Individualism and collectivism: Theory, method and application (pp. 85-119). Thousand Oaks, CA: Sage] were used. A strong degree of compatibility between the two was found and it is argued that rather than developing new indigenized therapies, with some structural changes to the processes of CBT, this therapy can be effective for Chinese clients. It is further proposed that Chinese clients may benefit from challenging their irrational cognitions that are bound up in their strict adherence to social norms. Future recommendations for increasing the compatibility of CBT to Chinese culture are discussed.
Chouet, Justine; Ferland, Guylaine; Féart, Catherine; Rolland, Yves; Presse, Nancy; Boucher, Kariane; Barberger-Gateau, Pascale; Beauchet, Olivier; Annweiler, Cedric
Our objective was to determine whether dietary vitamin K intake was associated with cognition and behavior among older adults. 192 consecutive participants ≥65 years, recruited in the cross-sectional CLIP (Cognition and LIPophilic vitamins) study, were separated into two groups according to the tertiles of dietary phylloquinone intake (i.e., lowest third below 207 µg/day versus the other two thirds combined). Daily dietary phylloquinone intake was estimated from 50-item interviewer-administered food frequency questionnaire. Cognition was assessed with Mini-Mental State Examination (MMSE); behaviour with Frontotemporal Behavioral Rating Scale (FBRS). Age, gender, social problems, education, body mass index (BMI), comorbidities, history of stroke, use vitamin K antagonists, inadequate fatty fish intake, serum thyroid-stimulating hormone (TSH), vitamin B12, albumin, and estimated glomerular filtration rate were used as confounders. Compared to participants in the lowest third of dietary phylloquinone intake (n = 64), those with higher intake had higher (i.e., better) mean MMSE score (22.0 ± 5.7 versus 19.9 ± 6.2, p = 0.024) and lower (i.e., better) FBRS score (1.5 ± 1.2 versus 1.9 ± 1.3, p = 0.042). In multivariate linear regressions, log dietary phylloquinone intake was positively associated with MMSE score (adjusted β = 1.66, p = 0.013) and inversely associated with FBRS score (adjusted β = -0.33, p = 0.037). Specifically, log dietary phylloquinone intake correlated negatively with FBRS subscore of physical neglect (r = -0.24, p = 0.001). Higher dietary phylloquinone intake was associated with better cognition and behavior among older adults.
Full Text Available Our objective was to determine whether dietary vitamin K intake was associated with cognition and behavior among older adults. 192 consecutive participants ≥65 years, recruited in the cross-sectional CLIP (Cognition and LIPophilic vitamins study, were separated into two groups according to the tertiles of dietary phylloquinone intake (i.e., lowest third below 207 µg/day versus the other two thirds combined. Daily dietary phylloquinone intake was estimated from 50-item interviewer-administered food frequency questionnaire. Cognition was assessed with Mini-Mental State Examination (MMSE; behaviour with Frontotemporal Behavioral Rating Scale (FBRS. Age, gender, social problems, education, body mass index (BMI, comorbidities, history of stroke, use vitamin K antagonists, inadequate fatty fish intake, serum thyroid-stimulating hormone (TSH, vitamin B12, albumin, and estimated glomerular filtration rate were used as confounders. Compared to participants in the lowest third of dietary phylloquinone intake (n = 64, those with higher intake had higher (i.e., better mean MMSE score (22.0 ± 5.7 versus 19.9 ± 6.2, p = 0.024 and lower (i.e., better FBRS score (1.5 ± 1.2 versus 1.9 ± 1.3, p = 0.042. In multivariate linear regressions, log dietary phylloquinone intake was positively associated with MMSE score (adjusted β = 1.66, p = 0.013 and inversely associated with FBRS score (adjusted β = −0.33, p = 0.037. Specifically, log dietary phylloquinone intake correlated negatively with FBRS subscore of physical neglect (r = −0.24, p = 0.001. Higher dietary phylloquinone intake was associated with better cognition and behavior among older adults.
Vacha-Haase, Tammi; Ness, Carin M.; Dannison, Linda; Smith, Andrea
Presents results of study exploring use of psychoeducational group sessions on topics such as parenting skills, personal well-being, relationships, managing finances, and legal issues, specifically developed for custodial grandparents. Grandparents consistently met objectives of the content areas, with increased mastery as sessions progressed.…
Females care for individuals with chronic illness more commonly than males and have different attitudes to illness. Additionally, they experience greater burden and reduced quality of life, when compared to their male counterparts. Since knowledge has been shown to be related to burden, we sought to determine whether there were gender differences in knowledge acquisition during a six-week caregiver psychoeducation programme (CPP).
Hetrick, Sarah E; Yuen, Hok P; Bailey, Eleanor; Cox, Georgina R; Templer, Kate; Rice, Simon M; Bendall, Sarah; Robinson, Jo
Suicide-related behaviours are common in young people and associated with a range of negative outcomes. There are few evidence-based interventions; however, cognitive behavioural therapy (CBT) shows promise. Internet delivery of CBT is popular, with potential to increase reach and accessibility. To test the effectiveness of an internet-based CBT program (Reframe-IT) in reducing suicide-related behaviours, depression, anxiety, hopelessness and improving problem solving and cognitive and behavioural skills in school students with suicide-related behaviours. A parallel randomised controlled trial testing the effectiveness of Reframe-IT plus treatment as usual (TAU) compared with TAU alone in reducing suicidal ideation, suicide attempts, depression, hopelessness, symptoms of anxiety, negative problem orientation and cognitive and behavioural skill acquisition was undertaken. We recruited students experiencing suicidal ideation from 18 schools in Melbourne, Australia, between August 2013 and December 2016. The intervention comprised eight modules of CBT delivered online over 10 weeks with assessments conducted at baseline, 10 weeks and 22 weeks. Only 50 of the planned 169 participants were recruited. There were larger improvements in the Reframe-IT group compared with the TAU group for the primary outcome of suicidal ideation (intervention -61.6, SD 41.6; control -47.1, SD 42.3, from baseline to 22-week follow-up intervention); however, differences were non-significant (p=0.593). There were no increases in distress in the majority of participants (91.1%) after completion of each module. Changes in depression and hopelessness partly mediated the effect of acquisition of CBT skills on suicidal ideation. The trial was underpowered due to difficulties recruiting participants as a result of the complex recruitment procedures that were used to ensure safety of participants. Although there were no significant differences between groups, young people were safely and generally
Objective: To determine the effectiveness of a psycho-educational group intervention for chronically ill children. Methods: Based on principles from cognitive behavior therapy and information from previous research about children's experiences with coping with a chronic disease we developed an
Last, B.F.; Stam, H.; Onland-van Nieuwenhuizen, A.M.; Grootenhuis, M.A.
Objective: To determine the effectiveness of a psycho-educational group intervention for chronically ill children. Methods: Based on principles from cognitive behavior therapy and information from previous research about children's experiences with coping with a chronic disease we developed an
Buunk, Anne M; Spikman, Jacoba M; Veenstra, Wencke S; van Laar, Peter Jan; Metzemaekers, Jan D M; van Dijk, J Marc C; Meiners, Linda C; Groen, Rob J M
Behavioural disturbances are frequently found after aneurysmal subarachnoid haemorrhage (aSAH). Social cognition impairments have been suggested as a possible underlying mechanism for behavioural problems. Also, aSAH is likely to result in damage affecting frontal-subcortical circuits underlying social cognition. Therefore, we aimed to investigate social cognition after aSAH and its associations with behavioural problems (deficits in interpersonal behaviour, apathy, and impaired self-awareness) and focal as well as diffuse brain damage. 88 aSAH patients (in the subacute phase post-aSAH) and 60 age-, sex- and education-matched healthy controls participated. Tasks for emotion recognition, Theory of Mind (ToM), and empathy as well as questionnaires were used. Cortical infarctions in frontal and non-frontal areas on MRI, aneurysm circulation and aSAH-related events were taken into account. Compared to healthy controls, aSAH patients performed significantly worse on tasks for emotion recognition, ToM and empathy. Poor performance on ToM and emotion recognition was associated with proxy-ratings indicating impaired interpersonal behaviour and apathy and with indications of impaired self-awareness. No associations were found between deficits in social cognition and frontal or non-frontal cortical lesions on MRI. Also, aneurysm circulation and aSAH-related events such as hydrocephalus, vasospasm, and treatment method did not explain why and how social cognitive deficits did occur after aSAH. In conclusion, emotion recognition, ToM and empathy were clearly impaired in aSAH patients and these deficits were related to apathy and deficits in interpersonal behaviour as reported by proxies and to impaired self-awareness. This association strengthens the assumption of impaired social cognition as an underlying construct of behavioural problems after aSAH. Consequently, social cognition tests and proxy-ratings should be used in clinical practice, irrespective of lesion location on
Tavares, Leonor S; Plotnikoff, Ronald C; Loucaides, Constantinos
Chronic disease interventions for women have been understudied in the workplace domain. Understanding the role of cognitions in individual behaviour can help motivate change and suggest directions for achieving improvements in health. The purpose of this study was to identify psychosocial constructs and social-cognitive theories [e.g. Transtheoretical model (TTM), Theory of Planned Behaviour (TPB), Protection Motivation Theory (PMT) and Social Cognitive Theory (SCT)] that are most salient for explaining physical activity behaviour among employed women (n = 1183). Demographic information, and social-cognitive measures related to physical activity, intention and behaviours (e.g. stage of change, energy expenditure) were assessed. A series of multiple regression analyses predicting intention, energy expenditure and stage of change were conducted separately for: (1) women with young children (n = 302), and (2) women without young children (n = 881) for each of the respective social-cognitive theories. Although taken as a whole the results were relatively similar between the two sub-groups of women for each of the socio-cognitive theories examined in this study, differences were observed in the relative contributions of the theoretical constructs between the two sub-groups. Results also indicate that self-efficacy and intention were the strongest predictors of behaviour among both women with and without young children. The explained variances (R(2)) for the theories examined in this study for different sub-groups ranged from 16 to 60%, generally reflecting what has been reported in other studies within the physical activity domain. The results of this study could be useful in guiding future research and in designing physical activity intervention programs for these specific population groups. Integrating approaches of individual lifestyle change while addressing issues related to creating supportive environments for women in various life stages is a suggested strategy
Månsson, Kristoffer N T; Salami, Alireza; Carlbring, Per
Effective psychiatric treatments ameliorate excessive anxiety and induce neuroplasticity immediately after the intervention, indicating that emotional components in the human brain are rapidly adaptable. Still, the interplay between structural and functional neuroplasticity is poorly understood......, and studies of treatment-induced long-term neuroplasticity are rare. Functional and structural magnetic resonance imaging (using 3T MRI) was performed in 13 subjects with social anxiety disorder on 3 occasions over 1year. All subjects underwent 9 weeks of Internet-delivered cognitive behaviour therapy...... were compared between treatment responders and non-responders using 2×2 (group×time; pretreatment to follow-up) ANOVA. At 1-year follow-up, 7 (54%) subjects were classified as CGI-I responders. Left amygdala GM volume was more reduced in responders relative to non-responders from pretreatment to 1-year...
Full Text Available Depression is a common complication of Parkinson's disease (PD with considerable impact on patients' quality of life. However, at present the most appropriate treatment approach is unclear. There are limited data on antidepressant medications in PD-associated depression (dPD and those available suggest limited efficacy and tolerability of these drugs. Cognitive behavioural therapy (CBT has been shown to be an effective treatment of depressive disorders. Treatment of dPD with CBT may pose particular challenges, including possible different pathophysiology, physical and mental comorbidities, and barriers to treatment through disability, which do not allow simple transfer of these results to patients with dPD. However, a number of case reports, case series, and small pilot studies suggest that this is a promising treatment for patients with PD. We here summarise the published evidence on this treatment in dPD.
Riddle-Walker, Lori; Veale, David; Chapman, Cynthia; Ogle, Frank; Rosko, Donna; Najmi, Sadia; Walker, Lana M; Maceachern, Pete; Hicks, Thomas
This is the first randomised controlled trial to evaluate a protocol for cognitive behaviour therapy (CBT) for a Specific Phobia of Vomiting (SPOV) compared with a wait list and to use assessment scales that are specific for a SPOV. 24 participants (23 women and 1 man) were randomly allocated to either 12 sessions of CBT or a wait list. At the end of the treatment, CBT was significantly more efficacious than the wait list with a large effect size (Cohen's d=1.53) on the Specific Phobia of Vomiting Inventory between the two groups after 12 sessions. Six (50%) of the participants receiving CBT achieved clinically significant change compared to 2 (16%) participants in the wait list group. Eight (58.3%) participants receiving CBT achieved reliable improvement compared to 2 (16%) participants in the wait list group. A SPOV is a condition treatable by CBT but further developments are required to increase efficacy. Copyright © 2016 Elsevier Ltd. All rights reserved.
Christodoulides, T; Dudley, R; Brown, S; Turkington, D; Beck, Aaron T
Cognitive behaviour therapy (CBT) as an adjunct to medication has been shown to improve symptom management in patients with schizophrenia. However, little is understood about the value of CBT for people who are not prescribed antipsychotic medication. A post hoc case series design was used to examine the outcome data of three participants selected from a randomized controlled trial for CBT for schizophrenia. The participants were included if they had received CBT and were not prescribed antipsychotic medication during active treatment. The three patients improved on outcome measures of psychopathology, depression, or negative symptoms, some to a clinically significant degree. CBT is a feasible treatment for people with schizophrenia who are not prescribed antipsychotic medication. It may be a valuable alternative to medication in treating symptoms of schizophrenia.
Riccardo eDalle Grave
Full Text Available Introduction: Inpatient treatment for anorexia nervosa is often successful in restoring body weight, but a high percentage of patients relapse following discharge. The aim of the present study was to establish the immediate and longer-term effects of a novel inpatient program for adolescents that was designed to produce enduring change. Method: Twenty-seven consecutive patients with severe anorexia nervosa were admitted to a 20-week inpatient treatment program based upon enhanced cognitive behaviour therapy (CBT-E. The patients were assessed before and after hospitalization, and six and 12 months later. Results: Twenty-six patients (96% completed the program. In these patients there was a substantial improvement in weight, eating disorder features and general psychopathology that was well maintained at 12-month follow-up. Conclusions: These findings suggest that inpatient CBT-E is a promising approach to the treatment of adolescents with severe anorexia nervosa.
Xu, Zhouwei; Alruwaili, Ashwag Rafea S; Henderson, Robert David; McCombe, Pamela Ann
To screen for cognitive and behavioural impairment in people with amyotrophic lateral sclerosis (ALS) and controls with neuromuscular disease and to correlate these with clinical features. 108 people with ALS and 60 controls with other neuromuscular diseases were recruited and assessed with the Addenbrooke's cognitive examination-III (ACE-III), the frontal assessment battery (FAB), and the executive function component of the Edinburgh cognitive and behavioural ALS screen (ECAS). The Amyotrophic lateral sclerosis-Frontotemporal dementia questionnaire (ALS-FTD-Q) and the Motor Neuron Disease Behavioural instrument (MiND-B) were administered to the caregivers of people with ALS. The prevalence of abnormalities was determined and correlated with clinical features and survival. In 37 people with ALS, serial studies were performed. The frequencies of cognitive impairment based on the ACE-III and FAB were 30.0% and 14.0%, in ALS and 11.7% and 3.3% in controls, respectively. Age and years of education influence the results of the ACE-III and ECAS executive function. In ALS, the frequencies of behavioural impairment based on ALS-FTD-Q and MiND-B were 32.1% and 39.4%, respectively. There is significant correlation of ALS-FTD-Q and MiND-B with the ALSFRS-R score. ALS participants with cognitive impairment measured with ACE-III had significantly shorter survival time than those without. ALS participants with behavioural impairment measured with ALS-FTD-Q had worse prognosis than those without. No significant difference was found between the first two serial cognitive tests based on ACE-III and FAB by using generalized estimating equation. There is a greater frequency of cognitive impairment in people with ALS than in patients with other neuromuscular diseases. The cognitive and behavioural tests are potential biomarkers of the prognosis of ALS. The results of cognitive tests are stable over 6months and possibly longer. Copyright © 2017 Elsevier B.V. All rights reserved.
Cheng, Hong-Yu; Guan, Shu-Yi
This study was designed to investigate how cognitive style affects Chinese students' learning behaviours in the classroom. A concept labelled as the structure-oriented vs. depth-oriented learning approach was constructed, and its mediating effects in the link between cognitive style and learning behaviour were proposed and examined in this study.…
Full Text Available Abstract Background Psychological therapies especially Cognitive Behaviour Therapy (CBT are used widely in the West to help patients with psychiatric problems. Cognitive Behaviour Therapy has an established evidence base for the treatment of different emotional disorders. In spite of these developments in the developed world, patients in most developing countries hardly benefit from non pharmacological interventions. Although a significant number of psychologists are trained in Pakistan each year, psychological interventions play only a minor role in treatment plans in Pakistan. We conducted interviews with psychologists in Pakistan, to explore their experiences and their views on "providing CBT in Pakistan". These interviews were conducted as part of a project whose focus was to try to develop culturally-sensitive CBT in Pakistan. Methods In depth semi structured interviews were conducted with 5 psychologists working in psychiatry departments in Lahore, Pakistan. Results All the psychologists reported that psychotherapies, including CBT, need adjustments for use in Pakistan, although they were not able to elicit on these in details. Four major themes were discovered, hurdles in therapy, therapy related issues, involvement of the family and modification in therapy. The biggest hurdles in therapy were described to be service and resource issues. Conclusions For CBT to be acceptable, accessible and effective in Non Western cultures numerous adjustments need to be made, taking into consideration; factors related to service structure and delivery, patient's knowledge and beliefs about health and the therapy itself. Interviews with the psychologists in these countries can give us insights which can guide development of therapy and manuals to support its delivery.
Pinto-Grau, Marta; Burke, Tom; Lonergan, Katie; McHugh, Caroline; Mays, Iain; Madden, Caoifa; Vajda, Alice; Heverin, Mark; Elamin, Marwa; Hardiman, Orla; Pender, Niall
Cognitive and behavioural changes are an important aspect in Amyotrophic Lateral Sclerosis (ALS). The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) briefly assesses these changes in ALS. To validate the ECAS against a standardised neuropsychological battery and assess its sensitivity and specificity using age and education adjusted cut-off scores. 30 incident ALS cases were assessed on both, ECAS and neuropsychological battery. Age and education adjusted cut-off scores were created from a sample of 82 healthy controls. ECAS composite scores (Total, ALS Specific and Non-Specific) were highly correlated with battery composite scores. High correlations were also observed between ECAS and full battery cognitive domains and subtests. The ECAS Total, ALS Specific and Non-Specific scores were highly sensitive to cognitive impairment. ECAS ALS-Specific cognitive domains also evidenced high sensitivity. Individual subtest sensitivity was medium to low, suggesting that caution should be used when interpreting these scores. Low positive predictive values indicated the presence of false positives. Psychometric properties of the ECAS using age and education adjusted norms indicate that the ECAS, when used as an overall measure of cognitive decline, is highly sensitive. Further comprehensive assessment is required for patients that present as impaired on the ECAS.
Anna Lucia Spear King
Full Text Available Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive, especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.
Brown, Kyle G.; Stautz, Kaidy; Hollands, Gareth J.; Winpenny, Eleanor M.; Marteau, Theresa M.
