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Sample records for psychotherapy gmp therapeutic

  1. HELPFUL ASPECTS OF THE THERAPEUTIC RELATIONSHIP IN INTEGRATIVE PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    Karmen Urška Modic

    2015-12-01

    Full Text Available This article describes a qualitative study of helpful aspects of the therapeutic relationship in Integrative Psychotherapy. Participants of the study were sixteen clients who were in the process of Integrative Psychotherapy for at least a year. Participants were interviewed with the adapted version of the Change Interview (Elliott, 1999, which involves a semi-structured empathic exploration of the client's experience in therapy. The analysis of the clients’ experience of Integrative Psychotherapy revealed six categories of helpful aspects of therapeutic relationship: the therapist’s empathic attunement, the therapist’s acceptance, the match between the client and the therapist, feelings of trust and safety, feeling of connection, and experience of a new relational experience. Based on results of the research, we developed a model of the healing relationship in integrative psychotherapy. This model describes the interrelatedness of these six helpful aspects of the therapeutic relationship. The categories of empathic attunement and acceptance proved to be the most important categories relating to the therapist’s contribution to the healing therapeutic relationship. Clients described that the therapist’s empathic attunement and acceptance influenced the development of safety and trust, feelings of connection and promotion of new relational experiences. The results of this study are discussed in relation to the theories of Integrative Psychotherapy and research regarding the therapeutic relationship in psychotherapy.

  2. Therapy Processes and Outcomes of Psychological Interventions for Women Diagnosed with Gynecological Cancers: A Test of the Generic Process Model of Psychotherapy

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    Manne, Sharon; Winkel, Gary; Zaider, Talia; Rubin, Stephen; Hernandez, Enrique; Bergman, Cynthia

    2010-01-01

    Objective: Little attention has been paid to the role of nonspecific therapy processes in the efficacy of psychological interventions for individuals diagnosed with cancer. The goal of the current study was to examine the three constructs from the generic model of psychotherapy (GMP): therapeutic alliance, therapeutic realizations, and therapeutic…

  3. [Relationship experiences and therapeutic outcome in inpatient psychotherapy].

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    Sammet, Isa; Staats, Herrmann; Schauenburg, Henning

    2004-01-01

    Inpatient psychotherapy includes the patient's manifold contacts with different therapists, nurses and fellow patients. The present study investigated the association between these multiple relationships and therapy outcome. Pre-post measures of symptom load (Brief Symptom Inventory), interpersonal problems (IIP) and self-efficacy (SEB) were used to define three groups with positive (N=129), unchanged (N=44) or negative (N=40) outcome. These groups were compared 1) by their alliance with an individual therapist, their relationship to the therapeutic team, their experience of cohesion and climate concerning fellow patients in the ward (measured weekly by the "Stationserfahrungsbogen" SEB), and 2) by their differences in mean correlations between the courses of relationship experiences and symptom load. Cohesion and relationship to the therapeutic team were not associated with therapy outcome. Therapeutic alliance with the individual therapist and climate among fellow patients turned out to be moderate indicators of the therapeutic outcome. It is recommended to include these process parameters systematically into the process diagnostics of inpatient psychotherapy.

  4. The Psychotherapy Process with Adolescents: A First Pilot Study and Preliminary Comparisons between Different Therapeutic Modalities Using the "Adolescent Psychotherapy Q-Set"

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    Bychkova, Tetyana; Hillman, Saul; Midgley, Nick; Schneider, Celeste

    2011-01-01

    An innovative methodology is presented for describing the therapeutic processes involved in five types of adolescent treatments: psychoanalysis, psychodynamic psychotherapy, cognitive-behavioural therapy, mentalisation-based treatment and interpersonal psychotherapy. Using the "Adolescent Psychotherapy Q-Set" (APQ), 18 experienced clinicians…

  5. Synchrony in Psychotherapy: A Review and an Integrative Framework for the Therapeutic Alliance

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    Koole, Sander L.; Tschacher, Wolfgang

    2016-01-01

    During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship– or alliance– and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy. According to the model, the alliance is grounded in the coupling of patient and therapist’s brains. Because brains do not interact directly, movement synchrony may help to establish inter-brain coupling. Inter-brain coupling may provide patient and therapist with access to another’s internal states, which facilitates common understanding and emotional sharing. Over time, these interpersonal exchanges may improve patients’ emotion-regulatory capacities and related therapeutic outcomes. We discuss the empirical assessment of interpersonal synchrony and review preliminary research on synchrony in psychotherapy. Finally, we summarize our main conclusions and consider the broader implications of viewing psychotherapy as the product of two interacting brains. PMID:27378968

  6. Synchrony in Psychotherapy: A Review and an Integrative Framework for the Therapeutic Alliance.

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    Koole, Sander L; Tschacher, Wolfgang

    2016-01-01

    During psychotherapy, patient and therapist tend to spontaneously synchronize their vocal pitch, bodily movements, and even their physiological processes. In the present article, we consider how this pervasive phenomenon may shed new light on the therapeutic relationship- or alliance- and its role within psychotherapy. We first review clinical research on the alliance and the multidisciplinary area of interpersonal synchrony. We then integrate both literatures in the Interpersonal Synchrony (In-Sync) model of psychotherapy. According to the model, the alliance is grounded in the coupling of patient and therapist's brains. Because brains do not interact directly, movement synchrony may help to establish inter-brain coupling. Inter-brain coupling may provide patient and therapist with access to another's internal states, which facilitates common understanding and emotional sharing. Over time, these interpersonal exchanges may improve patients' emotion-regulatory capacities and related therapeutic outcomes. We discuss the empirical assessment of interpersonal synchrony and review preliminary research on synchrony in psychotherapy. Finally, we summarize our main conclusions and consider the broader implications of viewing psychotherapy as the product of two interacting brains.

  7. Financialization may affect the therapeutic relationship in psychotherapy

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    Marcin Jacek Jabłoński

    2015-04-01

    Full Text Available Background: The therapeutic relationship is one of the most important and independent predictors in psychotherapy. Therapeutic relationships take place in a social environment, which shapes the mentality of therapists. One of the important aspects of this environment is financialization, which is considered to be the most significant socioeconomic phenomenon characteristic of capitalism. The aim of this paper is to discuss the effect of financialization on the attitudes of psychotherapists and on the quality of care they provide. Discussion: The paper presents a theoretical analysis of the relationship between the primary constituents of the therapeutic relationship (i.e. trust, realness, individuality of approach, honesty, truth, ethics, the good of the patient and the phenomena characteristic of the process of financialization (such as replacement of relationship for transaction, distrust, advertisement, statistics, profitability, acceptance of a lie, relativism, consumptionism, perception of own benefits. Summary: Financialization can change the therapeutic relationship through indiscriminate introjection of financialization by the therapist. The primary cognitive and behavioural effect of this process is a shift in the proportions between the foundations of therapeutic relationship towards the foundations of financialization (as defined in this article. To the best of our knowledge, this is the first article presenting the correlation between financialization and psychotherapy.

  8. Psychotherapy role expectations and experiences - discrepancy and therapeutic alliance among patients with substance use disorders.

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    Frankl, My; Philips, Björn; Wennberg, Peter

    2014-12-01

    The main aim of the study was to examine how the discrepancy between role expectations prior to psychotherapy and experiences of ongoing psychotherapy related to therapeutic alliance. We hypothesized that a similarity between patient role expectations and experiences would be associated with a stronger alliance. The study also examined whether different dimensions of psychotherapy role expectations predicted retention in psychotherapy. A naturalistic study design was used with data collected prior to therapy and during the first 6 months of therapy. Patients with substance use disorders completed the Psychotherapy Expectation Questionnaire-short version (PEX-S) at the time of therapy assessment. A subsample of these patients (n = 41; n = 24 in individual therapy and n = 17 in group therapy) provided data from therapy including psychotherapy experiences (also measured with PEX-S) and therapeutic alliance, measured with Working Alliance Questionnaire-short version. For patients in group therapy, discrepancy between role expectations and experiences correlated negatively with alliance. Expectations prior to psychotherapy characterized by defensiveness correlated negatively with therapy retention. The finding that disconfirmation of patients' role expectations in group therapy were associated with weaker therapeutic alliance highlights the importance of discussing psychotherapy expectations at an early stage in treatment. Expectations characterized by defensiveness predicted worse retention in psychotherapy, which indicates that the PEX-S can be helpful in detecting patients at risk for dropout. In targeting a patient's role expectancies prior to treatment, possible discrepancies between patient and therapist are made visible and possible to examine. Clarifying the patient's role expectations and the therapist's rationale might be a first step towards establishing a strong working alliance. Surveying the patient's defensiveness tendencies at the beginning of therapy

  9. The future orientation of constructive memory: an evolutionary perspective on therapeutic hypnosis and brief psychotherapy.

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    Rossi, Ernest; Erickson-Klein, Roxanna; Rossi, Kathryn

    2008-04-01

    We explore a new distinction between the future, prospective memory system being investigated in current neuroscience and the past, retrospective memory system, which was the original theoretical foundation of therapeutic hypnosis, classical psychoanalysis, and psychotherapy. We then generalize a current evolutionary theory of sleep and dreaming, which focuses on the future, prospective memory system, to conceptualize a new evolutionary perspective on therapeutic hypnosis and brief psychotherapy. The implication of current neuroscience research is that activity-dependent gene expression and brain plasticity are the psychobiological basis of adaptive behavior, consciousness, and creativity in everyday life as well as psychotherapy. We summarize a case illustrating how this evolutionary perspective can be used to quickly resolve problems with past obstructive procrastination in school to facilitate current and future academic success.

  10. Therapeutic hypnosis, psychotherapy, and the digital humanities: the narratives and culturomics of hypnosis, 1800-2008.

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    Rossi, Ernest; Mortimer, Jane; Rossi, Kathryn

    2013-04-01

    Culturomics is a new scientific discipline of the digital humanities-the use of computer algorithms to search for meaning in large databases of text and media. This new digital discipline is used to explore 200 years of the history of hypnosis and psychotherapy in over five million digitized books from more than 40 university libraries around the world. It graphically compares the frequencies of English words about hypnosis, hypnotherapy, psychoanalysis, psychotherapy, and their founders from 1800 to 2008. This new perspective explore issues such as: Who were the major innovators in the history of therapeutic hypnosis, psychoanalysis, and psychotherapy? How well does this new digital approach to the humanities correspond to traditional histories of hypnosis and psychotherapy?

  11. Addressing clients' racism and racial prejudice in individual psychotherapy: Therapeutic considerations.

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    Bartoli, Eleonora; Pyati, Aarti

    2009-06-01

    Psychotherapists lack clear guidelines regarding how to address clients' racist and prejudicial comments in clinical work. The authors explore the contributions of multicultural, social justice, feminist, and ethical theories to the field of psychotherapy and apply these theories to 2 clinical vignettes in which clients made racially charged statements. These clinical examples highlight the importance of using racial, in addition to traditional, theories to decipher the clinical meanings of racial comments and dynamics in clinical work. The article provides therapeutic conceptualizations regarding how to address clients' racist and prejudicial comments in psychotherapy and elaborates on the complex meanings that might arise from engaging in racially charged discussions with clients depending on the racial composition of the therapeutic dyad. In addition to highlighting how social justice, multicultural, and feminist lenses are necessary to fully understand the meaning of clients' comments, the argument is made that addressing clients' racist and prejudicial comments is at once a clinical and a social justice issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  12. Examining the therapeutic relationship and confronting resistances in psychodynamic psychotherapy: a certified public accountant case.

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    Manetta, Christopher T; Gentile, Julie P; Gillig, Paulette Marie

    2011-05-01

    Psychodynamic psychotherapy is effective for a variety of mental health symptoms. This form of psychotherapy uses patient self reflection and self examination, as well as the therapeutic relationship between the patient and psychiatrist, to explore maladaptive coping strategies and relationship patterns of the patient. A thorough understanding of resistance and the core conflictual relationship theme afford the psychiatrist the ability to facilitate this work. In this article, the composite case illustrates some of the psychodynamic psychotherapy techniques that can be employed in a psychotherapy case. In this example, the case is about a certified public accountant that came to treatment because of an acute stressor that put her career goals at risk. An acute episode or event can bring to light chronic and ongoing symptoms, which have had a remitting and relapsing course, and leave the patient unable to compensate on his or her own.

  13. Integrative Psychotherapy ‘Revisited’

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    Marye O’Reilly-Knapp

    2017-02-01

    Full Text Available This article revisits aspects of the theory and methods of Integrative Psychotherapy as written and discussed by Richard G. Erskine, PhD and others. A case study demonstrates the use of Integrative Psychotherapy as the basis for therapeutic interventions that allow the client to interpret early experiences of relational failures, via a relationally based psychotherapy. Revisiting the theory and methods of Integrative Psychotherapy served to further validate the core of IP and its value as a cohesive and comprehensive psychotherapy.

  14. Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy.

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    Wagner, Mark T; Mithoefer, Michael C; Mithoefer, Ann T; MacAulay, Rebecca K; Jerome, Lisa; Yazar-Klosinski, Berra; Doblin, Rick

    2017-08-01

    A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of "openness" occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of change. The present study investigated whether heightened Openness and decreased Neuroticism served as a mechanism of change within a randomized trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD. The Clinician-Administered PTSD Scale (CAPS) Global Scores and NEO PI-R Personality Inventory (NEO) Openness and Neuroticism Scales served as outcome measures. Results indicated that changes in Openness but not Neuroticism played a moderating role in the relationship between reduced PTSD symptoms and MDMA treatment. Following MDMA-assisted psychotherapy, increased Openness and decreased Neuroticism when comparing baseline personality traits with long-term follow-up traits also were found. These preliminary findings suggest that the effect of MDMA-assisted psychotherapy extends beyond specific PTSD symptomatology and fundamentally alters personality structure, resulting in long-term persisting personality change. Results are discussed in terms of possible mechanisms of psychotherapeutic change.

  15. Relationships among alexithymia, therapeutic alliance, and psychotherapy outcome in major depressive disorder.

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    Quilty, Lena C; Taylor, Graeme J; McBride, Carolina; Bagby, R Michael

    2017-08-01

    Previous studies have found that alexithymia predicts process and outcome of psychodynamic psychotherapy across a range of psychiatric disorders. There is preliminary evidence that alexithymia may exert its effects on outcome through the therapist. Other studies have found that alexithymia does not influence outcome of cognitive-behavioral therapy (CBT). The aim of the current study was to investigate the capacity of alexithymia to predict therapist- and patient-rated therapeutic alliance and response to CBT and interpersonal psychotherapy (IPT) for major depressive disorder. A total of 75 adults with major depressive disorder were randomized to receive weekly sessions of manualized individual CBT or IPT for a period of 16 weeks. Pre-treatment alexithymia exhibited a positive direct effect on depression change, and a negative indirect effect on depression change via patient-rated alliance at week 13. There was no mediating role of therapist-rated alliance. Although these findings are preliminary, they suggest that pre-treatment alexithymia has meaningful links to psychotherapy process and outcome, and that nuanced analyses incorporating intervening variables are necessary to elucidate the nature of these links. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  16. Integrative Psychotherapy ‘Revisited’

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    Marye O’Reilly-Knapp

    2017-01-01

    This article revisits aspects of the theory and methods of Integrative Psychotherapy as written and discussed by Richard G. Erskine, PhD and others. A case study demonstrates the use of Integrative Psychotherapy as the basis for therapeutic interventions that allow the client to interpret early experiences of relational failures, via a relationally based psychotherapy. Revisiting the theory and methods of Integrative Psychotherapy served to further validate the core of IP and its value as a ...

  17. Integrative psychotherapy.

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    Kozarić-Kovacić, Dragica

    2008-09-01

    The main purposes of the article are to present the history of integration in psychotherapy, the reasons of the development integrative approaches, and the approaches to integration in psychotherapy. Three approaches to integration in psychotherapy exist: theoretical integration, theoretical eclecticism, and common factors in different psychotherapeutic trends. In integrative psychotherapy, the basic epistemology, theory, and clinical practice are based on the phenomenology, field theory, holism, dialogue, and co-creation of dialogue in the therapeutic relationship. The main criticism is that integrative psychotherapy suffers from confusion and many unresolved controversies. It is difficult to theoretically and methodologically define the clinically applied model that is based on such a different epistemological and theoretical presumptions. Integrative psychotherapy is a synthesis of humanistic psychotherapy, object relations theory, and psychoanalytical self psychology. It focuses on the dynamics and potentials of human relationships, with a goal of changing the relations and understanding internal and external resistances. The process of integrative psychotherapy is primarily focused on the developmental-relational model and co-creation of psychotherapeutic relationship as a single interactive event, which is not unilateral, but rather a joint endeavor by both the therapist and the patient/client. The need for a relationship is an important human need and represents a process of attunement that occurs as a response to the need for a relationship, a unique interpersonal contact between two people. If this need is not met, it manifests with the different feelings and various defenses. To meet this need, we need to have another person with whom we can establish a sensitive, attuned relationship. Thus, the therapist becomes this person who tries to supplement what the person did not receive. Neuroscience can be a source of integration through different therapies. We

  18. Book Review of Relational Patterns, Therapeutic Presence: Concepts and practice of Integrative Psychotherapy by Richard G. Erskine

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    Marye O'Reilly-Knapp

    2015-01-01

    Book Review of Relational Patterns, Therapeutic Presence: Concepts and practice of Integrative Psychotherapy by Richard G. Erskine. Published by Karnac Books: London, 2015 Paperback, Pages 366, ISBN 13: 978-1-78220-190-8

  19. Book Review of Relational Patterns, Therapeutic Presence: Concepts and practice of Integrative Psychotherapy by Richard G. Erskine

    Directory of Open Access Journals (Sweden)

    Marye O'Reilly-Knapp

    2015-12-01

    Full Text Available Book Review of Relational Patterns, Therapeutic Presence: Concepts and practice of Integrative Psychotherapy by Richard G. Erskine. Published by Karnac Books: London, 2015 Paperback, Pages 366, ISBN 13: 978-1-78220-190-8

  20. Mindful Processing in Psychotherapy - Facilitating Natural Healing Process within Attuned Therapeutic Relationship

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    Gregor Žvelc

    2012-06-01

    Full Text Available Mindfulness is non-judgmental, accepting awareness of what is going on in the present moment. The author proposes that mindfulness promotes natural healing of the organism, where the change comes spontaneously by acceptance and awareness of internal experience. Such process the author describes as ‘mindful processing’, because with mindful awareness disturbing experiences can be processed and integrated. The author’s interest in how mindfulness can be systematically applied in psychotherapy led to the development of the ‘mindful processing’ method, which invites the client to become aware of the moment-to-moment subjective experience. The method is used within attuned therapeutic relationship and thetheoretical framework of Integrative Psychotherapy. Mindful Processing is not goal-oriented and doesn’t strive to achieve a positive outcome. Such an outcome is a natural by-product of accepting awareness of both pleasant and unpleasant inner experience (body sensations, affects and/or thoughts. The method is illustrated with a transcript of a session with commentary.

  1. Therapeutic effect of increased openness: Investigating mechanism of action in MDMA-assisted psychotherapy

    OpenAIRE

    Wagner, Mark T; Mithoefer, Michael C; Mithoefer, Ann T; MacAulay, Rebecca K; Jerome, Lisa; Yazar-Klosinski, Berra; Doblin, Rick

    2017-01-01

    A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of ?openness? occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of c...

  2. The Therapeutic Alliance in Schema-Focused Therapy and Transference-Focused Psychotherapy for Borderline Personality Disorder

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    Spinhoven, Philip; Giesen-Bloo, Josephine; van Dyck, Richard; Kooiman, Kees; Arntz, Arnoud

    2007-01-01

    This study investigated the quality and development of the therapeutic alliance as a mediator of change in schema-focused therapy (SFT) and transference-focused psychotherapy (TFP) for borderline personality disorder. Seventy-eight patients were randomly allocated to 3 years of biweekly SFT or TFP. Scores of both therapists and patients for the…

  3. Technological progress and challenges towards cGMP manufacturing of human pluripotent stem cells based therapeutic products for allogeneic and autologous cell therapies.

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    Abbasalizadeh, Saeed; Baharvand, Hossein

    2013-12-01

    Recent technological advances in the generation, characterization, and bioprocessing of human pluripotent stem cells (hPSCs) have created new hope for their use as a source for production of cell-based therapeutic products. To date, a few clinical trials that have used therapeutic cells derived from hESCs have been approved by the Food and Drug Administration (FDA), but numerous new hPSC-based cell therapy products are under various stages of development in cell therapy-specialized companies and their future market is estimated to be very promising. However, the multitude of critical challenges regarding different aspects of hPSC-based therapeutic product manufacturing and their therapies have made progress for the introduction of new products and clinical applications very slow. These challenges include scientific, technological, clinical, policy, and financial aspects. The technological aspects of manufacturing hPSC-based therapeutic products for allogeneic and autologous cell therapies according to good manufacturing practice (cGMP) quality requirements is one of the most important challenging and emerging topics in the development of new hPSCs for clinical use. In this review, we describe main critical challenges and highlight a series of technological advances in all aspects of hPSC-based therapeutic product manufacturing including clinical grade cell line development, large-scale banking, upstream processing, downstream processing, and quality assessment of final cell therapeutic products that have brought hPSCs closer to clinical application and commercial cGMP manufacturing. © 2013.

  4. Ethical reflection and psychotherapy.

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    Vyskocilová, Jana; Prasko, Jan

    2013-01-01

    Theories of ethics and ethical reflection may be applied to both theory and practice in psychotherapy. There is a natural affinity between ethics and psychotherapy. Psychotherapy practice is concerned with human problems, dilemmas and emotions related to both one's own and other people's values. Ethics is also concerned with dilemmas in human thinking and with how these dilemmas reflect other individuals' values. Philosophical reflection itself is not a sufficient basis for the ethics of psychotherapy but it may aid in exploring attitudes related to psychotherapy, psychiatry and health care. PubMed, Web of Science and Scopus databases were searched for articles containing the keywords "psychotherapy", "ethics", "therapeutic relationship" and "supervision". The search was conducted by repeating the terms in various combinations without language or time restrictions. Also included were data from monographs cited in reviews. The resulting text is a review with conclusions concerning ethical aspects of psychotherapy. The ability to behave altruistically, sense for justice and reciprocity and mutual help are likely to be genetically determined as dispositions to be later developed by upbringing or to be formed or deformed by upbringing. Early experiences lead to formation of ethical attitudes which are internalized and then applied to both one's own and other people's behavior. Altruistic behavior has a strong impact on an individual's health and its acceptance may positively influence the pathophysiological mechanisms underlying numerous diseases. Ethical theory and reflection, however, may be applied to both theory and practice of psychotherapy in a conscious, targeted and thoughtful manner. In everyday practice, psychotherapists and organizations must necessarily deal with conscious conflicts between therapeutic possibilities, clients' wishes, their own as well as clients' ideas and the real world. Understanding one's own motives in therapy is one of the aims of a

  5. [Therapeutic goals and indications: psychotherapy patient's self-reports during diagnostic assessment].

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    Faller, H

    2000-07-01

    Although individual therapeutic goals are considered to be important factors motivating patients to engage in therapeutic work, they have gained little attention in empirical research. In the present study, patients were given a questionnaire containing 24 therapeutic goals which could be rated according to their subjective relevance on a 5-point scale. N = 152 patients (mean age 34.5 years, 59.2% female) who presented at a university psychotherapy outpatient department to attend a diagnostic interview participated in the study. "To solve my problems" and "to get relief from my complaints" were the goals that were rated as most important. Goals pertaining to mental health such as more contentness and calmness, self-assertion and insight scored high, too. Three rational scales were constructed: 1. insight, 2. sociability, and 3. self-assertion. These scales were correlated with both patients' causal attributions and therapy expectations in plausible ways. However, the general strength of intercorrelations point of the conception patients goals were not very succinct at the time of the intake interview. Indication groups regarding specific therapeutic measures did not differ with respect to therapy goals. Only the general decision whether to recommend a psychotherapeutic intervention or not seemed to be influenced by patients' therapeutic aims.

  6. [Inpatient psychotherapy].

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    Spitzer, C; Rullkötter, N; Dally, A

    2016-01-01

    In German-speaking countries inpatient psychotherapy plays a major role in the mental healthcare system. Due to its characteristic features, i. e. multiprofessionalism, multimodality and method integration, the inpatient approach represents a unique and independent type of psychotherapy. In order to be helpful, the manifold verbal and non-verbal methods need to be embedded into an overall treatment plan. Additionally, the therapeutic milieu of the hospital represents an important effective factor and its organization requires a more active construction. The indications for inpatient psychotherapy are not only based on the mental disorder but also on illness, setting and healthcare system-related criteria. In integrative concepts, the multiprofessional team is a key component with many functions. The effectiveness of psychotherapeutic hospital treatment has been proven by meta-analysis studies; however, 20-30% of patients do not benefit from inpatient psychotherapy and almost 13% drop-out prematurely.

  7. Predictive value of object relations for therapeutic alliance and outcome in psychotherapy for depression: an exploratory study.

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    Van, Henricus L; Hendriksen, Mariëlle; Schoevers, Robert A; Peen, Jaap; Abraham, Robert A; Dekker, Jack

    2008-09-01

    The concept of object relations has been shown to be relevant for the process and outcome of psychodynamic psychotherapies. However, little is known about its relevance for the psychotherapeutic treatment of depression. In this study, we explored the predictive value of object relational functioning (ORF) for the therapeutic alliance and outcome of short-term psychodynamic supportive psychotherapy in patients with mild to moderately severe depression. The ORF of 81 patients was rated by using the Developmental Profile. The overall maturity of ORF measured at baseline was higher in patients who showed a better treatment response. In multiple regression analysis, the adaptive level of individuation appeared to be specifically predictive of outcome. Patients with a recurrent depression showed less mature levels of ORF, lower adaptive levels and a higher score on the symbiotic level. No association was found between ORF and therapeutic alliance during treatment. In contrast to the single measure of alliance early in therapy, the growth of the alliance was related to outcome. The study indicated the relevance of ORF for depression and established that it is distinctive from the actual therapeutic alliance.

  8. Goethe's anxieties, depressive episodes and (self-)therapeutic strategies: a contribution to method integration in psychotherapy.

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    Holm-Hadulla, Rainer M

    2013-01-01

    In psychiatry and psychotherapy, abstract scientific principles need to be exemplified by narrative case reports to gain practical precision. Goethe was one of the most creative writers, productive scientists, and effective statesmen that ever lived. His descriptions of feelings, emotions, and mental states related to anxieties, depressive episodes, dysthymia, and creativity are unique in their phenomenological precision and richness. His life and work can thus serve as an excellent example enhancing our understanding of the relationship between anxiety, depression and creativity. Furthermore, he described (self-)therapeutic strategies that reinforce and refine modern views. Goethe's self-assessments in his works and letters, and the descriptions by others are analyzed under the perspective of current psychiatric classification. His therapeutic techniques and recommendations are compared with cognitive-behavioral, psychodynamic, and existential psychotherapy to amplify modern concepts of psychotherapy. From a scientific perspective, several distinctive depressive episodes can be diagnosed in Goethe's life. They were characterized by extended depressive moods, lack of drive, and loss of interest and self-esteem combined with social retreat. Goethe displayed diffuse and phobic anxieties as well as dysthymia. His (self-)therapeutic strategies were: (a) the systematic use of helping alliances, (b) behavioral techniques, (c) cognitive reflection on meanings and beliefs, (d) psychodynamic and psychoanalytic remembering, repeating, and working through, and (e) existential striving for self-actualization, social commitment, meaning, and creativity. In Goethe's life, creative incubation, illumination, and elaboration appear to have been associated with psychic instability and dysthymia, sometimes with depressive episodes in a clinical sense. On the one hand, his creative work was triggered by anxieties, dysthymia, and depressive moods. On the other hand, his creativity

  9. Informed consent in psychotherapy.

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    Beahrs, J O; Gutheil, T G

    2001-01-01

    The authors sought a rational approach to implementing informed consent within the practice of psychotherapy. The history of informed consent in psychotherapy was reviewed to define a common synthesis that maximizes the potential benefits and minimizes the potential hazards. The benefits of informed consent in psychotherapy include fostering a positive treatment outcome through enhancing patient autonomy, responsibility, and self-therapeutic activity; lessening the risks of regressive effects and therapist liability; and helping the practice of psychotherapy extend beyond particular parochialisms by providing checks and balances on therapist judgments. The hazards include the unpredictability of interactional outcomes and the possibilities of replacing positive expectancy with negative suggestion, replacing a therapeutic alliance with a legalistic stance, and misimplying that patients are passive recipients. Practical implementation of informed consent in psychotherapy must balance such tensions in service of optimal treatment. As a guiding principle, the authors recommend that psychotherapists convey to a prospective patient information that is material to the particular patient's decision. The level of detail needed in informed consent discussions varies directly with the cost and risks of the proposed treatment, the presence of viable alternatives and their relative grounding in scientific data and professional acceptance, and the presence of significant controversy. Unresolved is the question of how to address problematic or controversial psychotherapeutic trends that temporarily enjoy wide professional support.

  10. Specificity of the Cyclic GMP-Binding Activity and of a Cyclic GMP-Dependent Cyclic GMP Phosphodiesterase in Dictyostelium discoideum

    NARCIS (Netherlands)

    Haastert, Peter J.M. van; Walsum, Hans van; Meer, Rob C. van der; Bulgakov, Roman; Konijn, Theo M.

    1982-01-01

    The nucleotide specificity of the cyclic GMP-binding activity in a homogenate of Dictyostelium discoideum was determined by competition of cyclic GMP derivatives with [8-3H] cyclic GMP for the binding sites. The results indicate that cyclic GMP is bound to the binding proteins by hydrogen bonds at

  11. Tele-analysis: the use of media technology in psychotherapy and its impact on the therapeutic relationship.

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    Roesler, Christian

    2017-06-01

    A growing number of approaches in psychotherapy make use of internet- and other media-based interactions. This paper discusses the impact on the therapist-client relationship of using media technology and gives an overview of the current state of the debate. It is suggested that the technical conditions of internet-based interactions produce new forms of social relationships that differ significantly from face-to-face-interactions and that unconscious, nonverbal cues get lost. Research on the therapeutic interaction making use of 'discourse linguistic' methods is presented. The loss of nonverbal cues has implications for psychotherapy in general and especially for the treatment of patients who have difficulties relying on a secure therapeutic relationship. Emotional security in interactional relationships is transmitted to a much greater extent by nonverbal cues than by verbal content; psychoanalytic methods are specialized to refer to this level of interaction. Two alternative scenarios are discussed based on the psychoanalytic theories of Winnicott and Lacan: the risk of an illusionary, idealized image of the other and the possibility that cyberspace can be used for psychological development as a transitional space. © 2017, The Society of Analytical Psychology.

  12. Naikan psychotherapy for alcohol dependence syndrome

    OpenAIRE

    堀井, 茂男

    1987-01-01

    To evaluate the therapeutic effect of Naikan psychotherapy for alcohol dependence syndrome, a comparison was made between 31 patients who were treated with Naikan psychotherapy (Naikan group) and 34 patients who were not treated with Naikan psychotherapy (non-Naikan group) on the following profiles : general characteristics, social adaptation occuring 6 months to 2 years 6 months after discharge (short-term follow-up) and social adaptation occuring 3 years 5 months to 5 years 5 months after d...

  13. Is IPT Time-Limited Psychodynamic Psychotherapy?

    Science.gov (United States)

    Markowitz, John C.; Svartberg, Martin; Swartz, Holly A.

    1998-01-01

    Interpersonal psychotherapy (IPT) has sometimes but not always been considered a psychodynamic psychotherapy. The authors discuss similarities and differences between IPT and short-term psychodynamic psychotherapy (STPP), comparing eight aspects: 1) time limit, 2) medical model, 3) dual goals of solving interpersonal problems and syndromal remission, 4) interpersonal focus on the patient solving current life problems, 5) specific techniques, 6) termination, 7) therapeutic stance, and 8) empirical support. The authors then apply both approaches to a case example of depression. They conclude that despite overlaps and similarities, IPT is distinct from STPP.(The Journal of Psychotherapy Practice and Research 1998; 7:185–195) PMID:9631340

  14. The relationship between adult attachment style and therapeutic alliance in individual psychotherapy: a meta-analytic review.

    Science.gov (United States)

    Diener, Marc J; Monroe, Joel M

    2011-09-01

    The present study examined the relationship between adult attachment style and therapeutic alliance in individual psychotherapy. Search procedures yielded 17 independent samples (total N = 886, average n = 52, standard deviation = 24) for inclusion in the meta-analysis. Results indicated that greater attachment security was associated with stronger therapeutic alliances, whereas greater attachment insecurity was associated with weaker therapeutic alliances, with an overall weighted effect size of r = .17, p .10) with the exception of the source of alliance ratings; results indicated that patient-rated alliance demonstrated a significantly larger relationship with attachment compared with therapist-rated alliance (Qbetween = 3.95, df = 1, p = .047). Implications for clinical practice and future research are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved). (c) 2011 APA, all rights reserved.

  15. Promoting Efficacy Research on Functional Analytic Psychotherapy

    Science.gov (United States)

    Maitland, Daniel W. M.; Gaynor, Scott T.

    2012-01-01

    Functional Analytic Psychotherapy (FAP) is a form of therapy grounded in behavioral principles that utilizes therapist reactions to shape target behavior. Despite a growing literature base, there is a paucity of research to establish the efficacy of FAP. As a general approach to psychotherapy, and how the therapeutic relationship produces change,…

  16. The Grandmaternal Transference in Parent-Infant/Child Psychotherapy

    Science.gov (United States)

    Dugmore, Nicola

    2013-01-01

    The psychic significance of the figure of the grandmother in psychodynamic psychotherapy has received scant attention. This paper develops the concept of the "grandmaternal transference" in parent-infant psychotherapy and explores its identification, its possible functions and its therapeutic significance. The grandmaternal transference has…

  17. The Achievement of Therapeutic Objectives Scale: Interrater Reliability and Sensitivity to Change in Short-Term Dynamic Psychotherapy and Cognitive Therapy

    Science.gov (United States)

    Valen, Jakob; Ryum, Truls; Svartberg, Martin; Stiles, Tore C.; McCullough, Leigh

    2011-01-01

    This study examined interrater reliability and sensitivity to change of the Achievement of Therapeutic Objectives Scale (ATOS; McCullough, Larsen, et al., 2003) in short-term dynamic psychotherapy (STDP) and cognitive therapy (CT). The ATOS is a process scale originally developed to assess patients' achievements of treatment objectives in STDP,…

  18. Integrating Expressive Methods in a Relational-Psychotherapy

    Directory of Open Access Journals (Sweden)

    Richard G. Erskine

    2011-06-01

    Full Text Available Therapeutic Involvement is an integral part of all effective psychotherapy.This article is written to illustrate the concept of Therapeutic Involvement in working within a therapeutic relationship – within the transference -- and with active expressive and experiential methods to resolve traumatic experiences, relational disturbances and life shaping decisions.

  19. Bentuhua: culturing psychotherapy in postsocialist China.

    Science.gov (United States)

    Zhang, Li

    2014-06-01

    The breathless pace of market reform in China has brought about profound ruptures in socioeconomic structures and increased mental distress in the population. In this context, more middle-class urbanites are turning to nascent psychological counseling to grapple with their problems. This article examines how Chinese psychotherapists attempt to "culture" or indigenize (bentuhua) three imported psychotherapy models in order to fit their clients' expectations, desires, and sensibilities: the Satir family therapy, cognitive behavioral therapy, and sandplay therapy. It addresses three interrelated questions: What is the role of culture in adopting, translating, and recasting psychotherapy in contemporary China? How is cultural difference understood and mobilized by therapists in the therapeutic encounter? What kind of distinct therapeutic relationship is emerging in postsocialist China? Data presented here are drawn from my semistructured interviews and extensive participant observation at various counseling offices and psychotherapy workshops in the city of Kunming. My ethnographic account suggests that it is through constant dialog, translation, and re-articulation between multiple regimes of knowledge, cultural values, and social practices that a new form of talk therapy with "Chinese characteristics" is emerging. Finally, I reflect upon what this dialogic process of transformation means for psychotherapy as a form of globally circulating knowledge/practice.

  20. The early impact of therapeutic alliance in brief psychodynamic psychotherapy O impacto inicial da aliança terapêutica em psicoterapia psicodinâmica breve

    Directory of Open Access Journals (Sweden)

    José Alvaro Marques Marcolino

    2003-06-01

    Full Text Available INTRODCTION: Therapeutic alliance is a key component of the psychotherapeutic process. This study estimated the impact of the therapeutic alliance as measured by CALPAS-P in an individual brief psychodynamic psychotherapy program. METHODS: To study the impact of the therapeutic alliance patients in psychotherapy answered to the CALPAS-P at the first and third session and to the Self-report Questionnaire (SRQ-20, to the Beck Depression Inventory (BDI and to the Hamilton Anxiety Scale at the beginning and at the end of psychotherapy. RESULTS: The study of the impact of the therapeutic alliance in brief psychodynamic psychotherapy showed that higher TUI scores in the first session were significantly associated to the improvement on the BDI. Patients with best scores in the working alliance, measured at the third PWC session had also significant symptomatic changes. DISCUSSION: The study of the impact of the therapeutic alliance in brief psychotherapy indicated that patients who perceived that their therapists had the best capability to understand and to be involved in their issues had best results in reducing depressive symptoms and patients with higher capability to form the working alliance reached the best psychotherapy outcomes.INTRODUÇÃO: A aliança terapêutica é um conceito central do processo psicoterápico. Este estudo avaliou o impacto da aliança terapêutica em um programa de psicoterapia individual psicodinâmica breve. MÉTODO: Para o estudo do impacto da aliança, pacientes em psicoterapia responderam, ao início e ao final de cada psicoterapia, ao Questionário de auto-avaliação (SRQ-20, ao Inventário de Depressão de Beck (BDI e à Escala de Ansiedade de Hamilton. Responderam também a CALPAS-P ao término da primeira e da terceira sessão. RESULTADOS: Os resultados mostraram que os pacientes com uma pontuação mais alta da TUI na primeira sessão tiveram um impacto significativo sobre a mudança da sintomatologia medida

  1. Conceptual Frame for Selecting Individual Psychotherapy in the Schools

    Science.gov (United States)

    Hughes, Tammy L.; Theodore, Lea A.

    2009-01-01

    Psychotherapy is a service-delivery that is provided for both general and special education students. This manuscript examines a conceptual framework for determining when to employ psychotherapy within the school-based setting. Decisions are informed by the relationship between problem behavior, therapeutic techniques, short-term outcomes, and…

  2. Characteristics and experience of the patient in psychotherapy and the psychotherapy's effectiveness. A structural approach.

    Science.gov (United States)

    Szymańska, Agnieszka; Dobrenko, Kamila; Grzesiuk, Lidia

    2017-08-29

    The study concerns the relationship between three groups of variables presenting the patient's perspective: (1) "patient's characteristics" before psychotherapy, including "expectations of the therapy"; (2) "experience in the therapy", including the "psychotherapeutic relationship"; and (3) "assessment of the direct effectiveness of the psychotherapy". Data from the literature are the basis for predicting relationships between all of these variables. Measurement of the variables was conducted using a follow-up survey. The survey was sent to a total of 1,210 former patients of the Academic Center for Psychotherapy (AOP) in which the therapy is conducted mainly with the students and employees of the University of Warsaw. Responses were received from 276 people. 55% of the respondents were women and 45% were men, under 30 years of age. The analyses were performed using structural equations. Two models emerged from an analysis of the relationship between the three above-mentioned groups of variables. One concerns the relationship between (1) the patient's characteristics (2) the course of psychotherapy, in which -from the perspective of the patient - there is a good relationship with the psychotherapist and (3) psychotherapy is effective. The second model refers to (2) the patient's experience of poor psychotherapeutic relationship and (3) ineffective psychotherapy. Patient's expectations of the psychotherapy (especially "the expectation of support") proved to be important moderating variablesin the models-among the characteristics of the patient. The mathematical model also revealed strong correlation of variables measuring "the relationship with the psychotherapist" and "therapeutic interventions".

  3. Beyond the Therapeutic Hour: An Exploratory Pilot Study of Using Technology to Enhance Alliance and Engagement within Face-to-Face Psychotherapy

    Science.gov (United States)

    Richards, Penelope; Simpson, Susan

    2015-01-01

    In this paper we introduce and investigate the capacity for a novel, technologically advanced system (goACT) to enhance face-to-face psychotherapy. Specifically, we explore the capacity for goACT to enhance therapeutic alliance (TA) and engagement, and reduce distress. Using a mixed-methods, multiple-baseline design we present the first study to…

  4. Predicting Psychotherapy Dropouts: A Multilevel Approach.

    Science.gov (United States)

    Kegel, Alexander F; Flückiger, Christoph

    2015-01-01

    The role of therapeutic processes in predicting premature termination of psychotherapy has been a particular focus of recent research. The purpose of this study was to contrast outpatients who completed therapy and those who dropped out with respect to their self-reported in-session experiences of self-esteem, mastery, clarification and the therapeutic alliance. The 296 patients with mixed disorders were treated with an integrative form of cognitive-behavioural therapy without pre-determined time limit (M = 20.2 sessions). Multilevel analyses indicated that patients who did not completetreatment reported, on average, lower levels of self-esteem, mastery and clarification and lower ratings of their therapeutic alliance in treatment in contrast to patients who completed therapy. Patient-reported change in self-esteem experiences over the course of treatment turned out to be the strongest predictor of dropout from psychotherapy or successful completion. When dropout occurred before the average treatment length was reached, patients reported fewer clarifying experiences as early as the first session and their ratings of the therapeutic alliance were characterized by an absence of positive development. Both of these aspects seem to be involved in patients' decisions to leave treatment early. The findings underscore the importance of the therapeutic process in understanding the mechanisms behind treatment dropout. Analyses data from 296 patients at a private outpatient clinic in a routine practice setting (CBT). Completer/dropout definition: presence or absence of measurement battery at post-assessment. Focuses on change in therapy processes by investigating post-session reports. Finds that positive changes in self-esteem experiences is the most robust predictor of dropout, followed by ratings of clarification experiences and the global alliance. In line with recent dropout research, these process indicators might help to detect therapeutic situations that are

  5. INTEGRATIVE PSYCHOTHERAPY AND MINDFULNESS: THE CASE OF SARA

    Directory of Open Access Journals (Sweden)

    Mihael Černetič

    2015-02-01

    Full Text Available The article explores the relationship between Integrative Psychotherapy and mindfulness on a theoretical as well as practical level. Although mindfulness is not an explicit constituent of Integrative Psychotherapy, the two are arguably a natural fit. Mindfulness has the potential to enhance internal and external contact, a central concept in Integrative Psychotherapy, as well as strengthen a client’s Adult ego state. This article presents a case study whereby Integrative Psychotherapy is analysed from the perspective of mindfulness. Within the course of therapy, parallels were observed between the client's increased mindfulness, improved internal and external contact, strengthened Adult ego state, mastery of introjections, as well as diminished feelings of guilt, improved mood, self care and ability to engage in appropriate separation and individuation. These gains support the conclusion that Integrative Psychotherapy and mindfulness are inherently related and that explicit incorporation of mindfulness may enhance the therapeutic process of Integrative Psychotherapy.

  6. [Body-centered psychotherapy IKP (Institute of Body-Centered Psychotherapy): holistic psychotherapy].

    Science.gov (United States)

    Maurer-Groeli, Y

    1996-03-01

    Body centered Psychotherapy IKP is treated in this article under the aspect of a holistic approach. First the theory and the system of science are summarised and shown as to which amount they are changing concerning knowledge of details and wholeness. It is pointed out that the actual paradigma "to the depth" has to be completed by that of "wideness". The way of holistic-multirelational thinking, stating a diagnosis and doing therapy is demonstrated along a case study going on at the background of a therapeutic encounter-relationship which is emotionally warm (Gestalt-approach).

  7. Cellular signaling with nitric oxide and cyclic GMP

    Directory of Open Access Journals (Sweden)

    F. Murad

    1999-11-01

    Full Text Available During the past two decades, nitric oxide signaling has been one of the most rapidly growing areas in biology. This simple free radical gas can regulate an ever growing list of biological processes. In most instances nitric oxide mediates its biological effects by activating guanylyl cyclase and increasing cyclic GMP synthesis. However, the identification of effects of nitric oxide that are independent of cyclic GMP is also growing at a rapid rate. The effects of nitric oxide can mediate important physiological regulatory events in cell regulation, cell-cell communication and signaling. Nitric oxide can function as an intracellular messenger, neurotransmitter and hormone. However, as with any messenger molecule, there can be too much or too little of the substance and pathological events ensue. Methods to regulate either nitric oxide formation, metabolism or function have been used therapeutically for more than a century as with nitroglycerin therapy. Current and future research should permit the development of an expanded therapeutic armamentarium for the physician to manage effectively a number of important disorders. These expectations have undoubtedly fueled the vast research interests in this simple molecule.

  8. Optogenetic Manipulation of Cyclic Di-GMP (c-di-GMP) Levels Reveals the Role of c-di-GMP in Regulating Aerotaxis Receptor Activity in Azospirillum brasilense.