Aims To assess the immediate effect of alcohol promoting and alcohol warning advertisements on implicit and explicit attitudes towards alcohol and on alcohol seeking behaviour. Methods We conducted a between-participants online experiment in which participants were randomly assigned to view one of three sets of advertisements: (a) alcohol promoting, (b) alcohol warning, or (c) unrelated to alcohol. A total of 373 participants (59.5% female) aged 18–40 (M = 28.03) living in the UK were recruited online through a research agency. Positive and negative implicit attitudes and explicit attitudes towards alcohol were assessed before and after advertisements were viewed. Alcohol seeking behaviour was measured by participants' choice of either an alcohol-related or non-alcohol-related voucher offered ostensibly as a reward for participation. Self-reported past week alcohol consumption was also recorded. Results There were no main effects on any of the outcome measures. In heavier drinkers, viewing alcohol promoting advertisements increased positive implicit attitudes (standardized beta = 0.15, P = 0.04) and decreased negative implicit attitudes (standardized beta = −0.17, P = 0.02). In heavier drinkers, viewing alcohol warning advertisements decreased negative implicit attitudes (standardized beta = −0.19, P = 0.01). Conclusions Viewing alcohol promoting advertisements has a cognitive impact on heavier drinkers, increasing positive and reducing negative implicit attitudes towards alcohol. Viewing alcohol warning advertisements reduces negative implicit attitudes towards alcohol in heavier drinkers, suggestive of a reactance effect. PMID:26391367
Beck, Andrew; Nadkarni, Abhijit; Calam, Rachel; Naeem, Farooq; Husain, Nusrat
Cognitive Behaviour Therapy has been demonstrated to be an effective intervention in outpatient and inpatient settings for a wide range of presenting mental health problems including depression, Obsessive Compulsive Disorder, Post traumatic Stress Disorder, Social Anxiety Disorder, Panic Disorder and Somatorform Disorder. There is likely to be an unmet need for this therapeutic approach in most Low and Middle Income Countries (LMIC). However, the training of therapists to deliver this intervention has historically been a lengthy and expensive process, with already highly trained staff such as psychiatrists and psychologists undertaking additional training of up to one year duration in order to develop expertise in this area. This paper proposes that a model where training, supervision, leadership and service evaluation is provided by a small number of highly trained staff to front-line non-specialist staff who will then deliver manualised therapy. These front-line staff may also be conceptualised as part of a stepped care model where self-help and manualised therapy approaches are used in the first instance. Where patient functioning does not improve there is then the possibility of being stepped-up for treatment by a more specialised and highly trained therapist. This approach may help in meeting the huge mental health treatment gap in LMIC. This paper also suggests that lessons learnt from the dissemination of behaviourally informed parenting interventions internationally can be applied to the dissemination of this therapeutic approach. Copyright © 2015 Elsevier B.V. All rights reserved.
Brown, Kyle G; Stautz, Kaidy; Hollands, Gareth J; Winpenny, Eleanor M; Marteau, Theresa M
To assess the immediate effect of alcohol promoting and alcohol warning advertisements on implicit and explicit attitudes towards alcohol and on alcohol seeking behaviour. We conducted a between-participants online experiment in which participants were randomly assigned to view one of three sets of advertisements: (a) alcohol promoting, (b) alcohol warning, or (c) unrelated to alcohol. A total of 373 participants (59.5% female) aged 18-40 (M = 28.03) living in the UK were recruited online through a research agency. Positive and negative implicit attitudes and explicit attitudes towards alcohol were assessed before and after advertisements were viewed. Alcohol seeking behaviour was measured by participants' choice of either an alcohol-related or non-alcohol-related voucher offered ostensibly as a reward for participation. Self-reported past week alcohol consumption was also recorded. There were no main effects on any of the outcome measures. In heavier drinkers, viewing alcohol promoting advertisements increased positive implicit attitudes (standardized beta = 0.15, P = 0.04) and decreased negative implicit attitudes (standardized beta = -0.17, P = 0.02). In heavier drinkers, viewing alcohol warning advertisements decreased negative implicit attitudes (standardized beta = -0.19, P = 0.01). Viewing alcohol promoting advertisements has a cognitive impact on heavier drinkers, increasing positive and reducing negative implicit attitudes towards alcohol. Viewing alcohol warning advertisements reduces negative implicit attitudes towards alcohol in heavier drinkers, suggestive of a reactance effect. © The Author 2015. Medical Council on Alcohol and Oxford University Press.
Marshall-Pescini, Sarah; Passalacqua, Chiara; Barnard, Shanis; Valsecchi, Paola; Prato-Previde, Emanuela
Both genetic factors and life experiences appear to be important in shaping dogs' responses in a test situation. One potentially highly relevant life experience may be the dog's training history, however few studies have investigated this aspect so far. This paper briefly reviews studies focusing on the effects of training on dogs' performance in cognitive tasks, and presents new, preliminary evidence on trained and untrained pet dogs' performance in an 'unsolvable task'. Thirty-nine adult dogs: 13 trained for search and rescue activities (S&R group), 13 for agility competition (Agility group) and 13 untrained pets (Pet group) were tested. Three 'solvable' trials in which dogs could obtain the food by manipulating a plastic container were followed by an 'unsolvable' trial in which obtaining the food became impossible. The dogs' behaviours towards the apparatus and the people present (owner and researcher) were analysed. Both in the first 'solvable' and in the 'unsolvable' trial the groups were comparable on actions towards the apparatus, however differences emerged in their human-directed gazing behaviour. In fact, results in the 'solvable' trial, showed fewer S&R dogs looking back at a person compared to agility dogs, and the latter alternating their gaze between person and apparatus more frequently than pet dogs. In the unsolvable trial no difference between groups emerged in the latency to look at the person however agility dogs looked longer at the owner than both pet and S&R dogs; whereas S&R dogs exhibited significantly more barking (always occurring concurrently to looking at the person or the apparatus) than both other groups. Furthermore, S&R dogs alternated their gaze between person and apparatus more than untrained pet dogs, with agility dogs falling in between these two groups. Thus overall, it seems that the dogs' human-directed communicative behaviours are significantly influenced by their individual training experiences.
Andersson, G.; Paxling, B.; Wiwe, M.; Vernmark, K.; Felix, C.B.; Lundborg, L.; Furmark, T.; Cuijpers, P.; Carlbring, P.
Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in
Richardson, Thomas; Stallard, Paul; Velleman, Sophie
Research has shown that computerised cognitive behaviour therapy (cCBT) can be effective in the treatment of depression and anxiety in adults, although the outcomes with children and adolescents are unclear. The aim of the study is to systematically review the literature on the effectiveness of cCBT for the prevention and treatment of depression…
Nijhof, S.L.; Bleijenberg, G.; Uiterwaal, C.S.; Kimpen, J.L.L.; Putte, E.M. van de
BACKGROUND: Chronic fatigue syndrome is characterised by persistent fatigue and severe disability. Cognitive behavioural therapy seems to be a promising treatment, but its availability is restricted. We developed Fatigue In Teenagers on the interNET (FITNET), the first dedicated internet-based
Williams, A.D.; O'Moore, Kathleen; Mason, Elizabeth; Andrews, Gavin
Social anxiety disorder (SAD) is a common, chronic and disabling mental disorder. Cognitive Behaviour Therapy (CBT) is a highly effective treatment of SAD and internet CBT (iCBT) offers a cost-effective and convenient alternative to face to face approaches, with high fidelity and demonstrated
Burford, B.; Jahoda, A.
Background: This study examined the potential of a retrospective video reviewing process [Burford Reviewing Process (BRP)] for enabling people with intellectual disabilities to describe their experiences of cognitive behaviour therapy (CBT). It is the first time that the BRP, described in this paper, has been used with people with intellectual…
Hudson, Jennifer L.; Lester, Kathryn J.; Lewis, Cathryn M.; Tropeano, Maria; Creswell, Cathy; Collier, David A.; Cooper, Peter; Lyneham, Heidi J.; Morris, Talia; Rapee, Ronald M.; Roberts, Susanna; Donald, Jennifer A.; Eley, Thalia C.
Background: Within a therapeutic gene by environment (G × E) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; "5HTTLPR" and marker rs6330 in Nerve Growth Factor gene; "NGF" is associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety…
van der Gaag, M.; Stant, A.D.; Wolters, Kerstin; Buskens, E.; Wiersma, D.
Background Evidence on cost-effectiveness is important to make well-informed decisions regarding care delivery. Aims To determine the balance between costs and health outcomes of cognitive-behavioural therapy (CBT) compared with treatment as usual (TAU) in people with schizophrenia who have
Richards, Derek; Timulak, Ladislav
Participants with symptoms of depression received either eight sessions of therapist-delivered email cognitive behaviour therapy (eCBT; n = 37), or eight sessions of computerised CBT self-administered treatment (cCBT; n = 43). At post-treatment participants completed a questionnaire to determine what they found satisfying about their online…
Coleman, Jonathan R I; Lester, Kathryn J; Keers, Robert; Roberts, Susanna; Curtis, Charles; Arendt, Kristian; Bögels, Susan; Cooper, Peter; Creswell, Cathy; Dalgleish, Tim; Hartman, Catharina A; Heiervang, Einar R; Hötzel, Katrin; Hudson, Jennifer L; In-Albon, Tina; Lavallee, Kristen; Lyneham, Heidi J; Marin, Carla E; Meiser-Stedman, Richard; Morris, Talia; Nauta, Maaike H; Rapee, Ronald M; Schneider, Silvia; Schneider, Sophie C; Silverman, Wendy K; Thastum, Mikael; Thirlwall, Kerstin; Waite, Polly; Wergeland, Gro Janne; Breen, Gerome; Eley, Thalia C
BACKGROUND: Anxiety disorders are common, and cognitive-behavioural therapy (CBT) is a first-line treatment. Candidate gene studies have suggested a genetic basis to treatment response, but findings have been inconsistent. AIMS: To perform the first genome-wide association study (GWAS) of
Micali, N.; De Stavola, B.; Ploubidis, G.; Simonoff, E.; Treasure, J.; Field, A. E.
Background Eating disorder behaviours begin in adolescence. Few longitudinal studies have investigated childhood risk and protective factors. Aims To investigate the prevalence of eating disorder behaviours and cognitions and associated childhood psychological, physical and parental risk factors among a cohort of 14-year-old children. Method Data were collected from 6140 boys and girls aged 14 years. Gender-stratified models were used to estimate prospective associations between childhood body dissatisfaction, body mass index (BMI), self-esteem, maternal eating disorder and family economic disadvantage on adolescent eating disorder behaviours and cognitions. Results Childhood body dissatisfaction strongly predicted eating disorder cognitions in girls, but only in interaction with BMI in boys. Higher self-esteem had a protective effect, particularly in boys. Maternal eating disorder predicted body dissatisfaction and weight/shape concern in adolescent girls and dieting in boys. Conclusions Risk factors for eating disorder behaviours and cognitions vary according to gender. Prevention strategies should be gender-specific and target modifiable predictors in childhood and early adolescence. PMID:26206865
Koulil, S. van; Effting, M.; Kraaimaat, F.W.; Lankveld, W.G.J.M. van; Helmond, T. van; Cats, H.; Riel, P.L.C.M. van; Jong, A.J.L. de; Haverman, J.F.; Evers, A.W.M.
This review provides an overview of the effects of non-pharmacological treatments for patients with fibromyalgia (FM), including cognitive-behavioural therapy, exercise training programmes, or a combination of the two. After summarising and discussing preliminary evidence of the rationale of
Vroling, M.S.; Wiersma, F.E.; Lammers, M.W.; Noorthoorn, E.O.
Background: Dropout rates in binge eating disorder (BED) treatment are high (17-30%), and predictors of dropout are unknown. Method: Participants were 376 patients following an intensive outpatient cognitive behavioural therapy programme for BED, 82 of whom (21.8%) dropped out of treatment. An
Hartmann, Jessica A.; McGorry, Patrick D.; Schmidt, Stefanie J.
Background: Cognitive-behavioural therapy (CBT) is the first-choice treatment in clients with ultra-high risk (UHR) for psychosis. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between the intensity and content of CBT...
Lundkvist-Houndoumadi, Irene; Hougaard, Esben; Thastum, Mikael
BACKGROUND: Cognitive behavioural therapy (CBT) has been found to be effective for children and adolescents (6-18 years) with anxiety disorders, but the non-response rate is high-a fact that may argue for the importance of studies on pre-treatment characteristics of children and their families...
Huyser, C.; van den Heuvel, O.A.; Wolters, L.; Haan, E.; Lindauer, R.; Veltman, D.J.
Objectives. To identify neurodevelopmental differences in regional brain volume between medication-free paediatric obsessive-compulsive disorder (OCD) patients and controls at 2-year follow-up after cognitive behavioural therapy. Methods. We assessed 17 medication-free paediatric OCD patients (mean
Huyser, C.; van den Heuvel, O.A.; Wolters, L.; de Haan, E.; Lindauer, R.; Veltman, D.J.
Objectives: To identify neurodevelopmental differences in regional brain volume between medication-free paediatric obsessive-compulsive disorder (OCD) patients and controls at 2-year follow-up after cognitive behavioural therapy. Methods: We assessed 17 medication-free paediatric OCD patients (mean
Huyser, Chaim; van den Heuvel, Odile A.; Wolters, Lidewij; de Haan, Else; Lindauer, Ramon; Veltman, Dick J.
To identify neurodevelopmental differences in regional brain volume between medication-free paediatric obsessive-compulsive disorder (OCD) patients and controls at 2-year follow-up after cognitive behavioural therapy. We assessed 17 medication-free paediatric OCD patients (mean age 13.8 years; SD =
Monti, Fiorella; Tonetti, Lorenzo; Ricci Bitti, Pio Enrico
The aim of the present study was to compare the effectiveness of cognitive-behavioural (CBT) and psychodynamic (PDT) therapies in the treatment of anxiety among university students. To this aim, the Symptom Questionnaire (SQ) was completed by 30 students assigned to CBT and by 24 students assigned to PDT, both at the beginning and at the end of…
McGillivray, J. A.; Evert, H. T.
We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a…
Pert, C.; Jahoda, A.; Stenfert Kroese, B.; Trower, P.; Dagnan, D.; Selkirk, M.
Background: Clinicians working with clients who have mild intellectual disabilities (IDs) have shown growing enthusiasm for using a cognitive behavioural approach, amid increasing evidence of good treatment outcomes for this client group. However, very little is known about the views and experiences of clients with IDs who have undergone cognitive…
Polman, Annemiek; Bouman, Theo K.; van Hout, Wiljo J. P. J.; de Jong, Peter J.; den Boer, Johan A.
The present paper discusses theoretical and methodological issues involved in the processes of change in cognitive-behavioural treatment (CBT) of obsessive-compulsive disorder (OCD). Treatment outcome studies showed that CBT is effective in reducing obsessive-compulsive symptoms. However, why and
Smith, Jessica; Newby, Jill M; Burston, Nicole; Murphy, Michael J.; Michael, Sarah; Mackenzie, Anna; Kiln, Felicity; Loughnan, Siobhan A.; O'Moore, Kathleen A.; Allard, Benjamin J.; Williams, A.D.; Andrews, Gavin
Major Depressive Disorder (MDD) is a leading cause of the Global Burden of Disease. Cognitive Behavioural Therapy (CBT) is an effective treatment for MDD, but access can be impaired due to numerous barriers. Internet-delivered CBT (iCBT) can be utilised to overcome treatment barriers and is an
Graaf, de L.E.; Gerhards, S.A.H.; Arntz, A.; Riper, H.; Metsemakers, J.F.M.; Evers, S.M.; Severens, J.L.; Widdershoven, G.A.M.; Huibers, M.J.H.
BACKGROUND: Computerised cognitive-behavioural therapy (CCBT) might offer a solution to the current undertreatment of depression. AIMS: To determine the clinical effectiveness of online, unsupported CCBT for depression in primary care. METHOD: Three hundred and three people with depression were
Gerhards, S.A.H.; Abma, T.A.; Arntz, A.; de Graaf, L.E.; Evers, S.M.A.A.; Huibers, M.J.H.; Widdershoven, G.A.M.
Background: Several studies have evaluated the efficacy and effectiveness of computerized cognitive behavioural therapy (CCBT) for depression, but research on the patient perspective is limited. Aims: To gain knowledge on patient experiences with the online self-help CCBT program Colour Your Life
Bakker, Minne; Schipper, Karen; Koopman, Fieke S.; Nollet, Frans; Abma, Tineke A.
Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life. Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or
K.A.C. Berk (Kirsten); H. Buijks (Hanneke); A.J.M. Verhoeven (Adrie); Mulder, M.T. (Monique T.); B. Özcan (Behiye); van ’T Spijker, A. (Adriaan); R. Timman (Reinier); J.J. van Busschbach (Jan); E.J.G. Sijbrands (Eric)
textabstractAims/hypothesis: Weight-loss programmes for adults with type 2 diabetes are less effective in the long term owing to regain of weight. Our aim was to determine the 2 year effectiveness of a cognitive behavioural group therapy (group-CBT) programme in weight maintenance after diet-induced
Shukitt-Hale, Barbara; Bielinski, Donna F; Lau, Francis C; Willis, Lauren M; Carey, Amanda N; Joseph, James A
Previously, it has been shown that strawberry (SB) or blueberry (BB) supplementations, when fed to rats from 19 to 21 months of age, reverse age-related decrements in motor and cognitive performance. We have postulated that these effects may be the result of a number of positive benefits of the berry polyphenols, including decreased stress signalling, increased neurogenesis, and increased signals involved in learning and memory. Thus, the present study was carried out to examine these mechanisms in aged animals by administering a control, 2 % SB- or 2 % BB-supplemented diet to aged Fischer 344 rats for 8 weeks to ascertain their effectiveness in reversing age-related deficits in behavioural and neuronal function. The results showed that rats consuming the berry diets exhibited enhanced motor performance and improved cognition, specifically working memory. In addition, the rats supplemented with BB and SB diets showed increased hippocampal neurogenesis and expression of insulin-like growth factor 1, although the improvements in working memory performance could not solely be explained by these increases. The diverse polyphenolics in these berry fruits may have additional mechanisms of action that could account for their relative differences in efficacy.
Lindsay N. Friesen
Full Text Available Guided Internet-delivered cognitive behaviour therapy (ICBT is efficacious for the treatment of a variety of clinical disorders (Spek et al., 2007, yet minimal research has investigated training students in guided ICBT. To contribute to the training literature, through qualitative interviews, this study explored how ICBT was perceived by student therapists (n = 12 trained in guided ICBT. Additionally, facilitators and challenges encountered by students learning guided ICBT were examined. Qualitative analysis revealed that students perceived training to enhance their professional skills in guided ICBT such as how to gain informed consent, address emergencies, and facilitate communication over the Internet. Students described guided ICBT as beneficial for novice therapists learning cognitive behavior therapy as asynchronous communication allowed them to reflect on their clinical emails and seek supervision. Further, students perceived guided ICBT as an important skill for future practice and an avenue to improve patient access to mental health care. Specific facilitators of learning guided ICBT included having access to formal and peer supervision as well as technical assistance, ICBT modules, a functional web application, and detailed policies and procedures for the practice of guided ICBT. Challenges in delivering guided ICBT were also identified by participants such as finding time to learn the approach given other academic commitments, working with non-responsive clients, addressing multiple complex topics over email, and communicating through asynchronous emails. Based on the feedback collected from participants, recommendations for training in guided ICBT are offered along with future research directions.