    Science.gov (United States)

    O'Neal, Lindsey; Ryu, Min-Hyung; Gomelsky, Mark; Alexandre, Gladys

    2017-09-15

    Bacterial chemotaxis receptors provide the sensory inputs that inform the direction of navigation in changing environments. Recently, we described the bacterial second messenger cyclic di-GMP (c-di-GMP) as a novel regulator of a subclass of chemotaxis receptors. In Azospirillum brasilense , c-di-GMP binds to a chemotaxis receptor, Tlp1, and modulates its signaling function during aerotaxis. Here, we further characterize the role of c-di-GMP in aerotaxis using a novel dichromatic optogenetic system engineered for manipulating intracellular c-di-GMP levels in real time. This system comprises a red/near-infrared-light-regulated diguanylate cyclase and a blue-light-regulated c-di-GMP phosphodiesterase. It allows the generation of transient changes in intracellular c-di-GMP concentrations within seconds of irradiation with appropriate light, which is compatible with the time scale of chemotaxis signaling. We provide experimental evidence that binding of c-di-GMP to the Tlp1 receptor activates its signaling function during aerotaxis, which supports the role of transient changes in c-di-GMP levels as a means of adjusting the response of A. brasilense to oxygen gradients. We also show that intracellular c-di-GMP levels in A. brasilense change with carbon metabolism. Our data support a model whereby c-di-GMP functions to imprint chemotaxis receptors with a record of recent metabolic experience, to adjust their contribution to the signaling output, thus allowing the cells to continually fine-tune chemotaxis sensory perception to their metabolic state. IMPORTANCE Motile bacteria use chemotaxis to change swimming direction in response to changes in environmental conditions. Chemotaxis receptors sense environmental signals and relay sensory information to the chemotaxis machinery, which ultimately controls the swimming pattern of cells. In bacteria studied to date, differential methylation has been known as a mechanism to control the activity of chemotaxis receptors and

  9. Partial reconstitution of photoreceptor cGMP phosphodiesterase characteristics in cGMP phosphodiesterase-5.

    Science.gov (United States)

    Granovsky, A E; Artemyev, N O

    2001-06-15

    Photoreceptor cGMP phosphodiesterases (PDE6) are uniquely qualified to serve as effector enzymes in the vertebrate visual transduction cascade. In the dark-adapted photoreceptors, the activity of PDE6 is blocked via tight association with the inhibitory gamma-subunits (Pgamma). The Pgamma block is removed in the light-activated PDE6 by the visual G protein, transducin. Transducin-activated PDE6 exhibits an exceptionally high catalytic rate of cGMP hydrolysis ensuring high signal amplification. To identify the structural determinants for the inhibitory interaction with Pgamma and the remarkable cGMP hydrolytic ability, we sought to reproduce the PDE6 characteristics by mutagenesis of PDE5, a related cyclic GMP-specific, cGMP-binding PDE. PDE5 is insensitive to Pgamma and has a more than 100-fold lower k(cat) for cGMP hydrolysis. Our mutational analysis of chimeric PDE5/PDE6alpha' enzymes revealed that the inhibitory interaction of cone PDE6 catalytic subunits (PDE6alpha') with Pgamma is mediated primarily by three hydrophobic residues at the entry to the catalytic pocket, Met(758), Phe(777), and Phe(781). The maximal catalytic rate of PDE5 was enhanced by at least 10-fold with substitutions of PDE6alpha'-specific glycine residues for the corresponding PDE5 alanine residues, Ala(608) and Ala(612). The Gly residues are adjacent to the highly conserved metal binding motif His-Asn-X-X-His, which is essential for cGMP hydrolysis. Our results suggest that the unique Gly residues allow the PDE6 metal binding site to adopt a more favorable conformation for cGMP hydrolysis.

  10. The role of identification in dynamic psychiatry and psychotherapy.

    Science.gov (United States)

    Corradi, Richard B

    2011-01-01

    Identification-a psychic process in which a person takes on characteristics of another-is a concept important to the understanding of human nature. It plays an important role in how our personalities develop, in our ability to deal with life's stresses, and in how we interact with other people. Knowledge of its manifestations is essential to dynamic psychiatry and to its applications in psychotherapy. This article defines identification and reviews its role in development and as a defense. It discusses its role in the psychopathology of disorders commonly encountered in psychotherapy practice-depression and anxiety states reactive to losses in life, and borderline states. Clinical vignettes illustrate how identification functions in these conditions, and also how identifications reveal themselves in the transference and are utilized in psychotherapy. A teaching vignette illustrates how important it is that residents learning the art of psychotherapy appreciate the therapeutic potential of identification. The article maintains that, although it often goes unrecognized, identification with the therapist is one of the most effective therapeutic devices in the transference.

  11. Does psychotherapy work with school-aged youth? A meta-analytic examination of moderator variables that influence therapeutic outcomes.

    Science.gov (United States)

    Fedewa, Alicia L; Ahn, Soyeon; Reese, Robert J; Suarez, Marietta M; Macquoid, Ahjane; Davis, Matthew C; Prout, H Thompson

    2016-06-01

    The present study is a quantitative synthesis of the available literature to investigate the efficacy of psychotherapy for children's mental health outcomes. In particular, this study focuses on potential moderating variables-study design, treatment, client, and therapist characteristics-that may influence therapeutic outcomes for youth but have not been thoroughly accounted for in prior meta-analytic studies. An electronic search of relevant databases resulted in 190 unpublished and published studies that met criteria for inclusion in the analysis. Effect sizes differed by study design. Pre-post-test designs resulted in absolute magnitudes of treatment effects ranging from |-0.02| to |-0.76| while treatment versus control group comparison designs resulted in absolute magnitudes of treatment effects ranging from |-0.14| to |-2.39|. Changes in youth outcomes larger than 20% were found, irrespective of study design, for outcomes focused on psychosomatization (29% reduction), school attendance (25% increase), and stress (48% reduction). The magnitude of changes after psychotherapy ranged from 6% (externalizing problems) to 48% (stress). Several moderator variables significantly influenced psychotherapy treatment effect sizes, including frequency and length of treatment as well as treatment format. However, results did not support the superiority of a single type of intervention for most outcomes. Implications for therapy with school-aged youth and future research are discussed. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  12. Psychotherapy Outcome Research: Issues and Questions.

    Science.gov (United States)

    Shean, Glenn

    2016-03-01

    Emphasis on identifying evidence-based therapies (EBTs) has increased markedly. Lists of EBTs are the rationale for recommendations for how psychotherapy provider training programs should be evaluated, professional competence assessed, and licensure and reimbursement policies structured. There are however methodological concerns that limit the external validity of EBTs. Among the most salient is the circularity inherent in randomized control trials (RCTs) of psychotherapy that constrains the manner in which the psychological problems are defined, psychotherapy can be practiced, and change evaluated. RCT studies favor therapies that focus of specific symptoms and can be described in a manual, administered reliably across patients, completed in relatively few sessions, and involve short-term evaluations of outcome. The epistemological assumptions of a natural science approach to psychotherapy research limit how studies are conducted and assessed in ways that that advantage symptom-focused approaches and disadvantage those approaches that seek to bring broad recovery-based changes. Research methods that are not limited to RCTs and include methodology to minimize the effects of "therapist allegiance" are necessary for valid evaluations of therapeutic approaches that seek to facilitate changes that are broader than symptom reduction. Recent proposals to adopt policies that dictate training, credentialing, and reimbursement based on lists of EBTs unduly limit how psychotherapy can be conceptualized and practiced, and are not in the best interests of the profession or of individuals seeking psychotherapy services.

  13. 3',5'-Cyclic diguanylic acid (c-di-GMP) inhibits basal and growth factor-stimulated human colon cancer cell proliferation

    International Nuclear Information System (INIS)

    Karaolis, David K.R.; Cheng, Kunrong; Lipsky, Michael; Elnabawi, Ahmed; Catalano, Jennifer; Hyodo, Mamoru; Hayakawa, Yoshihiro; Raufman, Jean-Pierre

    2005-01-01

    The novel cyclic dinucleotide, 3',5'-cyclic diguanylic acid, cGpGp (c-di-GMP), is a naturally occurring small molecule that regulates important signaling mechanisms in prokaryotes. Recently, we showed that c-di-GMP has 'drug-like' properties and that c-di-GMP treatment might be a useful antimicrobial approach to attenuate the virulence and pathogenesis of Staphylococcus aureus and prevent or treat infection. In the present communication, we report that c-di-GMP (≤50 μM) has striking properties regarding inhibition of cancer cell proliferation in vitro. c-di-GMP inhibits both basal and growth factor (acetylcholine and epidermal growth factor)-induced cell proliferation of human colon cancer (H508) cells. Toxicity studies revealed that exposure of normal rat kidney cells and human neuroblastoma cells to c-di-GMP at biologically relevant doses showed no lethal cytotoxicity. Cyclic dinucleotides, such as c-di-GMP, represent an attractive and novel 'drug-platform technology' that can be used not only to develop new antimicrobial agents, but also to develop novel therapeutic agents to prevent or treat cancer

  14. Therapeutic self-disclosure in integrative psychotherapy: When is this a clinical error?

    Science.gov (United States)

    Ziv-Beiman, Sharon; Shahar, Golan

    2016-09-01

    Ascending to prominence in virtually all forms of psychotherapy, therapist self-disclosure (TSD) has recently been identified as a primarily integrative intervention (Ziv-Beiman, 2013). In the present article, we discuss various instances in which using TSD in integrative psychotherapy might constitute a clinical error. First, we briefly review extant theory and empirical research on TSD, followed by our preferred version of integrative psychotherapy (i.e., a version of Wachtel's Cyclical Psychodynamics [Wachtel, 1977, 1997, 2014]), which we title cognitive existential psychodynamics. Next, we provide and discuss three examples in which implementing TSD constitutes a clinical error. In essence, we submit that using TSD constitutes an error when patients, constrained by their representational structures (object relations), experience the subjectivity of the other as impinging, and thus propels them to "react" instead of "emerge." (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. LA PSICOTERAPIA: ¿OFICIO SIN CIENCIA Y CIENCIA SIN OFICIO? / PSYCHOTHERAPY: PRACTICE WITHOUT SCIENCE OR SCIENCE WITHOUT PRACTICE?

    Directory of Open Access Journals (Sweden)

    MARIANE KRAUSE

    2011-06-01

    Full Text Available This article analyzes the persistent divorce between clinicalpractice and research in psychotherapy, examining theunderlying reasons in both contexts. With respect to clinicalpractice, the article discusses the characteristics of theteaching of psychotherapy, therapeutic schools as communities,and the fear of research. In the case of research in psychotherapy,the article analyzes research results regarding theeffectiveness of psychotherapy, the therapeutic alliance, andthe elements of the process. Finally, it presents some of thetransformations in research and its dissemination, which cancontribute to closing the gap between practice and science inpsychotherapy.

  16. Can the use of humor in psychotherapy be taught?

    Science.gov (United States)

    Valentine, Lisa; Gabbard, Glen O

    2014-02-01

    Despite an abundance of literature detailing the potential benefits of the use of humor in therapy, humor is rarely taught to psychiatric residents as a method of therapeutic intervention. This communication attempts to explain how current understanding of attachment theory and neuroscience may assist psychiatric faculty and supervisors in their teaching of humorous therapeutic interventions. This article reviews and synthesizes the extant literature on the use of humor, as well as recent work in neuroscience, attachment theory, and mentalization. Humor can be conceptualized as an instance of implicit relational knowing and may thus contribute significantly to the therapeutic action of psychotherapy as a subcategory of "moments of meeting" between therapist and patient. However, training residents to use humor in psychotherapy requires more individualized attention in supervision and classroom seminars. Factors such as individual proclivities for humorous repartee, mentalizing capacity, and an authentic interest in adding humor to the session may be necessary to incorporate spontaneous humor into one's technique. New findings from the areas of attachment theory, neuroscience, and right-hemisphere learning are providing potential opportunities for sophisticated teaching of the use of humor in psychotherapy.

  17. Crystal Structure of PKG I:cGMP Complex Reveals a cGMP-Mediated Dimeric Interface that Facilitates cGMP-Induced Activation

    KAUST Repository

    Kim, Jeong Joo

    2016-04-09

    Cyclic guanosine monophosphate (cGMP)-dependent protein kinase (PKG) is a key regulator of smooth muscle and vascular tone and represents an important drug target for treating hypertensive diseases and erectile dysfunction. Despite its importance, its activation mechanism is not fully understood. To understand the activation mechanism, we determined a 2.5 Å crystal structure of the PKG I regulatory (R) domain bound with cGMP, which represents the activated state. Although we used a monomeric domain for crystallization, the structure reveals that two R domains form a symmetric dimer where the cGMP bound at high-affinity pockets provide critical dimeric contacts. Small-angle X-ray scattering and mutagenesis support this dimer model, suggesting that the dimer interface modulates kinase activation. Finally, structural comparison with the homologous cyclic AMP-dependent protein kinase reveals that PKG is drastically different from protein kinase A in its active conformation, suggesting a novel activation mechanism for PKG. Kim et al. obtain the first crystal structure of the PKG I R domain bound with cGMP representing its activated state. It reveals a symmetric R dimer where cGMP molecules provide dimeric contacts. This R-R interaction prevents the high-affinity inhibitory interaction between R-C domain and sustains activation. © 2016 Elsevier Ltd.

  18. Crystal Structure of PKG I:cGMP Complex Reveals a cGMP-Mediated Dimeric Interface that Facilitates cGMP-Induced Activation

    KAUST Repository

    Kim, Jeong  Joo; Lorenz, Robin; Arold, Stefan T.; Reger, Albert  S.; Sankaran, Banumathi; Casteel, Darren  E.; Herberg, Friedrich  W.; Kim, Choel

    2016-01-01

    Cyclic guanosine monophosphate (cGMP)-dependent protein kinase (PKG) is a key regulator of smooth muscle and vascular tone and represents an important drug target for treating hypertensive diseases and erectile dysfunction. Despite its importance, its activation mechanism is not fully understood. To understand the activation mechanism, we determined a 2.5 Å crystal structure of the PKG I regulatory (R) domain bound with cGMP, which represents the activated state. Although we used a monomeric domain for crystallization, the structure reveals that two R domains form a symmetric dimer where the cGMP bound at high-affinity pockets provide critical dimeric contacts. Small-angle X-ray scattering and mutagenesis support this dimer model, suggesting that the dimer interface modulates kinase activation. Finally, structural comparison with the homologous cyclic AMP-dependent protein kinase reveals that PKG is drastically different from protein kinase A in its active conformation, suggesting a novel activation mechanism for PKG. Kim et al. obtain the first crystal structure of the PKG I R domain bound with cGMP representing its activated state. It reveals a symmetric R dimer where cGMP molecules provide dimeric contacts. This R-R interaction prevents the high-affinity inhibitory interaction between R-C domain and sustains activation. © 2016 Elsevier Ltd.

  19. Spiritual Psychotherapy for Adolescents with Conduct Disorder: Designing and Piloting a Therapeutic Package.

    Science.gov (United States)

    Mohammadi, Mohammad Reza; Salmanian, Maryam; Ghobari-Bonab, Bagher; Bolhari, Jafar

    2017-10-01

    Objective: Spiritual psychotherapy has been conceptualized in the context of love and belief as principles of existence. Spiritual psychotherapy can provide an opportunity to design programs to treat conduct disorder. The aim of this study was to introduce the Spiritual Psychotherapy Package for Adolescents with Conduct Disorder and execute it as a pilot study. Method: The intervention is a manual-guided program conducted over 14 group sessions, using the perspectives of object relations and attachment approach. It was executed for a group of eight adolescent boys with conduct disorder (mean age: 17.01 years) at Tehran reformatory. The Aggression Questionnaire and the Attachment to God Inventory were completed pre- and post-intervention. Results: There were no significant differences in outcome measures from pre- to post- intervention. Cohen's dav was applied to estimate the measure of the effect size in this study. Cohen's dav measures of avoidance and anxious attachment to God showed acceptable effect sizes. However, Cohen's dav measure of verbal aggression indicated a small effect size. Conclusion: We found evidence indicating acceptability of spiritual psychotherapy among adolescents with conduct disorder in attachment to God.

  20. Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol.

    Science.gov (United States)

    Pepping, Christopher A; Lyons, Anthony; Morris, Eric M J

    2018-03-01

    Lesbian, gay, bisexual, and transgender (LGBT) people seek psychotherapy at high rates, and the importance of providing culturally appropriate and LGBT-affirmative psychotherapy has been widely acknowledged. Despite this, remarkably little research has investigated the effects of therapist training in LGBT-affirmative psychotherapy. Here we examined the effectiveness of a training protocol for LGBT-affirmative psychotherapy with 96 mental health professionals, ranging in therapeutic experience from LGBT clients following the training. Therapists also displayed reductions in homo-negativity and trans-negativity. Therapists' characteristics did not influence the extent to which they benefited from training. Specifically, years of clinical experience, therapist religiosity, and therapist psychological flexibility were unrelated to changes in attitudes, knowledge, and skills. The results of this study clearly suggest that providing training in LGBT-affirmative psychotherapy can enhance therapists' attitudes, knowledge, and skills. Of particular importance is that the benefits associated with such training appear to hold regardless of therapists' characteristics. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  1. Synchrony in Dyadic Psychotherapy Sessions

    Science.gov (United States)

    Ramseyer, Fabian; Tschacher, Wolfgang

    Synchrony is a multi-faceted concept used in diverse domains such as physics, biology, and the social sciences. This chapter reviews some of the evidence of nonverbal synchrony in human communication, with a main focus on the role of synchrony in the psychotherapeutic setting. Nonverbal synchrony describes coordinated behavior of patient and therapist. Its association with empathy, rapport and the therapeutic relationship has been pointed out repeatedly, yet close evaluation of empirical studies suggests that the evidence remains inconclusive. Particularly in naturalistic studies, research with quantitative measures of synchrony is still lacking. We introduce a new empirical approach for the study of synchrony in psychotherapies under field conditions: Motion Energy Analysis (MEA). This is a video-based algorithm that quantifies the amount of movement in freely definable regions of interest. Our statistical analysis detects synchrony on a global level, irrespective of the specific body parts moving. Synchrony thus defined can be considered as a general measure of movement coordination between interacting individuals. Data from a sequence of N = 21 therapy sessions taken from one psychotherapy dyad shows a high positive relationship between synchrony and the therapeutic bond. Nonverbal synchrony can thus be considered a promising concept for research on the therapeutic alliance. Further areas of application are discussed.

  2. ASEAN GMP and pharmaceutical industries in Indonesia.

    Science.gov (United States)

    Soesilo, S; Sitorus, U

    1995-01-01

    Indonesia was appointed by the ASEAN Technical Cooperation in Pharmaceutical as a focal point and to coordinate the development of practical guidelines for the implementation of GMP. The ASEAN GMP Guidelines were endorsed by the ASEAN Technical Cooperation in Pharmaceutical in 1988, which among others required separation of Beta-Lactam dedicated facilities and three degrees of cleanliness for production areas. As it was realised that drug manufacturers in developing countries need more detailed guidelines to be able to implement the GMP, an Operational Manual for GMP was also prepared for providing examples of SOPs lay-outs, documentation etc. It was agreed by the technical cooperation group to leave the implementation of GMP to each member country. However, the ASEAN Manual for Inspection of GMP was drafted and endorsed by the group and training of ASEAN Drug Inspectors was organized to support the implementation. The ASEAN GMP is being implemented in Indonesia through a five-year, stepwise implementation plan, starting in 1989.

  3. USING BACH FLOWER IN HOLISTIC PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    Vagner Ferreira do Nascimento

    2017-05-01

    Full Text Available This is a narrative review from scientific literature that aimed to describe concepts and approaches for indications of the therapeutic use of Bach flower remedies in holistic psychotherapy. The review was developed in February 2016 from books, official documents and articles indexed in Lilacs and Scielo databases. Bach flower remedies is a therapeutic method that aims to restore the balance of human being, restoring its vital energy through holistic care. Because the flower essences act on psychic and emotional dimension of individual, when employed in holistic psychotherapy can provide greater autonomy, self-care and effectiveness compared to other alternative methods. The literature indicated that flower essence therapy is a safe practice and can be used in a complementary to health care, but should be performed by qualified professionals. It has also shown to be a promising and important area for nursing professional, but it still requires greater investment in research in the area to support the practice.

  4. The brassinosteroid receptor BRI1 can generate cGMP enabling cGMP-dependent downstream signaling

    KAUST Repository

    Wheeler, Janet I.

    2017-05-08

    The brassinosteroid receptor BRASSINOSTEROID INSENSITIVE 1 (BRI1) is a member of the leucine rich repeat receptor like kinase family. The intracellular kinase domain of BRI1 is an active kinase and also encapsulates a guanylate cyclase catalytic centre. Using liquid chromatography tandem mass spectrometry, we confirmed that the recombinant cytoplasmic domain of BRI1 generates pmol amounts of cGMP per μg protein with a preference for magnesium over manganese as a co-factor. Importantly, a functional BRI1 kinase is essential for optimal cGMP generation. Therefore, the guanylate cyclase activity of BRI1 is modulated by the kinase while cGMP, the product of the guanylate cyclase, in turn inhibits BRI1 kinase activity. Furthermore, we show using Arabidopsis root cell cultures that cGMP rapidly potentiates phosphorylation of the downstream substrate BRASSINOSTEROID SIGNALING KINASE 1 (BSK1). Taken together, our results suggest that cGMP acts as a modulator that enhances downstream signaling while dampening signal generation from the receptor. This article is protected by copyright. All rights reserved.

  5. The brassinosteroid receptor BRI1 can generate cGMP enabling cGMP-dependent downstream signaling

    KAUST Repository

    Wheeler, Janet I.; Wong, Aloysius Tze; Marondedze, Claudius; Groen, Arnoud J.; Kwezi, Lusisizwe; Freihat, Lubna; Vyas, Jignesh; Raji, Misjudeen; Irving, Helen R.; Gehring, Christoph A

    2017-01-01

    The brassinosteroid receptor BRASSINOSTEROID INSENSITIVE 1 (BRI1) is a member of the leucine rich repeat receptor like kinase family. The intracellular kinase domain of BRI1 is an active kinase and also encapsulates a guanylate cyclase catalytic centre. Using liquid chromatography tandem mass spectrometry, we confirmed that the recombinant cytoplasmic domain of BRI1 generates pmol amounts of cGMP per μg protein with a preference for magnesium over manganese as a co-factor. Importantly, a functional BRI1 kinase is essential for optimal cGMP generation. Therefore, the guanylate cyclase activity of BRI1 is modulated by the kinase while cGMP, the product of the guanylate cyclase, in turn inhibits BRI1 kinase activity. Furthermore, we show using Arabidopsis root cell cultures that cGMP rapidly potentiates phosphorylation of the downstream substrate BRASSINOSTEROID SIGNALING KINASE 1 (BSK1). Taken together, our results suggest that cGMP acts as a modulator that enhances downstream signaling while dampening signal generation from the receptor. This article is protected by copyright. All rights reserved.

  6. Efficacy and enlightenment: LSD psychotherapy and the Drug Amendments of 1962.

    Science.gov (United States)

    Oram, Matthew

    2014-04-01

    The decline in therapeutic research with lysergic acid diethylamide (LSD) in the United States over the course of the 1960s has commonly been attributed to the growing controversy surrounding its recreational use. However, research difficulties played an equal role in LSD psychotherapy's demise, as they frustrated researchers' efforts to clearly establish the efficacy of treatment. Once the Kefauver Harris Drug Amendments of 1962 introduced the requirement that proof of efficacy be established through controlled clinical trials before a drug could be approved to market, the value of clinical research became increasingly dependent on the scientific rigor of the trial's design. LSD psychotherapy's complex method of utilizing drug effects to catalyze a psychological treatment clashed with the controlled trial methodology on both theoretical and practical levels, making proof of efficacy difficult to obtain. Through a close examination of clinical trials performed after 1962, this article explores how the new emphasis on controlled clinical trials frustrated the progress of LSD psychotherapy research by focusing researchers' attention on trial design to the detriment of their therapeutic method. This analysis provides a new perspective on the death of LSD psychotherapy and explores the implications of the Drug Amendments of 1962.

  7. Transient Kinetics of a cGMP-dependent cGMP-specific Phosphodiesterase from Dictyostelium discoideum

    NARCIS (Netherlands)

    Haastert, Peter J.M. van; Lookeren Campagne, Michiel M. van

    1984-01-01

    Chemotactic stimulation of Dictyostelium discoideum cells induces a fast transient increase of cGMP levels which reach a peak at 10 s. Prestimulation levels are recovered in ~30 s, which is achieved mainly by the action of a guanosine 3',5'-monophosphate cGMP-specific phosphodiesterase. This enzyme

  8. Current Perspective on MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder

    OpenAIRE

    Thal, Sascha B.; Lommen, Miriam J.J.

    2018-01-01

    The present paper discusses the current literature with regard to substance-assisted psychotherapy with Methylenedioxymethamphetamine (MDMA) for posttraumatic stress disorder (PTSD). The aim of the paper is to give a comprehensive overview of the development from MDMA’s early application in psychotherapy to its present and future role in the treatment of PTSD. It is further attempted to increase the attention for MDMA’s therapeutic potential by providing a thorough depiction of the scientific...

  9. Psychosis and the dynamics of the psychotherapy process

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Harder, Susanne

    2007-01-01

    The role of psychotherapy in the treatment of psychoses remains controversial but there is improving acceptance that an understanding of the dynamics of the psychological processes involved in treatment and in the disorder itself may be important. Psychosis is understood as a detachment of the 's......The role of psychotherapy in the treatment of psychoses remains controversial but there is improving acceptance that an understanding of the dynamics of the psychological processes involved in treatment and in the disorder itself may be important. Psychosis is understood as a detachment......-subjective process, a therapeutic relationship is disrupted and a therapeutic alliance is not assured. Therapists have to pay particular attention to the empathic aspects of the interaction as they attempt to integrate affects to restore meaning to the inner life of the patient. The psychodynamics of this process...

  10. Identification and Characterization of c-di-GMP Metabolic Enzymes of Leptospira interrogans and c-di-GMP Fluctuations After Thermal Shift and Infection

    Directory of Open Access Journals (Sweden)

    Guohui Xiao

    2018-04-01

    Full Text Available Leptospirosis is a widespread zoonotic disease caused by pathogenic Leptospira species. The most common species, Leptospira interrogans, can transfer from contaminated soil or water to the human body. It is able to survive these changing environments through sensing and responding to the changes of environmental cues. Cyclic di-GMP (c-di-GMP is a special secondary messenger in bacteria, which can respond to the environment and regulate diverse bacterial behaviors. The c-di-GMP levels in bacterial cells are regulated by diguanylatecyclases (DGC and phosphodiesterases (PDE, which are responsible for synthesizing or hydrolyzing c-di-GMP, respectively. In this study, distribution and phylogenetics of c-di-GMP metabolic genes among 15 leptospiral species were systematically analyzed. Bioinformatics analysis revealed that leptospiral species contain a multitude of c-di-GMP metabolic genes. C-di-GMP metabolic genes in L. interrogans strain Lai 56601 were further analyzed and the results showed that these genes have very diverse expression patterns. Most of the putative DGCs and PDEs possess enzymatic activities, as determined by riboswitch-based dual-fluorescence reporters in vivo or HPLC in vitro. Furtherer analysis of subdomains from GGDEF-containing proteins revealed that the ability to synthesize c-di-GMP was lost when the GAF domain from LA1483 and PAS domain from LA2932 were deleted, while deletion of the REC domain from LA2528 did not affect its ability to synthesize c-di-GMP. Furthermore, high temperatures generally resulted in low c-di-GMP concentrations in L. interrogans and most of the c-di-GMP metabolic genes exhibited differential temperature regulation. Also, infection of murine J774A.1 cells resulted in reduced c-di-GMP levels, while no significant change of c-di-GMP metabolic genes on transcriptional levels were observed during the infection of J774A.1 cells. Taken together, these results provide a basic platform for future studies of c-di-GMP

  11. The therapeutic factor inventory-8: Using item response theory to create a brief scale for continuous process monitoring for group psychotherapy.

    Science.gov (United States)

    Tasca, Giorgio A; Cabrera, Christine; Kristjansson, Elizabeth; MacNair-Semands, Rebecca; Joyce, Anthony S; Ogrodniczuk, John S

    2016-01-01

    We tested a very brief version of the 23-item Therapeutic Factors Inventory-Short Form (TFI-S), and describe the use of Item Response Theory (IRT) for the purpose of developing short and reliable scales for group psychotherapy. Group therapy patients (N = 578) completed the TFI-S on one occasion, and their data were used for the IRT analysis. Of those, 304 completed the TFI-S and other measures on more than one occasion to assess sensitivity to change, concurrent, and predictive validity of the brief version. Results suggest that the new TFI-8 is a brief, reliable, and valid measure of a higher-order group therapeutic factor. The TFI-8 may be used for continuous process measurement and feedback to improve the functioning of therapy groups.

  12. Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers.

    Science.gov (United States)

    Myers Virtue, Shannon; Manne, Sharon L; Darabos, Kathleen; Heckman, Carolyn J; Ozga, Melissa; Kissane, David; Rubin, Stephen; Rosenblum, Norman

    2015-09-01

    The aim of this study was to describe emotion episodes during early and late psychotherapy sessions among women newly diagnosed with gynecological cancer and to examine whether the total number of emotion episodes during early and later sessions was associated with baseline psychological distress, dispositional emotion expressivity, and patient-rated therapeutic progress. The study utilized data from an ongoing study examining the efficacy of two psychotherapy interventions, a coping and communication intervention and a supportive counseling intervention, for women diagnosed with gynecological cancer. Emotion episode coding was completed for the first and sixth psychotherapy sessions for each patient randomized to receive psychotherapy (N = 173). Patients completed baseline survey measures of psychological distress and dispositional emotional expressivity and post-session ratings of therapeutic progress. The average number of emotion episodes was 7.4 in the first session and 5.2 episodes in the sixth session. In both sessions, the majority of emotion episodes contained only negative emotions and focused on a cancer-related topic. A higher number of emotion episodes in the first session was associated with higher psychological distress reported in the baseline survey (p = 0.02). A higher number of emotion episodes in the sixth session was associated with a higher number of emotion episodes in the first session (p psychotherapy among women diagnosed with gynecological cancer. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Interventions and Strategies in Counseling and Psychotherapy.

    Science.gov (United States)

    Watts, Richard E., Ed.; Carlson, Jon, Ed.

    This book acknowledges the contributions of Alfred Adler and illustrates the many ways in which Adlerian ideas underpin and influence contemporary therapeutic approaches. It brings together today's leading thinkers to address the practice of counseling and psychotherapy from a social-cognitive perspective. Contributors apply the basic ideas of…

  14. [The Application of Body-Mind-Spirit Integrated Psychotherapy in Nursing Practice].

    Science.gov (United States)

    Hsiao, Fei-Hsiu

    2017-06-01

    Body-mind-spirit integrated psychotherapy reflects the core value of nursing by emphasizing the inseparable concept of body, mind, and spirit and caring for the holistic needs of the patient. Body-mind-spirit integrated psychotherapy was developed based on Western psychotherapy (positive psychology and forgiveness therapy), traditional Chinese medicine, and the Eastern philosophies of Buddhism, Taoism, and Confucianism. The present paper describes the holistic concepts that underpin this therapeutic approach. Physical health is sustained through proper nutrition, physical relaxation, and harmonized breathing; psychological well-being helps maintain inner peace and harmony in interpersonal relationships; and spiritual well-being helps develop an optimistic and meaningful life. We report on several cases in which body-mind-spirit integrated psychotherapy was applied to the care of clients with depressive disorders and of breast cancer survivors and their partners as well as the related efficacy of this intervention in these cases. Finally, we discuss the potential for culturally-enriched psychotherapy to help clients transform illness suffering into life-growth experiences.

  15. Emerging and continuing trends in psychotherapy: views from an editor's eye.

    Science.gov (United States)

    Gelso, Charles J

    2011-06-01

    It is proposed that six major trends in psychotherapy have continued or emerged over the course of the author's editorship of Psychotherapy, the past seven years. These trends are (a) the increasing integration of techniques and the therapeutic relationship; (b) increasing focus on theoretical integration; (c) increasing efforts at research-practice integration; (d) increases in more specific, integrative reviews; (e) integration of biological, neuroscience understandings; and (f) integration of diversity and cultural considerations into psychotherapy. Each trend is described and its impact on the field is discussed. Cautions about each trend are also noted. The six trends are discussed in the context of integration.

  16. Interpersonal psychotherapy (IPT) in major depressive disorder.

    Science.gov (United States)

    Brakemeier, Eva-Lotta; Frase, Lukas

    2012-11-01

    In this article, we will introduce interpersonal psychotherapy as an effective short-term treatment strategy in major depression. In IPT, a reciprocal relationship between interpersonal problems and depressive symptoms is regarded as important in the onset and as a maintaining factor of depressive disorders. Therefore, interpersonal problems are the main therapeutic targets of this approach. Four interpersonal problem areas are defined, which include interpersonal role disputes, role transitions, complicated bereavement, and interpersonal deficits. Patients are helped to break the interactions between depressive symptoms and their individual interpersonal difficulties. The goals are to achieve a reduction in depressive symptoms and an improvement in interpersonal functioning through improved communication, expression of affect, and proactive engagement with the current interpersonal network. The efficacy of this focused and structured psychotherapy in the treatment of acute unipolar major depressive disorder is summarized. This article outlines the background of interpersonal psychotherapy, the process of therapy, efficacy, and the expansion of the evidence base to different subgroups of depressed patients.

  17. Replication of Child-Parent Psychotherapy in Community Settings: Models for Training

    Science.gov (United States)

    Van Horn, Patricia; Osofsky, Joy D.; Henderson, Dorothy; Korfmacher, Jon; Thomas, Kandace; Lieberman, Alicia F.

    2012-01-01

    Child-parent psychotherapy (CPP), an evidence-based dyadic therapeutic intervention for very young children exposed to trauma, is becoming the go-to therapeutic intervention for infant mental health practitioners. Although CPP has been shown to be effective for rebuilding the parent-child relationship, reducing trauma symptoms, and reducing…

  18. Teaching psychotherapy by use of brief typescripts.

    Science.gov (United States)

    Kepecs, J G

    1977-07-01

    A typescript of a 10-minute segment of a taped therapeutic interview, coded by using a modification of the Gottshalk scales, quite clearly demonstrates the patient's current focal conflict. Recognition of the current focal conflict is thus taught, and this is used as an organizing principle in supervision of psychotherapy.

  19. Is Exposure Necessary? A Randomized Clinical Trial of Interpersonal Psychotherapy for PTSD

    Science.gov (United States)

    Markowitz, John C.; Petkova, Eva; Neria, Yuval; Van Meter, Page E.; Zhao, Yihong; Hembree, Elizabeth; Lovell, Karina; Biyanova, Tatyana; Marshall, Randall D.

    2015-01-01

    Background Exposure to trauma reminders has been considered imperative in psychotherapy for posttraumatic stress disorder (PTSD). No treatment benefits all patients, however. We tested Interpersonal Psychotherapy, which has demonstrated antidepressant efficacy and showed promise in pilot PTSD research, as a non-exposure-based, non-cognitive behavioral PTSD treatment. Methods A randomized, fourteen-week trial compared Interpersonal Psychotherapy; Prolonged Exposure, an exposure-based exemplar; and Relaxation Therapy, an active control psychotherapy. Subjects were 110 unmedicated patients having DSM-IV chronic PTSD and Clinician-Administered PTSD Scale (CAPS) score >50. Randomization stratified for comorbid major depression. We hypothesized Interpersonal Psychotherapy would be no more than minimally inferior (CAPS difference 30% CAPS improvement) were: Interpersonal Psychotherapy 63%, Prolonged Exposure 47%, Relaxation Therapy 38% (n.s.). Interpersonal psychotherapy and Prolonged Exposure CAPS outcome differed by 5.5 points (n.s.); the null hypothesis of more than minimal Interpersonal Psychotherapy inferiority was rejected (p=0.035). Patients with comorbid major depression dropped out from Prolonged Exposure nine times more than non-depressed Prolonged Exposure patients. Interpersonal Psychotherapy and Prolonged Exposure improved quality of life and social functioning more than Relaxation Therapy. Conclusions This first controlled study of individual Interpersonal Psychotherapy for PTSD demonstrated non-inferiority to the “gold standard” PTSD treatment. Interpersonal Psychotherapy had (non-significantly) lower attrition and higher response rates than Prolonged Exposure. Contradicting a widespread clinical belief, PTSD treatment may not require cognitive behavioral exposure to trauma reminders. Moreover, as differential therapeutics, patients with comorbid major depression may fare better in Interpersonal Psychotherapy than Prolonged Exposure. PMID:25677355

  20. [New Paradigms? Current Trends within National and International Psychotherapy Research].

    Science.gov (United States)

    Strauß, Bernhard

    2015-09-01

    This article is devoted to the question which paradigms currently determine psychotherapy and psychotherapy research, and if there are indicators of paradigm changes in this field. The question of the efficacy and effectiveness (including the effectiveness of a transfer of psychotherapeutic knowledge to service) is specifically focussed as well as the question of the central therapeutic factors and the significance of the person of the therapist. It is argued that there are really some signals of a paradigm switch, with a turn away from controlled outcome research, representing only a minor part of patients in need of psychotherapy, towards a more specific process oriented research, also considering differential effects of the therapist. The most prominent indicator of a paradigm change is reflected by an increasing influence of patient oriented psychotherapy research which - consequently - should also be supported by the insurances as well as the funding organisations. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Client attachment security predicts alliance in a randomized controlled trial of two psychotherapies for bulimia nervosa

    DEFF Research Database (Denmark)

    Folke, Sofie; Daniel, Sarah Ingrid Franksdatter; Poulsen, Stig Bernt

    2016-01-01

    interaction whereby dismissing clients would develop weaker alliances in psychoanalytic psychotherapy and preoccupied clients would develop weaker alliances in cognitive-behavioral therapy. Conclusions: As the first study to examine client attachment and therapeutic alliance using observer-based instruments......Objective: This study investigated the relation between clients’ attachment patterns and the therapeutic alliance in two psychotherapies for bulimia nervosa. Method: Data derive from a randomized clinical trial comparing cognitive-behavioral therapy and psychoanalytic psychotherapy for bulimia...... to be a significant (p = .007) predictor of alliance levels at the three measured time points, with clients higher on attachment security developing stronger alliances with their therapists in both treatments as compared to clients higher on attachment insecurity. No evidence was found to support a hypothesized...

  2. [New Developments in Video Games for Psychotherapy].

    Science.gov (United States)

    Brezinka, Veronika

    2016-01-01

    A literature survey on new developments in the area of video games and psychotherapy of children and adolescents was conducted. Despite the omnipresence of computers and the internet, development of therapeutic games seems rather slow. The video game Treasure Hunt was introduced in 2008 to support treatment of children with internalizing and externalizing disorders. Camp Cope-A-Lot was developed for treatment of anxious children, whereas the self-help game SPARX is directed at depressed adolescents. Rage-Control is a biofeedback game for children with anger problems. The game Zoo U aims to assess and train social skills of primary school children. Ricky and the Spider for young children with obsessive compulsive disorder is meant to support the cognitive-behavioural treatment of these patients. Clash- Back is a French game for adolescents with externalizing problems. Possible reasons for the relatively slow development of therapeutic games are the high methodological demands concerning an evaluation as well as the high costs of game development. Nonetheless, computers and the internet are bound to influence psychotherapy with children and adolescents in the long run.

  3. C-di-GMP regulates antimicrobial peptide resistance in Pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    Chua, Song Lin; Tan, Sean Yang-Yi; Rybtke, Morten Theil

    2013-01-01

    Bis-(3'-5')-cyclic dimeric GMP (c-di-GMP) is an intracellular second messenger which controls the life styles of many bacteria. A high intracellular level of c-di-GMP induces a biofilm lifestyle, whereas a low intracellular level of c-di-GMP stimulates dispersal of biofilms and promotes...... a planktonic lifestyle. Here, we used expression of different reporters to show that planktonic cells (PCells), biofilm cells (BCells) and cells dispersed from biofilms (DCells) had distinct intracellular c-di-GMP levels. Proteomics analysis showed that the low intracellular c-di-GMP level of DCells induced...... the expression of proteins required for the virulence and development of antimicrobial peptide resistance in P. aeruginosa. In accordance, P. aeruginosa cells with low c-di-GMP levels were found to be more resistant to colistin than P. aeruginosa cells with high c-di-GMP levels. This contradicts the current...

  4. Advanced Psychotherapy Training: Psychotherapy Scholars' Track, and the Apprenticeship Model

    Science.gov (United States)

    Feinstein, Robert E.; Yager, Joel

    2013-01-01

    Background/Objective: Guided by ACGME's requirements, psychiatric residency training in psychotherapy currently focuses on teaching school-specific forms of psychotherapy (i.e., cognitive-behavioral, supportive, and psychodynamic psychotherapy). On the basis of a literature review of common factors affecting psychotherapy outcomes and…

  5. Psychodrama: group psychotherapy through role playing.

    Science.gov (United States)

    Kipper, D A

    1992-10-01

    The theory and the therapeutic procedure of classical psychodrama are described along with brief illustrations. Classical psychodrama and sociodrama stemmed from role theory, enactments, "tele," the reciprocity of choices, and the theory of spontaneity-robopathy and creativity. The discussion focuses on key concepts such as the therapeutic team, the structure of the session, transference and reality, countertransference, the here-and-now and the encounter, the group-as-a-whole, resistance and difficult clients, and affect and cognition. Also described are the neoclassical approaches of psychodrama, action methods, and clinical role playing, and the significance of the concept of behavioral simulation in group psychotherapy.

  6. Metaphor in Psychotherapy

    Directory of Open Access Journals (Sweden)

    Nergis Lapsekili

    2014-08-01

    Full Text Available A metaphor is a figüre of speech in which a word or phrase is applied to an object or an action that it does not literally denote in order to imply a resemblence. Metaphor has been an essential feature of human communication from time immemorial: fairy tales, parables, provers are all examples of metaphor. Human beings regularly use metaphors to communicate with each other, so it is reasonable to expect this figüre of speech to have a place in the process of communication we call psychotherapy. As well as carefully planned and developed majör metaphoric stories to achieve specific therapeutic goals, anectodes, similes, analogies, parables and other brief metaphorical statements, relationship metaphors, tasks with metaphorical meanings, objects can be used with their metaphorican meaning in psychotherapy. Stories when properly constucted and told, are usually more interesting than straight expositions of the points one wishws to make. Of course it is possible to construct boring stories or to tell good stories in a boring way. But well thought out and well narrated stories, told in the right context ca inspire people to undertake tasks and think about things they would not have considered before. Stories, because they deal indirectly with issues and have meanings that are in varying degrees veiled, tend to be less threatening and confronting than direct statements. Listeners are free to take stories at their face value, if their implicit meaning is unacceptable to them at the time. And this result will not damage the existing therapist-client rapport. Suggesting solutions to problems, helping people to recognize themselves, increasing motivation, reframing and redefining problems, reminding subjects of their own resources are all the benefits of clinical uses of metaphors in psychotherapy. In this text, the description of metaphor and usage of metaphor in psychotherapy will be reviewed with samples. [JCBPR 2014; 3(2.000: 116-125

  7. RELATIONAL GROUP PSYCHOTHERAPY: THE HEALING OF STRESS, NEGLECT AND TRAUMA

    Directory of Open Access Journals (Sweden)

    Richard G. Erskine

    2010-01-01

    Full Text Available This article is the Keynote Address given at the 4th International Integrative Psychotherapy Association Conference, April 17, 2009. In speaking to the conference theme of “Acute Trauma, Cumulative Neglect, and Chronic Stress” the article describes some of the principles of Relational Group Psychotherapy. The theory of methods is based on the concept that the healing of trauma, neglect and stress occurs through a contactful therapeutic relationship. Relational group psychotherapy draws from several developments in group therapy, particularly the cybernetic feedback and other-centered models. It emphasizes the healing power of relationships between group members and the importance of phenomenological inquiry, affective attunement, identification, and relational-needs. The leader’s tasks are to stimulate the flow of contactful dialogue and to teach about human needs and healthy relationships.

  8. Narrative research in psychotherapy: a critical review.

    Science.gov (United States)

    Avdi, Evrinomy; Georgaca, Eugenie

    2007-09-01

    This paper is a review of studies which utilise the notion of narrative to analyse psychotherapy. Its purpose is to systematically present this diverse field of research, to highlight common themes and divergences between different strands and to further the development and integration of narrative research in psychotherapy. The paper reviews studies which employ an applied textual analysis of narratives produced in the context of psychotherapy. Criteria for inclusion of studies are, firstly, the analysis of therapeutic and therapy-related texts and, secondly, the adoption of a narrative psychological perspective. The studies were examined on the basis of the notion of narrative they employ and the aspects of client narratives they focus on, and were grouped accordingly in the review. The majority of the studies reviewed assume a constructivist approach to narrative, adopt a representational view of language, focus primarily on client micro-narratives and relate to cognitive-constructivist and process-experiential psychotherapeutic approaches. A smaller group of studies assume a social constructionist approach to narrative and a functional view of language, focus on micro-narratives, highlight the interactional and wider social aspects of narrative and relate to postmodern trends in psychotherapy. The range of conceptualisations of narrative in the studies reviewed, from a representational psychological view to a constructionist social view, reflects tensions within narrative psychology itself. Moreover, two trends can be discerned in the field reviewed, narrative analysis of therapy, which draws from narrative theory and utilises the analytic approaches of narrative research to study psychotherapy, and analyses of narrative in therapy, which study client narratives using non-narrative qualitative methods. Finally, the paper highlights the need for integration of this diverse field of research and urges for the development of narrative studies of psychotherapy

  9. Psychological Mindedness and Psychotherapy Process in Short-Term Group Therapy.

    Science.gov (United States)

    Kealy, David; Sierra-Hernandez, Carlos A; Piper, William E; Joyce, Anthony S; Weideman, Rene; Ogrodniczuk, John S

    2017-01-01

    Psychological mindedness is regarded as an important patient characteristic that can influence the course of psychotherapy. The purpose of this study was to investigate the relationship between patients' capacity for psychological mindedness and aspects of the group psychotherapy process as experienced and rated by therapists and other group members. Participants were 110 patients who completed two forms of short-term group therapy for the treatment of complicated grief. Psychological mindedness was assessed at pretreatment by external raters using a video-interview procedure. Group therapists assessed patients' therapeutic work and therapeutic alliance following each group therapy session. Therapists and other group members rated each patient's expression of emotion and provided appraisals of their cohesion to each patient throughout the course of therapy. Psychological mindedness was found to be positively associated with several group process variables as rated by the therapist and other group members.

  10. Good Manufacturing Practices (GMP) manufacturing of advanced therapy medicinal products: a novel tailored model for optimizing performance and estimating costs.

    Science.gov (United States)

    Abou-El-Enein, Mohamed; Römhild, Andy; Kaiser, Daniel; Beier, Carola; Bauer, Gerhard; Volk, Hans-Dieter; Reinke, Petra

    2013-03-01

    Advanced therapy medicinal products (ATMP) have gained considerable attention in academia due to their therapeutic potential. Good Manufacturing Practice (GMP) principles ensure the quality and sterility of manufacturing these products. We developed a model for estimating the manufacturing costs of cell therapy products and optimizing the performance of academic GMP-facilities. The "Clean-Room Technology Assessment Technique" (CTAT) was tested prospectively in the GMP facility of BCRT, Berlin, Germany, then retrospectively in the GMP facility of the University of California-Davis, California, USA. CTAT is a two-level model: level one identifies operational (core) processes and measures their fixed costs; level two identifies production (supporting) processes and measures their variable costs. The model comprises several tools to measure and optimize performance of these processes. Manufacturing costs were itemized using adjusted micro-costing system. CTAT identified GMP activities with strong correlation to the manufacturing process of cell-based products. Building best practice standards allowed for performance improvement and elimination of human errors. The model also demonstrated the unidirectional dependencies that may exist among the core GMP activities. When compared to traditional business models, the CTAT assessment resulted in a more accurate allocation of annual expenses. The estimated expenses were used to set a fee structure for both GMP facilities. A mathematical equation was also developed to provide the final product cost. CTAT can be a useful tool in estimating accurate costs for the ATMPs manufactured in an optimized GMP process. These estimates are useful when analyzing the cost-effectiveness of these novel interventions. Copyright © 2013 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  11. Psychotherapy approaches for adult survivors of childhood sexual abuse: an integrative review of outcomes research.

    Science.gov (United States)

    Martsolf, Donna S; Draucker, Claire B

    2005-10-01

    This review synthesized results of 26 outcomes research studies and two meta-analyses that evaluated abuse-focused psychotherapy techniques for survivors of childhood sexual abuse. Different therapeutic approaches delivered in individual, group, or combination formats were evaluated with pre/post test, quasi-experimental, or randomized control designs. Accumulated research findings suggest that abuse-focused psychotherapy for adults sexually abused as children is generally beneficial in reducing psychiatric distress, depression, and trauma-specific symptoms. No one therapeutic approach was demonstrated to be superior. There was little evidence about the effectiveness of individual versus group therapy or the optimal treatment duration.

  12. [Integrative approach in the psychotherapy of borderline personality disorder].

    Science.gov (United States)

    Kuritárné Szabó, Ildikó

    2012-01-01

    In the last 20 years six psychotherapy methods have been developed specifically for borderline personality disorder. Solid RCT evidences suggests the efficacy of all the methods. Roughly equivalent improvement was obtained from the different types of psychotherapies. Today we have reached a new phase of the borderline "psychotherapy boom", the integrative approach. According to the integrative treatment advocates we should not choose among these effective treatments but we can incorporate in the therapy all the components that work. The integrative approach uses general factors common to all effective therapies, combined with specific treatment techniques taken from different therapies in order to treat the given patient's psychopathology. These common factors are: coherent framework; attention to strategies for building strong positive alliance and maintaining patient motivation; creating a safe and structured therapeutic environment; clear treatment frame; transparency of the goals and roles; focus upon presenting problems; higher level therapeutic activity; here-and-now focus; and facilitating self-reflection. Treatment focuses on change while maintaining a validating and supportive stance. General strategies can be supplemented by more specific techniques such as cognitive-behavioral interventions for reducing maladaptive behavior, training for developing emotion regulation skills and interpersonal skills coming from dialectical behavior therapy. Methods drawn from psychodynamic approaches can be used for the modification of underlying interpersonal cognitive-emotional schemas.

  13. Guanylin peptides: cyclic GMP signaling mechanisms

    Directory of Open Access Journals (Sweden)

    Forte L.R.

    1999-01-01

    Full Text Available Guanylate cyclases (GC serve in two different signaling pathways involving cytosolic and membrane enzymes. Membrane GCs are receptors for guanylin and atriopeptin peptides, two families of cGMP-regulating peptides. Three subclasses of guanylin peptides contain one intramolecular disulfide (lymphoguanylin, two disulfides (guanylin and uroguanylin and three disulfides (E. coli stable toxin, ST. The peptides activate membrane receptor-GCs and regulate intestinal Cl- and HCO3- secretion via cGMP in target enterocytes. Uroguanylin and ST also elicit diuretic and natriuretic responses in the kidney. GC-C is an intestinal receptor-GC for guanylin and uroguanylin, but GC-C may not be involved in renal cGMP pathways. A novel receptor-GC expressed in the opossum kidney (OK-GC has been identified by molecular cloning. OK-GC cDNAs encode receptor-GCs in renal tubules that are activated by guanylins. Lymphoguanylin is highly expressed in the kidney and heart where it may influence cGMP pathways. Guanylin and uroguanylin are highly expressed in intestinal mucosa to regulate intestinal salt and water transport via paracrine actions on GC-C. Uroguanylin and guanylin are also secreted from intestinal mucosa into plasma where uroguanylin serves as an intestinal natriuretic hormone to influence body Na+ homeostasis by endocrine mechanisms. Thus, guanylin peptides control salt and water transport in the kidney and intestine mediated by cGMP via membrane receptors with intrinsic guanylate cyclase activity.

  14. [Institutional psychotherapy, caring for patients and the place of care].

    Science.gov (United States)

    Drogoul, Frank

    2013-01-01

    Institutional psychotherapy was developed in the specific context of the "assassination" of the Spanish revolution. There are two distinct movements or two periods. The first, based around Georges Daumézon and Henri Ey gave birth to the sector. The second, around FrançoisTosquelles and Jean Oury emphasised the asylum as the place of care. The function of institutional psychotherapy is to care not only for the patients but also the place of treatment. To fulfil this function, it has a tool box: transfer, the fight against the overvaluation of hierarchy as well as the function of the therapeutic club.

  15. A manifesto of community-focused psychotherapy for the social participation: Does individual and group psychotherapy still meet the care needs of the society?

    Directory of Open Access Journals (Sweden)

    Simone Bruschetta

    2015-10-01

    Full Text Available This paper presents a critical, on a social-political level, of development of psychotherapy, seen as the health discipline, especially in that part of the world called West, scientifically established itself through the evaluation of the effectiveness of its two most common types of setting: Individual and Group- Psychotherapy. Through a social-anthropological interpretation of mental processes which it underpins, and a group analytical analysis of organizational and institutional dynamics that led to its evolution, the authors highlight the significant impasse in which psychotherapy finds itself today compared to new and more pervasive forms of mental suffering. Following on of the latest scientific research on the functioning of the mind and of new policy proposals from the World Health Organization, it is suggested so a form of basic psychotherapy, focused on the quality of the mental health of human contexts, defined Community-Focused Psychotherapy. This new form of psychotherapy is wrong simply understood as a new setting, alongside the classic individual, group, or family setting, but as a political-cultural background and a theoretical-methodological framework, so for different psychotherapeutic treatment (individual, group , family put in place in cases of specific psychopathological symptoms, as for a number of other clinical and social programs, carried out by professionals, workers and (formerly users, who support the empowerment of people, with serious psychological disorders or severe mental illness, in their own social contexts of belonging, and in their own recovery, through the active participation of all those therapeutic processes that support their care. 

  16. Multiple Degradation Pathways of Chemoattractant Mediated Cyclic GMP Accumulation in Dictyostelium

    NARCIS (Netherlands)

    Haastert, Peter J.M. van; Lookeren Campagne, Michiel M. van; Kesbeke, Fanja

    1983-01-01

    Chemoattractants induce a transient accumulation of cGMP levels in Dictyostelium. Intracellular cGMP levels reach a peak at 10 s and prestimulated cGMP levels are recovered at about 30 s. Intracellular and extracellular cGMP levels were detected simultaneously after stimulation of D. lacteum cells

  17. Psychotherapy with people with developmental disabilities

    Directory of Open Access Journals (Sweden)

    Barbara Zafošnik

    2011-08-01

    Full Text Available People with developmental disabilities can experience any psychological abnormalitiy and psychiatric illness as do people without developmental disabilities. Due to different diagnostic criteria, assessment procedures and instruments, we lack definite prevalence rates for people with developmental disabilities, also suffering from mental health problems, eventhough most studies place the rate at 20 to 40%. One of the possible treatment alternatives for augmenting psychological well-being is psychotherapy, but is extremely rarely used for people with severe and profound disabilities, where speech cannot be the main therapeutic medium. So, those that are included in the psychotherapuetic process are predominantly clients with mild developmental disabilities, and they are mostly in cognitive-behavioral therapy. Recently, two models of (psychotherapy for persons with severe and profound developmental disabilities were developed: developmental-dynamic relationship therapy and attachment-based behaviour therapy for children. Conceptually, they both originate form developmental psychoanalytic theories.

  18. [Psychoanalysis and psychoanalytic oriented psychotherapy: differences and similarities].

    Science.gov (United States)

    Rössler-Schülein, Hemma; Löffler-Stastka, Henriette

    2013-01-01

    Psychoanalysis as well as Psychoanalytic Psychotherapy derived from Psychoanalysis are efficient methods offered by the Austrian health care system in the treatment for anxiety, depression, personality disorders, neurotic and somatoform disorders. In both methods similar basic treatment techniques are applied. Therefore differentiation between both treatment options often is made pragmatically by the frequency of sessions or the use of the couch and seems to be vague in the light of empirical studies. This overview focuses a potential differentiation-the objective and subjective dimensions of the indication process. Concerning the latter it is to investigate, if reflective functioning and ego-integration can be enhanced in the patient during the interaction process between patient and psychoanalyst. Empirical data underline the necessity to investigate to which extent externalizing defence processes are used and to integrate such factors into the decision and indication process. Differing treatment aims display another possibility to differentiate psychoanalysis and psychoanalytic psychotherapy. Psychoanalytic psychotherapy aims for example more at circumscribed problem-foci, the capability for self-reflexion is one of the most prominent treatment effects in psychoanalysis that results in on-going symptom reduction and resilience. The most prominent differentiation lies in the utilization of technical neutrality. Within Psychoanalytic Psychotherapy neutrality has sometimes to be suspended in order to stop severe acting out. Empirical evidence is given concerning the differentiation between psychoanalysis and psychoanalytic psychotherapy, that treatment efficacy is not correlated with the duration of the treatment, but with the frequency of sessions. Results give support to the assumption that the dosage of specific and appropriate psychoanalytic techniques facilitates sustained therapeutic change.

  19. Psychedelics and hypnosis: Commonalities and therapeutic implications.

    Science.gov (United States)

    Lemercier, Clément E; Terhune, Devin B

    2018-06-01

    Recent research on psychedelics and hypnosis demonstrates the value of both methods in the treatment of a range of psychopathologies with overlapping applications and neurophenomenological features. The potential of harnessing the power of suggestion to influence the phenomenological response to psychedelics toward more therapeutic action has remained unexplored in recent research and thereby warrants empirical attention. Here we aim to elucidate the phenomenological and neurophysiological similarities and dissimilarities between psychedelic states and hypnosis in order to revisit how contemporary knowledge may inform their conjunct usage in psychotherapy. We review recent advances in phenomenological and neurophysiological research on psychedelics and hypnosis, and we summarize early investigations on the coupling of psychedelics and hypnosis in scientific and therapeutic contexts. Results/outcomes: We highlight commonalities and differences between psychedelics and hypnosis that point to the potential efficacy of combining the two in psychotherapy. We propose multiple research paths for coupling these two phenomena at different stages in the preparation, acute phase and follow-up of psychedelic-assisted psychotherapy in order to prepare, guide and integrate the psychedelic experience with the aim of enhancing therapeutic outcomes. Harnessing the power of suggestion to modulate response to psychedelics could enhance their therapeutic efficacy by helping to increase the likelihood of positive responses, including mystical-type experiences.

  20. Correlative intravital imaging of cGMP signals and vasodilation in mice

    Directory of Open Access Journals (Sweden)

    Martin eThunemann

    2014-10-01

    Full Text Available Cyclic guanosine monophosphate (cGMP is an important signaling molecule and drug target in the cardiovascular system. It is well known that stimulation of the vascular nitric oxide (NO-cGMP pathway results in vasodilation. However, the spatiotemporal dynamics of cGMP signals themselves and the cGMP concentrations within specific cardiovascular cell types in health, disease, and during pharmacotherapy with cGMP-elevating drugs are largely unknown. To facilitate the analysis of cGMP signaling in vivo, we have generated transgenic mice that express fluorescence resonance energy transfer (FRET-based cGMP sensor proteins. Here, we describe two models of intravital FRET/cGMP imaging in the vasculature of cGMP sensor mice: (1 epifluorescence-based ratio imaging in resistance-type vessels of the cremaster muscle and (2 ratio imaging by multiphoton microscopy within the walls of subcutaneous blood vessels accessed through a dorsal skinfold chamber. Both methods allow simultaneous monitoring of NO-induced cGMP transients and vasodilation in living mice. Detailed protocols of all steps necessary to perform and evaluate intravital imaging experiments of the vasculature of anesthetized mice including surgery, imaging, and data evaluation are provided. An image segmentation approach is described to estimate FRET/cGMP changes within moving structures such as the vessel wall during vasodilation. The methods presented herein should be useful to visualize cGMP or other biochemical signals that are detectable with FRET-based biosensors, such as cyclic adenosine monophosphate or Ca2+, and to correlate them with respective vascular responses. With further refinement and combination of transgenic mouse models and intravital imaging technologies, we envision an exciting future, in which we are able to ‘watch’ biochemistry, (patho physiology, and pharmacotherapy in the context of a living mammalian organism.

  1. Serious Games for Psychotherapy: A Systematic Review.

    Science.gov (United States)

    Eichenberg, Christiane; Schott, Markus

    2017-06-01

    In the evolving digital age, media applications are increasingly playing a greater role in the field of psychotherapy. While the Internet is already in the phase of being established when it comes to the care of mental disorders, experimentation is going on with other modern media such as serious games. A serious game is a game in which education and behavior change is the goal, alongside with entertainment. The objective of the present article was to provide a first empirical overview of serious games applied to psychotherapy and psychosomatic rehabilitation. Therefore, a systematic literature search, including the terms "serious game" or "computer game" and "psychotherapy" or "rehabilitation" or "intervention" or "mental disorders" in the databases Medline and PsycINFO, was performed. Subsequently, an Internet search was conducted to identify studies not published in journals. Publications not providing empirical data about effectiveness were excluded. On the basis of this systematic literature review, the results of N = 15 studies met inclusion criteria. They utilized primarily cognitive behavioral techniques and can be useful for treating a range of mental disorders. Serious games are effective both as a stand-alone intervention or part of psychotherapy and appeal to patients independent of age and sex. Included serious games proved to be an effective therapeutic component. Nonetheless, findings are not conclusive and more research is needed to further investigate the effectiveness of serious games for psychotherapeutic purposes.

  2. Computational psychotherapy research: scaling up the evaluation of patient-provider interactions.

    Science.gov (United States)

    Imel, Zac E; Steyvers, Mark; Atkins, David C

    2015-03-01

    In psychotherapy, the patient-provider interaction contains the treatment's active ingredients. However, the technology for analyzing the content of this interaction has not fundamentally changed in decades, limiting both the scale and specificity of psychotherapy research. New methods are required to "scale up" to larger evaluation tasks and "drill down" into the raw linguistic data of patient-therapist interactions. In the current article, we demonstrate the utility of statistical text analysis models called topic models for discovering the underlying linguistic structure in psychotherapy. Topic models identify semantic themes (or topics) in a collection of documents (here, transcripts). We used topic models to summarize and visualize 1,553 psychotherapy and drug therapy (i.e., medication management) transcripts. Results showed that topic models identified clinically relevant content, including affective, relational, and intervention related topics. In addition, topic models learned to identify specific types of therapist statements associated with treatment-related codes (e.g., different treatment approaches, patient-therapist discussions about the therapeutic relationship). Visualizations of semantic similarity across sessions indicate that topic models identify content that discriminates between broad classes of therapy (e.g., cognitive-behavioral therapy vs. psychodynamic therapy). Finally, predictive modeling demonstrated that topic model-derived features can classify therapy type with a high degree of accuracy. Computational psychotherapy research has the potential to scale up the study of psychotherapy to thousands of sessions at a time. We conclude by discussing the implications of computational methods such as topic models for the future of psychotherapy research and practice. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  3. Resistances in the first session of psychodrama psychotherapy group with adults.

    Science.gov (United States)

    Drakulić, Aleksandra Mindoljević

    2010-06-01

    Resistance refers to all types of behaviour that oppose the exploration processes in the therapeutic process and inhibit work. Very common types of resistances, such as forgetting the time of session, being late, non-payment of sessions and such are found in every type of psychotherapy, including psychodrama psychotherapy. The attempt to break resistance in order to evoke changes could be dangerous as it represents the necessary defence mechanism and it is also a vital element of the person's functioning in therapy. In psychodrama, which is a type of action method of group psychotherapy, resistance can manifest through continuous verbalization of problems, in not wanting to act out the problem, the protagonist's typical non-verbal message or the most obvious manifestation: the absence of the protagonist. This paper will be on the typical resistance which the therapist has noticed during the first session of psychodrama psychotherapy, with a small group of adult clients. As the group was young and with undeveloped cohesiveness, resistance represented a certain balancing power for maintaining mental homeostasis of the group.

  4. Psychotherapy and Traditional Healing for American Indians: Exploring the Prospects for Therapeutic Integration

    Science.gov (United States)

    Gone, Joseph P.

    2010-01-01

    Multicultural advocates within professional psychology routinely call for "culturally competent" counseling interventions. Such advocates frequently cite and celebrate traditional healing practices as an important resource for developing novel integrative forms of psychotherapy that are distinctively tailored for diverse populations. Despite this…

  5. Psychotherapy mediated by remote communication technologies: a meta-analytic review

    Directory of Open Access Journals (Sweden)

    Richards David

    2008-07-01

    Full Text Available Abstract Background Access to psychotherapy is limited by psychopathology (e.g. agoraphobia, physical disability, occupational or social constraints and/or residency in under-served areas. For these populations, interventions delivered via remote communication technologies (e.g. telephone, internet may be more appropriate. However, there are concerns that such delivery may influence the therapeutic relationship and thus reduce therapy effectiveness. This review aimed to determine the clinical effectiveness of remotely communicated, therapist-delivered psychotherapy. Methods Systematic review (including electronic database searching and correspondence with authors of randomised trials of individual remote psychotherapy. Electronic databases searched included MEDLINE (1966–2006, PsycInfo (1967–2006, EMBASE (1980–2006 and CINAHL databases (1982–2006. The Cochrane Central Register of Controlled Trials (CENTRAL and the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDAN-CTR. All searches were conducted to include studies with a publication date to July 2006. Results Thirteen studies were identified, ten assessing psychotherapy by telephone, two by internet and one by videoconference. Pooled effect sizes for remote therapy versus control conditions were 0.44 for depression (95%CI 0.29 to 0.59, 7 comparisons, n = 726 and 1.15 for anxiety-related disorders (95%CI 0.81 to 1.49, 3 comparisons, n = 168. There were few comparisons of remote versus face-to-face psychotherapy. Conclusion Remote therapy has the potential to overcome some of the barriers to conventional psychological therapy services. Telephone-based interventions are a particularly popular research focus and as a means of therapeutic communication may confer specific advantages in terms of their widespread availability and ease of operation. However, the available evidence is limited in quantity and quality. More rigorous trials are required to

  6. Integrative harm reduction psychotherapy: a case of substance use, multiple trauma, and suicidality.

    Science.gov (United States)

    Tatarsky, Andrew; Kellogg, Scott

    2010-02-01

    Harm reduction is a new paradigm that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence. This article discusses integrative harm reduction psychotherapy, one application of harm reduction principles to psychotherapy. Seven therapeutic tasks are described with attention to clinical process, skills, and strategies. A case is presented that illustrates the application of this approach with life-threatening substance use that was related to multiple trauma and suicidal depression. (c) 2010 Wiley Periodicals, Inc.

  7. Conversational evidence in therapeutic dialogue.

    Science.gov (United States)

    Strong, Tom; Busch, Robbie; Couture, Shari

    2008-07-01

    Family therapists' participation in therapeutic dialogue with clients is typically informed by evidence of how such dialogue is developing. In this article, we propose that conversational evidence, the kind that can be empirically analyzed using discourse analyses, be considered a contribution to widening psychotherapy's evidence base. After some preliminaries about what we mean by conversational evidence, we provide a genealogy of evaluative practice in psychotherapy, and examine qualitative evaluation methods for their theoretical compatibilities with social constructionist approaches to family therapy. We then move on to examine the notion of accomplishment in therapeutic dialogue given how such accomplishments can be evaluated using conversation analysis. We conclude by considering a number of research and pedagogical implications we associate with conversational evidence.

  8. First Steps in FAP: Experiences of Beginning Functional Analytic Psychotherapy Therapist with an Obsessive-Compulsive Personality Disorder Client

    Science.gov (United States)

    Manduchi, Katia; Schoendorff, Benjamin

    2012-01-01

    Practicing Functional Analytic Psychotherapy (FAP) for the first time can seem daunting to therapists. Establishing a deep and intense therapeutic relationship, identifying FAP's therapeutic targets of clinically relevant behaviors, and using contingent reinforcement to help clients emit more functional behavior in the therapeutic relationship all…

  9. Purification and characterization of cGMP binding protein-phosphodiesterase from rat lung

    International Nuclear Information System (INIS)

    Francis, S.H.; Walseth, T.F.; Corbin, J.D.

    1986-01-01

    The cGMP binding protein-phosphodiesterase (cG-BPP) with a phosphodiesterase specific activity of 7 μM/min/mg has been purified from rat lung by sequential chromatography on DEAE-cellulose, Blue-Sepharose, zinc chelate affinity adsorbent and HPLC-DEAE. Migration of the major band on SDS-PAGE corresponds to a MW of ∼93,000. Both cGMP phosphodiesterase activity and cGMP binding from the HPLC-DEAE profile correlate with this band. Since the authors previous work has determined the native MW to be ∼177,000, this suggests a dimeric structure comprised of two 93,000 MW subunits for the rat lung cG-BPP. At low cGMP concentrations, cGMP binding is stimulated ∼20-fold by histone and ∼5-fold by 3-isobutyl-1-methylxanthine(IBMX). The purified protein has one component of cGMP dissociation with a rate constant of 0.045/min. Photolysis of the purified protein in the presence of 32 P-cGMP labels the 93,000 MW band and this labeling is increased by IBMX, indicating that the 93,000 MW band is a subunit of the cGMP-BPP. This implies that the enzyme preparation is nearly homogeneous, a conclusion also supported by a minimum [ 3 H]-cGMP binding stoichiometry of 0.5 mol per 93,000 subunit. An additional protein band with a MW of ∼90,000 also occurs in these preparations which exhibits behavior similar to the 93,000 MW protein. N 2 -Hexyl-cGMP inhibits phosphodiesterase activity by competing with cGMP for hydrolysis at the catalytic site but not at the binding site. N 2 -Hexyl cGMP actually increases cGMP binding. This provides the first evidence that cGMP binding is increased by compounds hydrolyzed at the catalytic site. This interaction between the binding and phosphodiesterase sites could be important in the regulation of the functions of these sites in vivo

  10. [Integrative parent-infant psychotherapy for early regulatory and relationship disorders].

    Science.gov (United States)

    Papousek, Mechthild; de Chuquisengo, Ruth Wollwerth

    2006-01-01

    The author introduces both the concept and practice of Integrative Parent-Infant Psychotherapy (IPI-P), a treatment specifically designed for the most frequent developmental problems and psychological needs of infants and their parents. Based on growing knowledge from interdisciplinary infancy research, both basic and clinical, IPI-P has been developed and practised in the "Munich Interdisciplinary Research and Intervention Program" for early regulatory and relationship disorders since the early nineties. Preverbal parent-infant communication represents both the port of entry into the system and the main focus of diagnostics, developmental counselling, interaction guidance, or psychodynamic psychotherapy of distorted communication and distressed/disordered relationships. The method of videomicroanalysis during video-feedback with the parent has proven particularly efficient--while observing, reliving and working through brief episodes of recorded parent-infant interaction. The author illustrates the diagnostic and therapeutic procedures with excerpts from psychotherapy of a toddler with an age-specific regulatory disorder in the context of severely distressed primary relationships.

  11. cGMP signaling as a target for the prevention and treatment of breast cancer.

    Science.gov (United States)

    Windham, Perrin F; Tinsley, Heather N

    2015-04-01

    One in eight women in the United States will be diagnosed with invasive breast cancer in her lifetime. Advances in therapeutic strategies, diagnosis, and improved awareness have resulted in a significant reduction in breast cancer related mortality. However, there is a continued need for more effective and less toxic drugs for both the prevention and the treatment of breast cancer in order to see a continued decline in the morbidity and mortality associated with this disease. Recent studies suggest that the cGMP signaling pathway may be aberrantly regulated in breast cancer. As such, this pathway may serve as a source of novel targets for future breast cancer drug discovery efforts. This review provides an overview of cGMP signaling in normal physiology and in breast cancer as well as current strategies being investigated for targeting this pathway in breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. [Adaptation of psychodrama in psychotherapy of patients with anorexia nervosa and bulimia nervosa].

    Science.gov (United States)

    Izydorczyk, Bernadetta

    2011-01-01

    The aim of the article was an attempt to present selected theoretical motifs and moreover self experience in the adaptation of elements of psychodrama by Moreno in psychodynamic psychotherapy (individual and group psychotherapy) in a group of people with anorexia and bulimia nervosa. Psychodrama through own creativity, spontaneity and taking action on the "here and now" stage helps to attain and intensify therapeutic aims which concern the consciousness of inner conflict of persons with anorexia and bulimia nervosa, which is translocated on their body.

  13. Individual Psychotherapy ("Talking Therapy"): A Survey of Attitudes among Residents & Specialists in Psychiatry, Israel 2010-2011.

    Science.gov (United States)

    Levi Shachar, Orit; Mendlovic, Shlomo; Hertzberg, Libi; Baruch, Yehuda; Lurie, Ido

    2016-01-01

    Individual psychotherapy is an efficient tool and an integral part of psychiatric treatment. However, its status among psychiatrists in Israel has never been explored. To explore and map the attitudes of psychiatrists in Israel regarding psychotherapy and psychotherapy training during residency, with comparisons between residents vs. specialists, peripheral vs. central institutions and mental health vs. medical centers. We conducted a cross-sectional survey to examine the attitudes toward individual psychotherapy. The questionnaire was delivered via email and direct approach to psychiatrists in Israel. The survey was completed by 229 of 1,502 registered psychiatrists (15.3%). While 96% (n=218) had positive attitudes towards psychotherapy, 93.1% (n=215) thought psychotherapy was less available than pharmacotherapy. Psychiatrists from peripheral institutions prefer cognitive behavioral therapy, while psychiatrists from central institutions prefer dynamic psychotherapy. Psychiatrists from mental health centers use more dynamic psychotherapy compared to psychiatrists from medical centers. The number of dynamic psychotherapy treatments psychiatrists delivered during their residencies has been decreasing over time, meaning residents today deliver fewer dynamic psychotherapy treatments compared to the number of treatments specialists delivered during their residencies. Additionally, 97.4% (n=225) believed psychotherapy training should be included in the psychiatric residency and 87.3% thought that the training should be improved to a great extent. The survey demonstrates mixed but overall positive attitudes towards psychotherapy among psychiatrists in Israel. The findings should be taken into consideration by psychiatrists who design the residency program and by policy makers who are in charge of the mental health reform in Israel, or the psychotherapy usage and therapeutic potential may diminish, as has happened in other countries.

  14. A Systematic Review of the Combined Use of Electroconvulsive Therapy and Psychotherapy for Depression

    Science.gov (United States)

    McClintock, Shawn M.; Brandon, Anna R.; Husain, Mustafa M.; Jarrett, Robin B.

    2011-01-01

    Objective Electroconvulsive therapy (ECT) is one of the most effective treatments for severe Major Depressive Disorder (MDD). However, after acute phase treatment and initial remission, relapse rates are significant. Strategies to prolong remission include continuation phase ECT, pharmacotherapy, psychotherapy, or their combinations. This systematic review synthesizes extant data regarding the combined use of psychotherapy with ECT for the treatment of patients with severe MDD and offers the hypothesis that augmenting ECT with depression-specific psychotherapy represents a promising strategy for future investigation. Methods The authors performed two independent searches in PsychInfo (1806 – 2009) and MEDLINE (1948 – 2009) using combinations of the following search terms: Electroconvulsive Therapy (including ECT, ECT therapy, electroshock therapy, EST, shock therapy) and Psychotherapy (including cognitive behavioral, interpersonal, group, psychodynamic, psychoanalytic, individual, eclectic, and supportive). We included in this review a total of six articles (English language) that mentioned ECT and psychotherapy in the abstract, and provided a case report, series, or clinical trial. We examined the articles for data related to ECT and psychotherapy treatment characteristics, cohort characteristics, and therapeutic outcome. Results Although research over the past seven decades documenting the combined use of ECT and psychotherapy is limited, the available evidence suggests that testing this combination has promise and may confer additional, positive functional outcomes. Conclusions Significant methodological variability in ECT and psychotherapy procedures, heterogeneous patient cohorts, and inconsistent outcome measures prevent strong conclusions; however, existing research supports the need for future investigations of combined ECT and psychotherapy in well-designed, controlled clinical studies. Depression-specific psychotherapy approaches may need special

  15. [Multiprofessional inpatient psychotherapy of depression in old age].

    Science.gov (United States)

    Cabanel, N; Kundermann, B; Franz, M; Müller, M J

    2017-11-01

    Depression is common in old age but is often underdiagnosed and inadequately treated. Although psychotherapy is considered effective for treating elderly patients with depression, it is rarely applied in inpatient settings. Furthermore, treatment on inpatient units specialized for elderly patients and implementation of a psychotherapeutic treatment approach are currently more the exception. From this background, a multiprofessional inpatient behavioral treatment program (MVT) for elderly depressed patients was developed at a specialized unit of a university-affiliated regional psychiatric hospital. The MVT is based on specific and modularized group therapies accompanied by individual therapeutic interventions. While the provision of group therapies (such as psychotherapy, social skills training, relaxation training, euthymic and mindfulness-based methods, exercise and occupational therapy as well as psychoeducational sessions for relatives) is assigned to specific professional groups, a joint multiprofessional treatment planning is of central relevance. First evaluations of different treatment components support the high acceptability of the MVT and highlight that psychotherapeutic inpatient treatment programs for the elderly are feasible. Further research is required to investigate the clinical efficacy of psychotherapy in elderly depressive inpatients.

  16. The quest for connection in interpersonal and therapeutic relationships.

    Science.gov (United States)

    Wiseman, Hadas

    2017-07-01

    This paper focuses on the need for connection as a common core theme at the heart of both close relationships and therapeutic relationships and explores ways to connect these two research domains that have evolved as separate fields of study. Bowlby's attachment theory provides a strong conceptual and empirical base for linking human bonds and bonds in psychotherapy. The growing body of research intersecting attachment and psychotherapy (1980-2014) is documented, and meta-analytic studies on attachment-outcome and attachment-alliance links are highlighted. Five ways of studying attachment as a variable in psychotherapy are underscored: as moderator, as mediator, as outcome, client-therapist attachment match, and as process. By integrating conceptualizations and methods in studying relational narratives of client-therapist dyads (Core Conflictual Relationship Theme), measures of alliance, and client attachment to therapist during psychotherapy, we may discover unique client-therapist relational dances. Future fine-grained studies on how to promote core authentic relational relearning are important to clinicians, supervisors and trainers, who all share the common quest to alleviate interpersonal distress and enhance wellbeing. Directions for advancing research on interpersonal and therapeutic relationships are suggested. Learning from each other, both researchers of close relationships and of psychotherapy relationships can gain a deeper and multidimensional understanding of complex relational processes and outcomes.

  17. Psychotherapy in Contemporary Psychiatric Practice.

    Science.gov (United States)

    Hadjipavlou, George; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

    2015-06-01

    American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice. A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests. A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy. Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services.

  18. Harm reduction psychotherapy: extending the reach of traditional substance use treatment.

    Science.gov (United States)

    Tatarsky, Andrew

    2003-12-01

    Harm reduction is a paradigm-shifting idea that has the potential to significantly improve the treatment of problem substance users. The essence of harm reduction is the recognition that treatment must start from the client's needs and personal goals and that all change that reduces the harms associated with substance use can be regarded as valuable. The paper presents harm reduction's rationale, principles, treatment implications, and application to psychotherapy. The author describes his model of Integrative Harm Reduction Psychotherapy, an approach that integrates a strategic skills-building focus with an exploration of the multiple meanings of substance use and the importance of the therapeutic alliance.

  19. [Psychotherapy impact on effectiveness of in-hospital physical rehabilitation in patients with acute coronary syndrome].

    Science.gov (United States)

    Sumin, A N; Khaĭredinova, O P; Sumina, L Iu; Variushkina, E V; Doronin, D V; Galimzianov, D M; Masin, A N; Gol'dberg, G A

    2000-01-01

    Of 103 patients with acute coronary syndrome (mean age 51.6 +/- 0.9 years) 47 patients participated in 5 group psychotherapeutic sessions added to conversional rehabilitation program. Psychotherapy included progressive muscular relaxation, neurolinguistic programming, eriksonian hypnosis, therapeutic metaphora. Psychotherapy decreased the hear rate, number of ventricular extrasystoles, stimulated tonicity of the parasympathetic nervous system. Compared to the controls, the test patients developed higher exercise tolerance and lower reactivity of the central hemodynamics in all the exercise tests.

  20. Occurrence of Cyclic di-GMP-Modulating Output Domains in Cyanobacteria: an Illuminating Perspective

    Science.gov (United States)

    Agostoni, Marco; Koestler, Benjamin J.; Waters, Christopher M.; Williams, Barry L.; Montgomery, Beronda L.

    2013-01-01

    ABSTRACT Microorganisms use a variety of metabolites to respond to external stimuli, including second messengers that amplify primary signals and elicit biochemical changes in a cell. Levels of the second messenger cyclic dimeric GMP (c-di-GMP) are regulated by a variety of environmental stimuli and play a critical role in regulating cellular processes such as biofilm formation and cellular motility. Cyclic di-GMP signaling systems have been largely characterized in pathogenic bacteria; however, proteins that can impact the synthesis or degradation of c-di-GMP are prominent in cyanobacterial species and yet remain largely underexplored. In cyanobacteria, many putative c-di-GMP synthesis or degradation domains are found in genes that also harbor light-responsive signal input domains, suggesting that light is an important signal for altering c-di-GMP homeostasis. Indeed, c-di-GMP-associated domains are often the second most common output domain in photoreceptors—outnumbered only by a histidine kinase output domain. Cyanobacteria differ from other bacteria regarding the number and types of photoreceptor domains associated with c-di-GMP domains. Due to the widespread distribution of c-di-GMP domains in cyanobacteria, we investigated the evolutionary origin of a subset of genes. Phylogenetic analyses showed that c-di-GMP signaling systems were present early in cyanobacteria and c-di-GMP genes were both vertically and horizontally inherited during their evolution. Finally, we compared intracellular levels of c-di-GMP in two cyanobacterial species under different light qualities, confirming that light is an important factor for regulating this second messenger in vivo. PMID:23943760

  1. Towards a taxonomy of common factors in psychotherapy-results of an expert survey.

    Science.gov (United States)

    Tschacher, Wolfgang; Junghan, Ulrich Martin; Pfammatter, Mario

    2014-01-01

    How change comes about is hotly debated in psychotherapy research. One camp considers 'non-specific' or 'common factors', shared by different therapy approaches, as essential, whereas researchers of the other camp consider specific techniques as the essential ingredients of change. This controversy, however, suffers from unclear terminology and logical inconsistencies. The Taxonomy Project therefore aims at contributing to the definition and conceptualization of common factors of psychotherapy by analyzing their differential associations to standard techniques. A review identified 22 common factors discussed in psychotherapy research literature. We conducted a survey, in which 68 psychotherapy experts assessed how common factors are implemented by specific techniques. Using hierarchical linear models, we predicted each common factor by techniques and by experts' age, gender and allegiance to a therapy orientation. Common factors differed largely in their relevance for technique implementation. Patient engagement, Affective experiencing and Therapeutic alliance were judged most relevant. Common factors also differed with respect to how well they could be explained by the set of techniques. We present detailed profiles of all common factors by the (positively or negatively) associated techniques. There were indications of a biased taxonomy not covering the embodiment of psychotherapy (expressed by body-centred techniques such as progressive muscle relaxation, biofeedback training and hypnosis). Likewise, common factors did not adequately represent effective psychodynamic and systemic techniques. This taxonomic endeavour is a step towards a clarification of important core constructs of psychotherapy. This article relates standard techniques of psychotherapy (well known to practising therapists) to the change factors/change mechanisms discussed in psychotherapy theory. It gives a short review of the current debate on the mechanisms by which psychotherapy works. We

  2. Psychotherapy in Contemporary Psychiatric Practice

    Science.gov (United States)

    Hadjipavlou, George; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

    2015-01-01

    Objective: American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice. Method: A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests. Results: A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy. Conclusions: Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services. PMID:26175328

  3. Psychotherapy And Phenomenology

    African Journals Online (AJOL)

    denise

    psychology and psychotherapy since its beginnings. ... accountability of psychological meaning are ... the whole of human being as entirely representative ..... approaches and range across the areas of personality psychology, psychotherapy, ...

  4. The right brain is dominant in psychotherapy.

    Science.gov (United States)

    Schore, Allan N

    2014-09-01

    This article discusses how recent studies of the right brain, which is dominant for the implicit, nonverbal, intuitive, holistic processing of emotional information and social interactions, can elucidate the neurobiological mechanisms that underlie the relational foundations of psychotherapy. Utilizing the interpersonal neurobiological perspective of regulation theory, I describe the fundamental role of the early developing right brain in relational processes, throughout the life span. I present interdisciplinary evidence documenting right brain functions in early attachment processes, in emotional communications within the therapeutic alliance, in mutual therapeutic enactments, and in therapeutic change processes. This work highlights the fact that the current emphasis on relational processes is shared by, cross-fertilizing, and indeed transforming both psychology and neuroscience, with important consequences for clinical psychological models of psychotherapeutic change. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  5. The brassinosteroid receptor BRI1 can generate cGMP enabling cGMP-dependent downstream signaling

    CSIR Research Space (South Africa)

    Wheeler, J

    2017-06-01

    Full Text Available ) with the ll PickUp Injection mode using the loading pump at 15 ll min�1 flow rate for 3 min. Samples were then loaded on a RSLC, 75 lm 9 500 mm, nanoVi- per, C18, 2 lm, 100 �A column (Acclaim, PepMap) retrofitted to an EASY-spray source with a flow rate of 300... receptor BRI1 can generate cGMP enabling cGMP-dependent downstream signaling Janet I. Wheeler1,2,†, Aloysius Wong3,4, Claudius Marondedze3,5, Arnoud J. Groen5, Lusisizwe Kwezi1,6, Lubna Freihat1, Jignesh Vyas1, Misjudeen A. Raji7, Helen R. Irving1...

  6. Existentially informed HIV-related psychotherapy.

    Science.gov (United States)

    Farber, Eugene W

    2009-09-01

    This article describes an existentially informed approach to conducting psychotherapy with individuals living with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). Uses of existential concepts to guide a holistic conceptualization of the individual and illuminate core existential concerns and dilemmas in confronting HIV-related challenges are delineated. Applications of existential ideas regarding psychotherapy process and technique in HIV-related psychotherapy also are illustrated. It is concluded that existential psychotherapy offers a conceptual framework that is especially well suited to the work of psychotherapy with individuals living with HIV disease, although the approach has received only limited attention in the HIV-related psychotherapy literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  7. Psychotherapy for cancer patients.

    Science.gov (United States)

    Chong Guan, Ng; Mohamed, Salina; Kian Tiah, Lai; Kar Mun, Teoh; Sulaiman, Ahmad Hatim; Zainal, Nor Zuraida

    2016-07-01

    Objective Psychotherapy is a common non-pharmacological approach to help cancer patients in their psychological distress. The benefit of psychotherapies was documented, but the types of psychotherapies proposed are varied. Given that the previous literature review was a decade ago and no quantitative analysis was done on this topic, we again critically and systematically reviewed all published trials on psychotherapy in cancer patients. Method We identified 17 clinical trials on six types of psychotherapy for cancer patients by searching PubMed and EMBASE. Result There were four trials involved adjunct psychological therapy which were included in quantitative analysis. Each trial demonstrated that psychotherapy improved the quality of life and coping in cancer patients. There was also a reduction in distress, anxiety, and depression after a psychological intervention. However, the number and quality of clinical trials for each type of psychotherapy were poor. The meta-analysis of the four trials involved adjunct psychological therapy showed no significant change in depression, with only significant short-term improvement in anxiety but not up to a year-the standardized mean differences were -0.37 (95% confidence interval (CI) = -0.57, -0.16) at 2 months, -0.21 (95% CI = -0.42, -0.01) at 4 months, and 0.03 (95 % CI = -0.19, 0.24) at 12 months. Conclusion The evidence on the efficacy of psychotherapy in cancer patients is unsatisfactory. There is a need for more rigorous and well-designed clinical trials on this topic.

  8. cGMP may have trophic effects on beta cell function comparable to those of cAMP, implying a role for high-dose biotin in prevention/treatment of diabetes.

    Science.gov (United States)

    McCarty, Mark F

    2006-01-01

    Incretin hormones have trophic effects on beta cell function that can aid prevention and treatment of diabetes. cAMP is the primary mediator of these effects, and has been shown to potentiate glucose-stimulated insulin secretion, promote proper beta cells differentiation by increasing expression of the crucial transcription factor PDX-1, and prevent beta cell apoptosis. cGMP's role in beta cell function has received far less scrutiny, but there is emerging evidence that it may have a trophic impact on beta cell function analogous to that of cAMP. An increase in plasma glucose boosts beta cell production of cGMP, which acts as a feed-forward mediator to enhance glucose-stimulated insulin secretion. cGMP also has an anti-apoptotic effect in beta cells, and there is now indirect evidence that it promotes expression of PDX-1. Supraphysiological concentrations of biotin can directly activate guanylate cyclase, and there is limited evidence that high intakes of this vitamin can be therapeutically beneficial in diabetics and in rodent models of diabetes. Beneficial effects of cGMP on muscle insulin sensitivity and on control of hepatic glucose output may contribute to biotin's utility in diabetes. The fact that nitric oxide/cGMP exert a range of favorable effects on vascular health should further encourage exploration of biotin's preventive and therapeutic potential. If an appropriate high-dose biotin regimen could achieve a modest systemic increase in guanylate cyclase activity, without entailing unacceptable side effects or risks, such a regimen might have considerable potential for promoting vascular health and preventing or managing diabetes.

  9. Cultural sensitivity and supportive expressive psychotherapy: an integrative approach to treatment.

    Science.gov (United States)

    White, Tracela M; Gibbons, Mary Beth Connolly; Schamberger, Megan

    2006-01-01

    Cultural sensitivity is a concept that has become increasingly important in psychotherapy research and practice. In response to the growing ethnic minority population and the increased demand for psychological services among minority clients, many therapists and researchers have attempted to identify competencies and guidelines for providing culturally sensitive approaches to treatment. However, many cultural sensitivity concepts are theoretical and have rarely been integrated into an established psychotherapeutic framework. The purpose of this manuscript is to operationalize the concepts of cultural sensitivity into specific therapeutic techniques using a manual-guided Supportive Expressive Psychotherapy approach. Developing these strategies may serve to further assist therapists with the delivery of mental health services to ethnic minority clients.