Wright, Barry; Alderson-Day, Ben; Prendergast, Garreth; Kennedy, Juliette; Bennett, Sophie; Docherty, Mary; Whitton, Clare; Manea, Laura; Gouws, Andre; Tomlinson, Heather; Green, Gary
Cognitive behavioural therapy (CBT) can be an effective treatment for spider phobia, but the underlying neural correlates of therapeutic change are yet to be specified. The present study used magnetoencephalography (MEG) to study responses within the first half second, to phobogenic stimuli in a group of individuals with spider phobia prior to treatment (n=12) and then in nine of them following successful CBT (where they could touch and manage live large common house spiders) at least 9 months later. We also compared responses to a group of age-matched healthy control participants (n=11). Participants viewed static photographs of real spiders, other fear-inducing images (e.g. snakes, sharks) and neutral stimuli (e.g. kittens). Beamforming methods were used to localise sources of significant power changes in response to stimuli. Prior to treatment, participants with spider phobia showed a significant maximum response in the right frontal pole when viewing images of real spiders specifically. No significant frontal response was observed for either control participants or participants with spider phobia post-treatment. In addition, participants' subjective ratings of spider stimuli significantly predicted peak responses in right frontal regions. The implications for understanding brain-based effects of cognitive therapies are discussed. © 2013 Published by Elsevier Ireland Ltd.
Lawrence, Lee Matthew; Ciorciari, Joseph; Kyrios, Michael
The behavioural and cognitive phenomena associated with Compulsive Buying (CB) have been investigated previously but the underlying neurophysiological cognitive process has received less attention. This study specifically investigated the electrophysiology of CB associated with executive processing and cue-reactivity in order to reveal differences in neural connectivity (EEG Coherence) and distinguish it from characteristics of addiction or mood disorder. Participants (N=24, M=25.38 yrs, S.D.=7.02 yrs) completed the Sensitivity to Punishment Sensitivity to Reward Questionnaire and a visual memory task associated with shopping items. Sensitivities to reward and punishment were examined with EEG coherence measures for preferred and non-preferred items and compared to CB psychometrics. Widespread EEG coherence differences were found in numerous regions, with an apparent left shifted lateralisation for preferred and right shifted lateralisation for non-preferred items. Different neurophysiological networks presented with CB phenomena, reflecting cue reactivity and episodic memory, from increased arousal and attachment to items. © 2013 Published by Elsevier Ireland Ltd.
Keller, Jürgen; Krimly, Amon; Bauer, Lisa; Schulenburg, Sarah; Böhm, Sarah; Aho-Özhan, Helena E A; Uttner, Ingo; Gorges, Martin; Kassubek, Jan; Pinkhardt, Elmar H; Abrahams, Sharon; Ludolph, Albert C; Lulé, Dorothée
Reliable assessment of cognitive functions is a challenging task in amyotrophic lateral sclerosis (ALS) patients unable to speak and write. We therefore present an eye-tracking based neuropsychological screening tool based on the Edinburgh Cognitive and Behavioural ALS Screen (ECAS), a standard screening tool for cognitive deficits in ALS. In total, 46 ALS patients and 50 healthy controls matched for age, gender and education were tested with an oculomotor based and a standard paper-and-pencil version of the ECAS. Significant correlation between both versions was observed for ALS patients and healthy controls in the ECAS total score and in all of its ALS-specific domains (all r > 0.3; all p approach for assessing cognitive deficits in ALS patients who are unable to speak or write.
Full Text Available This study examined the relationship and contribution of exposure to public affairs news vis-à-vis the cognitive, and attitudinal components and the behavioural component of ethnic tolerance among Malaysian youths aged between 15 to 25 years. The survey data were collected using self-administered questionnaires. A total of 2,906 youths voluntarily participated in a survey. The results of regression analyses showed that when exposed to public affairs news, the cognitive and attitudinal components of ethnic tolerance were significant predictors and accounted for 16.5% of the variance in the behavioural component of ethnic tolerance. The cognitive component of ethnic tolerance was a better predictor, followed by the attitudinal component and exposure to public affairs news.
McGillivray, J A; Kershaw, M
A growing literature suggests that people with mild intellectual disability (ID) who have depressed mood may benefit from cognitive-behavioural interventions. There has been some speculation regarding the relative merit of the components of this approach. The aim of this study was to compare (i) cognitive strategies; (ii) behavioural strategies; and (iii) combined cognitive-behavioural (CB) strategies on depressed mood among a sample of 70 individuals with mild ID. Staff from three participating agencies received training in how to screen individuals with mild ID for depressive symptoms and risk factors for depression. Depressive symptoms and negative automatic thoughts were assessed prior to and at the conclusion of the intervention, and at 6-month follow-up. The interventions were run in groups by the same therapist. A post-intervention reduction in depression scores was evident in participants of all three interventions, with no significant difference between groups. A significant reduction in negative automatic thoughts post-intervention was evident in the CB combination group and was maintained at follow-up. Examination of clinical effectiveness suggests some advantage of the CB combination in terms of improvement and highlights the possible short term impact of behavioural strategies in comparison with the longer-term potential of cognitive strategies. The findings support the use of group cognitive-behavioural interventions for addressing symptoms of depression among people with ID. Further research is necessary to determine the effectiveness of components. © 2013 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Churchill, Rachel; Moore, Theresa H M; Furukawa, Toshi A; Caldwell, Deborah M; Davies, Philippa; Jones, Hannah; Shinohara, Kiyomi; Imai, Hissei; Lewis, Glyn; Hunot, Vivien
So-called 'third wave' cognitive and behavioural therapies represent a new generation of psychological therapies that are increasingly being used in the treatment of psychological problems. However, the effectiveness and acceptability of third-wave cognitive and behavioural therapy (CBT) approaches as treatment for acute depression remain unclear. 1. To examine the effects of all third wave CBT approaches compared with treatment as usual/waiting list/attention placebo/psychological placebo control conditions for acute depression.2. To examine the effects of different third wave CBT approaches (ACT, compassionate mind training, functional analytic psychotherapy, dialectical behaviour therapy, MBCT, extended behavioural activation and metacognitive therapy) compared with treatment as usual/waiting list/attention placebo/psychological placebo control conditions for acute depression.3. To examine the effects of all third wave CBT approaches compared with different types of comparators (treatment as usual, no treatment, waiting list, attention placebo, psychological placebo) for acute depression. We searched the Cochrane Depression Anxiety and Neurosis Group Trials Specialised Register (CCDANCTR to 01/01/12), which includes relevant randomised controlled trials from The Cochrane Library (all years), EMBASE, (1974-), MEDLINE (1950-) and PsycINFO (1967-). We also searched CINAHL (May 2010) and PSYNDEX (June 2010) and reference lists of the included studies and relevant reviews for additional published and unpublished studies. An updated search of CCDANCTR restricted to search terms relevant to third wave CBT therapies was conducted in March 2013 (CCDANCTR to 01/02/13). Randomised controlled trials that compared third wave CBT therapies with control conditions for acute depression in adults. Two review authors independently identified studies, assessed trial quality and extracted data. Study authors were contacted for additional information when required. We rated the
Full Text Available Several studies have proven the effectiveness of psychoeducation in bipolar II disorder patients; however, simpler psychoeducation is needed in daily medical practice. Therefore, we devised a simple individual psychoeducation program, which involved 20-minute sessions spent reading a textbook aloud in the waiting time before examination. Here, we report a successful case of simple individual psychoeducation with a patient with bipolar II disorder, a 64-year-old woman who had misconceptions surrounding her mood due to 24 years of treatment for depression. Her perception of mood state, particularly mixed state, was dramatically changed, and her quality of life was improved after the simple individual psychoeducation. This case suggests that the simple individual psychoeducation could be effective for bipolar II disorder by improving understanding of the disease and by meeting different individual needs.
Panourgia, Constantina; Comoretto, Amanda
Research has shown that children exposed to life adversity are at higher risk of negative developmental outcomes than those enduring lower stress levels. Life adversity can lead, among other things, to emotional and behavioural problems. Several factors have been studied to explain this relationship, with several investigators underlining the role of thought structures such as cognitive distortions, which refer to negatively biased information-processing of external events. This can help explain why some individuals characterised by adverse personal life stories interpret ambiguous events in a negatively biased way. This study was aimed at assessing the mediating role of cognitive distortions in the longitudinal relationship between life adversity and two dimensions of psychopathology, namely, emotional and behavioural problems in 247 secondary school children attending three state secondary schools in one county in the South East of England. An increase in life adversity was associated with an increase in cognitive distortions, which was in turn related to a higher number of symptoms reflecting behavioural issues. In terms of practical applications, an effort to protect children from further exposure to adverse life events could represent a step forward to prevent the development of future behavioural problems in at-risk children. © 2017 The Authors. Stress and Health published by John Wiley & Sons Ltd.
Goldstein, M J
Recent shifts to briefer hospitalization and an emphasis on community care have emphasized the significance of patient-family interactions in this phase of treatment. Psychoeducational family programs designed to increase medication compliance and effectiveness in coping with stressors have been successful in reducing the risk of relapse in the first year following hospital discharge. Various models for family intervention are discussed and their strengths and weaknesses evaluated.
Farrell, Nicholas R; Lee, Aaron A; Deacon, Brett J
Recent years have witnessed increasing popularity and promotion of biological influences (e.g., genetics) in eating disorder (ED) development. Although research suggests biological models of EDs reduce blame-oriented stigma in the general public, their effect on symptomatic individuals' attitudes toward themselves, treatment, and their prognosis has not been studied. Additionally, little is known about how other credible forms of conceptualizing ED development (e.g., cognitive-behavioral) affect individuals with disordered eating. Accordingly, the present study assessed the effects of three different forms of psychoeducation about ED development (biology-only, malleability of biology, cognitive-behavioral) among a sample high in ED symptoms. Participants (N = 216) viewed an audiovisual presentation describing ED development from one of the three perspectives before completing measures of self-blame for symptoms, prognostic expectations, self-efficacy in recovering, and attitudes toward a description of cognitive-behavioral therapy. There were no significant differences between conditions in self-blame. Relative to biology-only, the psychoeducational messages emphasizing malleable biology and cognitive-behavioral factors produced more prognostic optimism and self-efficacy in recovering. Perceived credibility of cognitive-behavioral therapy and expectations for its efficacy were highest in the cognitive-behavioral psychoeducation condition. Implications for efforts to educate the public and treatment-seeking individuals about the nature of EDs are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.
Hadjistavropoulos, Heather D; Pugh, Nicole E; Hesser, Hugo; Andersson, Gerhard
There has been limited research on therapeutic alliance in the context of therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) when delivered in clinical practice. The present study investigated therapeutic alliance in ICBT delivered to patients seeking treatment for symptoms of depression (n = 83) or generalized anxiety (n = 112) as part of an open dissemination trial. ICBT was provided by 27 registered therapists or 28 graduate students working in six geographically dispersed clinics; therapist-assistance was delivered primarily through secure messages and occasionally telephone calls. The Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were collected pre-, mid- and post-treatment, and the Therapeutic Alliance Questionnaire was assessed mid- and post-treatment. Therapeutic alliance ratings were high both at mid-treatment and post-treatment (above 80%). There was no relationship between therapeutic alliance ratings and improvement on primary outcomes. Among patients treated for depression, lower ratings of mid-treatment alliance were associated with concurrent treatment by a psychiatrist and fewer phone calls and emails from their therapist. Among patients treated for generalized anxiety, ratings of mid-treatment alliance were higher among registered providers as compared to graduate students. Multiple directions for future research on therapeutic alliance in ICBT are offered, including suggestions for developing a new measure of therapeutic alliance specific to ICBT and measuring therapeutic alliance throughout the treatment process. Copyright © 2016 John Wiley & Sons, Ltd. This research demonstrated that therapeutic alliance ratings were very strong at both mid- and post-treatment among patients who received Internet-delivered cognitive behaviour therapy (ICBT) for depression or anxiety in clinical practice. Among patients receiving ICBT for depression, lower ratings of therapeutic alliance were associated with
Macdonald, Geraldine; Higgins, Julian P T; Ramchandani, Paul; Valentine, Jeffrey C; Bronger, Latricia P; Klein, Paul; O'Daniel, Roland; Pickering, Mark; Rademaker, Ben; Richardson, George; Taylor, Matthew
Despite differences in how it is defined, there is a general consensus amongst clinicians and researchers that the sexual abuse of children and adolescents ('child sexual abuse') is a substantial social problem worldwide. The effects of sexual abuse manifest in a wide range of symptoms, including fear, anxiety, post-traumatic stress disorder and various externalising and internalising behaviour problems, such as inappropriate sexual behaviours. Child sexual abuse is associated with increased risk of psychological problems in adulthood. Cognitive-behavioural approaches are used to help children and their non-offending or 'safe' parent to manage the sequelae of childhood sexual abuse. This review updates the first Cochrane review of cognitive-behavioural approaches interventions for children who have been sexually abused, which was first published in 2006. To assess the efficacy of cognitive-behavioural approaches (CBT) in addressing the immediate and longer-term sequelae of sexual abuse on children and young people up to 18 years of age. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2011 Issue 4); MEDLINE (1950 to November Week 3 2011); EMBASE (1980 to Week 47 2011); CINAHL (1937 to 2 December 2011); PsycINFO (1887 to November Week 5 2011); LILACS (1982 to 2 December 2011) and OpenGrey, previously OpenSIGLE (1980 to 2 December 2011). For this update we also searched ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP). We included randomised or quasi-randomised controlled trials of CBT used with children and adolescents up to age 18 years who had experienced being sexually abused, compared with treatment as usual, with or without placebo control. At least two review authors independently assessed the eligibility of titles and abstracts identified in the search. Two review authors independently extracted data from included studies and entered these into Review Manager 5 software. We synthesised and presented
Kim, Jung-Hee; Yang, Younghee; Hwang, Eun-Suk
Although sexual health is a common concern for oncology patients, no practical guidelines to sexual intervention exist, perhaps because of a lack of systematic reviews or meta-analyses. The objectives of this study were to determine the effect size for psychoeducational intervention focused on sexuality and to compare effect sizes according to intervention outcomes and characteristic. We explored quantitative evidence for the effects of sexual intervention for cancer patients or partners by using the electronic databases. Among them, we considered 15 eligible articles. The meta-analysis provided 133 effect sizes from 15 primary studies. The analysis revealed significant improvements after intervention, with a random-effects standardized mean difference of 0.75. Psychoeducational interventions focused on sexuality after cancer diagnosis were effective for compliance (2.40), cognitive aspect (1.29), and psychological aspect (0.83). Individual-based interventions (0.85) were more effective in improving outcomes than group approach and group combined with individual intervention. With regard to intervention providers, registered nurse only (2.22) and team approach including the registered nurse (2.38) had the highest effect size. Face-to-face intervention combined with telephone or the Internet (1.04) demonstrated a higher effect size than face-to-face (0.62) and telephone (0.58) independently. We conducted an analysis of data from various subgroups of preexisting studies, obtained an overall estimate of the effectiveness of the intervention, and compared its effectiveness across variables that affect intervention outcomes. These results provide empirical data for evidence-based practice and inform the development of useful intervention programs through a comprehensive review and meta-analysis of the results.
Moss-Morris, R; Spence, M J; Hou, R
The cognitive behavioural model of chronic fatigue syndrome (CFS) suggests that the illness is caused through reciprocal interactions between physiology, cognition, emotion and behaviour. The purpose of this study was to investigate whether the psychological factors operationalized in this model could predict the onset of CFS following an acute episode of infectious mononucleosis commonly known as glandular fever (GF). A total of 246 patients with GF were recruited into this prospective cohort study. Standardized self-report measures of perceived stress, perfectionism, somatization, mood, illness beliefs and behaviour were completed at the time of their acute illness. Follow-up questionnaires determined the incidence of new-onset chronic fatigue (CF) at 3 months and CFS at 6 months post-infection. Of the participants, 9.4% met the criteria for CF at 3 months and 7.8% met the criteria for CFS at 6 months. Logistic regression revealed that factors proposed to predispose people to CFS including anxiety, depression, somatization and perfectionism were associated with new-onset CFS. Negative illness beliefs including perceiving GF to be a serious, distressing condition, that will last a long time and is uncontrollable, and responding to symptoms in an all-or-nothing behavioural pattern were also significant predictors. All-or-nothing behaviour was the most significant predictor of CFS at 6 months. Perceived stress and consistently limiting activity at the time of GF were not significantly associated with CFS. The findings from this study provide support for the cognitive behavioural model and a good basis for developing prevention and early intervention strategies for CFS.
Karly M. Turner
Full Text Available Schizophrenia is associated with many genetic and environmental risk factors and there is growing evidence that the interactions between genetic and environmental ‘hits’ are critical for disease onset. Animal models of schizophrenia have traditionally used specific strain and housing conditions to test potential risk factors. As the field moves towards testing gene (G x environment (E interactions the impact of these choices should be considered. Given the surge of research focused on cognitive deficits, we have examined studies of cognition in rodents from the perspective of GxE interactions, in which strain or housing manipulations have been varied. Behaviour is clearly altered by these factors, yet few animal models of schizophrenia have investigated cognitive deficits using different strain and housing conditions. It is important to recognise the large variation in behaviour observed when using different strain and housing combinations because GxE interactions may mask or exacerbate cognitive outcomes. Further consideration will improve our understanding of GxE interactions and the underlying neurobiology of cognitive impairments in neuropsychiatric disorders.