  10. Redefining Outcome Measurement: A Model for Brief Psychotherapy.

    Science.gov (United States)

    McGuinty, Everett; Nelson, John; Carlson, Alain; Crowther, Eric; Bednar, Dina; Foroughe, Mirisse

    2016-05-01

    The zeitgeist for short-term psychotherapy efficacy has fundamentally shifted away from evidence-based practices to include evidence-informed practices, resulting in an equally important paradigm shift in outcome measurement designed to reflect change in this short-term modality. The present article delineates a short-term psychotherapy structure which defines four fundamental stages that all brief therapies may have in common, and are represented through Cognitive Behavioral Therapy, Solution-Focused Brief Therapy, Narrative Therapy, and Emotion-Focused Therapy. These four theoretical approaches were analyzed via a selected literature review through comparing and contrasting specific and common tasks as they relate to the process of psychotherapy and change. Once commonalities were identified within session, they were categorized or grouped into themes or general stages of change within the parameters of a four to six session model of short-term therapy. Commonalities in therapeutic stages of change may more accurately and uniformly measure outcome in short-term work, unlike the symptom-specific psychometric instruments of longer-term psychotherapy. A systematic framework for evaluating the client and clinician adherence to 20 specific tasks for these four short-term therapies is presented through the newly proposed, Brief Task Acquisition Scale (BTAS). It is further proposed that the client-clinicians' adherence to these tasks will track and ultimately increase treatment integrity. Thus, when the client-clinician relationship tracks and evaluates the three pillars of (1) stage/process change, (2) task acquisition, and (3) treatment integrity, the culmination of these efforts presents a new way of more sensitively measuring outcome in short-term psychotherapy. Data collection is suggested as a first step to empirically evaluate the testable hypotheses suggested within this current model. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The

  11. Therapeutic Process and Outcome: The Interplay of Research

    Science.gov (United States)

    Campbel, Holly

    2008-01-01

    From Freud through to modern times researchers have aimed to develop a clearer understanding of therapeutic processes and outcomes. Despite this continued interest in the field, the representation of psychotherapy processes and the applicability of research findings and recommendations to the therapeutic field continue to prove difficult.…

  12. Neuroimaging for psychotherapy research: current trends.

    Science.gov (United States)

    Weingarten, Carol P; Strauman, Timothy J

    2015-01-01

    This article reviews neuroimaging studies that inform psychotherapy research. An introduction to neuroimaging methods is provided as background for the increasingly sophisticated breadth of methods and findings appearing in psychotherapy research. We compiled and assessed a comprehensive list of neuroimaging studies of psychotherapy outcome, along with selected examples of other types of studies that also are relevant to psychotherapy research. We emphasized magnetic resonance imaging (MRI) since it is the dominant neuroimaging modality in psychological research. We summarize findings from neuroimaging studies of psychotherapy outcome, including treatment for depression, obsessive compulsive disorder (OCD), and schizophrenia. The increasing use of neuroimaging methods in the study of psychotherapy continues to refine our understanding of both outcome and process. We suggest possible directions for future neuroimaging studies in psychotherapy research.

  13. Nuclear cGMP-dependent kinase regulates gene expression via activity-dependent recruitment of a conserved histone deacetylase complex.

    Directory of Open Access Journals (Sweden)

    Yan Hao

    2011-05-01

    Full Text Available Elevation of the second messenger cGMP by nitric oxide (NO activates the cGMP-dependent protein kinase PKG, which is key in regulating cardiovascular, intestinal, and neuronal functions in mammals. The NO-cGMP-PKG signaling pathway is also a major therapeutic target for cardiovascular and male reproductive diseases. Despite widespread effects of PKG activation, few molecular targets of PKG are known. We study how EGL-4, the Caenorhabditis elegans PKG ortholog, modulates foraging behavior and egg-laying and seeks the downstream effectors of EGL-4 activity. Using a combination of unbiased forward genetic screen and proteomic analysis, we have identified a conserved SAEG-1/SAEG-2/HDA-2 histone deacetylase complex that is specifically recruited by activated nuclear EGL-4. Gene expression profiling by microarrays revealed >40 genes that are sensitive to EGL-4 activity in a SAEG-1-dependent manner. We present evidence that EGL-4 controls egg laying via one of these genes, Y45F10C.2, which encodes a novel protein that is expressed exclusively in the uterine epithelium. Our results indicate that, in addition to cytoplasmic functions, active EGL-4/PKG acts in the nucleus via a conserved Class I histone deacetylase complex to regulate gene expression pertinent to behavioral and physiological responses to cGMP. We also identify transcriptional targets of EGL-4 that carry out discrete components of the physiological response.

  14. Cyclic GMP alters Ca exchange in vascular smooth muscle

    International Nuclear Information System (INIS)

    Magliola, L.; Bailey, B.; Jones, A.W.

    1986-01-01

    Contraction and 42 K efflux from vascular smooth muscle stimulated either by norepinephrine (NE) or by K-depolarization is dependent on an increase in cytosolic Ca concentration. The purpose of this study was to determine if cyclic GMP (cGMP) inhibited these processes and if inhibition was secondary to the action of cGMP on Ca movements. Basal cGMP content of rat aorta was 1.2 fmol/mg wet wt. Sodium nitroprusside (NP) increased cGMP ∼2-fold at 1 nM and ∼750-fold at 1 μM with no effect on cAMP levels. A 5 min pretreatment with NP (1 μM) completely prevented tension development induced by 3 μM NE. The same concentration of NP also inhibited NE-stimulated 42 K and 45 Ca efflux > 90 and > 80%, respectively. Removal of NP in the continued presence of NE (3 μM) caused recovery of the 42 K efflux response to ∼75% of control with a half-time of ∼2.5 min. NP (1 μM) also caused a rapid relaxation of aorta contracted with 3 μM NE and a loss of the 42 K efflux response with half-times of 2-3 min. In contrast, 100 μM NP produced only a 50% inhibition of contraction induced by high K (55 mM). Also, NP (1 μM) inhibited K-stimulated 42 K efflux only ∼25%. These results demonstrate both a concentration- and a time-dependent relationship between increases in cGMP induced by NP and decreases in NE-stimulated contraction, 42 K and 45 Ca effluxes. They also indicate that the sensitivity of NE-induced contraction and 42 K efflux to NP is greater than that induced by high K. These studies suggest that cGMP modulates the control sites for Ca exchange in the plasma membrane and sarcoplasmic reticulum

  15. Psychotherapy Training: Residents' Perceptions and Experiences.

    Science.gov (United States)

    Kovach, Jessica G; Dubin, William R; Combs, Christopher J

    2015-10-01

    This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training. A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents. Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy. Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more

  16. Pro-survival Effects of 17β-Estradiol on Osteocytes Are Mediated by Nitric Oxide/cGMP via Differential Actions of cGMP-dependent Protein Kinases I and II*

    Science.gov (United States)

    Marathe, Nisha; Rangaswami, Hema; Zhuang, Shunhui; Boss, Gerry R.; Pilz, Renate B.

    2012-01-01

    Estrogens promote bone health in part by increasing osteocyte survival, an effect that requires activation of the protein kinases Akt and ERK1/2, but the molecular mechanisms involved are only partly understood. Because estrogens increase nitric oxide (NO) synthesis and NO can have anti-apoptotic effects, we examined the role of NO/cGMP signaling in estrogen regulation of osteocyte survival. Etoposide-induced death of MLO-Y4 osteocyte-like cells, assessed by trypan blue staining, caspase-3 cleavage, and TUNEL assays, was completely prevented when cells were pre-treated with 17β-estradiol. This protective effect was mimicked when cells were pre-treated with a membrane-permeable cGMP analog and blocked by pharmacological inhibitors of NO synthase, soluble guanylate cyclase, or cGMP-dependent protein kinases (PKGs), supporting a requirement for NO/cGMP/PKG signaling downstream of 17β-estradiol. siRNA-mediated knockdown and viral reconstitution of individual PKG isoforms demonstrated that the anti-apoptotic effects of estradiol and cGMP were mediated by PKG Iα and PKG II. Akt and ERK1/2 activation by 17β-estradiol required PKG II, and cGMP mimicked the effects of estradiol on Akt and ERK, including induction of ERK nuclear translocation. cGMP induced BAD phosphorylation on several sites, and experiments with phosphorylation-deficient BAD mutants demonstrated that the anti-apoptotic effects of cGMP and 17β-estradiol required BAD phosphorylation on Ser136 and Ser155; these sites were targeted by Akt and PKG I, respectively, and regulate BAD interaction with Bcl-2. In conclusion, 17β-estradiol protects osteocytes against apoptosis by activating the NO/cGMP/PKG cascade; PKG II is required for estradiol-induced activation of ERK and Akt, and PKG Iα contributes to pro-survival signaling by directly phosphorylating BAD. PMID:22117068

  17. Luteinizing hormone signaling phosphorylates and activates the cyclic GMP phosphodiesterase PDE5 in mouse ovarian follicles, contributing an additional component to the hormonally induced decrease in cyclic GMP that reinitiates meiosis.

    Science.gov (United States)

    Egbert, Jeremy R; Yee, Siu-Pok; Jaffe, Laurinda A

    2018-03-01

    Prior to birth, oocytes within mammalian ovarian follicles initiate meiosis, but then arrest in prophase until puberty, when with each reproductive cycle, one or more follicles are stimulated by luteinizing hormone (LH) to resume meiosis in preparation for fertilization. Within preovulatory follicles, granulosa cells produce high levels of cGMP, which diffuses into the oocyte to maintain meiotic arrest. LH signaling restarts meiosis by rapidly lowering the levels of cGMP in the follicle and oocyte. Part of this decrease is mediated by the dephosphorylation and inactivation the NPR2 guanylyl cyclase in response to LH, but the mechanism for the remainder of the cGMP decrease is unknown. At least one cGMP phosphodiesterase, PDE5, is activated by LH signaling, which would contribute to lowering cGMP. PDE5 exhibits increased cGMP-hydrolytic activity when phosphorylated on serine 92, and we recently demonstrated that LH signaling phosphorylates PDE5 on this serine and increases its activity in rat follicles. To test the extent to which this mechanism contributes to the cGMP decrease that restarts meiosis, we generated a mouse line in which serine 92 was mutated to alanine (Pde5-S92A), such that it cannot be phosphorylated. Here we show that PDE5 phosphorylation is required for the LH-induced increase in cGMP-hydrolytic activity, but that this increase has only a modest effect on the LH-induced cGMP decrease in mouse follicles, and does not affect the timing of meiotic resumption. Though we show that the activation of PDE5 is among the mechanisms contributing to the cGMP decrease, these results suggest that another cGMP phosphodiesterase is also activated by LH signaling. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. Psychotherapy of the child with true brain damage.

    Science.gov (United States)

    Christ, Adolph E

    1978-07-01

    Psychotherapy of the child with true brain damage presents special problems and requires special approaches. Those who are cognitively primitive--at the sensorimotor or preoperational stage of development--require a crisis approach; those at the concrete or formal operational stage can be treated with a modified insight-oriented approach. Development of a therapeutic alliance, establishment of workable defense mechanisms, identification and clarification of unalterable cognitive defects and issues of termination unique to this special population are discussed.

  19. Phosphodiesterase 9A regulates central cGMP and modulates responses to cholinergic and monoaminergic perturbation in vivo.

    Science.gov (United States)

    Kleiman, Robin J; Chapin, Douglas S; Christoffersen, Curt; Freeman, Jody; Fonseca, Kari R; Geoghegan, Kieran F; Grimwood, Sarah; Guanowsky, Victor; Hajós, Mihály; Harms, John F; Helal, Christopher J; Hoffmann, William E; Kocan, Geralyn P; Majchrzak, Mark J; McGinnis, Dina; McLean, Stafford; Menniti, Frank S; Nelson, Fredrick; Roof, Robin; Schmidt, Anne W; Seymour, Patricia A; Stephenson, Diane T; Tingley, Francis David; Vanase-Frawley, Michelle; Verhoest, Patrick R; Schmidt, Christopher J

    2012-05-01

    Cyclic nucleotides are critical regulators of synaptic plasticity and participate in requisite signaling cascades implicated across multiple neurotransmitter systems. Phosphodiesterase 9A (PDE9A) is a high-affinity, cGMP-specific enzyme widely expressed in the rodent central nervous system. In the current study, we observed neuronal staining with antibodies raised against PDE9A protein in human cortex, cerebellum, and subiculum. We have also developed several potent, selective, and brain-penetrant PDE9A inhibitors and used them to probe the function of PDE9A in vivo. Administration of these compounds to animals led to dose-dependent accumulation of cGMP in brain tissue and cerebrospinal fluid, producing a range of biological effects that implied functional significance for PDE9A-regulated cGMP in dopaminergic, cholinergic, and serotonergic neurotransmission and were consistent with the widespread distribution of PDE9A. In vivo effects of PDE9A inhibition included reversal of the respective disruptions of working memory by ketamine, episodic and spatial memory by scopolamine, and auditory gating by amphetamine, as well as potentiation of risperidone-induced improvements in sensorimotor gating and reversal of the stereotypic scratching response to the hallucinogenic 5-hydroxytryptamine 2A agonist mescaline. The results suggested a role for PDE9A in the regulation of monoaminergic circuitry associated with sensory processing and memory. Thus, PDE9A activity regulates neuronal cGMP signaling downstream of multiple neurotransmitter systems, and inhibition of PDE9A may provide therapeutic benefits in psychiatric and neurodegenerative diseases promoted by the dysfunction of these diverse neurotransmitter systems.

  20. Microbiological criteria for good manufacturing practice (GMP)

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, J [Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary); Zukal, E [Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary)

    1992-01-01

    Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.)

  1. Microbiological criteria for good manufacturing practice (GMP)

    International Nuclear Information System (INIS)

    Farkas, J.; Zukal, E.

    1992-01-01

    Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.) [de

  2. Reduced intracellular c-di-GMP content increases expression of quorum sensing-regulated genes in Pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    Chua, Song Lin; Liu, Yang; Li, Yingying

    2017-01-01

    Cyclic-di-GMP (c-di-GMP) is an intracellular secondary messenger which controls the biofilm life cycle in many bacterial species. High intracellular c-di-GMP content enhances biofilm formation via the reduction of motility and production of biofilm matrix, while low c-di-GMP content in biofilm...... cells leads to increased motility and biofilm dispersal. While the effect of high c-di-GMP levels on bacterial lifestyles is well studied, the physiology of cells at low c-di-GMP levels remains unclear. Here, we showed that Pseudomonas aeruginosa cells with high and low intracellular c-di-GMP contents...... possessed distinct transcriptome profiles. There were 535 genes being upregulated and 432 genes downregulated in cells with low c-di-GMP, as compared to cells with high c-di-GMP. Interestingly, both rhl and pqs quorum-sensing (QS) operons were expressed at higher levels in cells with low intracellular c-di-GMP...

  3. A cyclic GMP signalling module that regulates gliding motility in a malaria parasite.

    Directory of Open Access Journals (Sweden)

    Robert W Moon

    2009-09-01

    Full Text Available The ookinete is a motile stage in the malaria life cycle which forms in the mosquito blood meal from the zygote. Ookinetes use an acto-myosin motor to glide towards and penetrate the midgut wall to establish infection in the vector. The regulation of gliding motility is poorly understood. Through genetic interaction studies we here describe a signalling module that identifies guanosine 3', 5'-cyclic monophosphate (cGMP as an important second messenger regulating ookinete differentiation and motility. In ookinetes lacking the cyclic nucleotide degrading phosphodiesterase delta (PDEdelta, unregulated signalling through cGMP results in rounding up of the normally banana-shaped cells. This phenotype is suppressed in a double mutant additionally lacking guanylyl cyclase beta (GCbeta, showing that in ookinetes GCbeta is an important source for cGMP, and that PDEdelta is the relevant cGMP degrading enzyme. Inhibition of the cGMP-dependent protein kinase, PKG, blocks gliding, whereas enhanced signalling through cGMP restores normal gliding speed in a mutant lacking calcium dependent protein kinase 3, suggesting at least a partial overlap between calcium and cGMP dependent pathways. These data demonstrate an important function for signalling through cGMP, and most likely PKG, in dynamically regulating ookinete gliding during the transmission of malaria to the mosquito.

  4. c-di-GMP is an Effective Immunomodulator and Vaccine Adjuvant Against Pneumococcal Infection

    Science.gov (United States)

    Ogunniyi, Abiodun D.; Paton, James C.; Kirby, Alun C.; McCullers, Jonathan A.; Cook, Jan; Hyodo, Mamoru; Hayakawa, Yoshihiro; Karaolis, David K. R.

    2009-01-01

    Cyclic diguanylate (c-di-GMP) is a unique bacterial intracellular signaling molecule capable of stimulating enhanced protective innate immunity against various bacterial infections. The effects of intranasal pretreatment with c-di-GMP, or intraperitoneal coadministration of c-di-GMP with the pneumolysin toxoid (PdB) or PspA before pneumococcal challenge, was investigated in mice. We found that c-di-GMP had no significant direct short-term effect on the growth rate of S. pneumoniae either in vitro or in vivo. However, intranasal pretreatment of mice with c-di-GMP resulted in significant decrease in bacterial load in lungs and blood after serotypes 2 and 3 challenge, and significant decrease in lung titers after serotype 4 challenge. Potential cellular mediators of these enhanced protective responses were identified in lungs and draining lymph nodes. Intraperitoneal coadministration of c-di-GMP with PdB or PspA before challenge resulted in significantly higher antigen-specific antibody titers and increased survival of mice, compared to that obtained with alum adjuvant. These findings demonstrate that local or systemic c-di-GMP administration stimulates innate and adaptive immunity against invasive pneumococcal disease. We propose that c-di-GMP can be used as an effective broad spectrum immunomodulator and vaccine adjuvant to prevent infectious diseases. PMID:18640167

  5. The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study

    OpenAIRE

    Mithoefer, Michael C; Wagner, Mark T; Mithoefer, Ann T; Jerome, Lisa; Doblin, Rick

    2011-01-01

    Case reports indicate that psychiatrists administered ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA as ‘Ecstasy’ resulted in its criminalization in 1985. Over two decades later, this study is the first completed clinical trial evaluating MDMA as a therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory to both psychotherapy and psychopharmacology, were randomly assigned to psychotherapy with concomi...

  6. AN INTEGRATIVE GROUP PSYCHOTHERAPY PROGRAM FOR CHILDREN. THE WIZARDING SCHOOL

    Directory of Open Access Journals (Sweden)

    Oana Maria Popescu

    2012-02-01

    Full Text Available One of the most important tendencies in child psychotherapy is the integration of various psychotherapeutic approaches and technical interventions belonging to different orientations. Based on the Harry Potter stories, the „Wizarding School” structured group therapy program is a 12-step integratively oriented program applicable in personal development, individual and group therapy for children aged 6 to 13 (at present being adapted for adult psychotherapy. The program takes place within a fairy tale, being therefore a type of informal hypnotic trance. The interventions are drawn from the lessons described in Harry Potter’s story at Hogwarts, based on the fundamental principles of child psychotherapy and including elements of play therapy, art therapy, hypnotherapy, cognitive- behavioural therapy, transactional analysis, supportive therapy, family therapy and person centred therapy. From a theoretical point of view the program is based on elements from a number of psychotherapeutic approaches, the main concept being that we need to create a therapeutic myth that is acceptable to a child. The program is not suitable for children with structural deficits, who have difficulties in making the difference between fantasy and reality.

  7. c-di-GMP Regulates Various Phenotypes and Insecticidal Activity of Gram-Positive Bacillus thuringiensis

    Directory of Open Access Journals (Sweden)

    Yang Fu

    2018-02-01

    Full Text Available C-di-GMP has been well investigated to play significant roles in the physiology of many Gram-negative bacteria. However, its effect on Gram-positive bacteria is less known. In order to more understand the c-di-GMP functions in Gram-positive bacteria, we have carried out a detailed study on the c-di-GMP-metabolizing enzymes and their physiological functions in Bacillus thuringiensis, a Gram-positive entomopathogenic bacterium that has been applied as an insecticide successfully. We performed a systematic study on the ten putative c-di-GMP-synthesizing enzyme diguanylate cyclases (DGCs and c-di-GMP-degrading enzyme phosphodiesterases (PDEs in B. thuringiensis BMB171, and artificially elevated the intracellular c-di-GMP level in BMB171 by deleting one or more pde genes. We found increasing level of intracellular c-di-GMP exhibits similar activities as those in Gram-negative bacteria, including altered activities in cell motility, biofilm formation, and cell-cell aggregation. Unexpectedly, we additionally found a novel function exhibited by the increasing level of c-di-GMP to promote the insecticidal activity of this bacterium against Helicoverpa armigera. Through whole-genome transcriptome profile analyses, we found that 4.3% of the B. thuringiensis genes were differentially transcribed when c-di-GMP level was increased, and 77.3% of such gene products are involved in some regulatory pathways not reported in other bacteria to date. In summary, our study represents the first comprehensive report on the c-di-GMP-metabolizing enzymes, their effects on phenotypes, and the transcriptome mediated by c-di-GMP in an important Gram-positive bacterium.

  8. Mixed methods in psychotherapy research: A review of method(ology) integration in psychotherapy science.

    Science.gov (United States)

    Bartholomew, Theodore T; Lockard, Allison J

    2018-06-13

    Mixed methods can foster depth and breadth in psychological research. However, its use remains in development in psychotherapy research. Our purpose was to review the use of mixed methods in psychotherapy research. Thirty-one studies were identified via the PRISMA systematic review method. Using Creswell & Plano Clark's typologies to identify design characteristics, we assessed each study for rigor and how each used mixed methods. Key features of mixed methods designs and these common patterns were identified: (a) integration of clients' perceptions via mixing; (b) understanding group psychotherapy; (c) integrating methods with cases and small samples; (d) analyzing clinical data as qualitative data; and (e) exploring cultural identities in psychotherapy through mixed methods. The review is discussed with respect to the value of integrating multiple data in single studies to enhance psychotherapy research. © 2018 Wiley Periodicals, Inc.

  9. "Many Secrets Are Told around Horses": An Ethnographic Study of Equine-Assisted Psychotherapy

    Science.gov (United States)

    Van Tiem, Jennifer

    2014-01-01

    This dissertation presents an ethnography of equine-assisted psychotherapy (EAP) based on nine months of fieldwork at "Equine Healers," a non-profit organization in central Colorado that specialized in various therapeutic modalities associated with EAP. In bridging scholarly work around animals, a literature suffused with the notion of…

  10. Regulation of the Na(+)-K(+)-2Cl(-) cotransporter by cGMP/cGMP-dependent protein kinase I after furosemide administration.

    Science.gov (United States)

    Limmer, Franziska; Schinner, Elisabeth; Castrop, Hayo; Vitzthum, Helga; Hofmann, Franz; Schlossmann, Jens

    2015-10-01

    Sodium chloride reabsorption in the thick ascending limb of the loop of Henle is mediated by the Na(+)-K(+)-2Cl(-) cotransporter (NKCC2). The loop diuretic furosemide is a potent inhibitor of NKCC2. However, less is known about the mechanism regulating the electrolyte transporter. Considering the well-established effects of nitric oxide on NKCC2 activity, cGMP is likely involved in this regulation. cGMP-dependent protein kinase I (cGKI; PKGI) is a cGMP target protein that phosphorylates different substrates after activation through cGMP. We investigated the potential correlation between the cGMP/cGKI pathway and NKCC2 regulation. We treated wild-type (wt) and cGKIα-rescue mice with furosemide. cGKIα-rescue mice expressed cGKIα only under the control of the smooth muscle-specific transgelin (SM22) promoter in a cGKI deficient background. Furosemide treatment increased the urine excretion of sodium and chloride in cGKIα-rescue mice compared to that in wt mice. We analyzed the phosphorylation of NKCC2 by western blotting and immunostaining using the phosphospecific antibody R5. The administration of furosemide significantly increased the phosphorylated NKCC2 signal in wt but not in cGKIα-rescue mice. NKCC2 activation led to its phosphorylation and membrane translocation. To examine whether cGKI was involved in this process, we analyzed vasodilator-stimulated phosphoprotein, which is phosphorylated by cGKI. Furosemide injection resulted in increased vasodilator-stimulated phosphoprotein phosphorylation in wt mice. We hypothesize that furosemide administration activated cGKI, leading to NKCC2 phosphorylation and membrane translocation. This cGKI-mediated pathway could be a mechanism to compensate for the inhibitory effect of furosemide on NKCC2. © 2015 FEBS.

  11. Group Psychotherapy in Italy.

    Science.gov (United States)

    Giannone, Francesca; Giordano, Cecilia; Di Blasi, Maria

    2015-10-01

    This article describes the history and the prevailing orientations of group psychotherapy in Italy (psychoanalytically oriented, psychodrama, CBT groups) and particularly group analysis. Provided free of charge by the Italian health system, group psychotherapy is growing, but its expansion is patchy. The main pathways of Italian training in the different group psychotherapy orientations are also presented. Clinical-theoretical elaboration on self development, psychopathology related to group experiences, and the methodological attention paid to objectives and methods in different clinical groups are issues related to group therapy in Italy. Difficulties in the relationship between research and clinical practice are discussed, as well as the empirical research network that tries to bridge the gap between research and clinical work in group psychotherapy. The economic crisis in Italy has led to massive cuts in health care and to an increasing demand for some forms of psychological treatment. For these reasons, and because of its positive cost-benefit ratio, group psychotherapy is now considered an important tool in the national health care system to expand the clinical response to different forms of psychological distress.

  12. Mapping patterns of change in emotion-focused psychotherapy: Implications for theory, research, practice, and training.

    Science.gov (United States)

    Watson, Jeanne C

    2018-05-01

    An important objective in humanistic-experiential psychotherapies and particularly emotion-focused psychotherapy (EFT) is to map patterns of change. Effective mapping of the processes and pathways of change requires that in-session processes be linked to in-session resolutions, immediate post-session changes, intermediate outcome, final therapy outcome, and longer-term change. This is a challenging and long-term endeavour. Fine-grained descriptions of in-session processes that lead to resolution of specific interpersonal and intrapersonal issues linked with longer-term outcomes are the foundation of EFT, the process-experiential approach. In this paper, evidence in support of EFT as a treatment approach will be reviewed along with research on two mechanisms of change, viewed as central to EFT, clients' emotional processing and the therapeutic relationship conditions. The implications for psychotherapy research are discussed. Given the methodological constraints, there is a need for more innovative methodologies and strategies to investigate specific psychotherapy processes within and across different approaches to map patterns and mechanisms of change to enhance theory, research, practice, and training.

  13. Psychotherapy of Mood Disorders

    Science.gov (United States)

    Picardi, Angelo; Gaetano, Paola

    2014-01-01

    In the last decades, psychotherapy has gained increasing acceptance as a major treatment option for mood disorders. Empirically supported treatments for major depression include cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), behavioural therapy and, to a lesser extent, short-term psychodynamic psychotherapy. Meta-analytic evidence suggests that psychotherapy has a significant and clinically relevant, though not large, effect on chronic forms of depression. Psychotherapy with chronic patients should take into account several important differences between patients with chronic and acute depression (identification with their depressive illness, more severe social skill deficits, persistent sense of hopelessness, need of more time to adapt to better circumstances). Regarding adolescent depression, the effectiveness of IPT and CBT is empirically supported. Adolescents require appropriate modifications of treatment (developmental approach to psychotherapy, involvement of parents in therapy). The combination of psychotherapy and medication has recently attracted substantial interest; the available evidence suggests that combined treatment has small but significant advantages over each treatment modality alone, and may have a protective effect against depression relapse or recurrence. Psychobiological models overcoming a rigid brain-mind dichotomy may help the clinician give patients a clear rationale for the combination of psychological and pharmacological treatment. In recent years, evidence has accumulated regarding the effectiveness of psychological therapies (CBT, family-focused therapy, interpersonal and social rhythm therapy, psychoeducation) as an adjunct to medication in bipolar disorder. These therapies share several common elements and there is considerable overlap in their actual targets. Psychological interventions were found to be useful not only in the treatment of bipolar depressive episodes, but in all phases of the disorder. PMID

  14. Psychotherapy Integration via Theoretical Unification

    Directory of Open Access Journals (Sweden)

    Warren W. Tryon

    2017-01-01

    Full Text Available Meaningful psychotherapy integration requires theoretical unification because psychotherapists can only be expected to treat patients with the same diagnoses similarly if they understand these disorders similarly and if they agree on the mechanisms by which effective treatments work. Tryon (in press has proposed a transtheoretic transdiagnostic psychotherapy based on an Applied Psychological Science (APS clinical orientation, founded on a BioPsychology Network explanatory system that provides sufficient theoretical unification to support meaningful psychotherapy integration. That proposal focused mainly on making a neuroscience argument. This article makes a different argument for theoretical unification and consequently psychotherapy integration. The strength of theories of psychotherapy, like all theory, is to focus on certain topics, goals, and methods. But this strength is also a weakness because it can blind one to alternative perspectives and thereby promote unnecessary competition among therapies. This article provides a broader perspective based on learning and memory that is consistent with the behavioral, cognitive, cognitive-behavioral, psychodynamic, pharmacologic, and Existential/Humanistic/Experiential clinical orientations. It thereby provides a basis for meaningful psychotherapy integration.

  15. High-Performance Liquid Chromatography (HPLC)-Based Detection and Quantitation of Cellular c-di-GMP.

    Science.gov (United States)

    Petrova, Olga E; Sauer, Karin

    2017-01-01

    The modulation of c-di-GMP levels plays a vital role in the regulation of various processes in a wide array of bacterial species. Thus, investigation of c-di-GMP regulation requires reliable methods for the assessment of c-di-GMP levels and turnover. Reversed-phase high-performance liquid chromatography (RP-HPLC) analysis has become a commonly used approach to accomplish these goals. The following describes the extraction and HPLC-based detection and quantification of c-di-GMP from Pseudomonas aeruginosa samples, a procedure that is amenable to modifications for the analysis of c-di-GMP in other bacterial species.

  16. cGMP-dependent protein kinase Iα associates with the antidepressant-sensitive serotonin transporter and dictates rapid modulation of serotonin uptake

    Directory of Open Access Journals (Sweden)

    Steiner Jennifer A

    2009-08-01

    Full Text Available Abstract Background The Na+/Cl--dependent serotonin (5-hydroxytryptamine, 5-HT transporter (SERT is a critical element in neuronal 5-HT signaling, being responsible for the efficient elimination of 5-HT after release. SERTs are not only targets for exogenous addictive and therapeutic agents but also can be modulated by endogenous, receptor-linked signaling pathways. We have shown that neuronal A3 adenosine receptor activation leads to enhanced presynaptic 5-HT transport in vitro and an increased rate of SERT-mediated 5-HT clearance in vivo. SERT stimulation by A3 adenosine receptors derives from an elevation of cGMP and subsequent activation of both cGMP-dependent protein kinase (PKG and p38 mitogen-activated protein kinase. PKG activators such as 8-Br-cGMP are known to lead to transporter phosphorylation, though how this modification supports SERT regulation is unclear. Results In this report, we explore the kinase isoform specificity underlying the rapid stimulation of SERT activity by PKG activators. Using immortalized, rat serotonergic raphe neurons (RN46A previously shown to support 8-Br-cGMP stimulation of SERT surface trafficking, we document expression of PKGI, and to a lower extent, PKGII. Quantitative analysis of staining profiles using permeabilized or nonpermeabilized conditions reveals that SERT colocalizes with PKGI in both intracellular and cell surface domains of RN46A cell bodies, and exhibits a more restricted, intracellular pattern of colocalization in neuritic processes. In the same cells, SERT demonstrates a lack of colocalization with PKGII in either intracellular or surface membranes. In keeping with the ability of the membrane permeant kinase inhibitor DT-2 to block 8-Br-cGMP stimulation of SERT, we found that DT-2 treatment eliminated cGMP-dependent kinase activity in PKGI-immunoreactive extracts resolved by liquid chromatography. Similarly, treatment of SERT-transfected HeLa cells with small interfering RNAs targeting

  17. Evidence-Based Psychotherapy: Advantages and Challenges.

    Science.gov (United States)

    Cook, Sarah C; Schwartz, Ann C; Kaslow, Nadine J

    2017-07-01

    Evidence-based psychotherapies have been shown to be efficacious and cost-effective for a wide range of psychiatric conditions. Psychiatric disorders are prevalent worldwide and associated with high rates of disease burden, as well as elevated rates of co-occurrence with medical disorders, which has led to an increased focus on the need for evidence-based psychotherapies. This chapter focuses on the current state of evidence-based psychotherapy. The strengths and challenges of evidence-based psychotherapy are discussed, as well as misperceptions regarding the approach that may discourage and limit its use. In addition, we review various factors associated with the optimal implementation and application of evidence-based psychotherapies. Lastly, suggestions are provided on ways to advance the evidence-based psychotherapy movement to become truly integrated into practice.

  18. Microbiological criteria for good manufacturing practice (GMP)

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, J. (Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary)); Zukal, E. (Inst. of Preservation and Livestock Products Technology, Univ. of Horticulture and Food Industry, Budapest (Hungary))

    1992-01-01

    Good manufacturing practice (GMP) consist of an effective manufacturing operation and an effective application of food control. GMP is best supported by the Hazard Analysis Critical Control Point system (HACCP) of the preventive quality assurance, which requires that food irradiation as any food processing technology should be used only with foods of an acceptable quality and adequate handling and storage procedures should precede and follow the processing. The paper concentrates on the first element of the HACCP system for an irradiation plant: the incoming product control, i.e. whether GMP of foods to be irradiated can be assessed by establishing microbiological criteria for their previous good manufacturing practice. In this regard, it summarizes considerations and findings of a ''Consultation on Microbiological Criteria for Foods to be Further Processed Including by Irradiation'' held in 1989 by the International Consultative Group on Food irradiation at the Headquarters of the World Health Organization, Geneva. Difficulties in establishing reference values and defining good manufacturing practices will be pointed out. (orig.)

  19. The cyclic-di-GMP signaling pathway in the Lyme disease spirochete, Borrelia burgdorferi

    Directory of Open Access Journals (Sweden)

    Elizabeth A. Novak

    2014-05-01

    Full Text Available In nature, the Lyme disease spirochete Borrelia burgdorferi cycles between the unrelated environments of the Ixodes tick vector and mammalian host. In order to survive transmission between hosts, B. burgdorferi must be able to not only detect changes in its environment, but also rapidly and appropriately respond to these changes. One manner in which this obligate parasite regulates and adapts to its changing environment is through cyclic-di-GMP (c-di-GMP signaling. c-di-GMP has been shown to be instrumental in orchestrating the adaptation of B. burgdorferi to the tick environment. B. burgdorferi possesses only one set of c-di-GMP-metabolizing genes (one diguanylate cyclase and two distinct phosphodiesterases and one c-di-GMP-binding PilZ-domain protein designated as PlzA. While studies in the realm of c-di-GMP signaling in B. burgdorferi have exploded in the last few years, there are still many more questions than answers. Elucidation of the importance of c-di-GMP signaling to B. burgdorferi may lead to the identification of mechanisms that are critical for the survival of B. burgdorferi in the tick phase of the enzootic cycle as well as potentially delineate a role (if any c-di-GMP may play in the transmission and virulence of B. burgdorferi during the enzootic cycle, thereby enabling the development of effective drugs for the prevention and/or treatment of Lyme disease.

  20. Introduction: attachment theory and psychotherapy.

    Science.gov (United States)

    Levy, Kenneth N

    2013-11-01

    In this introduction to the JCLP: In Session 69(11) issue on attachment theory and psychotherapy, the key points of attachment theory (Bowlby, , , 1981) and its relevance to psychotherapy are briefly described. The aim of this issue is to provide case illustrations of how an attachment theory perspective and principles can expand our understanding of psychotherapy practice. © 2013 Wiley Periodicals, Inc.

  1. Integration in psychotherapy: Reasons and challenges.

    Science.gov (United States)

    Fernández-Álvarez, Héctor; Consoli, Andrés J; Gómez, Beatriz

    2016-11-01

    Although integration has been formally influencing the field of psychotherapy since the 1930s, its impact gained significant momentum during the 1980s. Practical, theoretical, and scientific reasons help to explain the growing influence of integration in psychotherapy. The field of psychotherapy is characterized by many challenges which integration may change into meaningful opportunities. Nonetheless, many obstacles remain when seeking to advance integration. To appreciate the strength of integration in psychotherapy we describe an integrative, comprehensive approach to service delivery, research, and training. We then discuss the role of integration in the future of psychotherapy. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Making Psychotherapy Great Again?

    Science.gov (United States)

    Plakun, Eric M

    2017-05-01

    Psychotherapy never stopped being as "great" as other treatments. This column explores the evidence base for both psychotherapy and medications, using depression as a specific example. The limitations are comparable for psychotherapy and medication, with much of the evidence based on small degrees of "statistically significant" rather than "clinically meaningful" change. Our field's biomedical emphasis leads to a false assumption that most patients present with single disorders, when comorbidity is the rule rather than the exception. This false assumption contributes to limitations in the evidence base and in our ability to treat patients optimally.

  3. Psychotherapy in long-term care: A review.

    Science.gov (United States)

    Bharucha, Ashok J; Dew, Mary Amanda; Miller, Mark D; Borson, Soo; Reynolds, Charles

    2006-11-01

    Psychological distress in long-term care (LTC) settings is highly prevalent and crosses many conventional psychiatric diagnostic boundaries. Mental health professionals who consult in LTC facilities have experienced firsthand the impact of a variety of nonpharmacological therapeutic approaches on individual residents, yet these are rarely investigated in a systematic fashion, and even less commonly reported in the literature. The present report summarizes the state-of-evidence of "talk therapies" for depression and psychological well-being in LTC facilities by reviewing controlled trials of psychotherapy for LTC residents published in English-language peer-reviewed journals. We excluded studies of nonpharmacological approaches designed primarily to curb behavioral disturbances of dementia, and those psychosocial interventions using an approach other than "talk therapy" in individual or group format since they have been reviewed in detail elsewhere. A majority of the 18 studies that met our inclusion criteria reported significant short- and, in some cases, longer-term benefits on instruments measuring depression, hopelessness, self-esteem, perceived control, and a host of other psychological variables. However, these findings must be interpreted within the severe methodological limitations of many studies, including small sample sizes, variable study entry criteria, short duration of trials, heterogeneous outcome assessment methods, and lack of detail on intervention methods. Nevertheless, the positive efficacy of these approaches, when understood within the framework of potential serious complications of pharmacotherapy for frail elders with multiple comorbidities, polypharmacy, and a narrow therapeutic index, suggests a strong need for methodologically rigorous trials of psychotherapy in the LTC setting, especially in combination with pharmacotherapy.

  4. A study on relations between the levels of GMP-140 and microangiopathy in NIDDM

    International Nuclear Information System (INIS)

    Du Tongxin; Wang Zizheng; Shi Hongzhen

    1995-01-01

    The relations between the level of GMP-140 and microangiopathy in NIDDM for earlier diagnosis or better treatment are investigated, the level of GMP-140 in both platelet and plasma was measured. The level of GMP-140 in both platelet and plasma in 104 cases with NIDDM (55 with and 49 without microagiopathy) and 38 controls were assayed by RIA and also simultaneously with direct platelet count. The level of GMP-140 in both platelet and plasma in NIDDM was remarkably higher than that in controls (P 1 = 0.69, r 2 = 0.75). No differences existed in platelet count between NIDDM and controls. The level of GMP-140 and ophthalmoscopic study had no change after decreasing the concentration of blood glucose (<7.8 mmol/L) and administrating aspirin for 6 months. Microangiopathy in NIDDM had close relation with platelet function and the level of GMP-140

  5. Gauging and visualizing c-di-GMP levels in pseudomonas aeruginosa using fluorescence-based biosensors

    DEFF Research Database (Denmark)

    Rybtke, Morten; Chua, Song Lin; Yam, Joey Kuok Hoong

    2017-01-01

    Recent research has shown that the molecule c-di-GMP is an important second messenger regulating various functions in bacteria. In particular, the implication of c-di-GMP as a positive regulator of adhesion and biofilm formation has gained momentum as a highly relevant research topic, as detailed...... knowledge about the underlying regulatory mechanisms may enable the development of measures to control biofilms in both industrial and medical settings. Accordingly, it is in many cases of interest to measure the c-di-GMP level in bacteria under specific conditions or in specific mutant strains. We have...... developed a collection of fluorescence-based c-di-GMP biosensors capable of gauging the c-di-GMP level in Pseudomonas aeruginosa and closely related bacteria. Here, we describe protocols for the use of these biosensors in gauging and visualizing cellular c-di-GMP levels of P. aeruginosa both in in vitro...

  6. Disclosure of incidental constituents of psychotherapy as a moral obligation for psychiatrists and psychotherapists.

    Science.gov (United States)

    Trachsel, Manuel; Gaab, Jens

    2016-08-01

    Informed consent to medical intervention reflects the moral principle of respect for autonomy and the patient's right to self-determination. In psychotherapy, this includes a requirement to inform the patient about those components of treatment purported to cause the therapeutic effect. This information must encompass positive expectancies of change and placebo-related or incidental constituent therapy effects, which are as important as specific intervention techniques for the efficacy of psychotherapy. There is a risk that informing the patient about possible incidental constituents of therapy may reduce or even completely impede these effects, with negative consequences for overall outcome. However, withholding information about incidental constituents of psychotherapy would effectively represent a paternalistic action at the expense of patient autonomy; whether such paternalism might in certain circumstances be justified forms part of the present discussion. 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/

  7. Interpersonal psychotherapy for anorexia nervosa.

    Science.gov (United States)

    McIntosh, V V; Bulik, C M; McKenzie, J M; Luty, S E; Jordan, J

    2000-03-01

    This paper outlines the rationale for treating individuals with anorexia nervosa using interpersonal psychotherapy. We review theoretical, empirical, and psychotherapy literature relating to interpersonal functioning in anorexia nervosa. Etiological theories emphasize interpersonal and family dysfunction in the development of anorexia nervosa. Research supports the notion that families of individuals with anorexia nervosa have dysfunctional patterns of communication. The history of treatment for anorexia nervosa emphasizes the need for resolution of interpersonal dysfunction, within the traditions of psychodynamic, family therapy, and multidimensional therapies. Interpersonal psychotherapy is a time-limited psychotherapy based on the notion that regardless of etiology, interpersonal relationships are intertwined with symptomatology. The goals of the therapy are to improve interpersonal functioning and thereby decrease symptomatology. Factors identified as important in the development of anorexia nervosa are readily conceptualized within the interpersonal psychotherapy problem areas of grief, interpersonal disputes, interpersonal deficits, and role transitions. Copyright 2000 by John Wiley & Sons, Inc.

  8. Intercellular signaling via cyclic GMP diffusion through gap junctions restarts meiosis in mouse ovarian follicles.

    Science.gov (United States)

    Shuhaibar, Leia C; Egbert, Jeremy R; Norris, Rachael P; Lampe, Paul D; Nikolaev, Viacheslav O; Thunemann, Martin; Wen, Lai; Feil, Robert; Jaffe, Laurinda A

    2015-04-28

    Meiosis in mammalian oocytes is paused until luteinizing hormone (LH) activates receptors in the mural granulosa cells of the ovarian follicle. Prior work has established the central role of cyclic GMP (cGMP) from the granulosa cells in maintaining meiotic arrest, but it is not clear how binding of LH to receptors that are located up to 10 cell layers away from the oocyte lowers oocyte cGMP and restarts meiosis. Here, by visualizing intercellular trafficking of cGMP in real-time in live follicles from mice expressing a FRET sensor, we show that diffusion of cGMP through gap junctions is responsible not only for maintaining meiotic arrest, but also for rapid transmission of the signal that reinitiates meiosis from the follicle surface to the oocyte. Before LH exposure, the cGMP concentration throughout the follicle is at a uniformly high level of ∼2-4 μM. Then, within 1 min of LH application, cGMP begins to decrease in the peripheral granulosa cells. As a consequence, cGMP from the oocyte diffuses into the sink provided by the large granulosa cell volume, such that by 20 min the cGMP concentration in the follicle is uniformly low, ∼100 nM. The decrease in cGMP in the oocyte relieves the inhibition of the meiotic cell cycle. This direct demonstration that a physiological signal initiated by a stimulus in one region of an intact tissue can travel across many layers of cells via cyclic nucleotide diffusion through gap junctions could provide a general mechanism for diverse cellular processes.

  9. Psychotherapy, psychoanalysis and urban poverty in Argentina.

    Science.gov (United States)

    Epele, Maria Esther

    2016-12-01

    Based on ethnographic research carried out in the Buenos Aires Metropolitan Area, this paper examines the views of social actors on the psychoanalytically-oriented psychotherapy focused on marginalized populations. From Foucault's perspective on the forms of truth-telling, the aim of this paper is to analyze, as a preliminary research report, treatments according to the native ways of speaking and listening, which dominate the description of therapeutic experiences of patients who come to the treatment without any professional intermediation. The neoliberal transformations of the past decades in Argentina changed both the landscape of the public health system and the daily lives of marginalized people. Considering such changes, this paper examines the ways in which verbal actions (speaking and listening) take place in psychotherapy and mark the course not only of treatments but also the temporal rhythms of their development, and their various levels of efficacy. Finally, the discussion focuses on how ways of speaking and listening in treatments are modeled not only by institutional dynamics but also by the characteristics these verbal activities take in everyday life under the logics of power that prevail over them.

  10. Allogenic banking of dental pulp stem cells for innovative therapeutics.

    Science.gov (United States)

    Collart-Dutilleul, Pierre-Yves; Chaubron, Franck; De Vos, John; Cuisinier, Frédéric J

    2015-08-26

    Medical research in regenerative medicine and cell-based therapy has brought encouraging perspectives for the use of stem cells in clinical trials. Multiple types of stem cells, from progenitors to pluripotent stem cells, have been investigated. Among these, dental pulp stem cells (DPSCs) are mesenchymal multipotent cells coming from the dental pulp, which is the soft tissue within teeth. They represent an interesting adult stem cell source because they are recovered in large amount in dental pulps with non-invasive techniques compared to other adult stem cell sources. DPSCs can be obtained from discarded teeth, especially wisdom teeth extracted for orthodontic reasons. To shift from promising preclinical results to therapeutic applications to human, DPSCs must be prepared in clinical grade lots and transformed into advanced therapy medicinal products (ATMP). As the production of patient-specific stem cells is costly and time-consuming, allogenic biobanking of clinical grade human leukocyte antigen (HLA)-typed DPSC lines provides efficient innovative therapeutic products. DPSC biobanks represent industrial and therapeutic innovations by using discarded biological tissues (dental pulps) as a source of mesenchymal stem cells to produce and store, in good manufacturing practice (GMP) conditions, DPSC therapeutic batches. In this review, we discuss about the challenges to transfer biological samples from a donor to HLA-typed DPSC therapeutic lots, following regulations, GMP guidelines and ethical principles. We also present some clinical applications, for which there is no efficient therapeutics so far, but that DPSCs-based ATMP could potentially treat.

  11. Therapeutic Alliance in Telephone-Administered Cognitive-Behavioral Therapy for Hematopoietic Stem Cell Transplant Survivors

    Science.gov (United States)

    Applebaum, Allison J.; DuHamel, Katherine N.; Winkel, Gary; Rini, Christine; Greene, Paul B.; Mosher, Catherine E.; Redd, William H.

    2012-01-01

    Objective: A strong therapeutic alliance has been found to predict psychotherapeutic treatment success across a variety of therapeutic modalities and patient populations. However, only a few studies have examined therapeutic alliance as a predictor of psychotherapy outcome among cancer survivors, and none have examined this relation in…

  12. Attitudes of psychotherapists towards pharmacotherapy in the course of psychotherapy

    Directory of Open Access Journals (Sweden)

    Sławomir Murawiec

    2017-06-01

    Full Text Available Background: In contrast to the reality of clinical practice, in which psychotherapy and pharmacotherapy are frequently combined, the attitudes of psychotherapists towards the use of pharmacotherapy in conjunction with psychotherapy have to date been rarely studied. Method: A special questionnaire was designed for the purpose of the study. An electronic format allowing for anonymous online responses was sent to psychotherapists from two selected mental health institutions in Warsaw. The results were analysed statistically. Results: One hundred six psychotherapists returned a completed questionnaire. They were classified into three groups depending on the length of psychotherapeutic practice as well as into groups of  cognitive-behavioural, psychodynamic/psychoanalytic and  systemic/integrative psychotherapists. Although cognitive-behavioural therapists do not treat more patients than therapists of other modalities, they encounter significantly more patients who receive medications (p = 0.001 and the number of their patients receiving combined treatment is  increasing during psychotherapy. The  highest knowledge of  drug names was reported in  the group of psychodynamic/psychoanalytic therapists. Integrative and systemic therapists more often declared their positive attitude towards combining psychotherapy with pharmacotherapy (Chi-squared test, χ2; p = 0.04. Psychotherapists declaring a neutral attitude towards pharmacotherapy – regardless of the therapeutic modality – had generally more patients in therapy than therapists by whom the use of drugs in the course of psychotherapy was perceived positively or negatively (p < 0.05. Conclusions: The use of medications in the course of psychotherapy is a result of an interplay between many factors, including patients’ preferences, psychotherapeutic modality and the age of a psychotherapist.

  13. Should psychotherapy consider reincarnation?

    Science.gov (United States)

    Peres, Julio F P

    2012-02-01

    There is increasing recognition of the need to take into account the cultural environment and belief systems of psychotherapy patients because these values reflect basic assumptions about man's nature and the cognitive references used to cope with psychological difficulties. Currently accepted psychotherapeutic approaches take no account of the belief in life after death held by most of the world's population. The World Values Survey (http://www.worldvaluessurvey.org) showed that there are large numbers of reincarnationists around the world, and whatever the reasons for believing in reincarnation, psychotherapeutic approaches should not ignore this significant group of people. Respect for patient opinions and subjective realities is a therapeutic need and an ethical duty, even though therapists may not share the same beliefs. Guidelines are suggested for professionals to develop collaborative models that help patients mobilize their intrinsic intelligence to find solutions to their complaints.

  14. 8-Nitro-cGMP promotes bone growth through expansion of growth plate cartilage.

    Science.gov (United States)

    Hoshino, Marie; Kaneko, Kotaro; Miyamoto, Yoichi; Yoshimura, Kentaro; Suzuki, Dai; Akaike, Takaaki; Sawa, Tomohiro; Ida, Tomoaki; Fujii, Shigemoto; Ihara, Hideshi; Tanaka, Junichi; Tsukuura, Risa; Chikazu, Daichi; Mishima, Kenji; Baba, Kazuyoshi; Kamijo, Ryutaro

    2017-09-01

    In endochondral ossification, growth of bones occurs at their growth plate cartilage. While it is known that nitric oxide (NO) synthases are required for proliferation of chondrocytes in growth plate cartilage and growth of bones, the precise mechanism by which NO facilitates these process has not been clarified yet. C-type natriuretic peptide (CNP) also positively regulate elongation of bones through expansion of the growth plate cartilage. Both NO and CNP are known to use cGMP as the second messenger. Recently, 8-nitro-cGMP was identified as a signaling molecule produced in the presence of NO in various types of cells. Here, we found that 8-nitro-cGMP is produced in proliferating chondrocytes in the growth plates, which was enhanced by CNP, in bones cultured ex vivo. In addition, 8-nitro-cGMP promoted bone growth with expansion of the proliferating zone as well as increase in the number of proliferating cells in the growth plates. 8-Nitro-cGMP also promoted the proliferation of chondrocytes in vitro. On the other hand, 8-bromo-cGMP enhanced the growth of bones with expansion of hypertrophic zone of the growth plates without affecting either the width of proliferating zone or proliferation of chondrocytes. These results indicate that 8-nitro-cGMP formed in growth plate cartilage accelerates chondrocyte proliferation and bone growth as a downstream molecule of NO. Copyright © 2017. Published by Elsevier Inc.

  15. Psychotherapy Versus Pharmacotherapy of Depression: What's the Evidence?

    Science.gov (United States)

    Leichsenring, Falk; Steinert, Christiane; Hoyer, Jürgen

    Depression may be treated by psychotherapy or pharmacotherapy or their combination. There is an ongoing debate whether one of these approaches is possibly superior. A recent meta-analysis reported results in favour of pharmacotherapy. Individual studies and meta-analyses on the comparative efficacy of psychotherapy vs. pharmacotherapy were reviewed. Evidence suggests that psychotherapy and pharmacotherapy are equally efficacious in the short-term, but psychotherapy is superior in the long-term. For the recently stated hypothesis that pharmacotherapy is superior to psychotherapy in studies without a pill placebo condition, which implies equally including a positive expectancy effect for both pharmacotherapy and psychotherapy no evidence was found. Depression may be treated by psychotherapy or pharmacotherapy with equivalent results in the short-term and advantages for psychotherapy in the long-term. As the rates of response and remission are still limited in both treatments, further improvement of treatments is required.

  16. [Mythodrama--a group psychotherapy model for work with children and adolescents].

    Science.gov (United States)

    Guggenbühl, A

    1992-10-01

    This article discusses group psychotherapy as a possible crisis intervention technique for children and juveniles with behavioral problems at school or whose families are going through divorce, or as an intervention technique in trouble some school classes. The therapeutic group work at the Children and Juvenile Educational Counselling Centre in Bern, Switzerland, is described - "mythodrama" or the "tales, fiction and horror technique", a therapeutic approach which was developed during the last couple of years. The tale at the beginning of the article serves as an introduction and is followed by a description of the different phases of mythodrama. Finally, the main elements of this approach are summarized.

  17. Novel cyclic di-GMP effectors of the YajQ protein family control bacterial virulence.

    Directory of Open Access Journals (Sweden)

    Shi-qi An

    2014-10-01

    Full Text Available Bis-(3',5' cyclic di-guanylate (cyclic di-GMP is a key bacterial second messenger that is implicated in the regulation of many critical processes that include motility, biofilm formation and virulence. Cyclic di-GMP influences diverse functions through interaction with a range of effectors. Our knowledge of these effectors and their different regulatory actions is far from complete, however. Here we have used an affinity pull-down assay using cyclic di-GMP-coupled magnetic beads to identify cyclic di-GMP binding proteins in the plant pathogen Xanthomonas campestris pv. campestris (Xcc. This analysis identified XC_3703, a protein of the YajQ family, as a potential cyclic di-GMP receptor. Isothermal titration calorimetry showed that the purified XC_3703 protein bound cyclic di-GMP with a high affinity (K(d∼2 µM. Mutation of XC_3703 led to reduced virulence of Xcc to plants and alteration in biofilm formation. Yeast two-hybrid and far-western analyses showed that XC_3703 was able to interact with XC_2801, a transcription factor of the LysR family. Mutation of XC_2801 and XC_3703 had partially overlapping effects on the transcriptome of Xcc, and both affected virulence. Electromobility shift assays showed that XC_3703 positively affected the binding of XC_2801 to the promoters of target virulence genes, an effect that was reversed by cyclic di-GMP. Genetic and functional analysis of YajQ family members from the human pathogens Pseudomonas aeruginosa and Stenotrophomonas maltophilia showed that they also specifically bound cyclic di-GMP and contributed to virulence in model systems. The findings thus identify a new class of cyclic di-GMP effector that regulates bacterial virulence.

  18. Amyloid-β Peptide Is Needed for cGMP-Induced Long-Term Potentiation and Memory.

    Science.gov (United States)

    Palmeri, Agostino; Ricciarelli, Roberta; Gulisano, Walter; Rivera, Daniela; Rebosio, Claudia; Calcagno, Elisa; Tropea, Maria Rosaria; Conti, Silvia; Das, Utpal; Roy, Subhojit; Pronzato, Maria Adelaide; Arancio, Ottavio; Fedele, Ernesto; Puzzo, Daniela

    2017-07-19

    High levels of amyloid-β peptide (Aβ) have been related to Alzheimer's disease pathogenesis. However, in the healthy brain, low physiologically relevant concentrations of Aβ are necessary for long-term potentiation (LTP) and memory. Because cGMP plays a key role in these processes, here we investigated whether the cyclic nucleotide cGMP influences Aβ levels and function during LTP and memory. We demonstrate that the increase of cGMP levels by the phosphodiesterase-5 inhibitors sildenafil and vardenafil induces a parallel release of Aβ due to a change in the approximation of amyloid precursor protein (APP) and the β-site APP cleaving enzyme 1. Moreover, electrophysiological and behavioral studies performed on animals of both sexes showed that blocking Aβ function, by using anti-murine Aβ antibodies or APP knock-out mice, prevents the cGMP-dependent enhancement of LTP and memory. Our data suggest that cGMP positively regulates Aβ levels in the healthy brain which, in turn, boosts synaptic plasticity and memory. SIGNIFICANCE STATEMENT Amyloid-β (Aβ) is a key pathogenetic factor in Alzheimer's disease. However, low concentrations of endogenous Aβ, mimicking levels of the peptide in the healthy brain, enhance hippocampal long-term potentiation (LTP) and memory. Because the second messenger cGMP exerts a central role in LTP mechanisms, here we studied whether cGMP affects Aβ levels and function during LTP. We show that cGMP enhances Aβ production by increasing the APP/BACE-1 convergence in endolysosomal compartments. Moreover, the cGMP-induced enhancement of LTP and memory was disrupted by blockade of Aβ, suggesting that the physiological effect of the cyclic nucleotide on LTP and memory is dependent upon Aβ. Copyright © 2017 the authors 0270-6474/17/376926-12$15.00/0.

  19. The Cyclic AMP-Vfr Signaling Pathway in Pseudomonas aeruginosa Is Inhibited by Cyclic Di-GMP

    DEFF Research Database (Denmark)

    Almblad, Henrik; Harrison, Joe J; Rybtke, Morten

    2015-01-01

    infection give rise to rugose small colony variants (RSCVs), which are hyper-biofilm-forming mutants that commonly possess mutations that increase production of the biofilm-promoting secondary messenger cyclic di-GMP (c-di-GMP). We show that RSCVs display a decreased production of acute virulence factors...... as a direct result of elevated c-di-GMP content. Overproduction of c-di-GMP causes a decrease in the transcription of virulence factor genes that are regulated by the global virulence regulator Vfr. The low level of Vfr-dependent transcription is caused by a low level of its coactivator, cyclic AMP (c......AMP), which is decreased in response to a high level of c-di-GMP. Mutations that cause reversion of the RSCV phenotype concomitantly reactivate Vfr-cAMP signaling. Attempts to uncover the mechanism underlying the observed c-di-GMP-mediated lowering of cAMP content provided evidence that it is not caused...

  20. A novel bioassay for the activity determination of therapeutic human brain natriuretic peptide (BNP.

    Directory of Open Access Journals (Sweden)

    Lei Yu

    Full Text Available BACKGROUND: Recombinant human brain natriuretic peptide (rhBNP is an important peptide-based therapeutic drug indicated for the treatment of acute heart failure. Accurate determination of the potency of therapeutic rhBNP is crucial for the safety and efficacy of the drug. The current bioassay involves use of rabbit aortic strips, with experiments being complicated and time-consuming and markedly variable in results. Animal-less methods with better precision and accuracy should be explored. We have therefore developed an alternative cell-based assay, which relies on the ability of BNP to induce cGMP production in HEK293 cells expressing BNP receptor guanylyl cyclase-A. METHODOLOGY/PRINCIPAL FINDINGS: An alternative assay based on the measurement of BNP-induced cGMP production was developed. Specifically, the bioassay employs cells engineered to express BNP receptor guanylyl cyclase-A (GCA. Upon rhBNP stimulation, the levels of the second messager cGMP in these cells drastically increased and subsequently secreted into culture supernatants. The quantity of cGMP, which corresponds to the rhBNP activity, was determined using a competitive ELISA developed by us. Compared with the traditional assay, the novel cell-based assay demonstrated better reproducibility and precision. CONCLUSION/SIGNIFICANCE: The optimized cell-based assay is much simpler, more rapid and precise compared with the traditional assay using animal tissues. To our knowledge, this is the first report on a novel and viable alternative assay for rhBNP potency analysis.

  1. Therapeutic Doll Making in Art Psychotherapy for Complex Trauma

    Science.gov (United States)

    Stace, Sonia M.

    2014-01-01

    Therapeutic doll making can hold diverse functions for clients in therapy, particularly for those clients who are working through complex trauma histories. Recent literature pertaining to the treatment of complex trauma suggests that talking treatments have their limits; supplementary therapeutic approaches that focus on sensory, physical,…

  2. Cyclic GMP-mediated memory enhancement in the object recognition test by inhibitors of phosphodiesterase-2 in mice.

    Science.gov (United States)

    Lueptow, Lindsay M; Zhan, Chang-Guo; O'Donnell, James M

    2016-02-01

    Cyclic nucleotide phosphodiesterase-2 (PDE2) is a potential therapeutic target for the treatment of cognitive dysfunction. Using the object recognition test (ORT), this study assessed the effects of two PDE2 inhibitors, Bay 60-7550 and ND7001, on learning and memory, and examined underlying mechanisms. To assess the role of PDE2 inhibition on phases of memory, Bay 60-7550 (3 mg/kg) was administered: 30 min prior to training; 0, 1, or 3 h after training; or 30 min prior to recall testing. To assess cyclic nucleotide involvement in PDE2 inhibitor-enhanced memory consolidation, either the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME; 20 mg/kg; intraperitoneal (IP)), soluble guanylyl cyclase inhibitor 1H-[-1,2,4]oxadiazolo-[4,3-a]quinoxalin-1-one (ODQ; 20 mg/kg; IP), protein kinase G inhibitor KT5823 (2.5 μg; intracerebroventricular (ICV)), or protein kinase A inhibitor H89 (1 μg; ICV) was administered 30 min prior to the PDE2 inhibitor Bay 60-7550 (3 mg/kg) or ND7001 (3 mg/kg). Changes in the phosphorylation of 3'5'-cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) at Ser-133 and vasodilator-stimulated phosphoprotein (VASP) at Ser-239 were determined to confirm activation of cAMP and 3'5'-cyclic guanosine monophosphate (cGMP) signaling. Bay 60-7550 (3 mg/kg) enhanced memory of mice in the ORT when given 30 min prior to training, immediately after training, or 30 min prior to recall. Inhibitors of the cGMP pathway blocked the memory-enhancing effects of both Bay 60-7550 (3 mg/kg) and ND7001 (3 mg/kg) on early consolidation processes. Bay 60-7550 (3 mg/kg) enhanced phosphorylation of CREB and VASP, both targets of cGMP-dependent protein kinase (PKG). These results confirm a potential of PDE2, or components of its signaling pathway, as a therapeutic target for drug discovery focused on restoring memory function.

  3. Acute stress-induced antinociception is cGMP-dependent but heme oxygenase-independent

    International Nuclear Information System (INIS)

    Carvalho-Costa, P.G.; Branco, L.G.S.; Leite-Panissi, C.R.A.

    2014-01-01

    Endogenous carbon monoxide (CO), which is produced by the enzyme heme oxygenase (HO), participates as a neuromodulator in physiological processes such as thermoregulation and nociception by stimulating the formation of 3′,5′-cyclic guanosine monophosphate (cGMP). In particular, the acute physical restraint-induced fever of rats can be blocked by inhibiting the enzyme HO. A previous study reported that the HO-CO-cGMP pathway plays a key phasic antinociceptive role in modulating noninflammatory acute pain. Thus, this study evaluated the involvement of the HO-CO-cGMP pathway in antinociception induced by acute stress in male Wistar rats (250-300 g; n=8/group) using the analgesia index (AI) in the tail flick test. The results showed that antinociception induced by acute stress was not dependent on the HO-CO-cGMP pathway, as neither treatment with the HO inhibitor ZnDBPG nor heme-lysinate altered the AI. However, antinociception was dependent on cGMP activity because pretreatment with the guanylate cyclase inhibitor 1H-[1,2,4] oxadiazolo [4,3-a] quinoxaline-1-one (ODQ) blocked the increase in the AI induced by acute stress

  4. Acute stress-induced antinociception is cGMP-dependent but heme oxygenase-independent

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho-Costa, P.G. [Programa de Graduação em Psicobiologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Branco, L.G.S. [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Leite-Panissi, C.R.A. [Programa de Graduação em Psicobiologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2014-09-19

    Endogenous carbon monoxide (CO), which is produced by the enzyme heme oxygenase (HO), participates as a neuromodulator in physiological processes such as thermoregulation and nociception by stimulating the formation of 3′,5′-cyclic guanosine monophosphate (cGMP). In particular, the acute physical restraint-induced fever of rats can be blocked by inhibiting the enzyme HO. A previous study reported that the HO-CO-cGMP pathway plays a key phasic antinociceptive role in modulating noninflammatory acute pain. Thus, this study evaluated the involvement of the HO-CO-cGMP pathway in antinociception induced by acute stress in male Wistar rats (250-300 g; n=8/group) using the analgesia index (AI) in the tail flick test. The results showed that antinociception induced by acute stress was not dependent on the HO-CO-cGMP pathway, as neither treatment with the HO inhibitor ZnDBPG nor heme-lysinate altered the AI. However, antinociception was dependent on cGMP activity because pretreatment with the guanylate cyclase inhibitor 1H-[1,2,4] oxadiazolo [4,3-a] quinoxaline-1-one (ODQ) blocked the increase in the AI induced by acute stress.

  5. The Play of Psychotherapy

    Science.gov (United States)

    Marks-Tarlow, Terry

    2012-01-01

    The author reviews the role of play within psychotherapy. She does not discuss the formal play therapy especially popular for young children, nor play from the Jungian perspective that encourages the use of the sand tray with adults. Instead, she focuses on the informal use of play during psychotherapy as it is orchestrated intuitively. Because…

  6. [Psychotherapy with Adjuvant use of Serotonergic Psychoactive Substances: Possibilities and Challenges].

    Science.gov (United States)

    Majić, Tomislav; Jungaberle, Henrik; Schmidt, Timo T; Zeuch, Andrea; Hermle, Leo; Gallinat, Jürgen

    2017-07-01

    Background  Recently, scientific interest in the therapeutic potential of serotonergic and psilocybin hallucinogens (psychedelics) such as lysergic acid diethylamide (LSD) and entactogens like 3,4-methylendioxymethamphetamine (MDMA) within the framework of psychotherapy has resumed. The present article provides an overview on the current evidence on substance-assisted psychotherapy with these substances. Method  A selective search was carried out in the PubMed and Cochrane Library including studies investigating the clinical use of serotonergic psychoactive substances since 2000. Results  Studies were found investigating the following indications: alcohol (LSD and psilocybin) and tobacco addiction (psilocybin), anxiety and depression in patients suffering from life-threatening somatic illness (LSD and psilocybin), obsessive-compulsive disorder (OCD) (psilocybin), treatment-resistant major depression (psilocybin), and posttraumatic stress disorder (PTSD) (MDMA). Discussion  Substance use disorders, PTSD and anxiety and depression in patients suffering from life-threatening somatic illness belong to the indications with the best evidence for substance-assisted psychotherapy with serotonergic psychoactive agents. To date, studies indicate efficacy and relatively good tolerability. Further studies are needed to determine whether these substances may represent suitable and effective treatment options for some treatment-resistant psychiatric disorders in the future. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Disentangling the change-alliance relationship: Observational assessment of the therapeutic alliance during change and stuck episodes.

    Science.gov (United States)

    Mellado, Augusto; Suárez, Nicolás; Altimir, Carolina; Martínez, Claudio; Pérez, Janet; Krause, Mariane; Horvath, Adam

    2017-09-01

    The therapeutic alliance is considered the most robust process variable associated with positive therapeutic outcome in a variety of psychotherapeutic models [Alexander, L. B., & Luborsky, L. (1986). The Penn Helping Alliance Scales. In L. S. Greenberg & W. M. Pinsoff (Eds.), The psychotherapeutic process: A research handbook (pp. 325-356). New York: Guilford Press; Horvath, A. O., Gaston, L., & Luborsky, L. (1993). The alliance as predictor of benefits of counseling and therapy. In N. Miller, L. Luborsky, J. Barber, & J. P. Docherty (Eds.), Psychodynamic treatment research: A handbook for clinical practice (pp. 247-274). New York, NY: Basic Books; Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48, 9-16; Orlinky, D., Grawe, K., & Parks, B. (1994). Process and outcome in psychotherapy: Noch einmal. In A. Bergin & J. S. Garfield (Eds.), Handbook of psychotherapy and behaviour change (4th ed., pp. 270-378). New York, NY: Wiley and Sons]. The relationship between alliance and outcome has traditionally been studied based on measures that assess these therapy factors at a global level. However, the specific variations of the alliance process and their association with therapy segments that are relevant for change have not yet been fully examined. The present study examines the variations in the therapeutic alliance in 73 significant in-session events: 35 change and 38 stuck episodes identified through the observation of 14 short-term therapies of different theoretical orientations. Variations in the alliance were assessed using the VTAS-SF [Shelef, K., & Diamond, G. (2008). Short form of the revised Vanderbilt Therapeutic Alliance Scale: Development, reliability, and validity. Psychotherapy Research, 18, 433-443]. Nested analyses (HLM) indicate a statistically significant better quality of the alliance during change episodes.

  8. Cyclic GMP-AMP Displays Mucosal Adjuvant Activity in Mice

    OpenAIRE

    Škrnjug, Ivana; Guzmán, Carlos Alberto; Ruecker, Christine

    2014-01-01

    The recently discovered mammalian enzyme cyclic GMP-AMP synthase produces cyclic GMP-AMP (cGAMP) after being activated by pathogen-derived cytosolic double stranded DNA. The product can stimulate STING-dependent interferon type I signaling. Here, we explore the efficacy of cGAMP as a mucosal adjuvant in mice. We show that cGAMP can enhance the adaptive immune response to the model antigen ovalbumin. It promotes antigen specific IgG and a balanced Th1/Th2 lymphocyte response in immunized mice....

  9. Mind the gap: In-session silences are associated with client attachment insecurity, therapeutic alliance, and treatment outcome

    DEFF Research Database (Denmark)

    Daniel, Sarah Ingrid Franksdatter; Folke, Sofie; Lunn, Susanne

    2018-01-01

    Objective: The association between in-session silences and client attachment, therapeutic alliance, and treatment outcome was investigated in two treatments for bulimia nervosa. Method: 69 women and one man were randomized to two years of psychoanalytic psychotherapy (PPT) or 20 sessions of cogni......Objective: The association between in-session silences and client attachment, therapeutic alliance, and treatment outcome was investigated in two treatments for bulimia nervosa. Method: 69 women and one man were randomized to two years of psychoanalytic psychotherapy (PPT) or 20 sessions...

  10. Types of psychotherapy for pathological gamblers.

    Science.gov (United States)

    Fong, Timothy W

    2005-05-01

    Several types of psychotherapy are currently used to treat pathological gamblers. These include Gambler's Anonymous, cognitive behavioral therapy, behavioral therapy, psychodynamic therapy, and family therapy. Research into which types of psychotherapy are the most effective for pathological gambling is limited but is a growing area of study. Group therapy, namely Gambler's Anonymous, provides peer support and structure. Cognitive behavior therapy aims to identify and correct cognitive distortions about gambling. Psychodynamic psychotherapy can help recovering gamblers address core conflicts and hidden psychological meanings of gambling. Family therapy is helpful by providing support and education and eliminating enabling behaviors. To date, no single type of psychotherapy has emerged as the most effective form of treatment. As in other addictive disorders, treatment retention of pathological gamblers is highly variable. Understanding the types of psychotherapy that are available for pathological gamblers, as well their underlying principles, will assist clinicians in managing this complex behavioral disorder.

  11. Making a case for case studies in psychotherapy training

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward; Iwakabe, Shigeru

    2013-01-01

    articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory...... in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing...

  12. Some ethical issues in feminist-oriented therapeutic groups for women.

    Science.gov (United States)

    Lakin, M

    1991-04-01

    Review of the origins of group psychotherapy reveals concerns with social as well as with personal "psychopathology." Thus, group processes have been mobilized for curative or change purposes for ideological as well as individual therapeutic goals. Psychopolitical as well as personal change are the goals for some groups. The ethical problem stems from a persistent assumption that the group's processes are inherently benign and curative and beneficial to individual participants. A more sophisticated understanding takes into account their essential neutrality and their potential use (or abuse) for purposes of ideological persuasion that may or may not be personally therapeutic. As in other ethically implicated issues in the psychotherapies, the question becomes one of treatment versus exploitation, or therapy for the individual versus recruitment on behalf of a cause.

  13. [Healthier after Psychotherapy? Analysis of Claims Data (Lower Saxony, Germany) on Sickness Absence Duration before and after Outpatient Psychotherapy].

    Science.gov (United States)

    Epping, Jelena; de Zwaan, Martina; Geyer, Siegfried

    2017-11-17

    Introduction In employed populations sickness absence can be used as a good indicator of health status. In the present study, it was examined how periods of sickness absence are developing within one year before and after psychotherapy under comparison of three types of psychotherapy (behavior therapy, psychodynamic psychotherapy, and psychoanalysis), all fully covered by statutory health insurance. Methods and data The analyses were performed with pseudonymized claims data from the AOK Niedersachsen, a statutory health insurance (N=2,900,065 insured). Certified sickness absences before and after psychotherapy were examined for 9,916 patients. Parallelized controls were used to build a comparison of the length of sickness absences. Analyses were performed separately for women and for men. Results Within one year before starting psychotherapy, patients had longer sickness absences than controls on average. There was a reduction in the length of sickness absence of 20 days (median) within one year before to 12 days (median) within one year after the psychotherapy. The obtained differences between types of psychotherapy were considerable. Discussion Differences in terms of sickness absences may in part be explained by socio-demographic differences. Patients who underwent psychoanalysis were younger and had higher educational levels. However, it remains unclear why the differences of sickness absence periods were that high. It has to be discussed whether self-selection of patients with better health into psychoanalysis had occurred. Conclusions Patients undergoing psychoanalysis differ from patients who underwent other types of psychotherapy in terms of their duration of sickness absence as well as socio-demographic profile. Thus, due to differences in the composition of patients future research in psychotherapy will have to differentiate by type of psychotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Advances in Psychotherapy for Depressed Older Adults.

    Science.gov (United States)

    Raue, Patrick J; McGovern, Amanda R; Kiosses, Dimitris N; Sirey, Jo Anne

    2017-09-01

    We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk. Growing evidence supports the feasibility, acceptability, and effectiveness of psychotherapy modified for a variety of health care and social service settings. Research supports the benefits of selecting the type of psychotherapy based on a comprehensive assessment of the older adult's psychiatric, medical, functional, and cognitive status, and tailoring psychotherapy to the settings in which older depressed adults are most likely to present.

  15. Implementation of good manufacturing practices (GMP) on human blood irradiation

    International Nuclear Information System (INIS)

    Boghi, Claudio; Napolitano, Celia M.; Ferreira, Danilo C.; Rela, Paulo Roberto; Zarate, Herman S.

    2007-01-01

    The irradiation of human blood is used to avoid the TA-GVHD (transfusion-associated graft-versus-host-disease), a rare but devastating adverse effect of leukocytes present in blood components for a immuno-competent transfusion recipients. Usually this irradiation practice is performed to a physical elimination of lymphocytes. The implementation of the GMP will assure that the properly dose in a range of 25 Gy to 50 Gy will be delivered to the blood in the bag collected in a blood tissue bank. The studies to establish the GMP were developed under the guidelines of the standard ISO 11137 - Sterilization of health care products - Requirements for validation and routine control - Radiation sterilization. In this work, two dosimetric systems were used for dose mapping during the studies of irradiator qualification, loading pattern, irradiation process validation and auditing. The CaSO 4 : Dy dosimeter presented difficulties concerning to uncertainty on dose measurement, stability, trace ability and calibration system. The PMMA and gafchromic dosimetric systems have shown a better performance and were adopted on establishment of GMP procedures. The irradiation tests have been done using a Gammacell 220 Irradiator. The developed GMP can be adapted for different types of gamma irradiators, allowing to set up a quality assurance program for blood irradiation. (author)

  16. Implementation of good manufacturing practices (GMP) on human blood irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Boghi, Claudio; Napolitano, Celia M.; Ferreira, Danilo C.; Rela, Paulo Roberto [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)]. E-mails: cboghi@uol.com.br; cmnapoli@ipen.br; dancarde@ig.com.br; prela@ipen.br; Zarate, Herman S. [Comission Chilena de Energia Nuclear, Santiago (Chile)]. E-mail: hzarate@cchen.cl

    2007-07-01

    The irradiation of human blood is used to avoid the TA-GVHD (transfusion-associated graft-versus-host-disease), a rare but devastating adverse effect of leukocytes present in blood components for a immuno-competent transfusion recipients. Usually this irradiation practice is performed to a physical elimination of lymphocytes. The implementation of the GMP will assure that the properly dose in a range of 25 Gy to 50 Gy will be delivered to the blood in the bag collected in a blood tissue bank. The studies to establish the GMP were developed under the guidelines of the standard ISO 11137 - Sterilization of health care products - Requirements for validation and routine control - Radiation sterilization. In this work, two dosimetric systems were used for dose mapping during the studies of irradiator qualification, loading pattern, irradiation process validation and auditing. The CaSO{sub 4}: Dy dosimeter presented difficulties concerning to uncertainty on dose measurement, stability, trace ability and calibration system. The PMMA and gafchromic dosimetric systems have shown a better performance and were adopted on establishment of GMP procedures. The irradiation tests have been done using a Gammacell 220 Irradiator. The developed GMP can be adapted for different types of gamma irradiators, allowing to set up a quality assurance program for blood irradiation. (author)

  17. Good manufacturing practices (GMP utilized on human blood irradiation process

    Directory of Open Access Journals (Sweden)

    Cláudio Boghi

    2008-01-01

    Full Text Available Irradiation of human blood is used to avoid the TA-GVHD (transfusion-associated graft-versus-host-disease, a rare but devastating adverse effect of leukocytes present in blood components for immunocompetent transfusion recipients. Usually this irradiation practice is performed to a physical elimination of lymphocytes. The implementation of the GMP will assure that the properly dose in a range of 25Gy to 50Gy will be delivered to the blood in the bag collected in a blood tissue bank. The studies to establish the GMP were developed under the guidelines of the standard ISO 11137 - Sterilization of health care products - Requirements for validation and routine control - Radiation sterilization. In this work, two dosimetric systems were used for dose mapping during the studies of irradiator qualification, loading pattern, irradiation process validation and auditing. The CaSO4: Dy dosimeter presented difficulties concerning to uncertainty on dose measurement, stability, trace ability and calibration system. The PMMA and gafchromic dosimetric systems have shown a better performance and were adopted on establishment of GMP procedures. The irradiation tests have been done using a Gammacell 220 Irradiator. The developed GMP can be adapted for different types of gamma irradiators, allowing to set up a quality assurance program for blood irradiation.

  18. Cognitive Behavioral Psychotherapies: History and Development

    Directory of Open Access Journals (Sweden)

    M. Hakan Türkçapar

    2012-03-01

    Full Text Available Cognitive behavioral therapies are one of the most leading theories between current psychotherapies. As a psychotherapy school, besides sharing the common points reached collectively by the humanity throughout the history, it also achieved in integrating scientific and ampirical experiences into the psychotherapy practice. Having included mainstreams like Stoicism, Kantian philosopy in its historical roots, this approach has similarities with eastern philosophies, budism and sufism. Apart from its historical and cultural roots, cognitive approach integrated with behaviorism which applied scientific method in human psychology for the first time, and also implemented the scientific method in the cognitive field. Cognitive behavioral approaches shall make important contributions in the pathway that psychotherapies will cover.

  19. PSYCHOTHERAPY WITH THE PARENT EGO STATE

    Directory of Open Access Journals (Sweden)

    Maruša Zaletel

    2012-06-01

    Full Text Available In their article, the authors present the findings of the study in which they conceptualized the method of psychotherapy with the Parent ego state. Their aim was to explore whether this method could be divided into individual, content-wise separate chronological phases which can be observed with the majority of clients. By using a modified method of content analysis of five psychotherapy transcripts and a video recording of a psychotherapy session, nine chronological phases were identified. In order to illustrate the individual phases, excerpts from the transcripts and the video recording of psychotherapy have been included. The article proposes under what conditions can this method be used, and presents some of its limitations.

  20. The use of empathy and transference as interventions in psychotherapy with attention deficit hyperactive disorder latency-aged boys.

    Science.gov (United States)

    Conway, Francine

    2014-03-01

    Psychodynamic-oriented therapies are uniquely positioned to address the internal experiences of a child whose external presentation is consistent with an Attention Deficit Hyperactivity Disorder (ADHD) diagnosis, an area of treatment intervention that is conspicuously absent from common ADHD treatment modalities. This article presents two psychodynamic psychotherapy treatment interventions that demonstrate (1) the importance of empathy in the therapeutic relationship and (2) the use of transference in psychotherapy with ADHD children. Through the use of case examples, the use of empathy is demonstrated in developing the therapeutic alliance, facilitating the development of the child's reflective capacity on affective states, and organizing the child's affective experiences. The benefits of transference interventions with ADHD children are reviewed, and case examples are provided to demonstrate how the therapist worked with the idealized and mirroring transference. Interventions are presented in the context of Object Relations and Self-Psychology Theories. (c) 2014 APA, all rights reserved.

  1. Psychotherapy of the victims of massive violence: countertransference and ethical issues.

    Science.gov (United States)

    Kinzie, J D; Boehnlein, J K

    1993-01-01

    Psychotherapy with severely traumatized patients is a long, draining process that often produces strong countertransference reactions. It is difficult to therapeutically and ethically handle these personal responses. We feel that at different stages in therapy different ethical principles should guide the therapy. At the early stages, fidelity and nonmaleficence should be the guiding principles. As trust and confidence develop, therapists may have more personal freedom to act; beneficence, i.e., providing specific confident care then becomes the primary ethical principle. In later stages of therapy, promoting the principles of autonomy and justice come into play. As therapy further progresses, therapists' own needs, the principle of self-interest, may be utilized in the therapeutic relationship. Throughout therapeutic contacts with traumatized patients, therapists need to monitor their own needs, and find appropriate ways outside of therapy to cope with these often intense feelings. Continuing to feel therapeutically competent and ethically grounded, yet maintaining the personal strength and balance to treat traumatized patients, pose major challenges for therapists.

  2. Implementation of Good Maufacturing Practices (GMP) in the Kitchen Hospital

    OpenAIRE

    Sari, Fitria Novita

    2016-01-01

    Abstract: Food safety is one of the important thing in public health improvement in Indonesia. Hospitals are required to keep food safety for patients by conducting the principle Good Manufacturing Practices (GMP). The purpose of this research to -identify the application of GMP in Installation Nutrition Hospital. Design of this study was using descriptive research in observational method with cross sectional design. Variables the treatment were the physical building, utility, equipment, stor...

  3. Child Psychotherapy Dropout: An Empirical Research Review

    Science.gov (United States)

    Deakin, Elisabeth; Gastaud, Marina; Nunes, Maria Lucia Tiellet

    2012-01-01

    This study aims to discuss the most recent data about child psychotherapy dropout, especially child psychoanalytical psychotherapy. The authors also try to offer some possible alternatives to prevent such a phenomenon. The definition of "child psychotherapy dropout" is extensively discussed. The goal has been to attempt to create a standardised…

  4. Predictive value of object relations for therapeutic alliance and outcome in psychotherapy for depression: an exploratory study

    NARCIS (Netherlands)

    Van, H.L.; Hendriksen, M.; Schoevers, R.A.; Peen, J.; Abraham, R.A.; Dekker, J.J.M.

    2008-01-01

    The concept of object relations has been shown to be relevant for the process and outcome of psychodynamic psychotherapies. However, little is known about its relevance for the psychotherapeutic treatment of depression. In this study, we explored the predictive value of object relational functioning

  5. KAJIAN PENERAPAN GOOD MANUFACTURING PRACTICE (GMP DI INDUSTRI RAJUNGAN PT.KELOLA MINA LAUT MADURA

    Directory of Open Access Journals (Sweden)

    Bhiaztika Ristyanadi

    2016-11-01

    Full Text Available Good manufacturing practice is the first step implementation of food safety regulation. PT. Kelola Mina Laut is one of chilled sea crab producers in Madura. It has four branches in Madura,those are in Tanjung Bumi, Noreh, Sampang, and Lobuk. The objective of this research is to assess the effectiveness GMP in four branches of PT. Kelola Mina Laut. The research  uses field observation, data analysis and GMP development as the method. Based on GMP analysis, four branches of PT. Kelola Mina Laut appear to have a cummulative score between 337-369, in which Lobuk has the highest score. Therefore, it can be concluded that PT. Kelola Mina Laut has applied most of GMP elements

  6. Therapeutic relationship on the web: to face or not to face?

    Directory of Open Access Journals (Sweden)

    Ana Sfoggia

    2014-03-01

    Full Text Available In this age of unprecedented expansion of media and information dissemination and sharing, the use of electronic means should be reconsidered. The use of new technologies should be studied to understand how it may affect the relationship between patient and therapist during psychotherapy or psychoanalytic treatments. This study offers a critical discussion of the effect of technologies on clinical practice, and vignettes are used to describe their impact on frame, anonymity, abstinence and therapeutic neutrality. Transfer and countertransference issues resulting from these changes are also discussed. The potential benefits of new technologies in psychotherapy are appreciated, but the authors draw attention to the need to reflect about the presence of the therapist in those technologies and the preservation of the therapeutic setting, so that a satisfactory progression of the work of the dyad is ensured. This study also discusses the use of technologies in the expansion of learning and application of the therapeutic technique to overcome geographic and time barriers, among others.

  7. Modulation of cGMP by human HO-1 retrovirus gene transfer in pulmonary microvessel endothelial cells.

    Science.gov (United States)

    Abraham, Nader G; Quan, Shuo; Mieyal, Paul A; Yang, Liming; Burke-Wolin, Theresa; Mingone, Christopher J; Goodman, Alvin I; Nasjletti, Alberto; Wolin, Michael S

    2002-11-01

    Carbon monoxide (CO) stimulates guanylate cyclase (GC) and increases guanosine 3',5'-cyclic monophosphate (cGMP) levels. We transfected rat-lung pulmonary endothelial cells with a retrovirus-mediated human heme oxygenase (hHO)-1 gene. Pulmonary cells that expressed hHO-1 exhibited a fourfold increase in HO activity associated with decreases in the steady-state levels of heme and cGMP without changes in soluble GC (sGC) and endothelial nitric oxide synthase (NOS) proteins or basal nitrite production. Heme elicited significant increases in CO production and intracellular cGMP levels in both pulmonary endothelial and pulmonary hHO-1-expressing cells. N(omega)-nitro-L-arginine methyl ester (L-NAME), an inhibitor of NOS, significantly decreased cGMP levels in heme-treated pulmonary endothelial cells but not heme-treated hHO-1-expressing cells. In the presence of exogenous heme, CO and cGMP levels in hHO-1-expressing cells exceeded the corresponding levels in pulmonary endothelial cells. Acute exposure of endothelial cells to SnCl2, which is an inducer of HO-1, increased cGMP levels, whereas chronic exposure decreased heme and cGMP levels. These results indicate that prolonged overexpression of HO-1 ultimately decreases sGC activity by limiting the availability of cellular heme. Heme activates sGC and enhances cGMP levels via a mechanism that is largely insensitive to NOS inhibition.

  8. Review of Self-disclosure in psychotherapy.

    Science.gov (United States)

    Hamilton, Rachel A; Del Castillo, Darren M; Stiles, William B

    2007-09-01

    Reviews the book, Self-disclosure in psychotherapy by Barry A. Farber (see record 2006-11792-000). At one point or another, most therapists have wondered how much their patients are telling them and wrestled with how much they should reveal themselves to their patients. This book aims to provide an integrative and up-to-date review of the literature that has addressed these kinds of questions. By looking at patient, therapist, supervisee, and supervisor self-disclosure, Farber attempts to show both common and unique aspects of self-disclosure across the different parties involved in psychotherapy. Work from historical, clinical, research, and cultural perspectives comes together to provide readers with a multifaceted view of self-disclosure in psychotherapy. This book will be of interest to therapists, researchers, psychotherapy supervisors, and therapists-in-training. Farber's discussion of self-disclosure offers a nuanced perspective on the dilemmas involved in the psychotherapy process. By highlighting the features of self-disclosure across patients, therapists, supervisees, and supervisors, Farber enriches understanding of the phenomenon and encourages empathy for the perspectives of those in other psychotherapy roles. We believe that Farber has successfully synthesized work from various perspectives to create an illuminating review of self-disclosure in psychotherapy. The book condenses a broad range of literature into clearly organized and digestible chapters. The integration of research and theory with clinical vignettes, quotations from books and movies, and popular song lyrics make this work an unusually engaging and accessible read. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  9. The participation of elevated levels of cyclic GMP in the recovery from radiation-induced mitotic delay

    International Nuclear Information System (INIS)

    Daniel, J.W.; Oleinick, N.L.

    1984-01-01

    The levels of cyclic AMP and cyclic GMP have been measured in Physarum plasmodia before and after treatment with gamma-radiation, 2 mM caffeine, or combinations of the two agents compared to the length of the radiation-induced mitotic delay. Caffeine alone produces a rapid transient elevation of cyclic AMP and a slower delayed elevation of cyclic GMP. Irradiation elicits an immediate transient increase in cyclic AMP and a later cyclic GMP increase which accompanies or precedes the delayed mitosis. A composite pattern is produced by combinations of radiation and caffeine, a distinctive feature of which is an elevated level of cyclic GMP near the time of the radiation-delayed and caffeine-promoted mitosis. With pretreatment by caffeine, the least radiation-induced mitotic delay occurs when plasmodia are irradiated during the caffeine-elicited increase in cyclic GMP. The plasmodium becomes refractory to the reduction of mitotic delay by caffeine at approximately the time it becomes refractory to the further elevation of cyclic GMP by caffeine. The data support a role for cyclic AMP in the onset of and for cyclic GMP in the recovery from mitotic delay induced by ionizing radiation. (author)

  10. Piaget and psychotherapy.

    Science.gov (United States)

    Friedman, T L

    1978-04-01

    It is difficult to apply Piaget's theory to psychotherapy because the place of affect in it is ambiguous. When the alternatives are considered, it seems most consistent with Piaget's ideas to regard both cognitive and affective phenomena as problem-solving organizations. Piaget's remarkable discoveries in the cognitive sphere are a consequence of the easy access in that sphere to the kind of problems that need solving, and the phasic development of solutions. But the nature of the problems to be solved or the values to be guarded by a patient in psychotherapy are not knowable independently of the patient's actual behavior. In one respect all that is left from Piaget's approach for psychotherapy generally is the truism that therapy fosters differentiation and integration. However, even if we cannot frame a peculiarly Piagetian paradigm of psychotherapy, Piaget is valuable in posing a subsidiary question, namely, what in therapy fosters problem-solving activity. A reading of Piaget suggests that a patient learns by acting on his therapist and tacitly interpreting the results of his actions, that difficulties in therapy are the material from which therapy proceeds, and that in order to grasp the situation of the patient, the therapist himself may need to act on him and not just think about him. An implied lesson for training would be that supervision should instill a professional identity that is reinforced rather than challenged by therapy difficulties, and does not rely solely on theoretical categorizing.