Fernández, Manuel; Gobartt, Ana L; Balañá, Montse
Behavioural and psychological symptoms of dementia (BPSD) are non-cognitive symptoms commonly associated to Alzheimer's disease (AD). The characterization of the clinical profile of AD patients might help to better understand disease evolution and to improve diagnosis and treatment. Thus, the aim of the present study is to describe the clinical profile of AD patients, and to correlate the presence of BPSD with the severity of the disease. A cross-sectional, observational and multicenter study was conducted at 115 centres in Spain. Patients suffering from AD with higher and lower BPSD scores (ADAS-Noncog score 26-50 and ≤25, respectively) were included. Demographic and clinical data were collected, and dementia severity was assessed by the Mini Mental State Examination (MMSE) [mild 27-21, moderate 20-11, severe ≤10]. The use of ADAS-Noncog in clinical practice was also explored. A total of 1014 patients (463 with higher and 551 with lower BPSD scores) were included (mean age 77 ± 7 years, 65% women). Almost all patients (90%) had BPSD at inclusion, 17% of which reported psychotic outbreaks. The most prevalent symptoms were lack of concentration (56%), tremors (56%), depression (44%), lack of cooperation (36%), and delusions (32%). Patients with higher BPSD scores showed a significantly higher prevalence of psychotic symptoms (delusions, hallucinations, and delirium) and tremors, while emotional symptoms (tearfulness and apathy) predominated in patients with lower BPSD scores. MMSE and ADAS-Noncog scores were negatively associated (p = 0.0284), suggesting a correlation between cognitive impairment and BPSD. Lack of concentration and appetite change significantly correlated with MMSE (p = 0.0472 and p = 0.0346, respectively). Rivastigmine and donepezil were the first choice therapies in mild to moderate dementia. ADAS-Noncog was generally considered better or similar to other scales (82%), and 68% of the investigators were willing to use it in the future. Our
Full Text Available Abstract Background Behavioural and psychological symptoms of dementia (BPSD are non-cognitive symptoms commonly associated to Alzheimer's disease (AD. The characterization of the clinical profile of AD patients might help to better understand disease evolution and to improve diagnosis and treatment. Thus, the aim of the present study is to describe the clinical profile of AD patients, and to correlate the presence of BPSD with the severity of the disease. Methods A cross-sectional, observational and multicenter study was conducted at 115 centres in Spain. Patients suffering from AD with higher and lower BPSD scores (ADAS-Noncog score 26-50 and ≤25, respectively were included. Demographic and clinical data were collected, and dementia severity was assessed by the Mini Mental State Examination (MMSE [mild 27-21, moderate 20-11, severe ≤10]. The use of ADAS-Noncog in clinical practice was also explored. Results A total of 1014 patients (463 with higher and 551 with lower BPSD scores were included (mean age 77 ± 7 years, 65% women. Almost all patients (90% had BPSD at inclusion, 17% of which reported psychotic outbreaks. The most prevalent symptoms were lack of concentration (56%, tremors (56%, depression (44%, lack of cooperation (36%, and delusions (32%. Patients with higher BPSD scores showed a significantly higher prevalence of psychotic symptoms (delusions, hallucinations, and delirium and tremors, while emotional symptoms (tearfulness and apathy predominated in patients with lower BPSD scores. MMSE and ADAS-Noncog scores were negatively associated (p = 0.0284, suggesting a correlation between cognitive impairment and BPSD. Lack of concentration and appetite change significantly correlated with MMSE (p = 0.0472 and p = 0.0346, respectively. Rivastigmine and donepezil were the first choice therapies in mild to moderate dementia. ADAS-Noncog was generally considered better or similar to other scales (82%, and 68% of the investigators were
Neimeyer, Robert A; Kazantzis, Nikolaos; Kassler, Dina M; Baker, Kurt D; Fletcher, Richard
There is a need to understand the mechanism through which homework contributes to clinically meaningful change in therapy. Theoretically meaningful factors such as willingness to complete therapeutic assignments and cognitive skill acquisition have not been carefully studied in prior research. Depressed outpatients (N = 46) received cognitive behavioural group therapy for a 10-week period and were assigned relevant homework activities. Patient self-report and independent ratings of homework compliance were obtained on a session-by-session basis. Using path analysis, the authors found evidence that willingness to complete homework assignments and mastery of skill in cognitive restructuring helped account for the relationship between homework compliance and reduced symptom severity (R2 = .40). However, paths were only significant when patient self-report of homework compliance was used in the model. The present study highlights the problems in assessing homework compliance and in assuming that independent assessment of compliance is more accurate than patient self-report.
Full Text Available Introduction: Prevalence of violence is highly occur in mental disorders clients at psychiatric hospitals. The impact is injure to others. This research aims to examine the effectiveness of music therapy and RECBT to sign and symptom and ability to control violent behaviour. Methods: Quasi-experimental research design with a sample of 64 respondents. Result: The study found a decrease symptoms of violent behaviour, ability to control violent behavior include relaxation, change negative thingking, irational belief, and negative behavior have increased significantly than the clients that did not receiving therapy. Discussion: Music therapy and RECBT is recommended as a therapeutic nursing at the client’s violent behaviour. Key Word: violent, sign and simptom, ability, music therapy, RECBT
Choi, Y S; Lee, E J; Cho, Y
WHAT IS KNOWN ON THE SUBJECT?: Panic disorder patients display various panic-related physical symptoms and catastrophic misinterpretation of bodily sensations, which lower their quality of life by interfering with daily activities. Cognitive behavioural therapy (CBT) is a useful strategy for panic disorder patients to manage symptoms associated with inaccurate cognitive interpretation of situations resulting from the patient's cognitive vulnerability. In South Korea, however, despite the increasing prevalence of panic disorder, CBT is not a common element of nursing care plans for panic disorder patients. Moreover, few Korean researchers have attempted to assess the effects of CBT on such patients. WHAT THIS PAPER ADD TO EXISTING KNOWLEDGE?: In a strategy combining CBT and routine treatments, patients with panic disorder can experience greater positive effects in the acute treatment phase than those they experience when receiving only routine treatment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health professionals, especially psychiatric nurses in local clinics who operate most special mental health programmes for panic disorder patients, should apply a panic disorder management programme that integrates CBT and routine treatments. The integrated approach is more effective for reducing the number of panic attacks and cognitive misinterpretation in patients than providing routine treatment alone. For patients with panic disorder, the objective of CBT is to understand the relationship between psychological panic disorder sensations, emotions, thoughts and behaviours. Therefore, nurses can help patients address and improve biological, social and psychological aspects of physical health problems as well as help them improve their coping skills in general. Introduction In panic disorder, sensitivity to bodily sensations increases due to the patient's cognitive vulnerability. Cognitive behavioural therapy (CBT) can help to decrease sensitivity to bodily sensations
Mitchell, Jennifer H; Newall, Carol; Broeren, Suzanne; Hudson, Jennifer L
The main aim of this study was to determine whether pre-treatment levels of child perfectionism impacted on anxiety treatment outcomes for school-aged children. In addition, it was investigated whether child perfectionism decreased following treatment for anxiety. Participants were sixty-seven clinically anxious children aged 6-13 years (female = 34; majority Caucasian) who were enrolled in a group-based cognitive behaviour therapy program, and their parents. They completed self-report questionnaires on anxiety and depressive symptoms and were administered a diagnostic interview to determine the type and clinician rated severity of anxiety and related disorders pre- and post-treatment and at 6-month follow-up. Self- and parent-rated perfectionism were also measured pre-treatment, while a subset of children completed perfectionism measures post-treatment as well. Self-Oriented Perfectionism, but not Socially Prescribed Perfectionism, predicted poorer self-reported treatment outcome (higher levels of anxiety symptoms) immediately following treatment and at 6-month follow-up when using a multi-informant approach. Additionally, both Self-Oriented and Socially Prescribed child perfectionism significantly reduced immediately following treatment. Despite reductions in child perfectionism following anxiety treatment, higher Self-Oriented Perfectionism may impact negatively on child anxiety treatment outcome. Copyright © 2013 Elsevier Ltd. All rights reserved.
Forgas, Joseph P
This paper will discuss the importance of concepts such as belief and affect to the theory and practice of health psychology, and the potential contribution of the revised conceptualisation of belief proposed in the target article will be considered. In the first half of the paper a number of important differences between the new approach and established empirical approaches to the study of beliefs will be highlighted. The second half of the paper will focus on the important relationship between affect and beliefs, one of the key issues addressed in the target paper. A number of recent theories linking affect and belief will be reviewed, and recent empirical research demonstrating the psychological mechanisms linking affect and belief will be discussed. In light of the considerable achievements of this line of inquiry, it is concluded that the proposed new approach and definition of belief does not as yet offer a preferable alternative to understanding the role of belief in health-related cognition and behaviour.
van der Leeden, Adelinde J M; van Widenfelt, Brigit M; van der Leeden, Rien; Liber, Juliette M; Utens, Elisabeth M W J; Treffers, Philip D A
The current nonrandomized clinical trial explored changes over time in children with an anxiety disorder during stepped care, manual-based cognitive behaviour therapy (CBT). Clinically anxious children (8-12 years, n = 133) and their parents participated in child focused CBT (10 sessions). If assessments indicated additional treatment was necessary, participants could step up to a second and possibly third treatment phase (each 5 sessions) including more parental involvement. After the first treatment phase 45% of the Intention-To-Treat sample was free of any anxiety disorder; after the second and third phase an additional 17% and 11% respectively. In total, 74% of the children no longer met criteria for any anxiety disorder following treatment. Child and parent reported anxiety and depression symptoms of children improved significantly during all treatment phases, as well as child reported anxiety sensitivity and negative affect. Children participating in more treatment showed significant improvements during additional treatment phases, indicating that late change occurred for the subgroup that had not changed during the first phase. Stepped care offers a standardized, assessment based, yet tailored treatment approach for children with anxiety disorders. A more intensive treatment is offered when initial CBT is insufficient, providing children additional opportunities to reach the desired outcome.
Andersson, Gerhard; Rozental, Alexander; Shafran, Roz; Carlbring, Per
Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer. Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Sweden (n = 11) or the Netherlands (n = 3). Long-term outcome studies were found for panic disorder, social anxiety disorder, generalized anxiety disorder, depression, mixed anxiety and depression, obsessive-compulsive disorder, pathological gambling, stress and chronic fatigue. The duration of the treatments was usually short (8-15 weeks). The pre-to follow-up effect size was Hedge's g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%. Treatment seeking in the follow-up period was not documented and few studies mentioned negative effects. Expert commentary: While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects. Long-term follow-up data should be collected for more conditions and new technologies like smartphone-delivered treatments.
Full Text Available Athletes participating in sport are exposed to a relatively high injury risk. Previous research has suggested that it could be possible to reduce sports injuries through psychological skills training. The purpose of this study was to examine the extent to which a cognitive behavioural biofeedback intervention could reduce the number of sports injuries in a sample of players in Swedish elite football high schools. Participants from four elite football high schools (16-19 years old were divided into one experiment (n = 13 and one control group (n = 14. Participants were asked to complete three questionnaires to assess anxiety level (Sport Anxiety Scale, history of stressors (Life Event Scale for Collegiate Athletes and coping skills (Athletic Coping Skills Inventory - 28 in a baseline measure. Mann-Whitney U-tests showed no significant differences in pre-intervention scores based on the questionnaires. The experimental group participated in a nine-week intervention period consisting of seven sessions, including: somatic relaxation, thought stopping, emotions/problem focused coping, goal setting, biofeedback training as well as keeping a critical incident diary. A Mann-Whitney U test showed no significant difference between the control and experimental group U (n1 = 13, n2 = 14 = 51.00, p = 0.054. However, considering the small sample, the statistical power (0.05 for present study, to detect effects was low. The results of the study are discussed from a psychological perspective and proposals for future research are given
Hudson, Jennifer L; Rapee, Ronald M; Lyneham, Heidi J; McLellan, Lauren F; Wuthrich, Viviana M; Schniering, Carolyn A
The purpose of this study was to compare treatment outcomes following a group family-based cognitive behavioural therapy for children with different anxiety disorders (social anxiety disorder, separation anxiety disorder, generalised anxiety disorder, specific phobia and obsessive compulsive disorder). This study utilised a clinical sample of 842 children and adolescents (aged between 6 and 18 years) and assessed outcome using diagnostic interview, parent-report and child-report. Based on diagnostic data and parent-reported symptoms, results revealed that children with a diagnosis of social anxiety disorder experienced a slower rate of change and poorer diagnostic outcomes at post treatment and follow-up than children with other anxiety disorders. Children with GAD showed better response to this broad-based intervention and children with OCD showed better response on one measure. This study provides evidence for differential response to broad-based CBT for children, based on type of anxiety diagnoses. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Andrews, Gavin; Hobbs, Megan J; Newby, Jill M
Computerised cognitive behavioural therapy (CCBT) has been shown to be an efficacious treatment for depression. A recent meta-analysis of 9 studies showed a large mean effect size superiority over control group (effect size=0.86, number needed to treat=2), good adherence (69%) and benefits were evident at follow-up at a median of 26 weeks. In contrast, REEACT, a major study which compared usual general practitioner (GP) care versus usual GP care plus access to 1 of 2 pioneering CCBT courses detected no differences between the groups. We present the results and discuss possible explanations for these findings. In all 3 groups, usual care was extensive (9 visits in 12 months, 80% on medication, 8-23% getting psychological sessions). Adherence to CCBT courses was very poor (17%). Perhaps the surfeit of services meant there was no need for CCBT. Perhaps neither of the 2 CCBT courses encouraged adherence. What is certain is that this study did not test the potential of these CCBT courses to produce change in patients with depression presenting in primary care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
French, Lydia R M; Thomas, Laura; Campbell, John; Kuyken, Willem; Lewis, Glyn; Williams, Chris; Wiles, Nicola J; Turner, Katrina M
Cognitive Behavioural Therapy (CBT) aims to teach people skills to help them self-manage their depression. Trial evidence shows that CBT is an effective treatment for depression and individuals may experience benefits long-term. However, there is little research about individuals' continued use of CBT skills once treatment has finished. To explore whether individuals who had attended at least 12 sessions of CBT continued to use and value the CBT skills they had learnt during therapy. Semi-structured interviews were held with participants from the CoBalT trial who had received CBT, approximately 4 years earlier. Interviews were audio-recorded, transcribed and analysed thematically. 20 participants were interviewed. Analysis of the interviews suggested that individuals who viewed CBT as a learning process, at the time of treatment, recalled and used specific skills to manage their depression once treatment had finished. In contrast, individuals who viewed CBT only as an opportunity to talk about their problems did not appear to utilize any of the CBT skills they had been taught and reported struggling to manage their depression once treatment had ended. Our findings suggest individuals may value and use CBT skills if they engage with CBT as a learning opportunity at the time of treatment. Our findings underline the importance of the educational model in CBT and the need to emphasize this to individuals receiving treatment.
Newton-John, T R; Spence, S H; Schotte, D
Forty-four chronic, but relatively well functioning, low back pain patients were assigned to either Cognitive Behaviour Therapy (CBT). Electromyographic Biofeedback (EMGBF) or Wait List Control (WLC). Both treatments were conducted over eight sessions in groups of four subjects. Results at post-treatment indicated significant improvements in functioning on measures of pain intensity, perceived level of disability, adaptive beliefs about pain and the level of depression in both the CBT and EMGBF conditions. These improvements were not evident for the WLC condition. At 6 months follow-up, treatment gains were maintained in the areas of pain intensity, pain beliefs, and depression, for both treatment groups, with further improvements occurring in anxiety and use of active coping skills. No significant differences were found between CBT and EMGBF on any of the outcome measures at either post-treatment or at 6 months follow-up. Further research is required to determine the degree to which these results reflect the mild level of psychological impairment and disability status of patients in the present study.
Heins, Marianne J; Knoop, Hans; Bleijenberg, Gijs
Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) can reduce fatigue and impairment. Recently, it was found that changes in fatigue-perpetuating factors, i.e. focusing on symptoms, control over fatigue, perceived activity and physical functioning, are associated with and explain up to half of the variance in fatigue during CBT for CFS. The therapy relationship, e.g. outcome expectations and working alliance, may also contribute to treatment outcome. We aimed to examine the role of the therapy relationship in CBT and determine whether it exerts its effect independently of changes in fatigue-perpetuating factors. We used a cohort of 217 CFS patients in which the pattern of change in fatigue-perpetuating factors was examined previously. Fatigue, therapy relationship and fatigue-perpetuating factors were measured at the start of therapy, three times during CBT and at the end of therapy. Baseline outcome expectations and agreement about the content of therapy predicted post therapy fatigue. A large part of the variance in post-treatment fatigue (25%) was jointly explained by outcome expectations, working alliance and changes in fatigue-perpetuating factors. From this, we conclude that positive outcome expectations and task agreement seem to facilitate changes in fatigue-perpetuating factors during CBT for CFS. It is therefore important to establish a positive therapy relationship early in therapy. Copyright © 2013 Elsevier Ltd. All rights reserved.
Janse, Anthonie; Nikolaus, Stephanie; Wiborg, Jan F; Heins, Marianne; van der Meer, Jos W M; Bleijenberg, Gijs; Tummers, Marcia; Twisk, Jos; Knoop, Hans
Cognitive behaviour therapy (CBT) is an effective treatment for chronic fatigue syndrome (CFS). Main aim was to determine whether treatment effects were maintained up to 10years after treatment. Participants (n=583) of previously published studies on the effects of CBT for CFS were contacted for a long-term follow-up assessment. They completed questionnaires on main outcomes fatigue severity (CIS) and physical functioning (SF-36). The course of these outcomes since post-treatment assessment was examined using mixed model analyses. Between 21 and 125months after finishing CBT, 511 persons (response rate 88%) completed a follow-up assessment. At follow-up, mean fatigue severity was significantly increased to 37.60 (SD=12.76) and mean physical functioning significantly decreased to 73.16 (SD=23.56) compared to post-treatment assessment. At follow-up still 37% of the participants had fatigue scores in the normal range and 70% were not impaired in physical functioning. Positive effects of CBT for CFS on fatigue and physical functioning were partly sustained at long-term follow-up. However, a subgroup of patients once again reported severe fatigue, and compromised physical functioning. Further research should elucidate the reasons for this deterioration to facilitate the development of treatment strategies for relapse prevention. Copyright © 2017 Elsevier Inc. All rights reserved.
McCrone, Paul; Knapp, Martin; Kennedy, Tom; Seed, Paul; Jones, Roger; Darnley, Simon; Chalder, Trudie
Irritable bowel syndrome is often treated in primary-care settings, and it has a relatively large economic impact. Cognitive behaviour therapy (CBT) in addition to mebeverine has been shown to be effective in the short term, compared with treatment with mebeverine alone. This study assesses the impact that CBT in addition to mebeverine has on resource use, and its cost-effectiveness. Participants were recruited from general practices: those with ongoing symptoms were randomly allocated either to remain just on mebeverine or to receive CBT in addition to mebeverine. Service use and lost employment were measured at baseline and at the 3-month, 6-month and 12-month follow-ups. The net-benefit approach was used for combining the data on therapy costs and symptoms. The mean additional cost of CBT was pound 308. No significant impact of CBT on the use of other services or on lost employment was noted. The cost per clinically important reduction in symptoms was pound 220 by the end of treatment, pound 171 at the 3-month follow-up, pound 1027 at the 6-month follow-up and pound 3080 at the 12-month follow-up, for CBT in addition to mebeverine compared with mebeverine alone. CBT in addition to mebeverine seems to have reasonable cost-effectiveness in the short-term treatment of irritable bowel syndrome, but not beyond 3 months.
Abdollahi, Abbas; LeBouthillier, Daniel M; Najafi, Mahmoud; Asmundson, Gordon J G; Hosseinian, Simin; Shahidi, Shahriar; Carlbring, Per; Kalhori, Atefeh; Sadeghi, Hassan; Jalili, Marzieh
Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals. In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment. Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group. No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear. The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals. Copyright © 2017 Elsevier B.V. All rights reserved.
Lammers, Mirjam W; Vroling, Maartje S; Ouwens, Machteld A; Engels, Rutger C M E; van Strien, Tatjana
The aim of this naturalistic study was to identify pretreatment predictors of response to cognitive behaviour therapy in treatment-seeking patients with binge eating disorder (BED; N = 304). Furthermore, we examined end-of-treatment factors that predict treatment outcome 6 months later (N = 190). We assessed eating disorder psychopathology, general psychopathology, personality characteristics and demographic variables using self-report questionnaires. Treatment outcome was measured using the bulimia subscale of the Eating Disorder Inventory 1. Predictors were determined using hierarchical linear regression analyses. Several variables significantly predicted outcome, four of which were found to be both baseline predictors of treatment outcome and end-of-treatment predictors of follow-up: Higher levels of drive for thinness, higher levels of interoceptive awareness, lower levels of binge eating pathology and, in women, lower levels of body dissatisfaction predicted better outcome in the short and longer term. Based on these results, several suggestions are made to improve treatment outcome for BED patients. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
Kylie A. Bailey
Full Text Available Although assault exposure is common in mental health and substance misusing populations, screening for assaults in treatment settings is frequently overlooked. This secondary analysis explored the effects of past sexual (SA and physical (PA assault on depression, alcohol misuse, global functioning and attrition in the Depression and Alcohol Integrated and Single focussed Intervention (DAISI project, whose participants (N = 278 received cognitive behaviour therapy (CBT for their depression and/or alcohol misuse. Of the 278 DAISI participants, 220 consented to screening for past assault (either by a stranger or non-stranger at baseline. Depression, alcohol, and global functioning assessments were administered at baseline and 3, 12, 24, and 36 months post baseline. A between-group analysis was used to assess differences between SA and No SA, and PA and No PA groupings, on adjusted mean treatment outcomes across all assessment periods. SA and PA participants had similar mean symptom reductions compared to No SA and No PA participants except for lower depression and global functioning change scores at the 12-month follow-up. People with coexisting depression and alcohol misuse reporting SA or PA can respond well to CBT for depression and alcohol misuse. However, follow-up is recommended in order to monitor fluctuations in outcomes.