  11. The anti-cancerous drug doxorubicin decreases the c-di-GMP content in Pseudomonas aeruginosa but promotes biofilm formation

    DEFF Research Database (Denmark)

    Groizeleau, Julie; Rybtke, Morten; Andersen, Jens Bo

    2016-01-01

    Current antibiotic treatments are insufficient in eradicating bacterial biofilms, which represent the primary cause of chronic bacterial infections. Thus, there is an urgent need for new strategies to eradicate biofilm infections. The second messenger c-di-GMP is a positive regulator of biofilm...... formation in many clinically relevant bacteria. It is hypothesized that drugs lowering the intracellular level of c-di-GMP will force biofilm bacteria into a more treatable planktonic lifestyle. To identify compounds capable of lowering c-di-GMP levels in Pseudomonas aeruginosa, we screened 5000 compounds...... for their potential c-di-GMP-lowering effect using a recently developed c-di-GMP biosensor strain. Our screen identified the anti-cancerous drug doxorubicin as a potent c-di-GMP inhibitor. In addition, the drug decreased the transcription of many biofilm-related genes. However, despite its effect on the c-di-GMP...

  12. Tailored care for somatoform vertigo/dizziness: study protocol for a randomised controlled trial evaluating integrative group psychotherapy.

    Science.gov (United States)

    Lahmann, Claas; Henningsen, P; Dieterich, M; Radziej, K; Schmid, G

    2015-08-01

    Vertigo/dizziness (VD) ranks high in lifetime prevalence and clinical relevance. Nearly half of the complex VD disorders presenting at specialised units for vertigo or otoneurological disorders are not fully explained by an identifiable medical illness, but instead are related to anxiety, depressive, or somatoform disorders. Although there is some evidence that psychotherapy may be effective for these patients, therapeutic options remain unsatisfactory. This report describes the objectives, design and methods of a randomised, controlled clinical trial, evaluating the efficacy of manualised, multimodal group psychotherapy, based on integrative psychotherapy (IPT) and tailored to subgroups of mental disorders in medically unexplained VD. This psychotherapeutic approach will be compared to self-help groups (n = 172; n = 86 per study arm). Improvements with regard to handicap due to VD at 12 months follow-up will serve as primary outcome. Additionally, measures of generic quality of life, severity of vertigo, depression, anxiety, somatisation as well as Head Impulse Test and Computerized Static Posturography will be applied. We will also analyse the cost-effectiveness of this trial. The study aims to improve treatment of this therapeutically underserved population who are often severely impaired in their working and daily lives. ClinicalTrials.gov Identifier: NCT02320851. This is an on-going study; recruitment for the study is about to start.

  13. Auxin-induced nitric oxide, cGMP and gibberellins were involved in the gravitropism

    Science.gov (United States)

    Cai, Weiming; Hu, Liwei; Hu, Xiangyang; Cui, Dayong; Cai, Weiming

    Gravitropism is the asymmetric growth or curvature of plant organs in response to gravistimulation. There is a complex signal transduction cascade which involved in the differential growth of plants in response to changes in the gravity vector. The role of auxin in gravitropism has been demonstrated by many experiments, but little is known regarding the molecular details of such effects. In our studies before, mediation of the gravitropic bending of soybean roots and rice leaf sheath bases by nitric oxide, cGMP and gibberellins, are induced by auxin. The asymmetrical distribution of nitric oxide, cGMP and gibberellins resulted from the asymmetrical synthesis of them in bending sites. In soybean roots, inhibitions of NO and cGMP synthesis reduced differential NO and cGMP accumulation respectively, which both of these effects can lead to the reduction of gravitropic bending. Gibberellin-induced OsXET, OsEXPA4 and OsRWC3 were also found involved in the gravitropic bending. These data indicated that auxin-induced nitric oxide, cGMP and gibberellins were involved in the gravitropism. More experiments need to prove the more detailed mechanism of them.

  14. The pragmatics of therapeutic interaction: an empirical study.

    Science.gov (United States)

    Lepper, Georgia

    2009-10-01

    The research reported in this article aims to demonstrate a method for the systematic study of the therapist/patient interaction in psychoanalytic psychotherapy, drawing upon the tradition and methods of 'pragmatics'--the study of language in interaction. A brief introduction to the discipline of pragmatics demonstrates its relevance to the contemporary focus of clinical theory on the here-and-now dynamics of the relationship between analyst and patient. This is followed by a detailed study of five segments from the transcript of a therapeutic dialogue, drawn from a brief psychoanalytic psychotherapy, in which therapist and patient negotiate the meaning of the patient's symptom: Is it psychosomatic? The research seeks to show how the therapeutic process can be observed and studied as an interactional achievement, grounded in general and well-studied procedures through which meaning is intersubjectively developed and shared. Implications of the analysis for clinical theory and practice, and further research, are discussed.

  15. Assessing Attachment in Psychotherapy

    DEFF Research Database (Denmark)

    Talia, Alessandro; Miller-Bottome, Madeleine; Daniel, Sarah I.F.

    2017-01-01

    The authors present and validate the Patient Attachment Coding System (PACS), a transcript-based instrument that assesses clients' in-session attachment based on any session of psychotherapy, in multiple treatment modalities. One-hundred and sixty clients in different types of psychotherapy...... (cognitive–behavioural, cognitive–behavioural-enhanced, psychodynamic, relational, supportive) and from three different countries were administered the Adult Attachment Interview (AAI) prior to treatment, and one session for each client was rated with the PACS by independent coders. Results indicate strong...... inter-rater reliability, and high convergent validity of the PACS scales and classifications with the AAI. These results present the PACS as a practical alternative to the AAI in psychotherapy research and suggest that clinicians using the PACS can assess clients' attachment status on an ongoing basis...

  16. Cognitive Behavioral Psychotherapies: History and Development

    Directory of Open Access Journals (Sweden)

    M. Hakan Türkçapar

    2012-04-01

    Full Text Available Cognitive behavioral therapies are one of the most leading theories between current psychotherapies. As a psychotherapy school, besides sharing the common points reached collectively by the humanity throughout the history, it also achieved in integrating scientific and ampirical experiences into the psychotherapy practice. Having included mainstreams like Stoicism, Kantian philosopy in its historical roots, this approach has similarities with eastern philosophies, budism and sufism. Apart from its historical and cultural roots, cognitive approach integrated with behaviorism which applied scientific method in human psychology for the first time, and also implemented the scientific method in the cognitive field. Cognitive behavioral approaches shall make important contributions in the pathway that psychotherapies will cover. [JCBPR 2012; 1(1.000: 7-14

  17. Three Psychotherapies Examined: Ellis, Rogers, Perls

    Science.gov (United States)

    Stoten, J.; Goos, W.

    1974-01-01

    This study uses Bales' Interaction Process Analysis (I. P. A.) to identify significant process elements in counselling and psychotherapy. For this purpose, the film "Three Approaches to Psychotherapy" was analysed. (Editor)

  18. Patient affect experiencing following therapist interventions in short-term dynamic psychotherapy.

    Science.gov (United States)

    Town, Joel M; Hardy, Gillian E; McCullough, Leigh; Stride, Chris

    2012-01-01

    The aim of this research was to examine the relationship between therapist interventions and patient affect responses in Short-Term Dynamic Psychotherapy (STDP). The Affect Experiencing subscale from the Achievement of Therapeutic Objectives Scale (ATOS) was adapted to measure individual immediate affect experiencing (I-AES) responses in relation to therapist interventions coded within the preceding speaking turn, using the Psychotherapy Interaction Coding (PIC) system. A hierarchical linear modelling procedure was used to assess the change in affect experiencing and the relationship between affect experiencing and therapist interventions within and across segments of therapy. Process data was taken from six STDP cases; in total 24 hours of video-taped sessions were examined. Therapist interventions were found to account for a statistically significant amount of variance in immediate affect experiencing. Higher levels of immediate affect experiencing followed the therapist's use of Confrontation, Clarification and Support compared to Questions, Self-disclosure and Information interventions. Therapist Confrontation interventions that attempted to direct pressure towards either the visceral experience of affect or a patient's defences against feelings led to the highest levels of immediate affect experiencing. The type of therapist intervention accounts for a small but significant amount of the variation observed in a patient's immediate emotional arousal. Empirical findings support clinical theory in STDP that suggests strategic verbal responses promote the achievement of this specific therapeutic objective.

  19. The Bacterial Second Messenger Cyclic di-GMP Regulates Brucella Pathogenesis and Leads to Altered Host Immune Response.

    Science.gov (United States)

    Khan, Mike; Harms, Jerome S; Marim, Fernanda M; Armon, Leah; Hall, Cherisse L; Liu, Yi-Ping; Banai, Menachem; Oliveira, Sergio C; Splitter, Gary A; Smith, Judith A

    2016-12-01

    Brucella species are facultative intracellular bacteria that cause brucellosis, a chronic debilitating disease significantly impacting global health and prosperity. Much remains to be learned about how Brucella spp. succeed in sabotaging immune host cells and how Brucella spp. respond to environmental challenges. Multiple types of bacteria employ the prokaryotic second messenger cyclic di-GMP (c-di-GMP) to coordinate responses to shifting environments. To determine the role of c-di-GMP in Brucella physiology and in shaping host-Brucella interactions, we utilized c-di-GMP regulatory enzyme deletion mutants. Our results show that a ΔbpdA phosphodiesterase mutant producing excess c-di-GMP displays marked attenuation in vitro and in vivo during later infections. Although c-di-GMP is known to stimulate the innate sensor STING, surprisingly, the ΔbpdA mutant induced a weaker host immune response than did wild-type Brucella or the low-c-di-GMP guanylate cyclase ΔcgsB mutant. Proteomics analysis revealed that c-di-GMP regulates several processes critical for virulence, including cell wall and biofilm formation, nutrient acquisition, and the type IV secretion system. Finally, ΔbpdA mutants exhibited altered morphology and were hypersensitive to nutrient-limiting conditions. In summary, our results indicate a vital role for c-di-GMP in allowing Brucella to successfully navigate stressful and shifting environments to establish intracellular infection. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  20. Cognitive Behavioral Analysis System of Psychotherapy as group psychotherapy for chronically depressed inpatients: a naturalistic multicenter feasibility trial.

    Science.gov (United States)

    Sabaß, Lena; Padberg, Frank; Normann, Claus; Engel, Vera; Konrad, Carsten; Helmle, Kristina; Jobst, Andrea; Worlitz, Andrew; Brakemeier, Eva-Lotta

    2017-09-27

    The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is a relatively new approach in the treatment of chronic depression (CD). Adapted as group psychotherapy for inpatients, CBASP is attracting increasing attention. In this naturalistic multicenter trial, we investigated its feasibility after 10 sessions of CBASP group therapy over a treatment time of at least 5 to a maximum of 10 weeks. Treatment outcome was additionally assessed. Across four centers, 116 inpatients with CD (DSM-IV-TR) attended CBASP group psychotherapy. Feasibility was focused on acceptance, and evaluated for patients and therapists after five (t1) and ten sessions (t2) of group psychotherapy. Observer- and self-rating scales (Hamilton Depression Rating Scale-24 items, HDRS 24 ; Beck Depression Inventory-II, BDI-II; World Health Organization Quality of Life assessment, WHOQOL-BREF) were applied before group psychotherapy (t0) and at t2. Dropouts were low (10.3%). Patients' evaluation improved significantly from t1 to t2 with a medium effect size (d = 0.60). Most of the patients stated that the group had enriched their treatment (75.3%), that the size (74.3%) and duration (72.5%) were 'optimal' and 37.3% wished for a higher frequency. Patients gave CBASP group psychotherapy an overall grade of 2 ('good'). Therapists' evaluation was positive throughout, except for size of the group. Outcome scores of HDRS 24 , BDI-II, and WHOQOL-BREF were significantly reduced from t0 to t2 with medium to large effect sizes (d = 1.48; d = 1.11; d = 0.67). In this naturalistic open-label trial, CBASP, when applied as inpatient group psychotherapy, was well accepted by patients and therapists. The results point towards a clinically meaningful effect of inpatient treatment with CBASP group psychotherapy on depression and quality of life. Other potential factors that could have promoted symptom change were discussed. A future controlled study could investigate the safety and efficacy of CBASP

  1. The role of cGMP hydrolysing phosphodiesterases 1 and 5 in cerebral artery dilatation

    DEFF Research Database (Denmark)

    Kruuse, Christina; Rybalkin, S D; Khurana, T S

    2001-01-01

    The aim was to investigate the presence and activity of cGMP hydrolysing phosphodiesterases in guinea pig basilar arteries and the effect of selective and non-selective phosphodiesterase inhibitors on cerebral artery dilatation involving the nitric oxide (NO)-guanosine cyclic 3'5-monophosphate (cGMP...... a close relation to the nitric oxide-cGMP pathway. The responses to zaprinast and dipyridamole, however, were not only moderately affected, but also restored by sodium nitroprusside (0.1 microM) pretreatment. At high concentrations, the dilatory effects of zaprinast and dipyridamole were partly caused...... by cGMP-independent mechanisms. Targeting the phosphodiesterases present in cerebral arteries, with selective inhibitors or activators of phosphodiesterase, may be a possible new way of treating cerebrovascular disease....

  2. Individual Psychotherapy and Changes in Self-Experience in Schizophrenia: A Qualitative Comparison of Patients in Metacognitively Focused and Supportive Psychotherapy.

    Science.gov (United States)

    Lysaker, Paul H; Kukla, Marina; Belanger, Elizabeth; White, Dominique A; Buck, Kelly D; Luther, Lauren; Firmin, Ruth L; Leonhardt, Bethany

    2015-01-01

    Deficits in metacognition, or the ability to form complex ideas about self and others, may be a root cause of dysfunction in schizophrenia. Accordingly, forms of psychotherapy have been proposed to address metacognitive deficits. This study explored whether metacognitively focused individual psychotherapy can affect self-experience by conducting narrative interviews of patients with a schizophrenia spectrum disorder enrolled in either metacognitively oriented psychotherapy (n = 12) or supportive psychotherapy (n = 13) in a naturalistic setting. Participants in both groups completed a narrative interview consisting of questions that focused on perceptions and process of psychotherapy and its impact on outcomes. Interviews were audiotaped, transcribed, and coded using an inductive process informed by grounded theory. Qualitative analyses revealed all participants reported psychotherapy led to improvements in self-esteem and the ability to think more clearly and set meaningful goals. The group receiving metacognitively oriented therapy, in contrast to those receiving supportive therapy, reported being able to integrate their current experiences into the larger narratives of their lives and an increased experience of sense of agency and the ability to understand and manage pain. Results provide evidence that metacognitively oriented psychotherapy may promote subjective forms of recovery.

  3. Psychotherapy of gambling — how to effectively treat gamblers? The effectivenes of applied therapeutic methods

    OpenAIRE

    Jelonkiewicz, Irena

    2014-01-01

    The aim of the study was to indicate efficacy of various psychological therapies for pathological and problem gambling. The literature on psychotherapy of gambling (1983–2012) was reviewed and particular attention carried out to meta-analysis studies during the period in question. The definition and the place of pathological gambling in the international classifications of diseases DSM-IV and ICD-10, and the prevalence of this disorder was briefly explained. This article provides information ...

  4. Effects of the NO/soluble guanylate cyclase/cGMP system on the functions of human platelets.

    Science.gov (United States)

    Makhoul, Stephanie; Walter, Elena; Pagel, Oliver; Walter, Ulrich; Sickmann, Albert; Gambaryan, Stepan; Smolenski, Albert; Zahedi, René P; Jurk, Kerstin

    2018-06-01

    Platelets are circulating sentinels of vascular integrity and are activated, inhibited, or modulated by multiple hormones, vasoactive substances or drugs. Endothelium- or drug-derived NO strongly inhibits platelet activation via activation of the soluble guanylate cyclase (sGC) and cGMP elevation, often in synergy with cAMP-elevation by prostacyclin. However, the molecular mechanisms and diversity of cGMP effects in platelets are poorly understood and sometimes controversial. Recently, we established the quantitative human platelet proteome, the iloprost/prostacyclin/cAMP/protein kinase A (PKA)-regulated phosphoproteome, and the interactions of the ADP- and iloprost/prostacyclin-affected phosphoproteome. We also showed that the sGC stimulator riociguat is in vitro a highly specific inhibitor, via cGMP, of various functions of human platelets. Here, we review the regulatory role of the cGMP/protein kinase G (PKG) system in human platelet function, and our current approaches to establish and analyze the phosphoproteome after selective stimulation of the sGC/cGMP pathway by NO donors and riociguat. Present data indicate an extensive and diverse NO/riociguat/cGMP phosphoproteome, which has to be compared with the cAMP phosphoproteome. In particular, sGC/cGMP-regulated phosphorylation of many membrane proteins, G-proteins and their regulators, signaling molecules, protein kinases, and proteins involved in Ca 2+ regulation, suggests that the sGC/cGMP system targets multiple signaling networks rather than a limited number of PKG substrate proteins. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Attachment theory as a guide to understanding and working with transference and the real relationship in psychotherapy.

    Science.gov (United States)

    Gelso, Charles J; Palma, Beatriz; Bhatia, Avantika

    2013-11-01

    Recent decades have witnessed an extraordinary amount of conceptual and empirical work on attachment theory in psychology and psychotherapy. Attachment theory is discussed in the present article as a way of understanding and fostering therapeutic work with 2 other key relationship constructs that have been theorized to be elements of all psychotherapies: client transference and the real relationship existing between the therapist and patient. Fundamental features of attachment, transference, and the real relationship are summarized. Particular emphasis is given to the role of the therapist as a secure base and a safe haven within the real relationship, and to the patient's internal working model as it relates to transference. A case of long-term psychodynamic psychotherapy conducted by the first author is presented to illuminate the 3 main constructs. The case demonstrates both the usefulness of attachment theory and the fact that any single theory cannot explain all of the complex features of a given treatment. © 2013 Wiley Periodicals, Inc.

  6. INTEGRATIVE PSYCHOTHERAPY AND MINDFULNESS: THE CASE OF SARA

    OpenAIRE

    Mihael Černetič

    2015-01-01

    The article explores the relationship between Integrative Psychotherapy and mindfulness on a theoretical as well as practical level. Although mindfulness is not an explicit constituent of Integrative Psychotherapy, the two are arguably a natural fit. Mindfulness has the potential to enhance internal and external contact, a central concept in Integrative Psychotherapy, as well as strengthen a client’s Adult ego state. This article presents a case study whereby Integrative Psychotherapy is ana...

  7. Predictors of premature termination from psychotherapy for anorexia nervosa: Low treatment credibility, early therapy alliance, and self-transcendence.

    Science.gov (United States)

    Jordan, Jennifer; McIntosh, Virginia V W; Carter, Frances A; Joyce, Peter R; Frampton, Christopher M A; Luty, Suzanne E; McKenzie, Janice M; Carter, Janet D; Bulik, Cynthia M

    2017-08-01

    Failure to complete treatment for anorexia nervosa (AN) is- common, clinically concerning but difficult to predict. This study examines whether therapy-related factors (patient-rated pretreatment credibility and early therapeutic alliance) predict subsequent premature termination of treatment (PTT) alongside self-transcendence (a previously identified clinical predictor) in women with AN. 56 women aged 17-40 years participating in a randomized outpatient psychotherapy trial for AN. Treatment completion was defined as attending 15/20 planned sessions. Measures were the Treatment Credibility, Temperament and Character Inventory, Vanderbilt Therapeutic Alliance Scale and the Vanderbilt Psychotherapy Process Scale. Statistics were univariate tests, correlations, and logistic regression. Treatment credibility and certain early patient and therapist alliance/process subscales predicted PTT. Lower self-transcendence and lower early process accounted for 33% of the variance in predicting PTT. Routine assessment of treatment credibility and early process (comprehensively assessed from multiple perspectives) may help clinicians reduce PTT thereby enhancing treatment outcomes. © 2017 Wiley Periodicals, Inc.

  8. Power Politics of Family Psychotherapy.

    Science.gov (United States)

    Whitaker, Carl A.

    It is postulated that the standard framework for psychotherapy, a cooperative transference neurosis, does not validly carry over to the successful psychotherapy of a two-generation family group. In many disturbed families, the necessary and sufficient dynamics for change must be initiated, controlled, and augmented by a group dynamic power-play,…

  9. How Do Trainees Choose Their First Psychotherapy Training? The Case of Training in Psychotherapy Integration

    Science.gov (United States)

    Plchová, Romana; Hytych, Roman; Rihácek, Tomáš; Roubal, Jan; Vybíral, Zbynek

    2016-01-01

    Future trainees go through difficult decision-making processes when starting their first psychotherapy training. The choice of training in psychotherapy integration is a specific type of this process. In this study, qualitative data were obtained from the motivational letters, in-depth semi-structured interviews and e-mail questionnaires of 26…

  10. I was being myself but being an actor too: the experience of a Black male in interracial psychotherapy.

    Science.gov (United States)

    Qureshi, Adil

    2007-12-01

    In recent years, investigators have indicated that the psychotherapy process is of considerable importance in the context of interracial psychotherapy. Despite the interest in the area, minimal research has examined how racial difference impacts the psychotherapy process. This study examines the lived experience of interracial psychodynamic psychotherapy via an in-depth interview with an African-American man who had been in therapy with a European American therapist. This qualitative study utilizes a hermeneutic phenomenological approach, which accepts that understanding is contingent on both sociohistorical situatedness and relational dynamics. The study participant was chosen because of his interest in the area and willingness to explore it in detail with the interviewer. A number of themes emerged, the most salient of which are the multidimensionality of the experience and the 'absent presence' of race in the therapy process. This client's experience was both positive and negative, and in many cases, the same process-related variables contributed both positively and negatively to the client's therapeutic experience. Issues of trust, perceived cultural issues and therapy focus contributed to and detracted from the therapy experience. The depth of the therapy experience was limited by the therapist not explicitly addressing race.

  11. A cGMP kinase mutant with increased sensitivity to the protein kinase inhibitor peptide PKI(5-24).

    Science.gov (United States)

    Ruth, P; Kamm, S; Nau, U; Pfeifer, A; Hofmann, F

    1996-01-01

    Synthetic peptides corresponding to the active domain of the heat-stable inhibitor protein PKI are very potent inhibitors of cAMP-dependent protein kinase, but are extremely weak inhibitors of cGMP-dependent protein kinase. In this study, we tried to confer PKI sensitivity to cGMP kinase by site-directed mutagenesis. The molecular requirements for high affinity inhibition by PKI were deduced from the crystal structure of the cAMP kinase/PKI complex. A prominent site of interaction are residues Tyr235 and Phe239 in the catalytic subunit, which from a sandwich-like structure with Phe10 of the PKI(5-24) peptide. To increase the sensitivity for PKI, the cGMP kinase codons at the corresponding sites, Ser555 and Ser559, were changed to Tyr and Phe. The mutant cGMP kinase was stimulated half maximally by cGMP at 3-fold higher concentrations (240 nM) than the wild type (77 nM). Wild type and mutant cGMP kinase did not differ significantly in their Km and Vmax for three different substrate peptides. The PKI(5-24) peptide inhibited phosphotransferase activity of the mutant cGMP kinase with higher potency than that of wild type, with Ki values of 42 +/- .3 microM and 160 +/- .7 microM, respectively. The increased affinity of the mutant cGMP kinase was specific for the PKI(5-24) peptide. Mutation of the essential Phe10 in the PKI(5-24) sequence to an Ala yielded a peptide that inhibited mutant and wild type cGMP kinase with similar potency, with Ki values of 160 +/- 11 and 169 +/- 27 microM, respectively. These results suggest that the mutations Ser555Tyr and Ser559Phe are required, but not sufficient, for high affinity inhibition of cGMP kinase by PKI.

  12. Treatment preferences of psychotherapy patients with chronic PTSD.

    Science.gov (United States)

    Markowitz, John C; Meehan, Kevin B; Petkova, Eva; Zhao, Yihong; Van Meter, Page E; Neria, Yuval; Pessin, Hayley; Nazia, Yasmin

    2016-03-01

    Patient treatment preference may moderate treatment effect in major depressive disorder (MDD) studies. Little research has addressed preference in posttraumatic stress disorder (PTSD); almost none has assessed actual patients' PTSD psychotherapy preferences. From a 14-week trial of chronic PTSD comparing prolonged exposure, relaxation therapy, and interpersonal psychotherapy, we report treatment preferences of the 110 randomized patients, explore preference correlates, and assess effects on treatment outcome. Patients recruited between 2008 and 2013 with chronic DSM-IV PTSD (Clinician-Administered PTSD Scale [CAPS] score ≥ 50) received balanced, scripted psychotherapy descriptions prerandomization and indicated their preferences. Analyses assessed relationships of treatment attitudes to demographic and clinical factors. We hypothesized that patients randomized to preferred treatments would have better outcomes, and to unwanted treatment worse outcomes. Eighty-seven patients (79%) voiced treatment preferences or disinclinations: 29 (26%) preferred prolonged exposure, 29 (26%) preferred relaxation therapy, and 56 (50%) preferred interpersonal psychotherapy (Cochran Q = 18.46, P psychotherapy (Cochran Q = 22.71, P psychotherapy preferences to outcome. Despite explanations emphasizing prolonged exposure's greater empirical support, patients significantly preferred interpersonal psychotherapy. Preference subtly affected psychotherapy outcome; depression appeared an important moderator of the effect of unwanted treatment on outcome. Potential biases to avoid in future research are discussed. ClinicalTrials.gov identifier: NCT00739765. © Copyright 2015 Physicians Postgraduate Press, Inc.

  13. Radioimmunoassay for platelet activation specific protein GMP-140 on the platelet surface and in plasma

    International Nuclear Information System (INIS)

    Wu Guoxin; Li Jianyong; Ruan Changgeng

    1991-08-01

    Using monoclonal antibody (McAb) SZ-51 which is specific for an alpha-granule membrane protein (GMP-140) on the surface of human activated platelets, the platelet GMP-140 expression in fixed whole blood was measured by direct radioimmunoassay and GMP-140 microparticles in plasma was measured by sandwich method. The GMP-140 molecules per platelet or milliliter (mL) were calculated for the following subjects; acute myocardial infarction; cerebro thrombosis; diabetic mellitus; asthma attack; epidemic hemorrhagic fever etc.. By comparing with the concentration of thromboxane B 2 (TXB 2 ) and von Willebrand factor (vWF) in plasma, it is confirmed that the measurement of GMP-140 molecules is better than that of TXB 2 and vWF. It is a sensitive and specific method for evaluating the platelet activation degree in vivo. The establishment of this method will be useful to diagnosing the thrombotic disorders and studying the pathogenesis of some other diseases

  14. Psychotherapies for adult depression: recent developments.

    Science.gov (United States)

    Cuijpers, Pim

    2015-01-01

    Much has been learned from the 400 randomized trials on psychotherapies for adult depression that have been conducted, but much is also still unknown. In this study some recent attempts to further reduce the disease burden of depression through psychotherapies are reviewed. In the past, many new psychotherapies have promised to be more effective than existing treatments, usually without success. We describe recent research on two new therapies, acceptance and commitment therapy and cognitive bias modification, and conclude that both have also not shown to be more effective than existing therapies. A growing number of studies have also focused on therapies that may be successful in further reducing the disease burden, such as treatments for chronic depression and relapse prevention. Other studies are aimed at scaling up psychological services, such as the training of lay health counselors in low-income and middle-income countries, telephone-based, and internet-based therapies. Psychotherapies are essential tools in the treatment of adult depression. Randomized trials have shown that these treatments are effective, and by focusing on key issues, such as chronic depression, relapse, and scaling them up, psychotherapies contribute more and more to the reduction of the disease burden of depression.

  15. Spiritually and religiously integrated group psychotherapy

    DEFF Research Database (Denmark)

    Viftrup, Dorte Toudal; Hvidt, Niels Christian; Buus, Niels

    2013-01-01

    WE SYSTEMATICALLY REVIEWED THE RESEARCH LITERATURE ON SPIRITUALLY AND RELIGIOUSLY INTEGRATED GROUP PSYCHOTHERAPY TO ANSWER THE FOLLOWING THREE QUESTIONS: first, how are spirituality and religiosity defined; second, how are spiritual and religious factors characterized and integrated into group......, 8 articles were considered eligible for the review. Findings from the evaluation suggested that the concepts of spirituality and religiosity were poorly conceptualized and the way in which spiritual and religious factors were integrated into such group psychotherapies, which distinguished it from...... for spiritually or religiously integrated group psychotherapy and conducting research in this field are propounded....

  16. Atrial natriuretic peptide receptor heterogeneity and effects on cyclic GMP accumulation

    International Nuclear Information System (INIS)

    Leitman, D.C.

    1988-01-01

    The effects of atrial natriuretic peptide (ANP), oxytocin (OT) and vasopressin (AVP) on guanylate cyclase activity and cyclic GMP accumulation were examined, since these hormones appear to be intimately associated with blood pressure and intravascular volume homeostasis. ANP was found to increase cyclic GMP accumulation in ten cell culture systems, which were derived from blood vessels, adrenal cortex, kidney, lung, testes and mammary gland. ANP receptors were characterized in intact cultured cells using 125 I-ANP 8-33 . Specific 125 I-ANP binding was saturable and of high affinity. Scratchard analysis of the binding data for all cell types exhibited a straight line, indicating that these cells possessed a single class of binding sites. Despite the presence of linear Scatchard plots, these studies demonstrated that cultured cells possess two functionally and physically distinct ANP-binding sites. Most of the ANP-binding sites in cultured cells have a molecular size of 66,000 daltons under reducing conditions. The identification of cultured cell types in which hormones (ANP and oxytocin) regulate guanylate cyclase activity and increase cyclic GMP synthesis will provide valuable systems to determine the mechanisms of hormone-receptor coupling to guanylate cyclase and the cellular processes regulated by cyclic GMP

  17. MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms?

    Science.gov (United States)

    Feduccia, Allison A; Mithoefer, Michael C

    2018-06-08

    MDMA-assisted psychotherapy for treatment of PTSD has recently progressed to Phase 3 clinical trials and received Breakthrough Therapy designation by the FDA. MDMA used as an adjunct during psychotherapy sessions has demonstrated effectiveness and acceptable safety in reducing PTSD symptoms in Phase 2 trials, with durable remission of PTSD diagnosis in 68% of participants. The underlying psychological and neurological mechanisms for the robust effects in mitigating PTSD are being investigated in animal models and in studies of healthy volunteers. This review explores the potential role of memory reconsolidation and fear extinction during MDMA-assisted psychotherapy. MDMA enhances release of monoamines (serotonin, norepinephrine, dopamine), hormones (oxytocin, cortisol), and other downstream signaling molecules (BDNF) to dynamically modulate emotional memory circuits. By reducing activation in brain regions implicated in the expression of fear- and anxiety-related behaviors, namely the amygdala and insula, and increasing connectivity between the amygdala and hippocampus, MDMA may allow for reprocessing of traumatic memories and emotional engagement with therapeutic processes. Based on the pharmacology of MDMA and the available translational literature of memory reconsolidation, fear learning, and PTSD, this review suggests a neurobiological rationale to explain, at least in part, the large effect sizes demonstrated for MDMA in treating PTSD. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Receptors and cGMP signalling mechanism for E. coli enterotoxin in opossum kidney

    International Nuclear Information System (INIS)

    Forte, L.R.; Krause, W.J.; Freeman, R.H.

    1988-01-01

    Receptors for the heat-stable enterotoxin produced by Escherichia coli were found in the kidney and intestine of the North American opossum and in cultured renal cell lines. The enterotoxin markedly increased guanosine 3',5'-cyclic monophosphate (cGMP) production in slices of kidney cortex and medulla, in suspensions of intestinal mucosa, and in the opossum kidney (OK) and rat kangaroo kidney (PtK-2) cell lines. In contrast, atrial natriuretic factor elicited much smaller increases in cGMP levels of kidney, intestine, or cultured kidney cell lines. The enterotoxin receptors in OK cells had a molecular mass of approximately 120 kDa when measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of receptors crosslinked with 125 I-enterotoxin. The occurrence of receptors for the E. coli peptide in OK implies that these receptors may be involved in the regulation of renal tubular function in the opossum. E. coli enterotoxin caused a much larger increase in urine cGMP excretion than did atrial natriuretic factor when these peptides were injected intravenously into opossums. However, atrial natriuretic factor elicited a marked diuresis, natriuresis, and increased urinary excretion of calcium, phosphate, potassium, and magnesium. In contrast, the enterotoxin did not acutely influence OK fluid and electrolyte excretion. Thus the substantial increase in cGMP synthesis produced by the bacterial peptide in OK cortex and medulla in vitro and the increased renal excretion of cGMP in vivo were not associated with changes in electrolyte or water excretion. Whether cGMP represents a second messenger molecule in the kidney is an interesting question that was raised but not answered in this series of experiments

  19. Therapeutic working alliance: From a psychoanalitical to a pantheoretical conception

    Directory of Open Access Journals (Sweden)

    Peter Praper

    2004-05-01

    Full Text Available Although the concept of therapeutic working alliance was rooted in psychoanalysis, today it is more prominent in psychoanalytic psychotherapies than psychoanalysis. It is rather surprising that we cannot find the concept in the Laplanche and Pontalis Dictionary. During the last two decades a growing body of empirical research material on therapeutic working alliance was published, confirming the idea of the alliance as a separate dimension of therapeutic relationship with few recognisable components. The dimension of the therapeutic working alliance was examined in several approaches and proved as one of the most important therapeutic factors, regardless of the approach, and it has finally been accepted as a pantheoretical concept.

  20. Applied philosophy and psychotherapy: Heraclitus as case study

    Directory of Open Access Journals (Sweden)

    Johann Beukes

    2002-10-01

    Full Text Available This article investigates a recent attempt to apply philosophy within the discipline of psychotherapy and to investigate the somewhat undefined realm of philosophical counselling. After introducing the claims of this interdisciplinary exercise and after addressing the problems involved in crossing the boundaries between philosophy and psychotherapy, the article elaborates on  Alex Howard’s (2000 [Philosophy for counselling and psychotherapy: Pythagoras to post-modernism. London: Macmillan] attempt to make explicit use of philosophy in psychotherapy, using his interpretation and application of Heraclitus’ philosophy as case study.

  1. [Psychanalitic psychotherapy: practice and indications in the aged].

    Science.gov (United States)

    Claudel, Bertrand

    2004-09-01

    Use of psychoanalytic psychotherapy for the elderly remains an issue. Even though regular psychoanalysis cure is contraindicated for elderly patients in most cases, yet, face-to-face psychotherapies can prove useful. The methods used for psychoanalytic psychotherapy for elderly patients are different from those applicable to middle age patients. These methods take into account the mourning process experienced by the elderly patient in three spheres: loss of object, loss of function and loss of oneself. Indications concerning psychoanalytic psychotherapy for the elderly have to be carefully assessed and will be detailed throughout the paper.

  2. Succession and survival in psychotherapy organizations.

    Science.gov (United States)

    Khaleelee, Olya

    2008-11-01

    This paper examines the world of psychotherapy by applying a systemic and psychodynamic understanding of the family business as a way of understanding the dilemmas and challenges of leadership succession. Oedipal factors are explored as an important theme within the succession process. This exploration is set within the context of what function psychotherapy has performed in society over the last thirty years. The hypothesis is that the first generation of leaders aimed to provide containment for the individual citizen at a time of failed dependency in society. The suggestion is that this gave way to the primary task for the second generation, which has been to focus on the therapist in training. The challenge for the third generation is to develop a meaningful role for psychotherapy today and to ensure survival at a time when other shorter therapies such as CBT are gaining ascendancy over longer term psychoanalytic psychotherapy.

  3. The Process of Seeking Psychotherapy and Its Impact on Therapy Expectations and Experiences.

    Science.gov (United States)

    Elliott, Katherine P; Westmacott, Robin; Hunsley, John; Rumstein-McKean, Orly; Best, Marlene

    2015-01-01

    the benefits/challenges of therapy, potential clients may be able to progress through this step more rapidly and with less difficulty. Clients' expectations of the value of psychotherapy and their commitment to engage in therapy do not appear to be affected by how long it took, or how difficult it was, to obtain psychotherapy. Factors such as forming a strong therapeutic alliance and providing support and guidance during the initial sessions of therapy may be more important in helping potential clients commit to therapy than what they experienced in their efforts to receive psychotherapy. Copyright © 2014 John Wiley & Sons, Ltd.

  4. [Method of existence analytic psychotherapy].

    Science.gov (United States)

    Längle, A

    1990-01-01

    Introducing questions of individual purpose and meaning into psychotherapy was an important contribution of Viktor Frankl and a necessary supplement to traditional psychotherapy. V. Frankls "Logotherapy" (logos = meaning) however has found its main application in counselling (especially bereavement and grief processes) and prophylactic endeavours (e.g. pedagogics). Suffering from meaninglessness, on the other hand, showed up to be a respectively rare indication for psychotherapeutic interventions in its proper sense. Thus the question was arising how to apply Frankl's valuable meaning-centered concept of man (which he called "Existential Analysis") in a genuine way to other neurosis and to personality disorders, so far "unspecific indications" to Logotherapy. This paper gives an outline and methodological foundation of "Existential Analysis Psychotherapy". A case study finally is illustrating its phenomenological proceeding.

  5. Psychotherapy: a profile of current occupational therapy practice in Ontario.

    Science.gov (United States)

    Moll, Sandra E; Tryssenaar, Joyce; Good, Colleen R; Detwiler, Lisa M

    2013-12-01

    Psychotherapy can be an important part of psychosocial occupational therapy practice; however, it requires specialized training to achieve and maintain competence. Regulation varies by province, and in Ontario, occupational therapists were recently authorized to perform psychotherapy. The purpose of this study was to explore the psychotherapy practice, training, and support needs of Ontario occupational therapists. An online survey was sent to occupational therapists who had clients with mental health or chronic pain issues, asking about their expertise and support needs in relation to nine psychotherapy approaches. Of the 331 therapists who responded, there were variations in the nature and frequency of psychotherapy practice. Experienced therapists in outpatient settings were more likely to practice psychotherapy, and cognitive-behaviour therapy, motivational interviewing, and mindfulness were the most common approaches. Supervision and training varied, with many therapists interested in occupational therapy-specific training. Recommendations for a framework of support include education about the nature of psychotherapy, training and supervision guidelines, and advocacy for occupational therapy and psychotherapy.

  6. The crucial role of cyclic GMP in the eclosion hormone mediated signal transduction in the silkworm metamorphoses.

    Science.gov (United States)

    Shibanaka, Y; Hayashi, H; Okada, N; Fujita, N

    1991-10-31

    The signal transduction of the peptide, eclosion hormone, in the silkworm Bombyx mori appears to be mediated via the second messenger cyclic GMP throughout their life cycle. Injection of 8-bromo-cGMP induced the ecdysis behavior in pharate adults with similar latency to eclosion hormone-induced ecdysis; the moulting occurred 50-70 min after the injection. The potency of 8Br-cGMP was 10(2) fold higher than that of cGMP and the efficacy was increased by the co-injection of the phosphodiesterase inhibitor IBMX. On the other hand, in the silkworm pupal ecdysis the eclosion hormone and also 8Br-cGMP induced the moulting behavior in a dose-dependent manner. The adult development of the ability to respond to 8Br-cGMP took place concomitantly with the response to the eclosion hormone. Both the developmental time courses were shifted by a shift of light and dark cycles. Accordingly, the sensitivities to the peptide and cyclic nucleotide developed correspondently under the light and dark circadian rhythm. Thus throughout the silkworm life cycle, eclosion hormone is effective to trigger the ecdysis behavior and cGMP plays a crucial role as the second messenger in the eclosion hormone-mediated signal transduction.

  7. BolA Is Required for the Accurate Regulation of c-di-GMP, a Central Player in Biofilm Formation

    OpenAIRE

    Moreira, Ricardo N.; Dressaire, Clémentine; Barahona, Susana; Galego, Lisete; Kaever, Volkhard; Jenal, Urs; Arraiano, Cecília M.

    2017-01-01

    The bacterial second messenger cyclic dimeric GMP (c-di-GMP) is a nearly ubiquitous intracellular signaling molecule involved in the transition from the motile to the sessile/biofilm state in bacteria. C-di-GMP regulates various cellular processes, including biofilm formation, motility, and virulence. BolA is a transcription factor that promotes survival in different stresses and is also involved in biofilm formation. Both BolA and c-di-GMP participate in the regulation of motility mechanisms...

  8. C-di-GMP regulates Pseudomonas aeruginosa stress response to tellurite during both planktonic and biofilm modes of growth

    DEFF Research Database (Denmark)

    Chua, Song Lin; Sivakumar, Krishnakumar; Rybtke, Morten Levin

    2015-01-01

    tellurite (TeO3(2-)) exposure induced the intracellular content of the secondary messenger cyclic di-GMP (c-di-GMP) of Pseudomonas aeruginosa. Two diguanylate cyclases (DGCs), SadC and SiaD, were responsible for the increased intracellular content of c-di-GMP. Enhanced c-di-GMP levels by TeO3(2-) further...... increased P. aeruginosa biofilm formation and resistance to TeO3(2-). P. aeruginosa ΔsadCΔsiaD and PAO1/p(lac)-yhjH mutants with low intracellular c-di-GMP content were more sensitive to TeO3(2-) exposure and had low relative fitness compared to the wild-type PAO1 planktonic and biofilm cultures exposed...... to TeO3(2-). Our study provided evidence that c-di-GMP level can play an important role in mediating stress response in microbial communities during both planktonic and biofilm modes of growth....

  9. GMP-140 binds to a glycoprotein receptor on human neutrophils: Evidence for a lectin-like interaction

    International Nuclear Information System (INIS)

    Moore, K.L.; Varki, A.; McEver, R.P.

    1991-01-01

    GMP-140 is a rapidly inducible receptor for neutrophils and monocytes expressed on activated platelets and endothelial cells. It is a member of the selectin family of lectin-like cell surface molecules that mediate leukocyte adhesion. We used a radioligand binding assay to characterize the interaction of purified GMP-140 with human neutrophils. Unstimulated neutrophils rapidly bound [125I]GMP-140 at 4 degrees C, reaching equilibrium in 10-15 min. Binding was Ca2+ dependent, reversible, and saturable at 3-6 nM free GMP-140 with half-maximal binding at approximately 1.5 nM. Receptor density and apparent affinity were not altered when neutrophils were stimulated with 4 beta-phorbol 12-myristate 13-acetate. Treatment of neutrophils with proteases abolished specific binding of [125I]GMP-140. Binding was also diminished when neutrophils were treated with neuraminidase from Vibrio cholerae, which cleaves alpha 2-3-, alpha 2-6-, and alpha 2-8-linked sialic acids, or from Newcastle disease virus, which cleaves only alpha 2-3- and alpha 2-8-linked sialic acids. Binding was not inhibited by an mAb to the abundant myeloid oligosaccharide, Lex (CD15), or by the neoglycoproteins Lex-BSA and sialyl-Lex-BSA. We conclude that neutrophils constitutively express a glycoprotein receptor for GMP-140, which contains sialic acid residues that are essential for function. These findings support the concept that GMP-140 interacts with leukocytes by a lectin-like mechanism

  10. Cohesive Properties of the Caulobacter crescentus Holdfast Adhesin Are Regulated by a Novel c-di-GMP Effector Protein

    Directory of Open Access Journals (Sweden)

    Kathrin S. Sprecher

    2017-03-01

    Full Text Available When encountering surfaces, many bacteria produce adhesins to facilitate their initial attachment and to irreversibly glue themselves to the solid substrate. A central molecule regulating the processes of this motile-sessile transition is the second messenger c-di-GMP, which stimulates the production of a variety of exopolysaccharide adhesins in different bacterial model organisms. In Caulobacter crescentus, c-di-GMP regulates the synthesis of the polar holdfast adhesin during the cell cycle, yet the molecular and cellular details of this control are currently unknown. Here we identify HfsK, a member of a versatile N-acetyltransferase family, as a novel c-di-GMP effector involved in holdfast biogenesis. Cells lacking HfsK form highly malleable holdfast structures with reduced adhesive strength that cannot support surface colonization. We present indirect evidence that HfsK modifies the polysaccharide component of holdfast to buttress its cohesive properties. HfsK is a soluble protein but associates with the cell membrane during most of the cell cycle. Coincident with peak c-di-GMP levels during the C. crescentus cell cycle, HfsK relocalizes to the cytosol in a c-di-GMP-dependent manner. Our results indicate that this c-di-GMP-mediated dynamic positioning controls HfsK activity, leading to its inactivation at high c-di-GMP levels. A short C-terminal extension is essential for the membrane association, c-di-GMP binding, and activity of HfsK. We propose a model in which c-di-GMP binding leads to the dispersal and inactivation of HfsK as part of holdfast biogenesis progression.

  11. A relação entre os mecanismos de defesa e a qualidade da aliança terapêutica em psicoterapia de orientação analítica The relationship between defense mechanisms and the quality of therapeutic alliance in analytic psychotherapy

    Directory of Open Access Journals (Sweden)

    Fernando Grilo Gomes

    2008-08-01

    Full Text Available INTRODUÇÃO: O estabelecimento de uma aliança terapêutica de boa qualidade em uma psicoterapia psicanalítica é fundamental para o processo terapêutico. Este estudo avaliou a influência do nível de funcionamento defensivo do paciente na qualidade da aliança terapêutica estabelecida durante a psicoterapia. MÉTODO: Para avaliação da qualidade da aliança estabelecida, pacientes em psicoterapia psicanalítica e seus respectivos terapeutas responderam ao Helping Alliance Questionnaire (versão paciente e versão terapeuta, respectivamente. O nível defensivo foi inferido através da Escala de Funcionamento Defensivo proposta no Manual de Diagnóstico e Estatística das Perturbações Mentais, quarta edição, texto revisado. RESULTADOS: Não houve associação entre o estabelecimento de uma aliança terapêutica de boa qualidade e o nível defensivo do paciente. No entanto, houve diferença significativa quando a versão do terapeuta foi comparada com a respondida pelo paciente: os pacientes estabeleceram uma aliança terapêutica de melhor qualidade em relação a seus terapeutas do que o inverso. CONCLUSÕES: O fato de a aliança terapêutica de boa qualidade ter se estabelecido independentemente do nível defensivo do paciente sugere que o treinamento e as características pessoais do terapeuta podem levar a uma capacidade de conectar-se com o paciente, apesar do grau de comprometimento do seu funcionamento psíquico.BACKGROUND: The quality of a therapeutic alliance is essential in psychoanalytic psychotherapy and influences the therapeutic process. This study evaluated the relationship between the level of defense mechanisms and the quality of therapeutic alliance established during psychotherapy. METHOD: Patients in psychotherapy and their respective therapists completed the Helping Alliance Questionnaire (patient version and therapist version, respectively. The level of defenses was inferred by the Defensive Functioning Scale

  12. [The Contribution of GMP-grade Hospital Preparation to Translational Research].

    Science.gov (United States)

    Yonezawa, Atsushi; Kajiwara, Moto; Minami, Ikuko; Omura, Tomohiro; Nakagawa, Shunsaku; Matsubara, Kazuo

    2015-01-01

    Translational research is important for applying the outcomes of basic research studies to practical medical treatments. In exploratory early-phase clinical trials for an innovative therapy, researchers should generally manufacture investigational agents by themselves. To provide investigational agents with safety and high quality in clinical studies, appropriate production management and quality control are essential. In the Department of Pharmacy of Kyoto University Hospital, a manufacturing facility for sterile drugs was established, independent of existing manufacturing facilities. Manuals on production management and quality control were developed according to Good Manufacturing Practices (GMP) for Investigational New Drugs (INDs). Advanced clinical research has been carried out using investigational agents manufactured in our facility. These achievements contribute to both the safety of patients and the reliability of clinical studies. In addition, we are able to do licensing-out of our technique for the manufacture of investigational drugs. In this symposium, we will introduce our GMP grade manufacturing facility for sterile drugs and discuss the role of GMP grade hospital preparation in translational research.

  13. High-throughput screening for compounds that modulate the cellular c-di-GMP level in bacteria

    DEFF Research Database (Denmark)

    Groizeleau, Julie; Andersen, Jens Bo; Givskov, Michael

    2017-01-01

    . The secondary messenger c-di-GMP is a positive regulator of biofilm formation in many clinically relevant bacteria, and it is assumed that drugs that lower the intracellular level of c-di-GMP will force biofilm bacteria into a more treatable planktonic lifestyle. We describe a protocol for high......-throughput screening of chemical libraries for compounds that lower the c-di-GMP level in bacteria, and potentially can serve as lead compounds in the development of novel biofilm dismantling drugs....

  14. [How is burnout treated? Treatment approaches between wellness, job-related prevention of stress, psychotherapy, and social criticism].

    Science.gov (United States)

    Hillert, A

    2012-02-01

    The subjective illness burnout is often described as the combination of workload-related suffering and job dissatisfaction, thus, leading to depressive symptoms. Burnout is a serious model of personal illness perception, but not useful as a diagnosis term because of its lack of specification and reliability. In this respect, burnout therapy cannot be regarded as a specific form of psychotherapy or any other form of therapy, but rather a pragmatic procedure focusing on the burnout clients' needs. When applying scientific standards, the evidence of a more or less specific anti-burnout effect of such procedures involving relaxation, wellness, alternative medical approaches, and psychotherapy are between weak and non-existent. From a conceptual point of view, strategies focusing on relaxation and symptom-reduction can be distinguished from prospective, job-related stress management efforts. In clinical psychotherapeutic settings, aspects of both are usually combined in programs claimed to be integrative or holistic. However, whether these programs really enhance the individual therapeutic outcome has yet to be proved in controlled clinical trials. The efficacy of preventive anti-stress programs and of job-related therapeutic groups, offered complementary to common therapeutic programs in psychosomatic hospitals, have been demonstrated in several studies. Therapeutic information focusing on side effects of social and work-related changes on an individual's psychosomatic wellbeing are needed. The prominent term burnout may be helpful in the public discussion but is not useful in the conceptual framework of a rational, scientific-based procedure in this field.

  15. Molecular properties of mammalian proteins that interact with cGMP: protein kinases, cation channels, phosphodiesterases, and multi-drug anion transporters.

    Science.gov (United States)

    Francis, Sharron H; Blount, Mitsi A; Zoraghi, Roya; Corbin, Jackie D

    2005-09-01

    Cyclic GMP is a critical second messenger signaling molecule in many mammalian cell types. It is synthesized by a family of guanylyl cyclases that is activated in response to stimuli from hormones such as natriuretic peptides, members of the guanylin family, and chemical stimuli including nitric oxide and carbon monoxide. The resulting elevation of cGMP modulates myriad physiological processes. Three major groups of cellular proteins bind cGMP specifically at allosteric sites; interaction of cGMP with these sites modulates the activities and functions of other domains within these protein groups to bring about physiological effects. These proteins include the cyclic nucleotide (cN)-dependent protein kinases, cN-gated cation channels, and cGMP-binding phosphodiesterases (PDE). Cyclic GMP also interacts with the catalytic sites of many cN PDEs and with some members of the multi-drug anion transporter family (MRPs) which can extrude nucleotides from cells. The allosteric cN-binding sites in the kinases and the cN-gated channels are evolutionarily and biochemically related, whereas the allosteric cGMP-binding sites in PDEs (also known as GAF domains), the catalytic sites of PDEs , and the ligand-binding sites in the MRPs are evolutionarily and biochemically distinct from each other and from those in the kinase and channel families. The sites that interact with cGMP within each of these groups of proteins have unique properties that provide for cGMP binding. Within a given cell, cGMP can potentially interact with members of all these groups of proteins if they are present. The relative abundance and affinities of these various cGMP-binding sites in conjunction with their subcellular compartmentation, proximity to cyclases and PDEs, and post-translational modification contribute importantly in determining the impact of these respective proteins to cGMP signaling within a particular cell.

  16. [Aging reduces contents of endogenous CO, cAMP and cGMP in rat penile tissues].

    Science.gov (United States)

    Qin, Wen-Bo; Wang, Shu-Qiu; Li, Ming; Kang, Yu-Ming; Gui, Shi-Liang; Chi, Bao-Jin

    2009-02-01

    To explore the relationship of aging with the changes of endogenous carbon monoxide (CO), cGMP and cAMP contents in the penile tissues of rats. Twenty-four male rats were equally divided into an 8-month, a 16-month and a 24-month group, and their penile erection was detected by injecting apomorphine, their penile cavernous body harvested, and the contents of CO, cAPM and cGMP detected by improved dual wavelength spectrophotometry. The contents of CO, cAPM and cGMP were reduced with the increase of age, with statistically significant differences between the three age groups (P < 0.01). Aging significantly decreased the contents of CO, cAMP and cGMP in the penile tissues of the rats, which suggests that aging might play an important role in erectile dysfunction.

  17. Stimulation of cyclic GMP efflux in human melanocytes by hypergravity generated by centrifugal acceleration

    NARCIS (Netherlands)

    Ivanova, Krassimira; Zadeh, Nahid Hamidi; Block, Ingrid; Das, Pranab K.; Gerzer, Rupert

    2004-01-01

    Gravity alteration (micro- and hypergravity) is known to influence cell functions. As guanosine 3',5'-cyclic monophosphate (cGMP) plays an important role in human melanocyte functions and different guanylyl cyclase isoforms are responsible for cGMP synthesis in human non-metastatic and metastatic

  18. Interactions in the aqueous phase and adsorption at the air-water interface of caseinoglycomacropeptide (GMP) and beta-lactoglobulin mixed systems.

    Science.gov (United States)

    Martinez, María J; Sánchez, Cecilio Carrera; Patino, Juan M Rodríguez; Pilosof, Ana M R

    2009-01-01

    The aim of this work was to study the interactions and adsorption of caseinoglycomacropeptide (GMP) and GMP:beta-lactoglobulin (beta-lg) mixed system in the aqueous phase and at the air-water interface. The existence of associative interactions between GMP and beta-lg in the aqueous phase was investigated by dynamic light scattering, differential scanning calorimetry (DSC), fluorometry and native PAGE-electrophoresis. The surface pressure isotherm and the static and dynamic surface pressure were determined by tensiometry and surface dilatational properties. The results showed that GMP presented higher surface activity than beta-lg at a concentration of 4%wt but beta-lg showed higher film forming ability. In the mixed systems beta-lg dominated the static and dynamic surface pressure and the rheological properties of interfacial films suggesting that beta-lg hinders GMP adsorption because, in simple competition, GMP should dominate because of its higher surface activity. The surface predominance of beta-lg can be attributed to binding of GMP to beta-lg in the aqueous phase that prevents GMP adsorption on its own.

  19. Therapeutic Assessment in Personality Disorders: Toward the Restoration of Epistemic Trust.

    Science.gov (United States)

    Kamphuis, Jan H; Finn, Stephen E

    2018-06-06

    Research evidence suggests Therapeutic Assessment positively affects clients with problems in living, including clients with personality disorders, who are typically quite resistant to change. Importantly, this change takes place quickly, in relatively few sessions. This article draws on a relatively new evolutionary-based theory of epistemic trust (ET) and epistemic hypervigilance (EH) as a lens to plausibly explain the efficacy of TA, and especially its influence on PD clients' alliance and motivation for subsequent psychotherapy (Fonagy, Luyten, & Alison, 2015 ). ET is the willingness to take in relevant interpersonally transmited information and it is essential to the immediate success of psychotherapy and its long-term impact. The collaborative, intersubjective framework of TA and many of its specific techniques might be understood as highly relevant to restoring ET in clients, especially those with PD. We close by discussing implications for psychological assessment, psychotherapy, and research.

  20. Music Therapy as Psychotherapy in Psychiatry at all Levels of the GAF Scale

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2009-01-01

    Presentation and disussion on how to apply different music therapy methods and techniques in psychiatry at different levels of the GAF (Global Functioning Scoring system) scale described in combination with McGlashan's relational process levels and other therapeutic principles as illustrated in 5...... books on 'relational treatment in psychiatry' by Lars Thorgaard (DK) and Ejvind Haga (N). Is music therapy as psychotherapy applicable also at the lower GAF scorings? Which methods/techniques?......Presentation and disussion on how to apply different music therapy methods and techniques in psychiatry at different levels of the GAF (Global Functioning Scoring system) scale described in combination with McGlashan's relational process levels and other therapeutic principles as illustrated in 5...

  1. Review: Mäder, Maya (2017: Selbsterfahrung in der Psychotherapie (Self experience in Psychotherapy, Die Bedeutung für den Kompetenzerwerb in der Aus- und Weiterbildung zum transaktionalytischen Psychotherapeuten (The significance for getting competence in training of transactional psychotherapy Münster: Waxmann

    Directory of Open Access Journals (Sweden)

    Günther Mohr

    2017-07-01

    Full Text Available Review: Mäder, Maya (2017: Selbsterfahrung in der Psychotherapie (Self experience in Psychotherapy, Die Bedeutung für den Kompetenzerwerb in der Aus- und Weiterbildung zum transaktionalytischen Psychotherapeuten (The significance for getting competence in training of transactional psychotherapy Münster: Waxmann   Citation - APA format: Mohr, G. (2017. Review: Mäder, Maya (2017: Selbsterfahrung in der Psychotherapie (Self experience in Psychotherapy, Die Bedeutung für den Kompetenzerwerb in der Aus- und Weiterbildung zum transaktionalytischen Psychotherapeuten (The significance for getting competence in training of transactional psychotherapy Münster: Waxmann. International Journal of Transactional Analysis Research & Practice, 8(2, 49-50.

  2. Integrative dimensions of psychotherapy training.

    Science.gov (United States)

    Greben, Daniel H

    2004-04-01

    This paper investigates the influence of integrative factors on psychotherapy education. The broad relevance of integrative psychotherapy to residency training and continuing mental health education is discussed. Following a review of the existing literature on the education of integrative psychotherapists, the article systematically examines the integrative and pedagogic issues to be considered in planning psychotherapy training informed by integrative principles. The integrative issues are organized into 5 categories: attitudinal set, knowledge base, clinical techniques and skills, developmental tasks and challenges, and systemic institutional factors. The educational issues can be divided into 4 categories: content, format and process, sequence, and faculty development. Brief descriptions of actual educational interventions illustrate the implementation of such ideas. Specific recommendations are made regarding the development of integrative educational initiatives and future study of unresolved questions.

  3. The practice of analytical psychotherapy, counselling and examination. Institute for legal psychology, Uster (Zurich, Switzerland

    Directory of Open Access Journals (Sweden)

    Reinfried H.-W.

    2015-03-01

    Full Text Available Psychotherapy is often regarded as a technique by which convicts can be changed in accordance with the wishes of society. Independent client activity is paid too little attention to. However, it is the one on which it depends whether the therapeutic work will begin, as well as the extent to which the client will be able to transfer the acquired in the course of the therapy awareness so that it can last after his release from a prison. In order to check how deep the mental changes are, you can use some analytical therapeutic approaches that help the therapist to control the process. Therapeutic interventions of different psychological schools make it possible to enhance a customer and to stimulate his activity

  4. Gibberellic acid and cGMP-dependent transcriptional regulation in arabidopsis thaliana

    KAUST Repository

    Bastian, René

    2010-03-01

    An ever increasing amount of transcriptomic data and analysis tools provide novel insight into complex responses of biological systems. Given these resources we have undertaken to review aspects of transcriptional regulation in response to the plant hormone gibberellic acid (GA) and its second messenger guanosine 3\\',5\\'-cyclic monophosphate (cGMP) in Arabidopsis thaliana, both wild type and selected mutants. Evidence suggests enrichment of GA-responsive (GARE) elements in promoters of genes that are transcriptionally upregulated in response to cGMP but downregulated in a GA insensitive mutant (ga1-3). In contrast, in the genes upregulated in the mutant, no enrichment in the GARE is observed suggesting that GARE motifs are diagnostic for GA-induced and cGMP-dependent transcriptional upregulation. Further, we review how expression studies of GA-dependent transcription factors and transcriptional networks based on common promoter signatures derived from ab initio analyses can contribute to our understanding of plant responses at the systems level. © 2010 Landes Bioscience.

  5. Is psychotherapy for functional somatic syndromes harmful? A mixed methods study on negative effects.

    Science.gov (United States)

    Holsting, A F; Pedersen, H F; Rask, M T; Frostholm, L; Schröder, A

    2017-07-01

    Concern for negative effects of psychotherapy for functional somatic syndromes (FSS) has been expressed by clinicians and some patient associations, which may prevent patients from seeking treatment. Therefore, we sought to explore the occurrence and characteristics of negative effects from group-based psychotherapy as experienced by patients with severe or multiple FSS. An adapted version of the explanatory sequential mixed methods design was applied. We used data from an on-going pilot study on Acceptance and Commitment Therapy and Mindfulness-Based Stress Reduction. Negative effects were measured by Inventory for the assessment of Negative Effects of Psychotherapy (INEP). In addition, telephone interviews were conducted with randomly chosen patients and patients who reported negative effects. The latter were asked to elaborate on their INEP response. Quantitative data were analysed descriptively while interview transcripts were explored by thematic analysis. Eighty patients responded to the questionnaire (89%). Negative effects to different extent (from 'slightly agree' to 'fully agree') were reported by 25 (31%). The most frequent negative effects were dependence on the therapist (12%), feeling down after therapy (6%) and insurance problems (7%). By exploring 27 participants' experiences of negative effects 3 main themes were identified: relations in therapy, outcome and transition from therapy to everyday life. Patients with FSS reported a few specific negative effects, all with low frequency. Generally, therapy was well-received. Some patients did however express negative effects both within and outside the therapeutic context. It is important to inform patients about potential negative effects prior to psychotherapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Supercritical fluid chromatography for GMP analysis in support of pharmaceutical development and manufacturing activities.

    Science.gov (United States)

    Hicks, Michael B; Regalado, Erik L; Tan, Feng; Gong, Xiaoyi; Welch, Christopher J

    2016-01-05

    Supercritical fluid chromatography (SFC) has long been a preferred method for enantiopurity analysis in support of pharmaceutical discovery and development, but implementation of the technique in regulated GMP laboratories has been somewhat slow, owing to limitations in instrument sensitivity, reproducibility, accuracy and robustness. In recent years, commercialization of next generation analytical SFC instrumentation has addressed previous shortcomings, making the technique better suited for GMP analysis. In this study we investigate the use of modern SFC for enantiopurity analysis of several pharmaceutical intermediates and compare the results with the conventional HPLC approaches historically used for analysis in a GMP setting. The findings clearly illustrate that modern SFC now exhibits improved precision, reproducibility, accuracy and robustness; also providing superior resolution and peak capacity compared to HPLC. Based on these findings, the use of modern chiral SFC is recommended for GMP studies of stereochemistry in pharmaceutical development and manufacturing. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. cGMP Signaling in the Cardiovascular System—The Role of Compartmentation and Its Live Cell Imaging

    Science.gov (United States)

    Bork, Nadja I.; Nikolaev, Viacheslav O.

    2018-01-01

    The ubiquitous second messenger 3′,5′-cyclic guanosine monophosphate (cGMP) regulates multiple physiologic processes in the cardiovascular system. Its intracellular effects are mediated by stringently controlled subcellular microdomains. In this review, we will illustrate the current techniques available for real-time cGMP measurements with a specific focus on live cell imaging methods. We will also discuss currently accepted and emerging mechanisms of cGMP compartmentation in the cardiovascular system. PMID:29534460

  8. An evaluation of Neuro-Physiological Psychotherapy: An integrative therapeutic approach to working with adopted children who have experienced early life trauma.

    Science.gov (United States)

    McCullough, Elaine; Gordon-Jones, Susi; Last, Anna; Vaughan, Jay; Burnell, Alan

    2016-10-01

    Research into the effectiveness of therapeutic interventions for older children who have experienced multiple forms of trauma within the context of their early development is scant. This article explores the effectiveness of Neuro-Physiological Psychotherapy (NPP): a wrap-around multi-disciplinary, neuro-sequential, attachment-focussed intervention for children and families who present with multiple, clinically significant, emotional and behavioural difficulties. In total, 31 young people and their adoptive parents took part in the study. Baseline measures were repeated and parents and children interviewed. An assessment of the parent/child relationship and child attachment was undertaken but not analysed for this article. Analysis of the repeated measures received statistically significant changes in behavioural regulation, metacognitive executive functioning and externalising and internalising difficulties, alongside an improvement in thought and social problems. An analysis of the parent interviews provided positive results in terms of the children's engagement in education, an absence of further mental health diagnosis or involvement in the criminal justice system. Further hypotheses are posited regarding the impact of the treatment and further research into the effectiveness of the model outlined. © The Author(s) 2016.

  9. [Summary: Scientific evaluation of EMDR psychotherapy].

    Science.gov (United States)

    Haour, F; de Beaurepaire, C

    2016-06-01

    The evaluation of psychotherapy methods is made difficult by their practical and theoretical diversities as well as the increasing number of available therapies. Evaluation based on scientific criteria in randomized control trials is providing the highest level of proof and recognition by Health Agencies. A recently described integrative psychotherapy, eye movement desensitization and reprocessing (EMDR), developed by F. Shapiro since 1989, has been confronted with the validation procedure used in pharmacological treatment. It was of interest to review the scientific validation steps carried out for this EMDR psychotherapy and for its mechanisms of action. The practical and methodological protocol of the EMDR psychotherapy for trauma integration is reviewed as well as clinical results and mechanisms. This EMDR therapy, focused on the resolutions of traumas, was started by treating patients with post-traumatic stress disorders (PTSD). The integrative EMDR protocol obtained the highest level of efficiency, for PTSD treatment, twenty years after its first publication. The efficiency of the protocol is now under study and scientific evaluation for troubles in which the trauma experiences are triggers or factors of maintenance of the troubles: anxiety, depression, phobia, sexual troubles, schizophrenia, etc. This new integrative psychotherapy follows the pathways and the timing observed for the evaluation and the validation of other therapies. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  10. Clinical and no-clinical setting specificities in first session short-term psychotherapy psychodrama group.

    Science.gov (United States)

    Drakulić, Aleksandra Mindoljević

    2011-03-01

    Modern history of short-term group psychotherapy dates back to the late 1950-ies. From then to present day, this psychotherapeutic method has been used in various forms, from dynamic-oriented to cognitive behavioural psychotherapies. Although it has always been considered rather controversial, due its cost-effectiveness, it has been capturing more and more popularity. This paper presents the specificities of first session short-term psychotherapy psychodrama group through session work with two examined groups: a group of 20 adult women who suffer from mild or moderate forms of unipolar depression and a group of 20 students of the School of Medicine in Zagreb without any psychiatric symptomatology. The results indicate the high importance of having structure in first psychodrama session, of relating it with the previously thoroughly conducted, initial, clinical, interviews, and of the clarity and focus in terms of determining the goals of therapy, especially in a clinical context. This study also confirmed assumptions regarding the need for different approaches of warming-up in psychodrama, both in the clinical and in non-clinical samples. A psychodrama psychotherapist should have good time managing skills and capability to convert the time available into an opportunity for directly boosting the group energy and work on therapeutic alliance.

  11. The role of shame and self-compassion in psychotherapy for narcissistic personality disorder: An exploratory study.

    Science.gov (United States)

    Kramer, Ueli; Pascual-Leone, Antonio; Rohde, Kristina B; Sachse, Rainer

    2018-03-01

    This process-outcome study aims at exploring the role of shame, self-compassion, and specific therapeutic interventions in psychotherapy for patients with narcissistic personality disorder (NPD). This exploratory study included a total of N = 17 patients with NPD undergoing long-term clarification-oriented psychotherapy. Their mean age was 39 years, and 10 were male. On average, treatments were 64 sessions long (range between 45 and 99). Sessions 25 and 36 were rated using the Classification of Affective Meaning States and the Process-Content-Relationship Scale. Outcome was assessed using the Symptom Check List-90 and Beck Depression Inventory-II. Between Sessions 25 and 36, a small decrease in the frequency of shame was found (d = .30). In Session 36, the presence of self-compassion was linked with a set of specific therapist interventions (process-guidance and treatment of behaviour-underlying assumptions; 51% of variance explained and adjusted). This study points to the possible central role of shame in the therapeutic process of patients with NPD. Hypothetically, one way of resolving shame is, for the patient, to access underlying self-compassion. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Ayurvedic concepts related to psychotherapy.

    Science.gov (United States)

    Behere, Prakash B; Das, Anweshak; Yadav, Richa; Behere, Aniruddh P

    2013-01-01

    The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.

  13. Cyclic GMP-AMP Containing Mixed Phosphodiester Linkages Is An Endogenous High Affinity Ligand for STING

    OpenAIRE

    Zhang, Xu; Shi, Heping; Wu, Jiaxi; Zhang, Xuewu; Sun, Lijun; Chen, Chuo; Chen, Zhijian J.

    2013-01-01

    The presence of microbial or self DNA in the cytoplasm of mammalian cells is a danger signal detected by the DNA sensor cyclic-GMP-AMP (cGAMP) synthase (cGAS), which catalyzes the production of cGAMP that in turn serves as a second messenger to activate innate immune responses. Here we show that endogenous cGAMP in mammalian cells contains two distinct phosphodiester linkages, one between 2′-OH of GMP and 5′-phosphate of AMP, and the other between 3′-OH of AMP and 5′-phosphate of GMP. This mo...

  14. A cyclic GMP-dependent calcium-activated chloride current in smooth-muscle cells from rat mesenteric resistance arteries

    DEFF Research Database (Denmark)

    Matchkov, Vladimir; Aalkjær, Christian; Nilsson, Holger

    2004-01-01

    We have previously demonstrated the presence of a cyclic GMP (cGMP)-dependent calcium-activated inward current in vascular smooth-muscle cells, and suggested this to be of importance in synchronizing smooth-muscle contraction. Here we demonstrate the characteristics of this current. Using......M) in the pipette solution. The current was found to be a calcium-activated chloride current with an absolute requirement for cyclic GMP (EC50 6.4 microM). The current could be activated by the constitutively active subunit of PKG. Current activation was blocked by the protein kinase G antagonist Rp-8-Br-PET-cGMP...... differed from those of the calcium-activated chloride current in pulmonary myocytes, which was cGMP-independent, exhibited a high sensitivity to inhibition by niflumic acid, was unaffected by zinc ions, and showed outward current rectification as has previously been reported for this current. Under...

  15. Group Analytic Psychotherapy in Brazil.

    Science.gov (United States)

    Penna, Carla; Castanho, Pablo

    2015-10-01

    Group analytic practice in Brazil began quite early. Highly influenced by the Argentinean Pichon-Rivière, it enjoyed a major development from the 1950s to the early 1980s. Beginning in the 1970s, different factors undermined its development and eventually led to its steep decline. From the mid 1980s on, the number of people looking for either group analytic psychotherapy or group analytic training decreased considerably. Group analytic psychotherapy societies struggled to survive and most of them had to close their doors in the 1990s and the following decade. Psychiatric reform and the new public health system have stimulated a new demand for groups in Brazil. Developments in the public and not-for-profit sectors, combined with theoretical and practical research in universities, present promising new perspectives for group analytic psychotherapy in Brazil nowadays.

  16. Topoisomerase 1 Inhibition Promotes Cyclic GMP-AMP Synthase-Dependent Antiviral Responses

    Directory of Open Access Journals (Sweden)

    Geneviève Pèépin

    2017-10-01

    Full Text Available Inflammatory responses, while essential for pathogen clearance, can also be deleterious to the host. Chemical inhibition of topoisomerase 1 (Top1 by low-dose camptothecin (CPT can suppress transcriptional induction of antiviral and inflammatory genes and protect animals from excessive and damaging inflammatory responses. We describe the unexpected finding that minor DNA damage from topoisomerase 1 inhibition with low-dose CPT can trigger a strong antiviral immune response through cyclic GMP-AMP synthase (cGAS detection of cytoplasmic DNA. This argues against CPT having only anti-inflammatory activity. Furthermore, expression of the simian virus 40 (SV40 large T antigen was paramount to the proinflammatory antiviral activity of CPT, as it potentiated cytoplasmic DNA leakage and subsequent cGAS recruitment in human and mouse cell lines. This work suggests that the capacity of Top1 inhibitors to blunt inflammatory responses can be counteracted by viral oncogenes and that this should be taken into account for their therapeutic development.

  17. Star Wars in psychotherapy: video games in the office.

    Science.gov (United States)

    Ceranoglu, Tolga Atilla

    2010-01-01

    Video games are used in medical practice during psycho-education in chronic disease management, physical therapy, rehabilitation following traumatic brain injury, and as an adjunct in pain management during medical procedures or cancer chemotherapy. In psychiatric practice, video games aid in social skills training of children with developmental delays and in cognitive behavioral therapy (CBT). This most popular children's toy may prove a useful tool in dynamic psychotherapy of youth. The author provides a framework for using video games in psychotherapy by considering the characteristics of video games and describes the ways their use has facilitated various stages of therapeutic process. Just as other play techniques build a relationship and encourage sharing of emotional themes, sitting together in front of a console and screen facilitates a relationship and allows a safe path for the patient's conflict to emerge. During video game play, the therapist may observe thought processes, impulsivity, temperament, decision-making, and sharing, among other aspects of a child's clinical presentation. Several features inherent to video games require a thoughtful approach as resistance and transference in therapy may be elaborated differently in comparison to more traditional toys. Familiarity with the video game content and its dynamics benefits child mental health clinicians in their efforts to help children and their families.

  18. Quality Risk Management: Putting GMP Controls First.

    Science.gov (United States)

    O'Donnell, Kevin; Greene, Anne; Zwitkovits, Michael; Calnan, Nuala

    2012-01-01

    This paper presents a practical way in which current approaches to quality risk management (QRM) may be improved, such that they better support qualification, validation programs, and change control proposals at manufacturing sites. The paper is focused on the treatment of good manufacturing practice (GMP) controls during QRM exercises. It specifically addresses why it is important to evaluate and classify such controls in terms of how they affect the severity, probability of occurrence, and detection ratings that may be assigned to potential failure modes or negative events. It also presents a QRM process that is designed to directly link the outputs of risk assessments and risk control activities with qualification and validation protocols in the GMP environment. This paper concerns the need for improvement in the use of risk-based principles and tools when working to ensure that the manufacturing processes used to produce medicines, and their related equipment, are appropriate. Manufacturing processes need to be validated (or proven) to demonstrate that they can produce a medicine of the required quality. The items of equipment used in such processes need to be qualified, in order to prove that they are fit for their intended use. Quality risk management (QRM) tools can be used to support such qualification and validation activities, but their use should be science-based and subject to as little subjectivity and uncertainty as possible. When changes are proposed to manufacturing processes, equipment, or related activities, they also need careful evaluation to ensure that any risks present are managed effectively. This paper presents a practical approach to how QRM may be improved so that it better supports qualification, validation programs, and change control proposals in a more scientific way. This improved approach is based on the treatment of what are called good manufacturing process (GMP) controls during those QRM exercises. A GMP control can be considered

  19. Understanding the link between GMP and dough: from glutenin particles in flour towards developed dough

    NARCIS (Netherlands)

    Don, C.; Lichtendonk, W.J.; Plijter, J.J.; Hamer, R.J.

    2003-01-01

    Clear correlations exist for glutenin macropolymer (GMP) quantity and rheological properties vs. wheat quality and dough rheological properties, but real insight in understanding these links is still missing. The observation that GMP consists of glutenin particles opens up new possibilities to

  20. Understanding the link between GMP and dough: From glutenin particles in flour towards developed dough

    NARCIS (Netherlands)

    Don, C.; Lichtendonk, W.J.; Plijter, J.J.; Hamer, R.J.

    2003-01-01

    Clear correlations exist for glutenin macropolymer (GMP) quantity and rheological properties vs. wheat quality and dough rheological properties, but real insight in understanding these links is still missing. The observation that GMP consists of glutenin particles opens up new possibilities to

  1. Review of Dialogues on difference: Studies of diversity in the therapeutic relationship.

    Science.gov (United States)

    Consoli, Andrés J

    2007-12-01

    Reviews the book, Dialogues on difference: Studies of diversity in the therapeutic relationship edited by J. Christopher Muran (see record 2006-11731-000). Muran, the editor and one of the authors of the book being reviewed here, has contributed an excellent tome. The book fastens a time when speaking of psychotherapy and cultural competence will be unnecessary because of its redundancy. Furthermore, Muran has made use of a powerful, extremely relevant yet equally demanding structure to bring this book about: actual, consecutive dialogues between the chapter author(s), the respective two commentators, and the author(s) once again in a rejoinder. The dialogue format requires a significant commitment to the project over time and a systematic follow through for the dialogues to come to fruition. The final product is highly recommended reading for psychotherapy practitioners at all stages of professional development, for psychotherapy researchers seeking important lines of research on psychotherapy process, and for instructors wanting potent illustrations by courageous therapists willing to expose their internal processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  2. Thrombin has biphasic effects on the nitric oxide-cGMP pathway in endothelial cells and contributes to experimental pulmonary hypertension.

    Directory of Open Access Journals (Sweden)

    Katrin F Nickel

    Full Text Available BACKGROUND: A potential role for coagulation factors in pulmonary arterial hypertension has been recently described, but the mechanism of action is currently not known. Here, we investigated the interactions between thrombin and the nitric oxide-cGMP pathway in pulmonary endothelial cells and experimental pulmonary hypertension. PRINCIPAL FINDINGS: Chronic treatment with the selective thrombin inhibitor melagatran (0.9 mg/kg daily via implanted minipumps reduced right ventricular hypertrophy in the rat monocrotaline model of experimental pulmonary hypertension. In vitro, thrombin was found to have biphasic effects on key regulators of the nitric oxide-cGMP pathway in endothelial cells (HUVECs. Acute thrombin stimulation led to increased expression of the cGMP-elevating factors endothelial nitric oxide synthase (eNOS and soluble guanylate cyclase (sGC subunits, leading to increased cGMP levels. By contrast, prolonged exposition of pulmonary endothelial cells to thrombin revealed a characteristic pattern of differential expression of the key regulators of the nitric oxide-cGMP pathway, in which specifically the factors contributing to cGMP elevation (eNOS and sGC were reduced and the cGMP-hydrolyzing PDE5 was elevated (qPCR and Western blot. In line with the differential expression of key regulators of the nitric oxide-cGMP pathway, a reduction of cGMP by prolonged thrombin stimulation was found. The effects of prolonged thrombin exposure were confirmed in endothelial cells of pulmonary origin (HPAECs and HPMECs. Similar effects could be induced by activation of protease-activated receptor-1 (PAR-1. CONCLUSION: These findings suggest a link between thrombin generation and cGMP depletion in lung endothelial cells through negative regulation of the nitric oxide-cGMP pathway, possibly mediated via PAR-1, which could be of relevance in pulmonary arterial hypertension.

  3. "A qualitative meta-analysis examining clients' experiences of psychotherapy: A new agenda": Correction to Levitt, Pomerville, and Surace (2016).

    Science.gov (United States)

    2016-10-01

    Reports an error in "A qualitative meta-analysis examining clients’ experiences of psychotherapy: A new agenda" by Heidi M. Levitt, Andrew Pomerville and Francisco I. Surace ( Psychological Bulletin , 2016[Aug], Vol 142[8], 801-830). In the article, the 2nd sentence in the Broadening the Forms of Power When Considering Client–Therapist Differences section, “Indeed, most of the studies (55/66, 83.3%) in these categories focused either on the power differential within the therapeutic relationship (37) or culturally based power differences between therapists and clients (29).” should read: “Indeed, most of the studies (49/59, 83.1%) in these categories focused either on the power differential within the therapeutic relationship (38) or culturally based power differences between therapists and clients (31).” (The following abstract of the original article appeared in record 2016-21269-001.) This article argues that psychotherapy practitioners and researchers should be informed by the substantive body of qualitative evidence that has been gathered to represent clients’ own experiences of therapy. The current meta-analysis examined qualitative research studies analyzing clients’ experiences within adult individual psychotherapy that appeared in English-language journals. This omnibus review integrates research from across psychotherapy approaches and qualitative methods, focusing on the cross-cutting question of how clients experience therapy. It utilized an innovative method in which 67 studies were subjected to a grounded theory meta-analysis in order to develop a hierarchy of data and then 42 additional studies were added into this hierarchy using a content meta-analytic method—summing to 109 studies in total. Findings highlight the critical psychotherapy experiences for clients, based upon robust findings across these research studies. Process-focused principles for practice are generated that can enrich therapists’ understanding of their clients

  4. Multicultural approaches in psychotherapy: A rejoinder.

    Science.gov (United States)

    Owen, Jesse; Leach, Mark M; Wampold, Bruce; Rodolfa, Emil

    2010-12-20

    In this rejoinder, the authors address several issues raised by R. L. Worthington and F. R. Dillon (2011) and C. R. Ridley and M. Shaw-Ridley (2011) regarding (a) the measurement of multicultural competencies (MCCs), (b) sampling considerations in multicultural research, and (c) the conceptual frame of multicultural psychotherapy research. The authors challenge the wisdom of exploring MCCs in psychotherapy research and provide a different framework to understand therapists' multicultural effectiveness with clients based on their cultural race/ethnicity. Additionally, the concept of therapists' multicultural orientation or approach is introduced to illuminate the process of aligning with clients about salient cultural issues in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  5. Psychotherapy Is Chaotic—(Not Only in a Computational World

    Directory of Open Access Journals (Sweden)

    Günter K. Schiepek

    2017-04-01

    Full Text Available Objective: The aim of this article is to outline the role of chaotic dynamics in psychotherapy. Besides some empirical findings of chaos at different time scales, the focus is on theoretical modeling of change processes explaining and simulating chaotic dynamics. It will be illustrated how some common factors of psychotherapeutic change and psychological hypotheses on motivation, emotion regulation, and information processing of the client's functioning can be integrated into a comprehensive nonlinear model of human change processes.Methods: The model combines 5 variables (intensity of emotions, problem intensity, motivation to change, insight and new perspectives, therapeutic success and 4 parameters into a set of 5 coupled nonlinear difference equations. The results of these simulations are presented as time series, as phase space embedding of these time series (i.e., attractors, and as bifurcation diagrams.Results: The model creates chaotic dynamics, phase transition-like phenomena, bi- or multi-stability, and sensibility of the dynamic patterns on parameter drift. These features are predicted by chaos theory and by Synergetics and correspond to empirical findings. The spectrum of these behaviors illustrates the complexity of psychotherapeutic processes.Conclusion: The model contributes to the development of an integrative conceptualization of psychotherapy. It is consistent with the state of scientific knowledge of common factors, as well as other psychological topics, such as: motivation, emotion regulation, and cognitive processing. The role of chaos theory is underpinned, not only in the world of computer simulations, but also in practice. In practice, chaos demands technologies capable of real-time monitoring and reporting on the nonlinear features of the ongoing process (e.g., its stability or instability. Based on this monitoring, a client-centered, continuous, and cooperative process of feedback and control becomes possible. By

  6. Psychotherapy Is Chaotic—(Not Only) in a Computational World

    Science.gov (United States)

    Schiepek, Günter K.; Viol, Kathrin; Aichhorn, Wolfgang; Hütt, Marc-Thorsten; Sungler, Katharina; Pincus, David; Schöller, Helmut J.

    2017-01-01

    Objective: The aim of this article is to outline the role of chaotic dynamics in psychotherapy. Besides some empirical findings of chaos at different time scales, the focus is on theoretical modeling of change processes explaining and simulating chaotic dynamics. It will be illustrated how some common factors of psychotherapeutic change and psychological hypotheses on motivation, emotion regulation, and information processing of the client's functioning can be integrated into a comprehensive nonlinear model of human change processes. Methods: The model combines 5 variables (intensity of emotions, problem intensity, motivation to change, insight and new perspectives, therapeutic success) and 4 parameters into a set of 5 coupled nonlinear difference equations. The results of these simulations are presented as time series, as phase space embedding of these time series (i.e., attractors), and as bifurcation diagrams. Results: The model creates chaotic dynamics, phase transition-like phenomena, bi- or multi-stability, and sensibility of the dynamic patterns on parameter drift. These features are predicted by chaos theory and by Synergetics and correspond to empirical findings. The spectrum of these behaviors illustrates the complexity of psychotherapeutic processes. Conclusion: The model contributes to the development of an integrative conceptualization of psychotherapy. It is consistent with the state of scientific knowledge of common factors, as well as other psychological topics, such as: motivation, emotion regulation, and cognitive processing. The role of chaos theory is underpinned, not only in the world of computer simulations, but also in practice. In practice, chaos demands technologies capable of real-time monitoring and reporting on the nonlinear features of the ongoing process (e.g., its stability or instability). Based on this monitoring, a client-centered, continuous, and cooperative process of feedback and control becomes possible. By contrast, restricted

  7. Psychotherapy Is Chaotic-(Not Only) in a Computational World.

    Science.gov (United States)

    Schiepek, Günter K; Viol, Kathrin; Aichhorn, Wolfgang; Hütt, Marc-Thorsten; Sungler, Katharina; Pincus, David; Schöller, Helmut J

    2017-01-01

    Objective: The aim of this article is to outline the role of chaotic dynamics in psychotherapy. Besides some empirical findings of chaos at different time scales, the focus is on theoretical modeling of change processes explaining and simulating chaotic dynamics. It will be illustrated how some common factors of psychotherapeutic change and psychological hypotheses on motivation, emotion regulation, and information processing of the client's functioning can be integrated into a comprehensive nonlinear model of human change processes. Methods: The model combines 5 variables (intensity of emotions, problem intensity, motivation to change, insight and new perspectives, therapeutic success) and 4 parameters into a set of 5 coupled nonlinear difference equations. The results of these simulations are presented as time series, as phase space embedding of these time series (i.e., attractors), and as bifurcation diagrams. Results: The model creates chaotic dynamics, phase transition-like phenomena, bi- or multi-stability, and sensibility of the dynamic patterns on parameter drift. These features are predicted by chaos theory and by Synergetics and correspond to empirical findings. The spectrum of these behaviors illustrates the complexity of psychotherapeutic processes. Conclusion: The model contributes to the development of an integrative conceptualization of psychotherapy. It is consistent with the state of scientific knowledge of common factors, as well as other psychological topics, such as: motivation, emotion regulation, and cognitive processing. The role of chaos theory is underpinned, not only in the world of computer simulations, but also in practice. In practice, chaos demands technologies capable of real-time monitoring and reporting on the nonlinear features of the ongoing process (e.g., its stability or instability). Based on this monitoring, a client-centered, continuous, and cooperative process of feedback and control becomes possible. By contrast, restricted

  8. Group Supervision in Psychotherapy. Main Findings from a Swedish Research Project on Psychotherapy Supervision in a Group Format

    Science.gov (United States)

    Ogren, Marie-Louise; Sundin, Eva C.

    2009-01-01

    Psychotherapy supervision is considered crucial for psychotherapists in training. During the last decades, group supervision has been a frequently used format in many countries. Until recently, very few studies had evaluated the small-group format for training of beginner psychotherapists and psychotherapy supervisors. This article aims to…

  9. Gratitude in cognitive psychotherapy

    Directory of Open Access Journals (Sweden)

    Natalia C. Moyano

    2015-08-01

    Full Text Available Gratitude is a cognitive-affective state caused by the recognition that one has received a benefit from an external agent, due to the good intentions of this agent. Despite the evidence that associate gratitude with subjective well being, psychological well being, physical health and copping with stressful events, it is not enough taken in consideration in an academic level and in its interaction with psychotherapy instruments as well. In this article, the central concepts and information provided by the research are revised, intending to analyze possible ways to include gratitude into Cognitive Psychotherapy

  10. Evidence for the Effectiveness of Jungian Psychotherapy: A Review of Empirical Studies

    Directory of Open Access Journals (Sweden)

    Christian Roesler

    2013-10-01

    Full Text Available Since the 1990s several research projects and empirical studies (process and outcome on Jungian Psychotherapy have been conducted mainly in Germany and Switzerland. Prospective, naturalistic outcome studies and retrospective studies using standardized instruments and health insurance data as well as several qualitative studies of aspects of the psychotherapeutic process will be summarized. The studies are diligently designed and the results are well applicable to the conditions of outpatient practice. All the studies show significant improvements not only on the level of symptoms and interpersonal problems, but also on the level of personality structure and in every day life conduct. These improvements remain stable after completion of therapy over a period of up to six years. Several studies show further improvements after the end of therapy, an effect which psychoanalysis has always claimed. Health insurance data show that, after Jungian therapy, patients reduce health care utilization to a level even below the average of the total population. Results of several studies show that Jungian treatment moves patients from a level of severe symptoms to a level where one can speak of psychological health. These significant changes are reached by Jungian therapy with an average of 90 sessions, which makes Jungian psychotherapy an effective and cost-effective method. Process studies support Jungian theories on psychodynamics and elements of change in the therapeutic process. So finally, Jungian psychotherapy has reached the point where it can be called an empirically proven, effective method.

  11. [The Use of Humor in Psychotherapy: a View].

    Science.gov (United States)

    Chaloult, Guillaume; Blondeau, Claude

    The goal of this article is to expose different aspects of the use of humor in therapy. We hope that it will stimulate reflection and guide the clinician toward appropriate use of humorous interventions. Historical highlights of the topic will be presented. Then a practical definition of therapeutic humor and the main theories about humor will be reviewed. We will also discuss the probable mechanisms of action explaining the efficacy of humor in psychotherapy, as well as potential risks and benefits of its use. We will try to determine different factors influencing the patient's receptivity to humor. Subsequently, a classification of humor will be proposed, followed by a description of selected types of humor often used in therapy, with clinical cases as examples.

  12. Culture and demoralization in psychotherapy.

    Science.gov (United States)

    de Figueiredo, John M; Gostoli, Sara

    2013-01-01

    In most societies, members of a culture have attempted to help each other in times of trouble with various types of healing methods. Demoralization - an individual experience related to a group phenomenon - responds to certain elements shared by all psychotherapies. This article has three objectives: (1) to review the theoretical background leading to our current views on culture and demoralization in psychotherapy, (2) to discuss the methodological challenges faced in the cross-cultural study of demoralization and psychotherapy, and (3) to describe the clinical applications and research prospects of this area of inquiry. Demoralization follows a shattering of the individual's assumptive world and it is different from homeostatic responses to a stressful situation or from depressive disorders. Only a few comparative studies of this construct across cultures have been undertaken. The presentation of distress may vary widely from culture to culture and even within the same culture. To avoid 'category fallacy', it is important to understand the idioms of distress peculiar to a cultural group. A cultural psychiatrist or psychotherapist would have to identify patient's values and sentiments, reconstruct his/her personal and collective ambient worlds, and only then study demoralization. The limitations of our current diagnostic systems have resulted in methodological challenges. Cultural clinicians should consider using a combination of both 'clinimetric' and 'perspectivistic' approaches in order to arrive at a diagnosis and identify the appropriate intervention. The presenting problem has to be understood in the context of the patient's individual, social and cultural background, and patients unfamiliar with Western-type psychotherapies have to be prepared to guide their own expectations before the former are used. Future research should identify the gaps in knowledge on the effectiveness of cultural psychotherapy at reversing or preventing demoralization. Copyright

  13. Cognitive Behavioral Therapy versus Short Psychodynamic Supportive Psychotherapy in the outpatient treatment of depression: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kool Simone

    2007-10-01

    -effectiveness. Clinical predictors of treatment outcome include demographic variables, psychiatric symptoms, cognitive and psychological patient characteristics and the quality of the therapeutic relationship. Discussion This study evaluates Short Psychodynamic Supportive Psychotherapy as a treatment for depressed outpatients by comparing it to the established evidence-based treatment Cognitive Behavioral Therapy. Specific strengths of this study include its strong external validity and the clinical relevance of its research aims. Limitations of the study are discussed. Trial registration Current Controlled Trails ISRCTN31263312

  14. CASE STUDIES IN INTEGRATIVE PSYCHOTHERAPY PART 2 (EDITORIAL

    Directory of Open Access Journals (Sweden)

    Gregor Žvelc

    2013-05-01

    Full Text Available Announcement of the special issue of the International Journal of Integrative Psychotherapy, which is dedicated to the exploration and discussion of an integrative psychotherapy case study.