Rebecca C. Knibb
Full Text Available Background: Food allergy affects quality of life in patients and parents and mothers report high levels of anxiety and stress. Cognitive Behaviour Therapy (CBT may be helpful in reducing the psychological impact of food allergy. The aim of this study was to examine the appropriateness and effectiveness of CBT to improve psychological outcomes in parents of children with food allergy. Methods: Five parents (all mothers from a local allergy clinic requested to have CBT; six mothers acted as controls and completed questionnaires only. CBT was individual and face-to face and lasted 12 weeks. All participants completed measures of anxiety and depression, worry, stress, general mental health, generic and food allergy specific quality of life at baseline and at 12 weeks. Results: Anxiety, depression and worry in the CBT group significantly reduced and overall mental health and QoL significantly improved from baseline to 12 weeks (all p < 0.05 in mothers in the CBT group; control group scores remained stable. Conclusions: CBT appears to be appropriate and effective in mothers of children with food allergy and a larger randomised control trial now needs to be conducted. Ways in which aspects of CBT can be incorporated into allergy clinic visits need investigation.
Michail, Maria; Birchwood, Max; Tait, Lynda
Social anxiety is highly prevalent among people with psychosis and linked with significant social disability and poorer prognosis. Although cognitive-behavioural therapy (CBT) has shown to be effective for the treatment of social anxiety in non-psychotic populations, there is a lack of evidence on the clinical effectiveness of CBT for the treatment of social anxiety when this is co-morbid in psychosis. A systematic review to summarise and critically appraise the literature on the effectiveness of CBT interventions for the treatment of social anxiety in psychosis. Two studies were included in the review assessing the effectiveness of group CBT for social anxiety in schizophrenia, both of poor methodological quality. Preliminary findings suggest that group-based CBT is effective in treating symptoms of social anxiety, depression and associated distress in people with schizophrenia. The evidence-base is not robust enough to provide clear implications for practice about the effectiveness of CBT for the treatment of social anxiety in psychosis. Future research should focus on methodologically rigorous randomised controlled trials with embedded process evaluation to assess the effectiveness of CBT interventions in targeting symptoms of social anxiety in psychosis and identify mechanisms of change.
Ruwaard, Jeroen; Lange, Alfred; Broeksteeg, Janneke; Renteria-Agirre, Aitziber; Schrieken, Bart; Dolan, Conor V; Emmelkamp, Paul
Manualized cognitive-behavioural treatment (CBT) is underutilized in the treatment of bulimic symptoms. Internet-delivered treatment may reduce current barriers. This study aimed to assess the efficacy of a new online CBT of bulimic symptoms. Participants with bulimic symptoms (n = 105) were randomly allocated to online CBT, bibliotherapy or waiting list/delayed treatment condition. Data were gathered at pre-treatment, post-treatment and 1-year follow-up. The primary outcome measures were the Eating Disorder Examination Questionnaire (EDE-Q) and the frequency of binge eating and purging episodes. The secondary outcome measure was the Body Attitude Test. Dropout from Internet treatment was 26%. Intention-to-treat ANCOVAs of post-test data revealed that the EDE-Q scores and the frequency of binging and purging reduced more in the online CBT group compared with the bibliotherapy and waiting list groups (pooled between-group effect size: d = 0.9). At 1-year follow-up, improvements in the online CBT group had sustained. This study identifies online CBT as a viable alternative in the treatment of bulimic symptoms. Copyright © 2012 John Wiley & Sons, Ltd.
John A. Taylor
Full Text Available Small scale trials indicate that classroom-based Cognitive Behaviour Therapy (CBT for adolescents has good reach and can help prevent depression. However, under more diverse everyday conditions, such programmes tend not to show such positive effects. This study examined the process of implementing a classroom-based CBT depression prevention programme as part of a large (n = 5,030 randomised controlled trial across eight UK secondary schools which was not found to be effective (PROMISE, ISRCTN19083628. The views of young people (n = 42, teachers (n = 12 and facilitators (n = 16 involved in the Resourceful Adolescent Programme (RAP were obtained via focus groups and interviews which were thematically analysed. The programme was considered to be well structured and contain useful content, particularly for younger pupils. However, challenges associated with implementation were its age appropriateness for all year groups, its perceived lack of flexibility, the consistency of quality of delivery, the competing demands for teacher time and a culture where academic targets were prioritised over personal, social and health education. Whilst schools are convenient locations for introducing such programmes and allow good reach, the culture around improving well-being of young people in schools, increasing engagement with teachers and young people and sustaining such programmes are issues that need addressing.
Weiss, Jonathan A; Lunsky, Yona
Individuals with Asperger syndrome are at increased risk for mental health problems compared with the general population, especially with regard to mood and anxiety disorders. Generic mental health services are often ill-equipped to offer psychotherapeutic treatments to this population, and specialized supports are difficult to find. This case series used a manualized cognitive behaviour therapy group programme (Mind Over Mood) with three adults diagnosed with Asperger syndrome, who were each unable to access psychotherapy through mainstream mental health services. This review highlights the benefits of a cognitive behaviour therapy (CBT) group approach for adults with Asperger syndrome and suggests some potential modifications to traditional CBT provision. © 2010 John Wiley & Sons, Ltd.
Jørgensen, Marie B; Faber, Anne; Jespersen, Tobias
This study evaluates the implementation of physical coordination training (PCT) and cognitive behavioural training (CBTr) interventions in a randomised controlled trial at nine cleaners' workplaces. Female cleaners (n = 294) were randomised into a PCT, a CBTr or a reference (REF) group. Both 12...... intervention effects, more research on implementation is needed. Trial registration: ISRCTN96241850. Practitioner summary: Both physical coordination training and cognitive behavioural training are potential effective workplace interventions among low educated job groups with high physical work demands....... However, thorough consideration should be given to feasibility in the design of interventions. The optimal intervention should be tailored to closely match the implementation context and be robust and flexible to minimise susceptibility to changes in work organisation....
Full Text Available Abstract Background Several studies have showed that people with intellectual disabilities (ID have suitable skills to undergo cognitive behavioural therapy (CBT. Case studies have reported successful use of cognitive behavioural therapy techniques (with adaptations in people with ID. Modified cognitive behavioural therapy may be a feasible and effective approach for the treatment of depression, anxiety, and other mood disorders in ID. To date, two studies have reported group-based manaulised cognitive behavioural treatment programs for depression in people with mild ID. However, there is no individual manualised programme for anxiety or depression in people with intellectual disabilities. The aims of the study are to determine the feasibility of conducting a randomised controlled trial for CBT in people with ID. The data will inform the power calculation and other aspects of carrying out a definitive randomised controlled trial. Methods Thirty participants with mild ID will be allocated randomly to either CBT or treatment as usual (TAU. The CBT group will receive up to 20 hourly individual CBT over a period of 4 months. TAU is the standard treatment which is available to any adult with an intellectual disability who is referred to the intellectual disability service (including care management, community support, medical, nursing or social support. Beck Youth Inventories (Beck Anxiety Inventory & Beck Depression Inventory will be administered at baseline; end of treatment (4 months and at six months to evaluate the changes in depression and anxiety. Client satisfaction, quality of life and the health economics will be secondary outcomes. Discussion The broad outcome of the study will be to produce clear guidance for therapists to apply an established psychological intervention and identify how and whether it works with people with intellectual disabilities. Trial registration ISRCTN: ISRCTN38099525
Ewing, Donna L; Monsen, Jeremy J.; Thompson, Ellen J; Cartwright-Hatton, Sam; Field, Andy
Background: Previous meta-analyses of cognitive-behavioural therapy (CBT) for children and young people with anxiety disorders have not considered the efﬁcacy of transdiagnostic CBT for the remission of childhood anxiety. Aim: To provide a meta-analysis on the efﬁcacy of transdiagnostic CBT for children and young people with anxiety disorders. Methods: The analysis included randomized controlled trials using transdiagnostic CBT for children and young people formally diagnosed with an anxiety ...
In this thesis I have described a body of work designed to address the problem of depression in sexual minority youth. I started by determining whether sexual minority youth have unique mental health and help-seeking needs. Subsequently the primary aim of my doctoral project was to design and evaluate the acceptability of a self-help program, specifically a computerised cognitive behavioural therapy (CCBT) program specially adapted for sexual minority youth with mild to moderate depressive sy...
Discussion: This study will provide a definitive evaluation of the effects of adding trauma-focused cognitive behaviour therapy to physiotherapy exercise for individuals with chronic WAD and PTSD. This study is likely to influence the clinical management of whiplash injury and will have immediate clinical applicability in Australia, Denmark and the wider international community. The study will also have implications for both health and insurance policy makers in their decision-making regarding treatment options and funding.
Millings, Abigail; Carnelley, Katherine B.
Background: computerised cognitive behavioural therapy provides a unique opportunity to collect and analyse data regarding the idiosyncratic content of people’s core beliefs about the self, others and the world. Methods: ‘Beating the Blues’ users recorded a core belief derived through the downward arrow technique. Core beliefs from 1813 mental health patients were coded into ten categories.Results: the most common were global self-evaluation, attachment, and competence. Women were more likely...
Jonassaint, Charles R.; Gibbs, Patrice; Belnap, Bea Herbeck; Karp, Jordan F.; Abebe, Kaleab K.; Rollman, Bruce L
Background Computerised cognitive?behavioural therapy (CCBT) helps improve mental health outcomes in White populations. However, no studies have examined whether CCBT is acceptable and beneficial for African Americans. Aims We studied differences in CCBT use and self-reported change in depression and anxiety symptoms among 91 African Americans and 499 White primary care patients aged 18?75, enrolled in a randomised clinical trial of collaborative care embedded with an online treatment for dep...
Williams, A. D.; O'Moore, Kathleen; Mason, Elizabeth; Andrews, Gavin.
Social anxiety disorder (SAD) is a common, chronic and disabling mental disorder. Cognitive Behaviour Therapy (CBT) is a highly effective treatment of SAD and internet CBT (iCBT) offers a cost-effective and convenient alternative to face to face approaches, with high fidelity and demonstrated efficacy. The aim of the current paper was to evaluate the effectiveness of an iCBT programme for SAD (The This Way Up Clinic Shyness Programme) when delivered in routine practice through two different p...
Williams, Alishia D; Gavin Andrews
BACKGROUND: Depression is a common, recurrent, and debilitating problem and Internet delivered cognitive behaviour therapy (iCBT) could offer one solution. There are at least 25 controlled trials that demonstrate the efficacy of iCBT. The aim of the current paper was to evaluate the effectiveness of an iCBT Program in primary care that had been demonstrated to be efficacious in two randomized controlled trials (RCTs). METHOD: Quality assurance data from 359 patients prescribed the Sadness Pro...
Jessica Smith; Newby, Jill M.; Nicole Burston; Murphy, Michael J.; Sarah Michael; Anna Mackenzie; Felicity Kiln; Loughnan, Siobhan A; Kathleen A. O'Moore; Allard, Benjamin J.; Williams, Alishia D; Gavin Andrews
Major Depressive Disorder (MDD) is a leading cause of the Global Burden of Disease. Cognitive Behavioural Therapy (CBT) is an effective treatment for MDD, but access can be impaired due to numerous barriers. Internet-delivered CBT (iCBT) can be utilised to overcome treatment barriers and is an effective treatment for depression, but has never been compared to bibliotherapy. This Randomised Controlled Trial (RCT) included participants meeting diagnostic criteria for MDD (n = 270) being randomi...
Hull, L; Mandy, W.; Petrides, K.
Studies assessing sex/gender differences in autism spectrum conditions often fail to include typically developing control groups. It is, therefore, unclear whether observed sex/gender differences reflect those found in the general population or are particular to autism spectrum conditions. A systematic search identified articles comparing behavioural and cognitive characteristics in males and females with and without an autism spectrum condition diagnosis. A total of 13 studies were included ...
Lovell, K; Cox, D.; Haddock, G.; Jones, C.; Raines, D; Garvey, R.; Roberts, C; Hadley, S
Objectives: To compare the effectiveness of cognitive behaviour therapy delivered by telephone with the same therapy given face to face in the treatment of obsessive compulsive disorder. Design: Randomised controlled non-inferiority trial. Setting: Two psychology outpatient departments in the United Kingdom. Participants: 72 patients with obsessive compulsive disorder. Intervention: 10 weekly sessions of exposure therapy and response prevention delivered by telephone or fa...
The 'new paradigm' defines the high intellectual ability as a potential that should crystallize progressively throughout development. Its main feature is a high intellectual initial multidimensional potential, which is transformed so that, being a person with high intellectual ability is the result of a developmental process from a neurobiological substrate and the incidence of variables (psychosocial and education) which determines its manifestation more or less stable and optimal to excellence. It is interesting to know the effectiveness of psychoeducational intervention of the extracurricular enrichment programs and their effects on the expression of differential functioning and the optimization of the management of cognitive resources that lead to excellence. An extracurricular enrichment program is described and evaluated through: 1) the stability of the intellectual measures; 2) the satisfaction level of participants and families. Participants are 58 high ability students on the enrichment program and 25 parents. Intellectual profiles are obtained on T1-T2 and calculated their stability by regression analysis, the CSA and CSA-P questionnaires were applied in order to know the participants and families' satisfaction measure. Results show the basic stability of intellectual profiles with five cases of instability among the 58 profiles obtained, and a high satisfaction with the results obtained in the domain of cognitive and personal management among the participants.
Saskia Deppermann; Nadja Vennewald; Julia Diemer; Stephanie Sickinger; Florian B. Haeussinger; Thomas Dresler; Swantje Notzon; Inga Laeger; Volker Arolt; Ann-Christine Ehlis; Andreas J. Fallgatter; Peter Zwanzger
Background: A relevant proportion of patients with panic disorder (PD) does not improve even though they receive state of the art treatment for anxiety disorders such as cognitive-behavioural therapy (CBT...
Wiersma, D; Jenner, JA; van de Willige, G; Spakman, M; Nienhuis, FJ
Objective: To investigate the durability of positive effects of cognitive behaviour therapy (CBT) with coping training on psychotic symptoms and social functioning. Method: Forty patients with schizophrenia or related psychotic disorders and refractory auditory hallucinations were given CBT and
Buhmann, Caecilie Böck; Nordentoft, Merete; Ekstrøm, Morten
BACKGROUND: Little evidence exists on the treatment of traumatised refugees. AIMS: To estimate treatment effects of flexible cognitive-behavioural therapy (CBT) and antidepressants (sertraline and mianserin) in traumatised refugees. METHOD: Randomised controlled clinical trial with 2 × 2 factorial...
Romijn, G.A.; Riper, H.; Kok, R.N.; Donker, T.; Goorden, M.; Hakkaart-van Roijen, L.H.; Kooistra, L.C.; van Balkom, A.J.L.M.; Koning, J.P.F.
Background: Anxiety disorders are among the most prevalent psychiatric conditions, and are associated with poor quality of life and substantial economic burden. Cognitive behavioural therapy is an effective treatment to reduce anxiety symptoms, but is also costly and labour intensive.
Effectiveness of psycho-education on depression, hopelessness, suicidality, anxiety and substance use among basic diploma students at Kenya Medical ... South African Journal of Psychiatry ... Psycho-education was effective in reducing the severity of symptoms of depression, hopelessness, suicidality, anxiety and risk
Gilmore, Linda; Islam, Shaheen; Su, Hui; Younesian, Sharifeh
For psychologists in less developed countries, psycho-educational assessment is often challenging due to a lack of specialist training and a scarcity of appropriate, psychometrically robust instruments. This article focuses on school psychology and psycho-educational assessment in three countries: Bangladesh, China and Iran. Despite differences in…
Furr, Susan R.
Presents six-step model for moving from a general statement of purpose to a psychoeducational group design that includes didactic content, experiential activities, and processing. By following this model the group facilitator will be able to develop a psychoeducational group that provides a logical sequence of learning activities fostering…
Lichtwarck-Aschoff, Anna; van Geert, Paul
In this article we discussed a dynamic systems view on social behaviour in adolescence. Social behaviour is defined as a self-organizing attractor landscape, based on a network of proximal (i.e., direct) causes. In some cases, social development is disturbed, leading to problematic behaviour in
Silfvernagel, Kristin; Westlinder, Anna; Andersson, Stina; Bergman, Kajsa; Diaz Hernandez, Rosario; Fallhagen, Line; Lundqvist, Ida; Masri, Nicole; Viberg, Linda; Forsberg, Marie-Louise; Lind, Maria; Berger, Thomas; Carlbring, Per; Andersson, Gerhard
Mixed anxiety and depression is common among older adults. The aim of the study was to compare the effects of an eight-week-long tailored internet-supported cognitive behaviour therapy (ICBT) programme and to compare against the provision of weekly general support. A second aim was to investigate if pre-treatment cognitive flexibility and self-reported cognitive problems would predict outcome. We included 66 older adults (aged over 60 years) with mixed anxiety/depression following media recruitment and randomised them into treatment and control groups. We also included a one-year follow-up. As a measure of executive function, we used the Wisconsin Card Sorting Test (perseverative errors) and the Cognitive Failures Questionnaire during the pre-treatment phase. Results showed a moderate between-group effect on the main outcome measure, the Beck Anxiety Inventory (BAI) (d= .50), favouring the treatment group. Nearly half (45.5%) of that group were classified as responders. One person (3%) in the treatment group deteriorated. There were significant correlations between perseverative errors and outcome (on the BAI r = -.45), but not among self-reported cognitive function. We conclude that guided, tailored ICBT may be effective for some older adults and that the role of cognitive function needs to be investigated further.
Borst, Grégoire; Aïte, Ania; Houdé, Olivier
Cognitive development is generally conceived as incremental with knowledge of increasing complexity acquired throughout childhood and adolescence. However, several studies have now demonstrated not only that infants possess complex cognitive abilities but also that older children, adolescents, and adults tend to make systematic errors even in simple logical reasoning tasks. Therefore, one of the main issues for any theory of typical cognitive development is to provide an explanation of why at some age and in some contexts children, adolescents, and adults do not express a knowledge or cognitive principle that they already acquired when they were younger. In this review, we present convergent behavioural and neurocognitive evidence that cognitive development is more similar to a non-linear dynamic system than to a linear, stage-like system. In this theoretical framework, errors can emerge in problems similar to the ones infants or young children were succeeding when older children, adolescents, and adults rely on a misleading heuristic rather than on the correct logical algorithm to solve such problems. And the core mechanism for overcoming these errors is inhibitory control (i.e. the ability to inhibit the misleading heuristics). Therefore, typical cognitive development relies not only on the ability to acquire knowledge of incremental complexity but also to inhibit previously acquired knowledge. © 2015 The Authors. Developmental Medicine & Child Neurology © 2015 Mac Keith Press.
Romijn, Geke; Riper, Heleen; Kok, Robin; Donker, Tara; Goorden, Maartje; van Roijen, Leona Hakkaart; Kooistra, Lisa; van Balkom, Anton; Koning, Jeroen
Anxiety disorders are among the most prevalent psychiatric conditions, and are associated with poor quality of life and substantial economic burden. Cognitive behavioural therapy is an effective treatment to reduce anxiety symptoms, but is also costly and labour intensive. Cost-effectiveness could possibly be improved by delivering cognitive behavioural therapy in a blended format, where face-to-face sessions are partially replaced by online sessions. The aim of this trial is to determine the cost-effectiveness of blended cognitive behavioural therapy for adults with anxiety disorders, i.e. panic disorder, social phobia or generalized anxiety disorder, in specialized mental health care settings compared to face-to-face cognitive behavioural therapy. In this paper, we present the study protocol. It is hypothesized that blended cognitive behavioural therapy for anxiety disorders is clinically as effective as face-to-face cognitive behavioural therapy, but that intervention costs may be reduced. We thus hypothesize that blended cognitive behavioural therapy is more cost-effective than face-to-face cognitive behavioural therapy. In a randomised controlled equivalence trial 156 patients will be included (n = 78 in blended cognitive behavioural therapy, n = 78 in face-to-face cognitive behavioural therapy) based on a power of 0.80, calculated by using a formula to estimate the power of a cost-effectiveness analysis: [Formula: see text]. Measurements will take place at baseline, midway treatment (7 weeks), immediately after treatment (15 weeks) and 12-month follow-up. At baseline a diagnostic interview will be administered. Primary clinical outcomes are changes in anxiety symptom severity as measured with the Beck Anxiety Inventory. An incremental cost-effectiveness ratio will be calculated to obtain the costs per quality-adjusted life years (QALYs) measured by the EQ-5D (5-level version). Health-economic outcomes will be explored from a societal and health care
Haglund, Margaret; Cabaniss, Deborah; Kimhy, David; Corcoran, Cheryl M
Psychological treatments such as cognitive behavioural therapy (CBT) may have efficacy in young people at ultra-high risk (UHR) for psychosis. Case reports can illuminate the obstacles and challenges, and potential trajectory of symptom changes, observed with this treatment. This is a detailed case report of a young adult at UHR for psychosis who received manualized CBT for accompanying social anxiety. Cognitive deficits and suspiciousness created initial challenges for successful implementation of CBT. Engagement in treatment occurred with slowing of pace and simplification of material, and modelling of social interaction. Treatment of social anxiety was accompanied by decreases in suspiciousness, conceptual disorganization, and social anhedonia, and increase in range of affect. Adaptation of manualized CBT to accommodate cognitive deficits and suspiciousness in UHR patients may improve engagement. CBT focused on social anxiety can lead to improvement across symptom domains in UHR patients. © 2013 Wiley Publishing Asia Pty Ltd.
Ballesio, Andrea; Aquino, Maria Raisa Jessica V; Feige, Bernd; Johann, Anna F; Kyle, Simon D; Spiegelhalder, Kai; Lombardo, Caterina; Rücker, Gerta; Riemann, Dieter; Baglioni, Chiara
This review aimed to assess the impact of behavioural therapy for insomnia administered alone (BT-I) or in combination with cognitive techniques (cognitive-behavioural therapy for insomnia, CBT-I) on depressive and fatigue symptoms using network meta-analysis. PubMed, Scopus and Web of Science were searched from 1986 to May 2015. Studies were included if they incorporated sleep restriction, a core technique of BT-I treatment, and an adult insomnia sample, a control group and a standardised measure of depressive and/or fatigue symptoms. Face-to-face, group, self-help and internet therapies were all considered. Forty-seven studies were included in the meta-analysis. Eleven classes of treatment or control conditions were identified in the network. Cohen's d at 95% confidence interval (CI) was calculated to assess the effect sizes of each treatment class as compared with placebo. Results showed significant effects for individual face-to-face CBT-I on depressive (d = 0.34, 95% CI: 0.06-0.63) but not on fatigue symptoms, with high heterogeneity between studies. The source of heterogeneity was not identified even after including sex, age, comorbidity and risk of bias in sensitivity analyses. Findings highlight the need to reduce variability between study methodologies and suggest potential effects of individual face-to-face CBT-I on daytime symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background Reduced sleep quality is a common complaint among patients with chronic pain, with 50-80% of patients reporting sleep disturbance. Improvements in pain and quality of life measures have been achieved using a multidisciplinary cognitive behavioural therapy pain management programme (CBT-PMP that aims to recondition attitudes to pain, and improve patients' self-management of their condition. Despite its high prevalence in patients with chronic pain, there is very limited objective evidence for the effect of this intervention on sleep quality. The primary research objective is to investigate the short-term effect of a multidisciplinary CBT-PMP on subjective (measured by Pittsburg Sleep Quality Index and objective sleep quality (measured by Actigraphy in patients with chronic pain by comparison with a control group. The secondary objectives will investigate changes in function and mood, and then explore the relationship between objective and subjective sleep quality and physical and psychological outcome measures. Methods/Design Patients who fulfil the inclusion criteria for attendance on the multidisciplinary CBT-PMP in the Adelaide and Meath Hospital, Tallaght, Dublin and are currently listed on the PMP waiting list will be invited to participate in this pilot study. Potential patients will be screened for sleep disturbance [determined by the Pittsburgh Sleep Quality Index (PSQI]. Those patients with a sleep disturbance (PSQI >5 will be assigned to either the intervention group (immediate treatment, or control group (deferred treatment, i.e. the PMP they are listed for is more than six months away based on where they appear on the waiting list. Baseline measures of sleep, function, and mood will be obtained using a combination of self-report questionnaires (the Hospital Anxiety and Depression Scale, the Short Form 36 health survey, the Pittsburgh Sleep Quality Index, the Tampa Scale for Kinesiophobia, and functional outcome
Michail, Maria; Birchwood, Max; Tait, Lynda
Social anxiety is among the most prevalent and debilitating affective disturbances manifest in people with psychosis. It is usually accompanied by high levels of depression and leads to significant social disability, lower quality of life and poorer prognosis as it raises the possibility of an early relapse. Despite its elevated prevalence and severity in psychosis, social anxiety remains under-recognized and under-treated. Cognitive-behavioural therapy is recommended for the treatment of people with psychosis. However, its focus and evaluation has primarily revolved around the reduction of psychotic symptoms, and not for co-morbid affective disturbances such as social anxiety. There is lack of evidence on the clinical effectiveness and cost-effectiveness of cognitive-behavioural interventions for the treatment of social anxiety disorder in psychosis. Electronic databases will be systematically searched for randomised controlled trials and quasi-experimental studies investigating the effectiveness and cost-effectiveness of cognitive-behavioural interventions for the treatment of social anxiety disorder in people with psychosis. Grey literature will also be searched by screening trial registers. Only studies published in English will be included in the review. Date restrictions will not be applied. Eligible studies will have as the primary outcome social anxiety (continuous data) measured using any psychometrically validated scale both self-reported and clinician administered. Secondary outcomes will include general anxiety symptoms, distress, depression, positive and negative symptoms of schizophrenia, and quality of life measured using any psychometrically validated scale, both self-reported and clinician administered, and the cost of cognitive-behaviour therapy (CBT) intervention (with another treatment or treatment-as-usual). This review will provide an evidence synthesis of the effectiveness and cost-effectiveness of cognitive-behavioural interventions for the
Jung, Esther; Wiesjahn, Martin; Rief, Winfried; Lincoln, Tania M
The quality of therapeutic alliance is a consistent and stable predictor of therapy outcome. Recent studies have shown therapist characteristics to be relevant predictors of the alliance in psychological therapies in general. However, little is known about the specific therapist characteristics that explain differences in therapeutic alliance in cognitive behavioural therapy for psychosis (CBTp). The aim of this study was to identify relevant therapist characteristics that predict early therapeutic alliance in CBTp. Forty-eight patients with a DSM-IV diagnosis of a psychotic disorder participating in a CBTp trial and 11 therapists were included in the analysis. Therapist characteristics as perceived by the patients (empathy, genuineness, positive regard, competence, and convincingness) were assessed at baseline. Alliance was assessed after the fifth therapy session. Data were analyzed using bivariate correlations and multivariate hierarchic regression analysis. All therapist characteristics were positively associated with patient-rated alliance. Patient characteristics were not significantly associated with alliance and did not predict alliance in the multivariate analysis. Regression analysis revealed therapist genuineness and competence to significantly predict higher patient-rated alliance. Our results suggest that perceived therapist genuineness is the most relevant predictor of patient-rated therapeutic alliance in CBTp. Future trials using control samples with other mental disorders could clarify whether this finding is specific to CBTp. Therapist training concepts for increasing beneficial therapist qualities are needed. The patients' perception of the therapist as empathic, genuine, accepting, competent and convincing is associated with therapeutic alliance in CBTp. Perceived therapist genuineness and competence are the most relevant predictors of patient-rated therapeutic alliance. Training and supervision should focus on increasing basic therapist
McEvoy, Peter M; Burgess, Melissa M; Nathan, Paula
Cognitive behavioural therapy (CBT) is efficacious, but there remains individual variability in outcomes. Patient's interpersonal problems may affect treatment outcomes, either directly or through a relationship mediated by helping alliance. Interpersonal problems may affect alliance and outcomes differentially in individual and group (CBGT) treatments. The main aim of this study was to investigate the relationship between interpersonal problems, alliance, dropout and outcomes for a clinical sample receiving either individual or group CBT for anxiety or depression in a community clinic. Patients receiving individual CBT (N=84) or CBGT (N=115) completed measures of interpersonal problems, alliance, and disorder specific symptoms at the commencement and completion of CBT. In CBGT higher pre-treatment interpersonal problems were associated with increased risk of dropout and poorer outcomes. This relationship was not mediated by alliance. In individual CBT those who reported higher alliance were more likely to complete treatment, although alliance was not associated with symptom change, and interpersonal problems were not related to attrition or outcome. Allocation to group and individual therapy was non-random, so selection bias may have influenced these results. Some analyses were only powered to detect large effects. Helping alliance ratings were high, so range restriction may have obscured the relationship between helping alliance, attrition and outcomes. Pre-treatment interpersonal problems increase risk of dropout and predict poorer outcomes in CBGT, but not in individual CBT, and this relationship is not mediated by helping alliance. Stronger alliance is associated with treatment completion in individual, but not group CBT. Copyright © 2014 Elsevier B.V. All rights reserved.
Ray, John M; Kemp, Lakiesha L; Hubbard, Amanda; Cucciare, Michael A
Computer-delivered cognitive behavioural therapy (cCBT) is an effective alternative to provider-delivered treatment for depression and anxiety, but high attrition poses a significant challenge to its use. Peer support is a feasible approach to improving cCBT engagement, but less is known about its acceptability among Veterans. To obtain feedback from Veterans (n = 24) with depression and/or anxiety on their preferences for (a) activities of Veterans Administration Peer Support Specialists (VA PSS) in helping Veterans use Moving Forward, a cCBT-based protocol developed by VA, and (b) methods for delivering support to Veterans using this programme. Four focus groups (5-7 Veterans per group) provided feedback to be used in the development of a peer-supported engagement intervention to help Veterans with depression and anxiety use Moving Forward. Content areas included roles that a VA PSS might play in supporting the use of and engagement in Moving Forward, as well as methods of delivering that support. Veteran preferences for PSS activity focused on practical aspects of using Moving Forward, including orientation to the programme, technical support, and monitoring progress. Feedback also suggested that Veterans preferred more personal roles for the PSS, including emotional support, as well as application of Moving Forward to 'real life' problems. The findings extend the literature on online, patient-facing mental health protocols by identifying emotional support and 'real life' skills application as Veteran-preferred components of a peer-support protocol designed to enhance use of and engagement in cCBT for depression and anxiety.
Bolló-Gasol, S; Piñol-Ripoll, G; Cejudo-Bolivar, J C; Llorente-Vizcaino, A; Peraita-Adrados, H
The Rivermead Behavioural Memory Test (RBMT) is a short, ecologically-valid memory test battery that can provide data about a subject's memory function in daily life. We used RBMT to examine daily memory function in patients with mild cognitive impairment (MCI), Alzheimer disease (AD), and in healthy controls. We also evaluated differences between the memory profiles of subjects whose MCI remained stable after 1 year and those with conversion to AD. Sample of 91 subjects older than 60 years: 30 controls, 27 MCI subjects and 34 AD patients. Subjects were assessed using MMSE and RBMT. The 40 men and 51 women in the sample had a mean age of 74.29±6.71 and 5.87±2.93 years of education. For the total profile and screening RBMT scores (P<.001) and total MMSE scores (P<.05), control subjects scored significantly higher than those with MCI, who in turn scored higher than AD patients. In all subtests, the control group (P<.001) and MCI group (P<.05) were distinguishable from the AD group. Prospective, retrospective, and orientation subtests found differences between the MCI and control groups (P<.05). MCI subjects who progressed to AD scored lower at baseline on the total RBMT and MMSE, and on name recall, belongings, story-immediate recall, route-delayed recall, orientation (P<.05), face recognition, story-delayed recall, and messages-delayed recall sections (P<.01). RBMT is an ecologically-valid episodic memory test that can be used to differentiate between controls, MCI subjects, and AD subjects. It can also be used to detect patients with MCI who will experience progression to AD. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.
Dear, Blake F; Zou, Judy; Titov, Nickolai; Lorian, Carolyn; Johnston, Luke; Spence, Jay; Anderson, Tracy; Sachdev, Perminder; Brodaty, Henry; Knight, Robert G
Depression is an important health issue amongst older adults. Internet-delivered cognitive behaviour therapy (iCBT) may help to reduce barriers and improve access to treatment, but few studies have examined its use with older adults. The present study evaluated the efficacy, acceptability and feasibility of a brief iCBT program, the Managing Your Mood Program, to treat depression amongst adults aged 60 years and older. Using an open trial design, 20 participants with elevated symptoms of depression (Patient Health Questionnaire 9-item (PHQ-9) total scores ≥ 10) received access to five educational lessons and homework summaries, additional resources, a moderated discussion forum and weekly telephone or email contact from a clinical psychologist. Eighty percent of the sample met diagnostic criteria for a major depressive episode at pre-treatment. Completion rates and response rates were high, with 16/20 participants completing the five lessons within the 8 weeks, and post-treatment and 3-month follow-up data being collected from 17/20 participants. Participants improved significantly on the PHQ-9 and Geriatric Depression Scale (GDS), with large within-group effect sizes (Cohen's d) at follow-up of 1.41 and 2.04, respectively. The clinician spent a mean time of 73.75 minutes (SD = 36.10 minutes) contacting participants within the trial and the program was rated as highly acceptable by participants. The results are encouraging and support the potential value of iCBT in the treatment of depressive symptoms amongst older adults.
Millings, Abigail; Carnelley, Katherine B
Computerised cognitive behavioural therapy provides a unique opportunity to collect and analyse data regarding the idiosyncratic content of people's core beliefs about the self, others and the world. 'Beating the Blues' users recorded a core belief derived through the downward arrow technique. Core beliefs from 1813 mental health patients were coded into 10 categories. The most common were global self-evaluation, attachment, and competence. Women were more likely, and men were less likely (than chance), to provide an attachment-related core belief; and men were more likely, and women less likely, to provide a self-competence-related core belief. This may be linked to gender differences in sources of self-esteem. Those who were suffering from anxiety were more likely to provide power- and control-themed core beliefs and less likely to provide attachment core beliefs than chance. Finally, those who had thoughts of suicide in the preceding week reported less competence themed core beliefs and more global self-evaluation (e.g., 'I am useless') core beliefs than chance. Concurrent symptom level was not available. The sample was not nationally representative, and featured programme completers only. Men and women may focus on different core beliefs in the context of CBT. Those suffering anxiety may need a therapeutic focus on power and control. A complete rejection of the self (not just within one domain, such as competence) may be linked to thoughts of suicide. Future research should examine how individual differences and symptom severity influence core beliefs. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
Mantione, M; Nieman, D H; Figee, M; Denys, D
Deep brain stimulation (DBS) is a promising new treatment for patients with treatment-refractory obsessive-compulsive disorder (OCD). However, since most DBS patients only show a partial response, the treatment still needs to be improved. In this study we hypothesized that cognitive-behavioural therapy (CBT) could optimize the post-operative management in DBS and we evaluated the efficacy of CBT as augmentation to DBS targeted at the nucleus accumbens. A total of 16 patients with treatment-refractory OCD were treated with DBS targeted at the nucleus accumbens. After stabilization of decline in OCD symptoms, a standardized 24-week CBT treatment programme was added to DBS in an open-phase trial of 8 months. Changes in obsessive-compulsive, anxiety and depressive symptoms were evaluated using the Yale-Brown Obsessive Compulsive Scale, Hamilton Anxiety Scale and Hamilton Rating Scale for Depression. Following the addition of CBT to DBS, a significant decrease in obsessive-compulsive symptoms was observed, but not in anxiety and depressive symptoms. In a subsequent double-blind phase, in which stimulation was discontinued, OCD symptoms returned to baseline (relapse) and anxiety and depressive symptoms worsened (rebound) compared with baseline. The results of this explorative study suggest that a combined treatment of accumbens DBS and CBT may be optimal for improving obsessive-compulsive symptoms in treatment-refractory OCD. However, a subsequent randomized controlled trial is necessary to draw firm conclusions. It seems that DBS results in affective changes that may be required to enable response prevention in CBT. This may indicate that DBS and CBT act as two complementary treatments.
Bayliss, Paul; Holttum, Sue
To develop a preliminary model of the experiences of people undergoing combined treatment with antidepressant medication and cognitive-behavioural therapy (CBT) for depression. The study used a qualitative methodology informed by grounded theory. Participants were 12 adults who had received treatment with antidepressant medication and CBT for depression. Participants engaged in a semistructured interview about their experiences. Interviews were transcribed and analysed using components of grounded theory methodology. Medication was often seen as an initial aid to surviving a crisis. Staying on medication longer term resulted in some participants feeling caught in a 'drug loop'. Feeling that medication was unhelpful or actively harmful could contribute to participants seeking CBT. Medics also offered information on CBT and acted as gatekeepers, meaning that negotiation was sometimes necessary. CBT was described as a process of being guided towards skilled self-management. Occasionally, participants felt that medication had facilitated CBT at one or more stages. Conversely, developing skilled self-management through CBT could reduce feelings of dependency on medication and affect several of the other elements maintaining the 'drug loop'. Antidepressant medication and CBT are perceived and experienced differently, with CBT often being seen as an alternative to medication, or even as a means to discontinue medication. Service users' experiences and beliefs about medication may thus affect their engagement and goals in CBT, and it may be important for therapists to consider this. Practitioners who prescribe medication should ensure that they also provide information on the availability and appropriateness of CBT, and engage in an open dialogue about treatment options. CBT practitioners should explore aspects of clients' experiences and beliefs about medication. This would particularly include clients' experiences of the effects of medication, their beliefs about
Cooney, Patricia; Jackman, Catherine; Coyle, David; O'Reilly, Gary
BackgroundDespite the evidence base for computer-assisted cognitive-behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability.AimsTo evaluate the utility of a CBT computer game for adults who have an intellectual disability.MethodA 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis.ResultsA significant group × time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU.ConclusionsAs the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population. © The Royal College of Psychiatrists 2017.
Asghari, Elahe; Mohammmadi, Arsalan Khan
Introduction Stress induced by preeclampsia in pregnancy may have a detrimental effect on both the mother and child. Risk of anxiety, depression and stress during pregnancy is, therefore, commonly associated with preeclampsia. Aim To determine the effect of Cognitive Behavioural Therapy (CBT) on anxiety, depression and stress in pregnant women with preeclampsia. Materials and Methods In a clinical trial, 60 women with preeclampsia were selected by the convenience sampling method from the Imam-Ali Hospital of Amol city (North of Iran). The subjects were randomly divided into two groups; the study group (n=30) and the control (n=30). All participants completed the Hospital Anxiety and Depression Scale (HADS) and a Pregnancy Distress Questionnaire (PDQ) at the beginning and end of the study. The intervention group received 12 CBT sessions lasting for 90 minutes over 4 weeks (3 sessions in a week) and the control group received no treatment. Results A MANCOVA test showed that CBT significantly reduced the mean scores of anxiety (5.5 ± 3.2 vs. 9.7 ± 3.8) and depression (6.4±2.6 vs 9.3±4.0) in preeclamptic women (F: 19.933, p-value <0.01). In addition, ANCOVA also revealed that CBT significantly improved the mean scores of specific-stress pregnancy (15.9 ± 6.3 vs 22.2 ± 6.8) in women with preeclampsia (F: 10.214, p-value <0.01). Conclusion Psychotherapy was effective in reducing anxiety, depression and specific-stress pregnancy in pregnant women with preeclampsia. PMID:28050449
Asghari, Elahe; Faramarzi, Mahbobeh; Mohammmadi, Arsalan Khan
Stress induced by preeclampsia in pregnancy may have a detrimental effect on both the mother and child. Risk of anxiety, depression and stress during pregnancy is, therefore, commonly associated with preeclampsia. To determine the effect of Cognitive Behavioural Therapy (CBT) on anxiety, depression and stress in pregnant women with preeclampsia. In a clinical trial, 60 women with preeclampsia were selected by the convenience sampling method from the Imam-Ali Hospital of Amol city (North of Iran). The subjects were randomly divided into two groups; the study group (n=30) and the control (n=30). All participants completed the Hospital Anxiety and Depression Scale (HADS) and a Pregnancy Distress Questionnaire (PDQ) at the beginning and end of the study. The intervention group received 12 CBT sessions lasting for 90 minutes over 4 weeks (3 sessions in a week) and the control group received no treatment. A MANCOVA test showed that CBT significantly reduced the mean scores of anxiety (5.5 ± 3.2 vs. 9.7 ± 3.8) and depression (6.4±2.6 vs 9.3±4.0) in preeclamptic women (F: 19.933, p-value <0.01). In addition, ANCOVA also revealed that CBT significantly improved the mean scores of specific-stress pregnancy (15.9 ± 6.3 vs 22.2 ± 6.8) in women with preeclampsia (F: 10.214, p-value <0.01). Psychotherapy was effective in reducing anxiety, depression and specific-stress pregnancy in pregnant women with preeclampsia.
Lopez-Gomez, Irene; Chaves, Covadonga; Hervas, Gonzalo; Vazquez, Carmelo
There is growing evidence on the efficacy of positive psychology interventions (PPI) to treat clinical disorders. However, very few studies have addressed their acceptability. The present study aimed to analyse 2 key components of acceptability (i.e., client satisfaction and adherence to treatment) of a new PPI programme, the Integrative Positive Psychological Intervention for Depression (IPPI-D), in comparison to a standard cognitive behavioural therapy (CBT) programme in the treatment of clinical depression. One hundred twenty-eight women with a DSM-IV diagnosis of major depression or dysthymia were allocated to a 10-session IPPI-D or CBT group intervention condition. Results showed that both interventions were highly acceptable for participants. Attendance rates were high, and there were no significant differences between conditions. However, the IPPI-D condition showed significantly higher client satisfaction than the CBT condition. Moreover, acceptability did not differ based on participants' severity of symptoms, regardless of condition. These findings encourage further investigations of the applicability of PPI in clinical settings in order to broaden the range of acceptable and suitable therapies for depressed patients. Key Practitioner Message This study sheds light on the client satisfaction and adherence to a positive intervention. For participants, positive psychology interventions (PPI) may be more satisfactory than CBT as PPI are framed within a positive mental health model and, consequently, may reduce the risk of stigmatization Because acceptability of treatments and preferences may affect the efficacy of treatments, this study provides an excellent opportunity to offer professionals more therapeutic options to tailor treatments to clients' needs and expectations. Copyright © 2017 John Wiley & Sons, Ltd.
Full Text Available Abstract Background Subthreshold depression has a considerable impact on individuals’ subjective well-being and psychosocial functioning and is a predictor of major depressive disorder. Internet-based cognitive behavioural treatments (iCBTs have been used to reduce the symptoms of subthreshold depression. This meta-analysis aims to systematically review evidence indicating the efficacy of iCBT programs on the improvement of depressive symptoms in this population. Methods Articles published from January 2005 to July 2016 were searched in the following databases: Medline, PubMed, Web of Science, ScienceDirect, PsycArticles and the Cochrane Central Register of Controlled Trials. Only randomized controlled trials comparing the efficacy of iCBT programs with control groups for participants with subthreshold depression were selected. Both quantitative and qualitative analyses were conducted to examine the efficacy of iCBT interventions. Results Tenarticles from 8 randomized controlled trials were identified in this systematic review. The results suggested that iCBT programs had a superior efficacy compared to results from a non-active control group at the post-intervention stage (SMD = − 0.28, CI [− 0.42, − 0.14]; I2 = 49 %. However, evidence on the long-term efficacy of iCBT programs is still insufficient and needs further exploration. Conclusion There has been substantial evidence that iCBT intervention has a superior short-term efficacy compared to the results of control groups, while its long-term efficacy of iCBT for subthreshold depressive symptoms is inconclusive and must be examined in further research. Trial registration The protocol of this review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO, Protocol No. CRD42015023390 .
Zhou, Ting; Li, Xue; Pei, Ye; Gao, Jianan; Kong, Junhui
Subthreshold depression has a considerable impact on individuals' subjective well-being and psychosocial functioning and is a predictor of major depressive disorder. Internet-based cognitive behavioural treatments (iCBTs) have been used to reduce the symptoms of subthreshold depression. This meta-analysis aims to systematically review evidence indicating the efficacy of iCBT programs on the improvement of depressive symptoms in this population. Articles published from January 2005 to July 2016 were searched in the following databases: Medline, PubMed, Web of Science, ScienceDirect, PsycArticles and the Cochrane Central Register of Controlled Trials. Only randomized controlled trials comparing the efficacy of iCBT programs with control groups for participants with subthreshold depression were selected. Both quantitative and qualitative analyses were conducted to examine the efficacy of iCBT interventions. Tenarticles from 8 randomized controlled trials were identified in this systematic review. The results suggested that iCBT programs had a superior efficacy compared to results from a non-active control group at the post-intervention stage (SMD = - 0.28, CI [- 0.42, - 0.14]; I2 = 49 %). However, evidence on the long-term efficacy of iCBT programs is still insufficient and needs further exploration. There has been substantial evidence that iCBT intervention has a superior short-term efficacy compared to the results of control groups, while its long-term efficacy of iCBT for subthreshold depressive symptoms is inconclusive and must be examined in further research. The protocol of this review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), Protocol No. CRD42015023390 .
Full Text Available Objective. The most effective nonpharmacological treatment for insomnia disorder is cognitive behavioural therapy-insomnia (CBT-i. However CBT-i may not suit everyone. Auricular acupuncture (AA is a complementary treatment. Studies show that it may alleviate insomnia symptoms. The aim of this randomised controlled study was to compare treatment effects of AA with CBT-i and evaluate symptoms of insomnia severity, anxiety, and depression. Method. Fifty-nine participants, mean age 60.5 years (SD 9.4, with insomnia disorder were randomised to group treatment with AA or CBT-i. Self-report questionnaires, the Insomnia Severity Index (ISI, Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16, Epworth Sleepiness Scale (ESS, and Hospital Anxiety and Depression scale (HAD, were collected at baseline, after treatment, and at 6-month follow-up. A series of linear mixed models were performed to examine treatment effect over time between and within the groups. Results. Significant between-group improvements were seen in favour of CBT-i in ISI after treatment and at the 6-month follow-up and in DBAS-16 after treatment. Both groups showed significant within-group postintervention improvements in ISI, and these changes were maintained six months later. The CBT-i group also showed a significant reduction in DBAS-16 after treatment and six months later. Conclusions. Compared to CBT-i, AA, as offered in this study, cannot be considered an effective stand-alone treatment for insomnia disorder. The trial is registered with ClinicalTrials.gov NCT01765959.
Vigerland, Sarah; Ljótsson, Brjánn; Thulin, Ulrika; Öst, Lars-Göran; Andersson, Gerhard; Serlachius, Eva
Cognitive behaviour therapy (CBT) has been shown to be an effective treatment for anxiety disorders in children, but few affected seek or receive treatment. Internet-delivered CBT (ICBT) could be a way to increase the availability of empirically supported treatments. A randomised controlled trial was conducted to evaluate ICBT for children with anxiety disorders. Families (N = 93) with a child aged 8-12 years with a principal diagnosis of generalised anxiety disorder, panic disorder, separation anxiety, social phobia or specific phobia were recruited through media advertisement. Participants were randomised to 10 weeks of ICBT with therapist support, or to a waitlist control condition. The primary outcome measure was the Clinician Severity Rating (CSR) and secondary measures included child- and parent-reported anxiety. Assessments were made at pre-treatment, post-treatment and at three-month follow-up. At post-treatment, there were significant reductions on CSR in the treatment group, with a large between-group effect size (Cohen's d = 1.66). Twenty per cent of children in the treatment group no longer met criteria for their principal diagnosis at post-treatment and at follow-up this number had increased to 50%. Parent-reported child anxiety was significantly lower in the treatment group than in the waitlist group at post-treatment, with a small between-group effect size (Cohen's d = 0.45). There were no significant differences between the groups regarding child-ratings of anxiety at post-treatment. Improvements were maintained at three-month follow-up, although this should be interpreted cautiously due to missing data. Within the limitations of this study, results suggest that ICBT with therapist support for children with anxiety disorders can reduce clinician- and parent-rated anxiety symptoms. Clinicaltrials.gov: NCT01533402. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available Aim. To explore the efficacy of home-based, computerised, cognitive rehabilitation in patients with multiple sclerosis using neuropsychological assessment and advanced structural and functional magnetic resonance imaging (fMRI. Methods. 38 patients with MS and cognitive impairment on the Brief International Cognitive Assessment for MS (BICAMS were enrolled. Patients were randomised to undergo 45 minutes of computerised cognitive rehabilitation using RehaCom software (n=19 three times weekly for six weeks or to a control condition (n=19. Neuropsychological and MRI data were obtained at baseline (time 1, following the 6-week intervention (time 2, and after a further twelve weeks (time 3. Cortical activations were explored using fMRI and microstructural changes were explored using quantitative magnetisation transfer (QMT imaging. Results. The treatment group showed a greater improvement in SDMT gain scores between baseline and time 2 compared to the control group (p=0.005. The treatment group exhibited increased activation in the bilateral prefrontal cortex and right temporoparietal regions relative to control group at time 3 (p<0.05FWE corrected. No significant changes were observed on QMT. Conclusion. This study supports the hypothesis that home-based, computerised, cognitive rehabilitation may be effective in improving cognitive performance in patients with MS. Clinical trials registration is ISRCTN54901925.
Comparing cognitive behavioural therapy for eating disorders integrated with behavioural weight loss therapy to cognitive behavioural therapy-enhanced alone in overweight or obese people with bulimia nervosa or binge eating disorder: study protocol for a randomised controlled trial.
Palavras, Marly Amorim; Hay, Phillipa; Touyz, Stephen; Sainsbury, Amanda; da Luz, Felipe; Swinbourne, Jessica; Estella, Nara Mendes; Claudino, Angélica
Around 40 % of individuals with eating disorders of recurrent binge eating, namely bulimia nervosa and binge eating disorder, are obese. In contrast to binge eating disorder, currently there is no evidence base for weight management or weight loss psychological therapies in the treatment of bulimia nervosa despite their efficacy in binge eating disorder. Thus, a manualised therapy called HAPIFED (Healthy APproach to weIght management and Food in Eating Disorders) has been developed. HAPIFED integrates the leading evidence-based psychological therapies, cognitive behavioural therapy-enhanced (CBT-E) and behavioural weight loss treatment (BWLT) for binge eating disorder and obesity respectively. The aim of the present study is to detail the protocol for a randomised controlled trial (RCT) of HAPIFED versus CBT-E for people with bulimia nervosa and binge eating disorder who are overweight/obese. A single-blind superiority RCT is proposed. One hundred Brazilian participants aged ≥ 18 years, with a diagnosis of bulimia nervosa or binge eating disorder, BMI > 27 to < 40 kg/m(2), will be recruited from both community and clinics and individually randomised to a therapy arm. Five groups of ten participants will receive the experimental intervention (HAPIFED) and the other five groups of ten the control intervention (CBT-E). Both therapies are manualised, and in this RCT will comprise 1 individual session and 29 office-based group sessions over 6 months. Assessment points will be at baseline, end of therapy, and 6 and 12 months after end of therapy. The primary outcome of this intervention will be reduced weight. Secondary outcomes will be improved metabolic indicators of weight management, reduction in eating disorder symptoms including improved control over eating, improved adaptive function, physical and mental health-related quality of life, and reduced levels of depression and anxiety. This study will be the first to investigate a psychological therapy
Westenhoefer, Joachim; Engel, Daniel; Holst, Claus
Examine the association between components of restrained eating, cognitive performance and weight loss maintenance.......Examine the association between components of restrained eating, cognitive performance and weight loss maintenance....
Ho, Betty P. V.; Carter, Mark; Stephenson, Jennifer
This review examines the use of a cognitive-behavioural approach to anger management in children with special needs in community settings. Eighteen experimental studies involving a total of 408 children were located. The participants were mainly of high school age, with an IQ above 80, and with behavioural or emotional disorders. A moderate effect…
De Jong, Corina; Kikkert, Hedwig K.; Fidler, Vaclav; Hadders-Algra, Mijna
AIM: Long-chain polyunsaturated fatty acid (LCPUFA) supplementation of infant formula may have a beneficial effect on cognitive development. This study aimed to investigate the effect of LCPUFA formula supplementation primarily on cognition and secondarily on behaviour at age 9 years. Special
Williamson, Andrew Ian
Previous research has explored the applicability of Weiner’s (1986) attributional model of helping behaviour to support workers of people with learning disabilities regarding challenging behaviour using optimism as a measure of the expectancy of success. No research has investigated the applicability of Weiner’s (1993) attributional model of helping behaviour to this group which gives a role to attributions of responsibility. Other research has found that self efficacy affects emotional respo...
Turner, Hannah; Bryant-Waugh, Rachel; Marshall, Emily
The present study explored the impact of early symptom change (cognitive and behavioural) and the early therapeutic alliance on treatment outcome in cognitive-behavioural therapy (CBT) for the eating disorders. Participants were 94 adults with diagnosed eating disorders who completed a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment, following the 6th session and at the end of treatment. They also completed a measure of therapeutic alliance following the 6th session. Greater early reduction in dietary restraint and eating concerns, and smaller levels of change in shape concern, significantly predicted later reduction in global eating pathology. The early therapeutic alliance was strong across the three domains of tasks, goals and bond. Early symptom reduction was a stronger predictor of later reduction in eating pathology than early therapeutic alliance. The early therapeutic alliance did not mediate the relationship between early symptom reduction and later reduction in global eating pathology. Instead, greater early symptom reduction predicted a strong early therapeutic alliance. Early clinical change was the strongest predictor of treatment outcome and this also facilitated the development of a strong early alliance. Clinicians should be encouraged to deliver all aspects of evidence-based CBT, including behavioural change. The findings suggest that this will have a positive impact on both the early therapeutic alliance and later change in eating pathology. Copyright © 2015 Elsevier Ltd. All rights reserved.
Haciomeroglu, Bikem; Karanci, A Nuray
It is important to investigate the role of cognitive, developmental and environmental factors in the development and maintenance of Obsessive Compulsive Symptomatology (OCS). The main objective of this study was to examine the vulnerability factors of OCS in a non-clinical sample. On the basis of Salkovskis' cognitive model of OCD, the study aimed to investigate the role of perceived parental rearing behaviours, responsibility attitudes, and life events in predicting OCS. Furthermore, the mediator role of responsibility attitudes in the relationship between perceived parental rearing behaviours and OCS was examined. Finally, the specificity of these variables to OCS was evaluated by examining the relationship of the same variables with depression and trait anxiety. A total of 300 university students (M = 19.55±1.79) were administered the Padua Inventory-Washington State University Revision, Responsibility Attitudes Scale, s-EMBU (My memories of upbringing), Life Events Inventory for University Students, Beck Depression Inventory, and State-Trait Anxiety Inventory-Trait Form. Regression analysis revealed that perceived mother overprotection, responsibility attitudes and life events significantly predicted OCS. Furthermore, responsibility attitudes mediated the relationship between perceived mother overprotection and OCS. The predictive role of perceived mother overprotection and the mediator role responsibility attitudes were OCS specific. The findings of the present study supported that perceived mother over-protection as a developmental vulnerability factor significantly contributed to the explanation of a cognitive vulnerability factor (namely responsibility attitudes), and perceived maternal overprotection had its predictive role for OCS through responsibility attitudes.
Furnes, Bodil; Dysvik, Elin
To examine the experiences of therapeutic writing from the perspectives of patients attending a chronic pain management programme. Pain is a multifaceted experience. Increased awareness, understanding and gaining new insights are essential aspects of dealing with chronic pain. It is crucial to find powerful ways to cope with chronic pain. Several studies point to writing as a tool for managing such demanding life experiences. Therapeutic writing in a cognitive behavioural approach may be used to facilitate the rehabilitation process. A qualitative study with a descriptive and explorative design including a phenomenological perspective was used. A consecutive sample of 34 outpatients with chronic pain was recruited to an eight-week group-based pain management programme. A therapeutic writing tool was developed and included as part of the homework tasks. Guidelines were used to initiate and guide the therapeutic writing activity. Written reports were collected after completion. Three thematic findings emerged from the analysis: 'increased understanding of chronic pain as a multifaceted experience', 'new insights into managing the chronic pain situation' and 'different performances lead to different experiences with therapeutic writing'. Increased awareness, understanding and new insights are essential to dealing with chronic pain. People with chronic pain need tools and skills for optimal adaptation. Our findings suggest therapeutic writing may strengthen cognitive behavioural therapy by facilitating cognitive restructuring processes. Therapeutic writing may be used as a tool to express individual experiences and to improve adaptation to chronic pain. © 2012 Blackwell Publishing Ltd.
Overbeek, M.M.; de Schipper, J.C.; Lamers-Winkelman, F.; Schuengel, C.
Background: Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has
Lecomte, Tania; Leclerc, Claude; Wykes, Til
Group cohesion has been linked to positive changes in self-esteem and in symptoms during group psychotherapy in people with psychosis. These changes may be linked to changes in symptoms as fluctuations in self-esteem have been linked to symptom fluctuations. We aimed to determine the relationship between these three factors - group cohesion, self-esteem, and symptoms - during group cognitive behaviour therapy for psychosis (GCBTp). We hypothesized that group cohesion would precede changes in symptoms and self-esteem and that improvements in self-esteem would precede improvements in symptoms. This is an uncontrolled longitudinal study recruiting from a convenience sample within two early psychosis clinics. Sixty-six individuals from first episode of psychosis treatment programmes participated in this study and received 24 sessions of a validated GCBTp protocol. Participants answered a brief questionnaire at the end of each session, measuring their group cohesion, self-esteem, and perception of their symptoms as worse, same, or better than usual. Orthogonal polynomial contrasts for time effects were estimated with a mixed model for repeated measures with a random cluster effect and revealed a quartic trend regarding changes in symptoms over the 24 sessions. Self-esteem, symptoms, and group cohesion were strongly linked during a given session. Also, self-esteem changes predicted changes in symptoms up to two sessions later, and symptoms changes predicted self-esteem changes at the next session. Group cohesion preceded improvements in both self-esteem and symptoms; self-esteem also predicted improvements in group cohesion. These results suggest that self-esteem and symptoms influence each other during therapy, with improvements in one leading to improvements in the other. Group cohesion also appears to be an essential prerequisite to positive changes in self-esteem and symptoms during GCBTp. This study emphasizes the interrelation between self-esteem improvements and
Enander, Jesper; Andersson, Erik; Mataix-Cols, David; Lichtenstein, Linn; Alström, Katarina; Andersson, Gerhard; Ljótsson, Brjánn; Rück, Christian
To evaluate the efficacy of therapist guided internet based cognitive behavioural therapy (CBT) programme for body dysmorphic disorder (BDD-NET) compared with online supportive therapy. A 12 week single blind parallel group randomised controlled trial. Academic medical centre. 94 self referred adult outpatients with a diagnosis of body dysmorphic disorder and a modified Yale-Brown obsessive compulsive scale (BDD-YBOCS) score of ≥ 20. Concurrent psychotropic drug treatment was permitted if the dose had been stable for at least two months before enrolment and remained unchanged during the trial. Participants received either BDD-NET (n=47) or supportive therapy (n=47) delivered via the internet for 12 weeks. The primary outcome was the BDD-YBOCS score after treatment and follow-up (three and six months from baseline) as evaluated by a masked assessor. Responder status was defined as a ≥ 30% reduction in symptoms on the scale. Secondary outcomes were measures of depression (MADRS-S), global functioning (GAF), clinical global improvement (CGI-I), and quality of life (EQ5D). The six month follow-up time and all outcomes other than BDD-YBOCS and MADRS-S at 3 months were not pre-specified in the registration at clinicaltrials.gov because of an administrative error but were included in the original trial protocol approved by the regional ethics committee before the start of the trial. BDD-NET was superior to supportive therapy and was associated with significant improvements in severity of symptoms of body dysmorphic disorder (BDD-YBOCS group difference -7.1 points, 95% confidence interval -9.8 to -4.4), depression (MADRS-S group difference -4.5 points, -7.5 to -1.4), and other secondary measures. At follow-up, 56% of those receiving BDD-NET were classed as responders, compared with 13% receiving supportive therapy. The number needed to treat was 2.34 (1.71 to 4.35). Self reported satisfaction was high. CBT can be delivered safely via the internet to patients with body
Meuldijk, Denise; Carlier, Ingrid V E; van Vliet, Irene M; van Hemert, Albert M; Zitman, Frans G; van den Akker-van Marle, M Elske
Depressive and anxiety disorders cause great suffering and disability and are associated with high health care costs. In a previous conducted pragmatic randomised controlled trial, we have shown that a concise format of cognitive behavioural- and/or pharmacotherapy is as effective as standard care in reducing depressive and anxiety symptoms and in improving subdomains of general health and quality of life in secondary care psychiatric outpatients. In this economic evaluation, we examined whether a favourable cost-utility of concise care compared to standard care was attained. The economic evaluation was performed alongside a pragmatic randomised controlled trial. Health-related quality of life was measured using the Short-Form (SF-36) questionnaire. Cost of healthcare utilization and productivity loss (absenteeism and presenteeism) were assessed using the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P). A cost-utility analysis, using cost-effectiveness acceptability curves, comparing differences in societal costs and Quality-Adjusted Life Years (QALYs) at 1 year was performed. One year after study entry, the difference in mean cost per patient of the two primary treatments was not significant between both groups. No significant differences in other healthcare and non- healthcare costs could be detected between patients receiving concise care and standard care. Also, QALYs were not statistically different between the groups during the study period. From both the societal and healthcare perspective, the probability that concise care is more cost-effective compared to standard care remains below the turning point of 0.5 for all acceptable values of the willingness to pay for a QALY. The economic evaluation suggests that concise care is unlikely to be cost-effective compared to standard care in the treatment for depressive- and anxiety disorders in secondary mental health care during a one year follow up period. Total costs and QALYs
Wright, Barry; Tindall, Lucy; Littlewood, Elizabeth; Adamson, Joy; Allgar, Victoria; Bennett, Sophie; Gilbody, Simon; Verduyn, Chrissie; Alderson-Day, Ben; Dyson, Lisa; Trépel, Dominic; Ali, Shehzad
The 1 year prevalence of depression in adolescents is about 2%. Treatment with antidepressant medication is not recommended for initial treatment in young people due to concerns over high side effects, poor efficacy and addictive potential. Evidence suggests that cognitive behaviour therapy (CBT) is an effective treatment for depression and is currently one of the main treatment options recommended in adolescents. Given the affinity young people have with information technology they may be treated effectively, more widely and earlier in their illness evolution using computer-administered CBT (CCBT). Currently little is known about the clinical and resource implications of implementing CCBT within the National Health Service for adolescents with low mood/depression. We aim to establish the feasibility of running a fully powered randomised controlled trial (RCT). Adolescents aged 12-18 with low mood/depression, (scoring ≥20 on the Mood and Feelings Questionnaire (MFQ)), will be approached to participate. Consenting participants will be randomised to either a CCBT programme (Stressbusters) or accessing selected websites providing information about low mood/depression. The primary outcome measure will be the Beck Depression Inventory (BDI). Participants will also complete generic health measures (EQ5D-Y, HUI2) and resource use questionnaires to examine the feasibility of cost-effectiveness analysis. Questionnaires will be completed at baseline, 4 and 12-month follow-ups. Progress and risk will be monitored via the MFQ administered at each treatment session. The acceptability of a CCBT programme to adolescents; and the willingness of clinicians to recruit participants and of participants to be randomised, recruitment rates, attrition rates and questionnaire completion rates will be collected for feasibility analysis. We will estimate 'numbers needed' to plan a fully powered RCT of clinical and cost-effectiveness. The current trial protocol received a favourable
Full Text Available BACKGROUND: Access to Cognitive behavioural therapy (CBT for depression is limited. One solution is CBT self-help books. Trial Objectives: To assess the impact of a guided self-help CBT book (GSH-CBT on mood, compared to treatment as usual (TAU. HYPOTHESES: GSH-CBT will have improved mood and knowledge of the causes and treatment of depression compared to the control receiving TAUGuided self-help will be acceptable to patients and staff. METHODS AND FINDINGS: PARTICIPANTS: Adults attending seven general practices in Glasgow, UK with a BDI-II score of ≥14. 141 randomised to GSH-CBT and 140 to TAU. INTERVENTIONS: RCT comparing 'Overcoming Depression: A Five Areas Approach' book plus 3-4 short face to face support appointments totalling up to 2 hours of guided support, compared with general practitioner TAU. PRIMARY OUTCOME: The BDI (II score at 4 months. Numbers analysed: 281 at baseline, 203 at 4 months (primary outcome, 117 at 12 months. OUTCOME: Mean BDI-II scores were lower in the GSH-CBT group at 4 months by 5.3 points (2.6 to 7.9, p<0.001. At 4 and 12 months there were also significantly higher proportions of participants achieving a 50% reduction in BDI-II in the GSH-CBT arm. The mean support was 2 sessions with 42.7 minutes for session 1, 41.4 minutes for session 2 and 40.2 minutes of support for session 3. Adverse effects/Harms: Significantly less deterioration in mood in GSH-CBT (2.0% compared to 9.8% in the TAU group for BDI-II category change. LIMITATIONS: Weaknesses: Our follow-up rate of 72.2% at 4 months is better than predicted but is poorer at 12 months (41.6%. In the GSH-CBT arm, around 50% of people attended 2 or fewer sessions. 22% failed to take up treatment. CONCLUSIONS: GSH-CBT is substantially more effective than TAU. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN13475030.
Hartley, S; Dagneaux, S; Londe, V; Liane, M-T; Aussert, F; Colas des Francs, C; Royant-Parola, S
To evaluate the effectiveness of a short (3 session) programme of group cognitive behavioural therapy (CBT) on insomnia, sleepiness and symptoms of anxiety and depression. Prospective observational study of group CBT with follow-up at 3 months. Participants were self-referred patients with chronic insomnia. Outcome measures were the insomnia severity scale (ISI), the Epworth sleepiness scale (ESS), depression (Pichot scale), and the number of anxiety symptoms. Participation in CBT was offered to 489 patients of whom 474 completed the programme and 154 were followed up at 3 months. Significant improvements in insomnia were seen: ISI score (17.74-14.27, P<0.0001) after CBT and at follow-up (13.78, P<0.0001). At the end of CBT, 76% (59/78) with initial severe insomnia and 52% (132/255) with moderate insomnia were improved, maintained at 3 months in 71% (15/21) with severe insomnia and 56% (50/90) with moderate insomnia. Depression and anxiety symptoms were significantly improved: mean depression symptoms (4.15-3.35, P<0.0001) and anxiety symptoms (4.52-3.95, P<0.0001), maintained at 3 months with mean depression symptoms (3.17, P<0.0001) and mean anxiety symptoms (3.62, P<0.0001). Sleepiness increased between baseline and the end of the group (6.67-7.24, P=0.015) followed by a reduction at 3 months (7.19-6.34 at 3 months, P=0.001). Initial ISI score but neither sex nor age were predictive of outcome. A short programme of CBT can improve sleep, depression and anxiety symptoms in self-referred patients suffering from chronic insomnia with good adherence and maximum benefit in patients with severe insomnia. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
Moodie, Sue; Ialongo, Nick; López, Patricia; Rosado, Jorge; García-Vargas, Gonzalo; Ronquillo, Dolores; Kordas, Katarzyna
A range of studies has been conducted on the detrimental effects of lead in mining and smelting communities. The neurocognitive and behavioural health effects of lead on children are well known. This research characterized the conjoint influence of lead exposure and home enriched environment on neurocognitive function and behaviour for first-grade children living in a Mexican lead smelter community. Structural equation models were used for this analysis with latent outcome variables, Cognition and Behaviour, constructed based on a battery of assessments administered to the first-grade children, their parents, and teachers. Structural equation modelling was used to describe complex relationships of exposure and health outcomes in a manner that permitted partition of both direct and indirect effects of the factors being measured. Home Environment (a latent variable constructed from information on mother's education and support of school work and extracurricular activities), and child blood lead concentration each had a main significant effect on cognition and behaviour. However, there were no statistically significant moderation relationships between lead and Home Environment on these latent outcomes. Home Environment had a significant indirect mediation effect between lead and both Cognition and Behaviour (p-valueeducation. Further research may be able to develop approaches to support families to make changes within their home and child rearing practices, or advocate for different approaches to support their child's behaviour to reduce the impact of lead exposure on children's cognitive and behavioural outcomes. Copyright © 2012 Elsevier Inc. All rights reserved.
Guajardo, Nicole R.; Snyder, Gregory; Petersen, Rachel
The present study included observational and self-report measures to examine associations among parental stress, parental behaviour, child behaviour, and children's theory of mind and emotion understanding. Eighty-three parents and their 3- to 5-year-old children participated. Parents completed measures of parental stress, parenting (laxness,…
Menting, Juliane; Nikolaus, Stephanie; Wiborg, Jan-Frederic; Bazelmans, Ellen; Goedendorp, Martine M; van Bon, Arianne C; van den Bergh, Joop P; Mol, Marc J T M; Tack, Cees J; Knoop, Hans
Fatigue is frequently reported by patients with type 1 diabetes mellitus. A recent study showed that 40 % of patients experienced severe fatigue that lasted for more than six months and was accompanied by substantial impairments in daily functioning. Currently, there is no effective treatment available for chronic fatigue in patients with type 1 diabetes. Cognitive behaviour therapy aimed at cognitions and behaviours that perpetuate fatigue is effective in reducing fatigue in other chronic diseases. Recent research showed that these cognitions and behaviours are also potential determinants of fatigue in type 1 diabetes. We designed Dia-Fit, a web-based cognitive behaviour therapy for severe and chronic fatigue in patients with type 1 diabetes. This patient-tailored intervention is aimed at reducing fatigue by changing cognitions and behaviours assumed to maintain fatigue. The efficacy of Dia-Fit will be investigated in this study. A randomised controlled trial will be conducted in 120 patients with type 1 diabetes who are chronically and severely fatigued. Patients will be randomised to a treatment or waiting list group. The treatment group will receive Dia-Fit, a blended care therapy consisting of up to eight internet modules and face-to-face sessions with a therapist during a five-month period. The treatment will be tailored to the fatigue-maintaining cognitions and behaviours that are relevant for the patient and are determined at baseline. The waiting list group will receive Dia-Fit after a waiting period of five months. The primary outcome measure is fatigue severity. Secondary outcome measures are functional impairment and glucose control determined by haemoglobin A1c and blood glucose variability. To our knowledge, this is the first study investigating the efficacy of a cognitive behavioural intervention for chronic fatigue in patients with type 1 diabetes. Dutch trial register NTR4312 (10 December 2013).
Cacace, Silvana; Plescia, Fulvio; Sardo, Pierangelo; Cannizzaro, Carla
Alcohol abuse is a substantial and growing health problem in Western societies. In the last years in vivo and in vitro studies have suggested that males and females display a different alcohol drinking behaviour, with swingeing differences not only in the propensity for alcohol use but also in the metabolic and behavioural consequences. In this study we investigated, in adult female rats, ethanol self-administration and preference pattern using a 3-bottle paradigm with water, 10% ethanol solution, and white wine (10%, v/v), along a four-week period. The influence of alcohol free-access on explorative behaviour in the open field (OF), and on spatial learning and reference memory in the Morris water maze (MWM) were also evaluated. Our results indicate that: (i) female rats show a higher preference for alcohol, in the first two weeks of the paradigm, displaying a higher consumption of 10% ethanol solution than white wine; in the last two weeks, they reduce their alcoholic preference, drinking the same moderate amounts of the two alcoholic beverages; (ii) at the fourth week of the free-access paradigm rats show a lower explorative behaviour in the open field and a worsening in spatial memory retention in the Morris water maze. In conclusion our data suggest that, despite the ability to self-regulate alcohol intake, female rats suffer from relevant impairments in spatial memory retention and cognitive flexibility, displaying a sexually dimorphic modification in the adaptive strategies. Copyright © 2012 Elsevier B.V. All rights reserved.
A single blind randomized controlled trial of cognitive behavioural therapy in a help-seeking population with an At Risk Mental State for psychosis: the Dutch Early Detection and Intervention Evaluation (EDIE-NL trial
Full Text Available Abstract Background Psychotic disorders are a serious mental health problem. Intervention before the onset of psychosis might result in delaying the onset, reducing the impact or even preventing the first episode of psychosis. This study explores the effectiveness of cognitive behavioural therapy (CBT in targeting cognitive biases that are involved in the formation of delusions in persons with an ultra-high risk for developing psychosis. A single blind randomised controlled trial compares CBT with treatment as usual in preventing or delaying the onset of psychosis. Method/design All help seeking patients aged 14 to 35 years referred to the mental health services in three regions in the Netherlands are pre-screened with the Prodromal Questionnaire during a period of two years. Patients with a score of 18 or more on the sub-clinical positive symptoms items (45 items in total will be assessed with the Comprehensive Assessment of At Risk Mental State (CAARMS. In a different pathway to care model all referrals from the mental health services in Amsterdam to the specialized psychosis clinic of the Academic Medical Centre in Amsterdam are also assessed with the CAARMS. The primary outcome is the transition rate to psychosis according to the CAARMS-criteria. Group differences will be analysed with chi-square tests and survival analyses. Discussion CBT is a highly tolerated treatment. The psycho-educational CBT approach may prove to be a successful strategy since most people with an At Risk Mental State (ARMS are distressed by odd disturbing experiences. Giving explanations for and normalising these experiences may reduce the arousal (distress and therefore may prevent people from developing a catastrophic delusional explanation for their odd experiences and thus prevent them from developing psychosis. Screening the entire help-seeking population referred to community mental health services with a two-stage strategy, as compared with traditional referral
Heléne Zetterström Dahlqvist
Full Text Available Background: Adolescents are a vulnerable group when it comes to the risk of developing depression. Preventing the onset of depressive episodes in this group is therefore a major public health priority. In the last decades, school-based cognitive-behavioural interventions have been a common primary prevention approach. However, evidence on what girls actually are allocated to such interventions when no researchers are involved is scarce. Objective: To explore how a selective cognitive-behavioural program (Depression In Swedish Adolescents developed to prevent depression in adolescents, was implemented in a naturalistic setting in schools in northern part of Sweden. The focus was on characteristics of participants allocated to the intervention. Design: Cross-sectional baseline data on depressive symptoms, school environment and socio-economic factors were collected in 2011 by means of questionnaires in schools in a municipality in the northern part of Sweden. Intervention participants were identified in a follow-up questionnaire in 2012. Students (n=288 included in the analyses were in the ages of 14–15. Results: Sixty-six girls and no boys were identified as intervention participants. They reported higher levels of depressive symptoms, lower personal relative affluence, more sexual harassment victimization and less peer support compared to female non-participants (n=222. Intervention participants were more likely to attend schools with a higher proportion of low parental education levels and a lower proportion of students graduating with a diploma. Conclusions: The developers of the intervention originally intended the program to be universal or selective, but it was implemented as targeted in these schools. It is important for school administrations to adhere to program fidelity when it comes to what students it is aimed for. Implications for effectivenss trials of cognitive-behavioural interventions in the school setting is discussed.
Engelborghs, Sebastiaan; Vloeberghs, Ellen; Maertens, Karen; Mariën, Peter; Somers, Nore; Symons, Anoek; Clement, Frederik; Ketels, Veerle; Saerens, Jos; Goeman, Johan; Pickut, Barbara A; Vandevivere, Johan; De Deyn, Peter P
Associations between low levels of folate and vitamin B12 and cognitive impairment in patients with dementia have been reported. Some studies revealed correlations between low levels of vitamin B12 and behavioural and psychological signs and symptoms of dementia (BPSD) in Alzheimer's disease (AD) patients. Given the lack of studies in frontotemporal dementia (FTD) and on folate and given the methodological shortcomings of former publications, we set up a prospective study. At inclusion, AD (n=152) and FTD (n=28) patients underwent a neuropsychological examination. Behaviour was assessed using a battery of behavioural assessment scales. Determination of serum vitamin B12 and red cell folate levels were performed within a time frame of two weeks of inclusion. In both patient groups, significantly negative correlations between levels of serum vitamin B12 and red cell folate and the degree of cognitive deterioration were found. No correlations with BPSD were found in the AD patient group. In FTD patients, levels of vitamin B12 were negatively correlated with both hallucinations (p=0.022) and diurnal rhythm disturbances (p=0.036). The observed negative correlations between levels of vitamin B12 and folate and cognitive impairment in both AD and FTD patients, raise the possibility of a non-specific etiological role. Although levels of vitamin B12 and folate did not correlate with BPSD in AD patients, negative correlations between serum vitamin B12 levels and BPSD in FTD patients were revealed. Decreased serum vitamin B12 levels may predispose FTD patients to develop hallucinations and diurnal rhythm disturbances. Copyright 2004 John Wiley & Sons, Ltd.