  15. Opposing actions of dibutyryl cyclic AMP and GMP on temperature in conscious guinea-pigs

    Science.gov (United States)

    Kandasamy, S. B.; Williaes, B. A.

    1983-01-01

    It is shown that the intracerebroventricular administration of dibutyryl cyclic AMP (Db-cAMP) induced hyperthermia in guinea pigs which was not mediated through prostaglandins or norepinephrine since a prostaglandin synthesis inhibitor and an alpha-adrenergic receptor blocking agent did not antagonize the hyperthermia. However, the hyperthermic response to Db-cAMP was attenuated by the central administration of a beta-adrenergic receptor antagonist, which indicates that cAMP may be involved, through beta-adrenergic receptors, in the central regulation of heat production and conservation. The central administration of Db-cGMP produced hypothermia which was not mediated via histamine H1 or H2 receptors and serotonin. The antagonism of hypothermia induced by Db-cGMP and acetylcholine + physostigmine by central administration of a cholinergic muscarine receptor antagonist and not by a cholinergic nicotinic receptor antagonist suggests that cholinoceptive neurons and endogenous cGMP may regulate heat loss through cholinergic muscarine receptors. It is concluded that these results indicate a regulatory role in thermoregulation provided by a balance between opposing actions of cAMP and cGMP in guinea pigs.

  16. PERSONALITY THEORY IN INTEGRATIVE PERSONALITY-ORIENTED RECONSTRUCTIVE PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    V I Kurpatov

    2010-01-01

    approaches. V.N. Myasishchev's theory of personality relations in association with its universality, as well as pathogenetic psychotherapy may be the basis for the integration of other methods of psychotherapy

  17. Practice Parameter for Psychodynamic Psychotherapy with Children

    Science.gov (United States)

    Medicus, Jennifer

    2012-01-01

    This Practice Parameter describes the principles of psychodynamic psychotherapy with children and is based on clinical consensus and available research evidence. It presents guidelines for the practice of child psychodynamic psychotherapy, including indications and contraindications, the setting, verbal and interactive (play) techniques, work with…

  18. Interpersonal Psychotherapy: Past, Present and Future

    OpenAIRE

    Markowitz, John C.; Weissman, Myrna M.

    2012-01-01

    The authors briefly describe the origins, theory, and development of interpersonal psychotherapy: its roots in clinical outcome research, its spread from major depression to other psychiatric disorders and its increasing dissemination as an empirically validated clinical intervention included in treatment guidelines. They attempt to forecast research, organizational and training issues the growing interpersonal psychotherapy community may face in the future.

  19. [Psychotherapy of depression in old age].

    Science.gov (United States)

    Wächtler, C

    2013-02-01

    Depression in old age is common and also dangerous due to somatic comorbidity and suicide; however, it is often not recognized and not adequately treated. Psychotherapy is almost never offered to the elderly. However, clinical experience, single-case studies and some controlled trials show effectiveness--at least to the age of 75. The psychotherapist must be aware of unusual transference and countertransference between a younger therapist and elderly patient. Psychotherapy in old age requires some modifications, especially concerning special interest in biography and history, strong empathy, "container function", and focusing. In the future, psychotherapy for the elderly should be both investigated and educated more. In addition, it is hoped that psychotherapists offer to treat elderly people with depression and that more older patients accept this professional help.

  20. Stories from the Heart: Narratives of Change in Therapeutic Enactment

    Science.gov (United States)

    Black, Timothy G.

    2009-01-01

    Research was conducted on the experience of change for participants in a group-based psychotherapy approach called Therapeutic Enactment (TE), which involves the enactment of embodied narratives of participants' past experiences. This study asked the question, "What is your story of change in TE?" The author conducted in-depth interviews with five…

  1. cGMP-dependent protein kinase I, the circadian clock, sleep and learning

    OpenAIRE

    Feil, Robert; Hölter, Sabine M; Weindl, Karin; Wurst, Wolfgang; Langmesser, Sonja; Gerling, Andrea; Feil, Susanne; Albrecht, Urs

    2009-01-01

    The second messenger cGMP controls cardiovascular and gastrointestinal homeostasis in mammals. However, its physiological relevance in the nervous system is poorly understood.1 Now, we have reported that the cGMP-dependent protein kinase type I (PRKG1) is implicated in the regulation of the timing and quality of sleep and wakefulness.2 Prkg1 mutant mice showed altered distribution of sleep and wakefulness as well as reduction in rapid-eye-movement sleep (REMS) duration and in non-REMS consoli...

  2. Cyclic di-GMP is essential for the survival of the lyme disease spirochete in ticks.

    Directory of Open Access Journals (Sweden)

    Ming He

    2011-06-01

    Full Text Available Cyclic dimeric GMP (c-di-GMP is a bacterial second messenger that modulates many biological processes. Although its role in bacterial pathogenesis during mammalian infection has been documented, the role of c-di-GMP in a pathogen's life cycle within a vector host is less understood. The enzootic cycle of the Lyme disease pathogen Borrelia burgdorferi involves both a mammalian host and an Ixodes tick vector. The B. burgdorferi genome encodes a single copy of the diguanylate cyclase gene (rrp1, which is responsible for c-di-GMP synthesis. To determine the role of c-di-GMP in the life cycle of B. burgdorferi, an Rrp1-deficient B. burgdorferi strain was generated. The rrp1 mutant remains infectious in the mammalian host but cannot survive in the tick vector. Microarray analyses revealed that expression of a four-gene operon involved in glycerol transport and metabolism, bb0240-bb0243, was significantly downregulated by abrogation of Rrp1. In vitro, the rrp1 mutant is impaired in growth in the media containing glycerol as the carbon source (BSK-glycerol. To determine the contribution of the glycerol metabolic pathway to the rrp1 mutant phenotype, a glp mutant, in which the entire bb0240-bb0243 operon is not expressed, was generated. Similar to the rrp1 mutant, the glp mutant has a growth defect in BSK-glycerol medium. In vivo, the glp mutant is also infectious in mice but has reduced survival in ticks. Constitutive expression of the bb0240-bb0243 operon in the rrp1 mutant fully rescues the growth defect in BSK-glycerol medium and partially restores survival of the rrp1 mutant in ticks. Thus, c-di-GMP appears to govern a catabolic switch in B. burgdorferi and plays a vital role in the tick part of the spirochetal enzootic cycle. This work provides the first evidence that c-di-GMP is essential for a pathogen's survival in its vector host.

  3. Consequences of Psychotherapy Clients' Mental Health Ideology.

    Science.gov (United States)

    Milling, Len; Kirsch, Irving

    Current theoretical approaches to understanding emotional difficulties are dominated by the medical model of mental illness, which assumes that emotional dysfunction can be viewed the same way as physical dysfunction. To examine the relationship between psychotherapy clients' beliefs about the medical model of psychotherapy and their behavior…

  4. Book Review Psychotherapy and Phenomenology By Ian Rory ...

    African Journals Online (AJOL)

    Book Review Psychotherapy and Phenomenology By Ian Rory Owen (2006) ... Psychotherapy and Phenomenology: On Freud, Husserl and Heidegger. New York: iUniverse. Soft Cover (352 ... AJOL African Journals Online. HOW TO USE ...

  5. Regulation of Burkholderia cenocepacia biofilm formation by RpoN and the c-di-GMP effector BerB

    DEFF Research Database (Denmark)

    Fazli, Mustafa; Rybtke, Morten Levin; Steiner, Elisabeth

    2017-01-01

    Knowledge about the molecular mechanisms that are involved in the regulation of biofilm formation is essential for the development of biofilm-control measures. It is well established that the nucleotide second messenger cyclic diguanosine monophosphate (c-di-GMP) is a positive regulator of biofilm...... formation in many bacteria, but more knowledge about c-di-GMP effectors is needed. We provide evidence that c-di-GMP, the alternative sigma factor RpoN (σ54), and the enhancer-binding protein BerB play a role in biofilm formation of Burkholderia cenocepacia by regulating the production of a biofilm......-stabilizing exopolysaccharide. Our findings suggest that BerB binds c-di-GMP, and activates RpoN-dependent transcription of the berA gene coding for a c-di-GMP-responsive transcriptional regulator. An increased level of the BerA protein in turn induces the production of biofilm-stabilizing exopolysaccharide in response to high...

  6. [Systemic therapies--a contribution to psychotherapy integration].

    Science.gov (United States)

    Schiepek, Günter

    2012-06-01

    Some converging lines from neuroscience, neurobiological psychotherapy research, process-outcome-research, internet-based change monitoring and the systems and complexity sciences actually allow for an open and generic definition of systemic therapies. The "family" of systemic therapies as designed here is not restricted to the field of psychotherapy. It is a scientifically founded and engaged, bio-psycho-social multi-level approach to a common or integrative psychotherapy, not restricted to a psychotherapeutic confession or exclusively to family or couples therapy. A core element of systemic therapy is the support of self-organizing processes and the use of data-driven feedback tools. The conclusion goes to a modified concept of evidence-based practice and, vice versa, practice-based evidence, to an integration of the medical model and the common factors model into a self-organization theory of human change processes, and to a list of criteria for scientifically based practice in psychotherapy. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Types of Psychotherapy for Pathological Gamblers

    OpenAIRE

    Fong, Timothy W.

    2005-01-01

    Several types of psychotherapy are currently used to treat pathological gamblers. These include Gambler's Anonymous, cognitive behavioral therapy, behavioral therapy, psychodynamic therapy, and family therapy. Research into which types of psychotherapy are the most effective for pathological gambling is limited but is a growing area of study. Group therapy, namely Gambler's Anonymous, provides peer support and structure. Cognitive behavior therapy aims to identify and correct cognitive distor...

  8. Women, money, and psychodynamic group psychotherapy.

    Science.gov (United States)

    Motherwell, Lise

    2002-01-01

    Developmental concerns and sociocultural expectations may keep female patients and therapists from addressing financial issues openly in group psychotherapy. Interpersonal theory provides a different view of nurturing that may help women leaders deal better with financial discussions in group. This paper includes a review of the literature on group psychotherapy and fees; feminist literature relevant to leadership; money management in group therapy; countertransference; and case examples.

  9. Molecular Analysis of Sensory Axon Branching Unraveled a cGMP-Dependent Signaling Cascade.

    Science.gov (United States)

    Dumoulin, Alexandre; Ter-Avetisyan, Gohar; Schmidt, Hannes; Rathjen, Fritz G

    2018-04-24

    Axonal branching is a key process in the establishment of circuit connectivity within the nervous system. Molecular-genetic studies have shown that a specific form of axonal branching—the bifurcation of sensory neurons at the transition zone between the peripheral and the central nervous system—is regulated by a cyclic guanosine monophosphate (cGMP)-dependent signaling cascade which is composed of C-type natriuretic peptide (CNP), the receptor guanylyl cyclase Npr2, and cGMP-dependent protein kinase Iα (cGKIα). In the absence of any one of these components, neurons in dorsal root ganglia (DRG) and cranial sensory ganglia no longer bifurcate, and instead turn in either an ascending or a descending direction. In contrast, collateral axonal branch formation which represents a second type of axonal branch formation is not affected by inactivation of CNP, Npr2, or cGKI. Whereas axon bifurcation was lost in mouse mutants deficient for components of CNP-induced cGMP formation; the absence of the cGMP-degrading enzyme phosphodiesterase 2A had no effect on axon bifurcation. Adult mice that lack sensory axon bifurcation due to the conditional inactivation of Npr2-mediated cGMP signaling in DRG neurons demonstrated an altered shape of sensory axon terminal fields in the spinal cord, indicating that elaborate compensatory mechanisms reorganize neuronal circuits in the absence of bifurcation. On a functional level, these mice showed impaired heat sensation and nociception induced by chemical irritants, whereas responses to cold sensation, mechanical stimulation, and motor coordination are normal. These data point to a critical role of axon bifurcation for the processing of acute pain perception.

  10. Molecular Analysis of Sensory Axon Branching Unraveled a cGMP-Dependent Signaling Cascade

    Directory of Open Access Journals (Sweden)

    Alexandre Dumoulin

    2018-04-01

    Full Text Available Axonal branching is a key process in the establishment of circuit connectivity within the nervous system. Molecular-genetic studies have shown that a specific form of axonal branching—the bifurcation of sensory neurons at the transition zone between the peripheral and the central nervous system—is regulated by a cyclic guanosine monophosphate (cGMP-dependent signaling cascade which is composed of C-type natriuretic peptide (CNP, the receptor guanylyl cyclase Npr2, and cGMP-dependent protein kinase Iα (cGKIα. In the absence of any one of these components, neurons in dorsal root ganglia (DRG and cranial sensory ganglia no longer bifurcate, and instead turn in either an ascending or a descending direction. In contrast, collateral axonal branch formation which represents a second type of axonal branch formation is not affected by inactivation of CNP, Npr2, or cGKI. Whereas axon bifurcation was lost in mouse mutants deficient for components of CNP-induced cGMP formation; the absence of the cGMP-degrading enzyme phosphodiesterase 2A had no effect on axon bifurcation. Adult mice that lack sensory axon bifurcation due to the conditional inactivation of Npr2-mediated cGMP signaling in DRG neurons demonstrated an altered shape of sensory axon terminal fields in the spinal cord, indicating that elaborate compensatory mechanisms reorganize neuronal circuits in the absence of bifurcation. On a functional level, these mice showed impaired heat sensation and nociception induced by chemical irritants, whereas responses to cold sensation, mechanical stimulation, and motor coordination are normal. These data point to a critical role of axon bifurcation for the processing of acute pain perception.

  11. The NO/cGMP pathway inhibits transient cAMP signals through the activation of PDE2 in striatal neurons

    Directory of Open Access Journals (Sweden)

    Marina ePolito

    2013-11-01

    Full Text Available The NO-cGMP signaling plays an important role in the regulation of striatal function although the mechanisms of action of cGMP specifically in medium spiny neurons (MSNs remain unclear. Using genetically encoded fluorescent biosensors, including a novel Epac-based sensor (EPAC-SH150 with increased sensitivity for cAMP, we analyze the cGMP response to NO and whether it affected cAMP/PKA signaling in MSNs. The Cygnet2 sensor for cGMP reported large responses to NO donors in both striatonigral and striatopallidal MSNs, and this cGMP signal was controlled partially by PDE2. At the level of cAMP brief forskolin stimulations produced transient cAMP signals which differed between D1 and D2 medium spiny neurons. NO inhibited these cAMP transients through cGMP-dependent PDE2 activation, an effect that was translated and magnified downstream of cAMP, at the level of PKA. PDE2 thus appears as a critical effector of NO which modulates the post-synaptic response of MSNs to dopaminergic transmission.

  12. BolA Is Required for the Accurate Regulation of c-di-GMP, a Central Player in Biofilm Formation.

    Science.gov (United States)

    Moreira, Ricardo N; Dressaire, Clémentine; Barahona, Susana; Galego, Lisete; Kaever, Volkhard; Jenal, Urs; Arraiano, Cecília M

    2017-09-19

    The bacterial second messenger cyclic dimeric GMP (c-di-GMP) is a nearly ubiquitous intracellular signaling molecule involved in the transition from the motile to the sessile/biofilm state in bacteria. C-di-GMP regulates various cellular processes, including biofilm formation, motility, and virulence. BolA is a transcription factor that promotes survival in different stresses and is also involved in biofilm formation. Both BolA and c-di-GMP participate in the regulation of motility mechanisms leading to similar phenotypes. Here, we establish the importance of the balance between these two factors for accurate regulation of the transition between the planktonic and sessile lifestyles. This balance is achieved by negative-feedback regulation of BolA and c-di-GMP. BolA not only contributes directly to the motility of bacteria but also regulates the expression of diguanylate cyclases and phosphodiesterases. This expression modulation influences the synthesis and degradation of c-di-GMP, while this signaling metabolite has a negative influence in bolA mRNA transcription. Finally, we present evidence of the dominant role of BolA in biofilm, showing that, even in the presence of elevated c-di-GMP levels, biofilm formation is reduced in the absence of BolA. C-di-GMP is one of the most important bacterial second messengers involved in several cellular processes, including virulence, cell cycle regulation, biofilm formation, and flagellar synthesis. In this study, we unravelled a direct connection between the bolA morphogene and the c-di-GMP signaling molecule. We show the important cross-talk that occurs between these two molecular regulators during the transition between the motile/planktonic and adhesive/sessile lifestyles in Escherichia coli This work provides important clues that can be helpful in the development of new strategies, and the results can be applied to other organisms with relevance for human health. IMPORTANCE Bacterial cells have evolved several

  13. Plasma levels of cAMP, cGMP and CGRP in sildenafil-induced headache

    DEFF Research Database (Denmark)

    Kruuse, Christina Rostrup; Frandsen, E; Schifter, S

    2004-01-01

    Sildenafil, a selective inhibitor of the cyclic guanosine monophosphate (cGMP) degrading phosphodiestrase 5 (PDE5), induced migraine without aura in 10 of 12 migraine patients and in healthy subjects it induced significantly more headache than placebo. The aim of the present study was to determine...... whether the pain-inducing effects of sildenafil would be reflected in plasma levels of important signalling molecules in migraine: cGMP, cyclic adenosine monophosphate (cAMP) and calcitonin gene-related peptide (CGRP). Ten healthy subjects (four women, six men) and 12 patients (12 women) suffering from...... migraine without aura were included in two separate double-blind, placebo-controlled, cross-over studies in which placebo or sildenafil 100 mg was administered orally. Plasma levels of CGRP, cAMP and cGMP were determined in blood from the antecubital vein. Despite the ability of sildenafil to induce...

  14. THE FEMINIST APPROACH TO PSYCHOTHERAPY INTEGRATION

    Directory of Open Access Journals (Sweden)

    Lorena Božac Deležan

    2011-12-01

    Full Text Available The goal of Integrative Psychotherapy is to establish full inner and external contact (Moursund & Erskine, 2004. The most important goal in feminist therapy is the transformation of an individual as well as the transformation of the society as a whole (Herlihy & Corey, 2004. In my work I attempt to integrate both: to help the client establish inner and external contact, but also help him/her to become aware and recognize inner messages connected with his/her gender and replace them with constructive beliefs of his/her own, as well as for him/her to learn, regardless of his/her gender, to trust his/her intuition and experience. In this article I present my approach to integration in psychotherapy and the way I use feminist principles in Integrative Psychotherapy.

  15. The Effectiveness of Western Psychotherapy in treating ...

    African Journals Online (AJOL)

    Background: Psychotherapy has been shown to be effective in the treatment of mental disorders in the western world but viewed as an alien method of treatment to Africans. Aim: To review the literature on the effectiveness of psychotherapy in sub- Saharan Africa. Method: A systematic search of Medline, PsychINFO, ...

  16. The Mathematics of Psychotherapy: A Nonlinear Model of Change Dynamics.

    Science.gov (United States)

    Schiepek, Gunter; Aas, Benjamin; Viol, Kathrin

    2016-07-01

    Psychotherapy is a dynamic process produced by a complex system of interacting variables. Even though there are qualitative models of such systems the link between structure and function, between network and network dynamics is still missing. The aim of this study is to realize these links. The proposed model is composed of five state variables (P: problem severity, S: success and therapeutic progress, M: motivation to change, E: emotions, I: insight and new perspectives) interconnected by 16 functions. The shape of each function is modified by four parameters (a: capability to form a trustful working alliance, c: mentalization and emotion regulation, r: behavioral resources and skills, m: self-efficacy and reward expectation). Psychologically, the parameters play the role of competencies or traits, which translate into the concept of control parameters in synergetics. The qualitative model was transferred into five coupled, deterministic, nonlinear difference equations generating the dynamics of each variable as a function of other variables. The mathematical model is able to reproduce important features of psychotherapy processes. Examples of parameter-dependent bifurcation diagrams are given. Beyond the illustrated similarities between simulated and empirical dynamics, the model has to be further developed, systematically tested by simulated experiments, and compared to empirical data.

  17. Equine-Assisted Psychotherapy for adolescents experiencing depression and/or anxiety: A therapist's perspective.

    Science.gov (United States)

    Wilson, Kaitlyn; Buultjens, Melissa; Monfries, Melissa; Karimi, Leila

    2017-01-01

    Animal-Assisted Interventions (AAIs) are thought to overcome some of the limitations of traditional therapies as they do not rely exclusively on language as a medium for change. One such Animal-Assisted Therapy (AAT) approach involves horses as a therapeutic medium. Equine-Assisted Psychotherapy (EAP) comprises a collaborative effort between a licensed therapist and a horse professional working with clients to address treatment goals. The purpose of the present Australian-based qualitative study was to examine EAP facilitators' perspectives on the biospychosocial benefits and therapeutic outcomes of EAP for adolescents experiencing depression and/or anxiety. The findings suggest a range of improvements within adolescent clients, including increases in confidence, self-esteem and assertiveness, as well as a decrease in undesirable behaviours. The effectiveness of the therapy was thought to be due to the experiential nature of involving horses in therapy. The lack of understanding in the wider community about EAP was seen as a barrier to recognition and acceptance of EAP as a valid therapeutic intervention.

  18. Single amino acids in the carboxyl terminal domain of aquaporin-1 contribute to cGMP-dependent ion channel activation

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    Yool Andrea J

    2003-10-01

    Full Text Available Abstract Background Aquaporin-1 (AQP1 functions as an osmotic water channel and a gated cation channel. Activation of the AQP1 ion conductance by intracellular cGMP was hypothesized to involve the carboxyl (C- terminus, based on amino acid sequence alignments with cyclic-nucleotide-gated channels and cGMP-selective phosphodiesterases. Results Voltage clamp analyses of human AQP1 channels expressed in Xenopus oocytes demonstrated that the nitric oxide donor, sodium nitroprusside (SNP; 3–14 mM activated the ionic conductance response in a dose-dependent manner. Block of soluble guanylate cyclase prevented the response. Enzyme immunoassays confirmed a linear dose-dependent relationship between SNP and the resulting intracellular cGMP levels (up to 1700 fmol cGMP /oocyte at 14 mM SNP. Results here are the first to show that the efficacy of ion channel activation is decreased by mutations of AQP1 at conserved residues in the C-terminal domain (aspartate D237 and lysine K243. Conclusions These data support the idea that the limited amino acid sequence similarities found between three diverse classes of cGMP-binding proteins are significant to the function of AQP1 as a cGMP-gated ion channel, and provide direct evidence for the involvement of the AQP1 C-terminal domain in cGMP-mediated ion channel activation.

  19. Characteristics of Patients Involved in Psychotherapy in Bosnia and Herzegovina

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    Sabina Alispahić

    2014-04-01

    Full Text Available Introduction: The aim of this study was to determine the demographic and clinical characteristics of Bosnian and Herzegovinian patients involved in psychotherapeutic treatments in order to explore the current situation of psychotherapy in Bosnia and Herzegovina.Methods: The study included 213 patients (154 women and 47 men undergoing diverse psychotherapeutic treatments. Data about demographic and clinical characteristics were collected by questionnaire. Following characteristics were documented: age, sex, education, employment status, marital status, specific problem that got the client involved in psychotherapy, type of psychotherapy, and use of psychopharmacology.Results: Majority of the patients undergoing psychotherapy are age up to 40 and female. They are by vast majority holding a university degree and are employed. Nearly equal number of patients is living in partnership or marriage compared to single or never been married. Most frequent reasons for getting involved in the psychotherapy treatment are of the intrapersonal nature (depression, anxiety and panic attacks. Majority of the patients were involved in gestalt and cognitive behavioral psychotherapy, and at the same time majority of those were not prescribed medicaments.Conclusions: We point out and overview some of the most prominent socio-demographic traits of patients undergoing psychotherapy, the ones that could be important in the future research with the higher degree of control. In the terms of personal initiative, psychotherapy stops being a taboo in Bosnia and Herzegovina. However, there is still a long path until it reaches integration in daily life of the people.

  20. Attachment and group psychotherapy: introduction to a special section.

    Science.gov (United States)

    Tasca, Giorgio A

    2014-03-01

    The application of attachment theory to adult psychotherapy represents a growing area of research and practice. Despite the conceptual overlap between group therapeutic factors, attachment theory, and therapeutic tasks as outlined by Bowlby (1988), there is little research on attachment functioning in group therapy. Hence, there remain substantial questions about the role of attachment theory in understanding group therapy processes and outcomes. The three studies in this special section advance the research in some of these important areas, including showing that positive changes in self-reported attachment insecurity among clients persist long after group therapy ends; attachment anxiety affects the level and rate of interpersonal learning in groups; and change in attachment to the therapy group has an impact on longer term change in individual group members' attachment. Each article also examines the impact of these attachment concepts on treatment outcomes. Numerous areas remain to be explored when it comes to the implications of attachment theory for understanding and conducting group therapy, including the conceptual and practical overlap between attachment concepts such as security and exploration with group therapeutic factors such as cohesion and interpersonal learning. The articles in this special section begin to address some of these issues related to attachment theory and its implications for group therapists. (c) 2014 APA, all rights reserved.

  1. Self-Regulation and Mechanisms of Action in Psychotherapy: A Theory-Based Translational Perspective

    Science.gov (United States)

    Strauman, Timothy J.; Goetz, Elena L.; Detloff, Allison M.; MacDuffie, Katherine E.; Zaunmüller, Luisa; Lutz, Wolfgang

    2012-01-01

    Psychotherapy is a complex, multi-layered process with the potential to bring about changes at multiple levels of functioning, from the neurobiology of the brain to the individual’s role in the social world. Although studies of the mechanisms by which psychotherapy leads to change continue to appear, there remains much to be learned about how psychological interventions work. To guide explorations of how and for whom particular treatment approaches lead to change, researchers can rely on theory to identify potential loci for change and on translational research methods to integrate basic behavioral science and neuroscience with clinical science. In this article, we describe research linking individual differences in the self-regulation of personal goal pursuit with the etiology and treatment of mood disorders. The research draws upon regulatory focus theory as a model of self-regulation and on microintervention designs – controlled laboratory investigations of a specific therapeutic technique – to generate and test hypotheses about how psychological interventions can help to reverse maladaptive self-regulatory processes. PMID:23072383

  2. Applications of Mindfulness in Psychotherapy – Contemporary Dilemmas

    Directory of Open Access Journals (Sweden)

    Borut ŠKODLAR

    2016-08-01

    Full Text Available Mindfulness has without doubt been the fastest spreading and most popular concept in psychotherapy in the last two decades. Its influence exceeds that of any other individual concept or approach in modern psychotherapy. However, there are many dilemmas, open questions and controversies related to this rapid, almost fanatic spread, which obviously compensates for a certain lack in modern Euro- and Americo-centric societies. Similarly, we are witnessing in the West a lack of reflection, a process of limitless idealization, and the search for a panacea. This all flows with a tint of colonialism, presumptuously taking over ideas, concepts and techniques without a proper study of the primary sources, and with all the accompanying negative side-effects: profiteering, self-promotion, unethical conduct, empty promises of instant rewards, and so on. In the present paper, the development of interest in mindfulness in psychotherapy, as well as the research findings and dilemmas, and concepts and mechanisms of applying mindfulness in psychotherapy, will be reviewed. The main purpose of the paper is to contribute to the critical reflection in studying and applying mindfulness in psychotherapy.

  3. Integrative Treatment of Personality Disorder. Part I: Psychotherapy.

    Science.gov (United States)

    Jovanovic, Mirjana Divac; Svrakic, Dragan

    2017-03-01

    In this paper, we outline the concept of integrative therapy of borderline personality, also referred to as fragmented personality, which we consider to be the core psychopathology underlying all clinical subtypes of personality disorder. Hence, the terms borderline personality, borderline disorder, fragmented personality, and personality disorder are used interchangeably, as synonyms. Our integrative approach combines pharmacotherapy and psychotherapy, each specifically tailored to accomplish a positive feedback modulation of their respective effects. We argue that pharmacotherapy and psychotherapy of personality disorder complement each other. Pharmacological control of disruptive affects clears the stage, in some cases builds the stage, for the psychotherapeutic process to take place. In turn, psychotherapy promotes integration of personality fragments into more cohesive structures of self and identity, ultimately establishing self-regulation of mood and anxiety. We introduce our original method of psychotherapy, called reconstructive interpersonal therapy (RIT). The RIT integrates humanistic-existential and psychodynamic paradigms, and is thereby designed to accomplish a deep reconstruction of core psychopathology within the setting of high structure. We review and comment the current literature on the strategies, goals, therapy process, priorities, and phases of psychotherapy of borderline disorders, and describe in detail the fundamental principles of RIT.

  4. Changes of platelet GMP-140 in diabetic nephropathy and its multi-factor regression analysis

    International Nuclear Information System (INIS)

    Wang Zizheng; Du Tongxin; Wang Shukui

    2001-01-01

    The relation of platelet GMP-140 and its related factors with diabetic nephropathy was studied. 144 patients of diabetic mellitus without nephropathy (group without DN, mean suffering duration of 25.5 +- 18.6 months); 80 with diabetic nephropathy (group DN, mean suffering duration of 58.7 +- 31.6 months) and 50 normal controls were chosen in the research. Platelet GMP-140, plasma α 1 -MG, β 2 -MG, and 24 hour urine albumin (ALB), IgG, α 1 -MG, β 2 -MG were detected by RIA, while HBA 1 C via chromatographic separation and FBG, PBG, Ch, TG, HDL, FG via biochemical methods. All the data had been processed with software on computer with t-test and linear regression, and multi-factor analysis were done also. The levels of platelet GMP-140, FG, DBP, TG, HBA 1 C and PBG in group DN were significantly higher than those of group without DN and normal control (P 0.05), while they were higher than those of normal controls. Multi-factor analysis of platelet GMP-140 with TG, DBP and HBA 1 C were performed in 80 patients with DN (P 1 C are the independent factors enhancing the activation of platelets. The disturbance of lipid metabolism in type II diabetic mellitus may also enhance the activation of platelets. Elevation of blood pressure may accelerate the initiation and deterioration of DN in which change of platelet GMP-140 is an independent factor. Elevation of HBA 1 C and blood glucose are related closely to the diabetic nephropathy

  5. [Role of psychiatry and psychotherapy in sexual medicine after introductory marketing of viagra].

    Science.gov (United States)

    Weig, W

    2000-03-01

    Sildenafil (Viagra) is a substance for the treatment of erectile dysfunction. Great expectations are connected with its introduction into the market. In this situation the multidimensionality in the control-mechanismus of the sexual reaction and of the satisfaction in the sexual experience are pointed out. These aspects affect the diagnostic and therapeutic competence of psychiatry and psychotherapy in a high degree. Efficient psycho-educative and psychotherapeutic ways of treatment for sexual dysfunction are available. Increased specific knowledge in this area is required by psychiatrists, medical psychotherapists and neuropsychiatrists.

  6. Directive approach for Chinese clients receiving psychotherapy: Is that really a priority?

    Directory of Open Access Journals (Sweden)

    Chi Ting Connie eNg

    2013-02-01

    Full Text Available The academic literature often suggests that Chinese people prefer directive approaches in therapy. However, studies on this topic are often based on therapists’ self-reports: clients’ perceptions are rarely considered. What does directive approach mean? Is it what clients prefer? Using cultural psychology and medical anthropology as a theoretical framework, the ethnography explored the experience of psychotherapy from Chinese clients’ perspectives. Specifically, using ethnographic interview, eight informants, two male and six female, ranging in age from 40 to 55, were interviewed twice in-depth about their experiences of seeing Chinese therapists. All informants are Chinese immigrants who reside in a major Canadian city and saw at least one Chinese therapist in a community counselling agency within one year prior to the interview. In the first interview, informants created groups of cards describing a list of hypothesized cultural knowledge regarding psychotherapy. After initial data analysis, the cards were presented to the informants in the second interviews, in which they confirmed and/or rejected the hypotheses by grouping, reorganizing, and ranking the cards. In the end each informant created a number of mind-maps with the cards, which served as a representation of informants’ psychological reality of psychotherapy based on their ordinary language. The maps were then further analysed for themes among informants. Results suggest that clients appreciate therapists who give homework, analyse their problems, talk about strategies that other clients have found useful, chat, and provide resources. Results also highlight informants’ understanding of their own responsibility for the therapeutic relationship which has never been documented before and has important clinical implications.

  7. Establishing psychiatric registrars' competence in psychotherapy: a portfolio based model.

    Science.gov (United States)

    Naidu, T; Ramlall, S

    2008-11-01

    During most of the latter part of the last century, South Africa has followed international trends in the training of psychiatrists. Training programmes have become increasingly focused on the neurobiological aspects of psychiatric disorders with less attention being paid to psychotherapy. This is consistent with developments in psychiatric research. In the clinical arena this manifests as a focus on pharmacological and medically based interventions and a resulting relative inattention to non-pharmacological interventions, most especially psychotherapy. In an effort to address this imbalance there has been an international initiative, over the past two decades, to establish an acceptable level of competence in psychotherapy in the training of psychiatrists. A South African programme is needed that can take account of international trends and adapt them for the local context. In order to produce a programme for establishing competence in psychotherapy for psychiatric registrars at the Nelson R. Mandela School of Medicine, the authors examine directives for the development of psychotherapy skills from international regulatory bodies for graduate medical training and their application. Defining and setting preliminary standards for competence is emphasized. A programme based on five core psychotherapy components using a portfolio based model to facilitate learning and assessment of competence in psychotherapy, is proposed.

  8. Deconstructing Risk Management in Psychotherapy Supervision.

    Science.gov (United States)

    Kroll, Jerome; Radden, Jennifer

    2017-12-01

    In the ongoing controversy over how much regulation and standardization to impose on clinical practice and research, it is not surprising that the activity of psychotherapy supervision should be swept up in the drive for uniformity. The managers amongst us want to regulate and institutionalize all aspects of practice. In opposition, many clinicians resist the relentless march toward the safety of uniformity travel alongside managerial imposition of regulations. Psychotherapy supervision's method of a close apprenticeship relationship between supervisor and trainee and its focus on the process and ethics of professional interaction stand at the humanistic core of what is otherwise becoming an increasingly mechanistic model of providing care to persons with mental illness. Our commentary picks up on these themes as it reviews the work by Mehrtens et al about strengthening awareness of liability in psychiatry residency training programs. We argue that the practice of psychiatry is overburdened by documentation requirements. In imposing further record-keeping on psychotherapy supervision, we lose much more than we gain. We recommend that the supervisory process focus on the characterological virtues essential to functioning as an ethical therapist. We also argue that self-protective rules place restraints on possibilities for imaginative insights and innovations in psychotherapy. © 2017 American Academy of Psychiatry and the Law.

  9. New parity, same old attitude towards psychotherapy?

    Science.gov (United States)

    Clemens, Norman A

    2010-03-01

    Full parity of health insurance benefits for treatment of mental illness, including substance use disorders, is a major achievement. However, the newly-published regulations implementing the legislation strongly endorse aggressive managed care as a way of containing costs for the new equality of coverage. Reductions in "very long episodes of out-patient care," hospitalization, and provider fees, along with increased utilization, are singled out as achievements of managed care. Medical appropriateness as defined by expert medical panels is to be the basis of authorizing care, though clinicians are familiar with a history of insurance companies' application of "medical necessity" to their own advantage. The regulations do not single out psychotherapy for attention, but long-term psychotherapy geared to the needs of each patient appears to be at risk. The author recommends that the mental health professions strongly advocate for the growing evidence base for psychotherapy including long-term therapy for complex mental disorders; respect for the structure and process of psychotherapy individualized to patients' needs; awareness of the costs of aggressive managed care in terms of money, time, administrative burden, and interference with the therapy; and recognition of the extensive training and experience required to provide psychotherapy as well as the stresses and demands of the work. Parity in out-of-network benefits could lead to aggressive management of care given by non-network practitioners. Since a large percentage of psychiatrists and other mental health professionals stay out of networks, implementation of parity for out-of-network providers will have to be done in a way that respects the conditions under which they would be willing and able to provide services, especially psychotherapy, to insured patients. The shortage of psychiatrists makes this an important access issue for the insured population in need of care.

  10. Technology-enhanced human interaction in psychotherapy.

    Science.gov (United States)

    Imel, Zac E; Caperton, Derek D; Tanana, Michael; Atkins, David C

    2017-07-01

    Psychotherapy is on the verge of a technology-inspired revolution. The concurrent maturation of communication, signal processing, and machine learning technologies begs an earnest look at how these technologies may be used to improve the quality of psychotherapy. Here, we discuss 3 research domains where technology is likely to have a significant impact: (1) mechanism and process, (2) training and feedback, and (3) technology-mediated treatment modalities. For each domain, we describe current and forthcoming examples of how new technologies may change established applications. Moreover, for each domain we present research questions that touch on theoretical, systemic, and implementation issues. Ultimately, psychotherapy is a decidedly human endeavor, and thus the application of modern technology to therapy must capitalize on-and enhance-our human capacities as counselors, students, and supervisors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. The Role of Theory-Specific Techniques and Therapeutic Alliance in Promoting Positive Outcomes: Integrative Psychotherapy for World Trade Center Responders.

    Science.gov (United States)

    Haugen, Peter Tejas; Werth, Aditi Sinha; Foster, Alyce Lauren; Owen, Jesse

    2016-12-01

    World Trade Center responders demonstrate high symptom burden, underscoring the importance of refining treatment approaches for this cohort. One method is examining the impact of therapy techniques on outcomes, and the interactions between technique and alliance on outcomes. This study a) examined the interaction of early treatment techniques on integrative psychotherapy outcomes and b) explored whether associations differed at varying levels of alliance. Twenty-nine adult responders diagnosed with partial or full posttraumatic stress disorder received outpatient psychotherapy and completed weekly measures of alliance, technique, and symptom distress. Analyses indicated significant interactions between 1) alliance and psychodynamic interventions on outcomes and 2) alliance and cognitive behavioral (CB) interventions on outcomes. Clients with high alliance had better outcomes when their therapist used fewer CB techniques. No meaningful differences were found between technique and outcomes for clients with lower alliance. These findings reiterate the critical roles technique and responsiveness to the alliance play in engendering successful outcomes.

  12. The affective dimension of alliance in transactional analysis psychotherapy

    Directory of Open Access Journals (Sweden)

    Roland Johnsson

    2010-07-01

    Full Text Available The study describes an investigation of the significance of the affective dimension of the therapeutic alliance (Bordin 1979, in a psychodynamic form of transactional analysis therapy after the style of “Redecision therapy” (Goulding & Goulding, 1979. We explored the client’s pattern of affective relationships by use of CCRT (the Core Conflictual Relationship method, Luborsky & Crits-Christoph, 1990, 1998 and examined how the therapist responds to the client’s affective messages (“tests” by use of the Plan Diagnosis method (Weiss & Sampson, 1986. We found that “emotional” aspects play a more decisive role than has been envisioned in the TA redecision method and similar approaches of TA psychotherapy that emphasise contracts, tasks of therapy and a rational approach.

  13. Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer patients: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Zwerenz Rüdiger

    2012-12-01

    Full Text Available Abstract Background There is a lack of psychotherapeutic trials of treatments of comorbid depression in cancer patients. Our study determines the efficacy of a manualized short-term psychodynamic psychotherapy and predictors of outcome by personality and quality of the therapeutic relationship. Methods/design Eligible breast cancer patients with comorbid depression are assigned to short-term psychodynamic psychotherapy (up to 20 + 5 sessions or to treatment as usual (augmented by recommendation for counseling center and physician information. We plan to recruit a total of 180 patients (90 per arm in two centers. Assessments are conducted pretreatment, after 6 (treatment termination and 12 months (follow-up. The primary outcome measures are reduction of the depression score in the Hospital Anxiety and Depression Scale and remission of depression as assessed by means of the Structured Clinical Interview for DSM IV Disorders by independent, blinded assessors at treatment termination. Secondary outcomes refer to quality of life. Discussion We investigate the efficacy of short-term psychodynamic psychotherapy in acute care and we aim to identify predictors for acceptance and success of treatment. Trial registration ISRCTN96793588

  14. Nicorandil directly and cyclic GMP-dependently opens K+ channels in human bypass grafts

    Directory of Open Access Journals (Sweden)

    Marija Marinko

    2015-06-01

    Full Text Available As we previously demonstrated the role of different K+ channels in the action of nicorandil on human saphenous vein (HSV and human internal mammary artery (HIMA, this study aimed to analyse the contribution of the cGMP pathway in nicorandil-induced vasorelaxation and to determine the involvement of cGMP in the K+ channel-activating effect of nicorandil. An inhibitor of soluble guanylate cyclase (GC, ODQ, significantly inhibited nicorandil-induced relaxation, while ODQ plus glibenclamide, a selective ATP-sensitive K+ (KATP channel inhibitor, produced a further inhibition of both vessels. In HSV, ODQ in combination with 4-aminopyridine, a blocker of voltage-gated K+ (KV channels, did not modify the concentration-response to nicorandil compared with ODQ, whereas in HIMA, ODQ plus iberiotoxin, a selective blocker of large-conductance Ca2+-activated K+ (BKCa channels, produced greater inhibition than ODQ alone. We showed that the cGMP pathway plays a significant role in the vasorelaxant effect of nicorandil on HSV and HIMA. It seems that nicorandil directly opens KATP channels in both vessels and BKCa channels in HIMA, although it is possible that stimulation of GC contributes to KATP channels activation in HIMA. Contrary, the activation of KV channels in HSV is probably due to GC activation and increased levels of cGMP.

  15. MDMA and PTSD treatment: "PTSD: From novel pathophysiology to innovative therapeutics".

    Science.gov (United States)

    Sessa, Ben

    2017-05-10

    There is a range of therapies to treat Post Traumatic Stress Disorder (PTSD) but treatment resistance remains high, with many sufferers experiencing the chronic condition. Engagement in trauma-focused psychotherapy is difficult for some patients with PTSD, especially those with extreme affect dysregulation associated with recall of traumatic memories. In recent years there have been a number of neuroscientific and clinical studies examining the potential role for adjunctive drug-assisted psychotherapy using 3,4,-methylenedioxmethamphetamine (MDMA) as a treatment for PTSD. re-visiting of a novel approach to trauma-focused psychotherapy with Used just two or three times, under careful medical supervision and specialised psychotherapy support MDMA appears to facilitate the recall of traumatic memories without the user feeling overwhelmed by the negative affect that usually accompanies such memories. This therapeutic approach began in the 1980s and was subsequently shelved in the midst of public health concerns surrounding the recreational use of the drug ecstasy. When pharmaceutical grade MDMA is used in a clinical setting it does not share the same risk profiles as ecstasy. Recent phase one neurophysiological studies and phase two clinical studies are showing promise as a potential new approach to managing treatment-resistant PTSD. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  16. Lost in Transition: Examining Transitions in Psychotherapy Training.

    Science.gov (United States)

    Tan, Adrienne; Philipp, Diane; Malat, Jan; Feder, Victor; Kulkarni, Chetana; Lawson, Andrea; So, Vivien; Ravitz, Paula

    2015-10-01

    Disruptions are inevitable during psychiatry residency training and can affect resident learning and patient care. This exploratory study examined the nature and impact of transitions in psychotherapy training. PGY2-5 residents (45/150; 30% response rate) and psychotherapy supervisors (46/247; 18.6% response rate) were surveyed about transitional events during residency training in psychotherapy. Supervisors and residents ranked the frequency of occurrence of transitional events and their impact very similarly, as well as the "feed forward" items when transitioning to a new supervisor. Residents feeling confused or overwhelmed with the balancing of learning differing models with differing levels of comfort or knowledge was ranked as the issue that occurred most frequently by both supervisors and residents. This study highlights issues that arise at transitions during psychotherapy training in psychiatry residency. Strategies for managing these periods are discussed, with a focus on resident learning and improved continuity of patient care.

  17. Male erectile dysfunction: integrating psychopharmacology and psychotherapy.

    Science.gov (United States)

    Simopoulos, Eugene F; Trinidad, Anton C

    2013-01-01

    Erectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is the most common sexual problem in men. ED arises when there is disruption of the complex interplay between vascular, neurologic, hormonal and psychologic factors necessary for normal erectile function. It may have a significant effect on quality of life and portend undetected cardiovascular disease. Risk factors for development of ED include advancing age, tobacco use, a history of pelvic irradiation or surgery and antipsychotic use (Table 1) [1]. Treatment guidelines continue to evolve for optimal management of ED. In this article, we review diagnostic and treatment strategies for ED relevant to psychiatrists. We present an integrative approach to the treatment of ED based on a review of the urologic and psychiatric literature. ED is multifactorial in origin and responsive to a variety of therapeutic interventions, including psychopharmacology and psychotherapy in which cognitive underpinnings of poor sexual performance, including diminished self-esteem, lack of confidence and perceived failures in the male role, are examined. Psychiatrists can readily perform a basic workup for ED as they integrate both a medical and therapeutic model when confronted with such patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Simulation of an Aspheric Glass Lens Forming Behavior in Progressive GMP Process

    International Nuclear Information System (INIS)

    Chang, Sung Ho; Lee, Young Min; Kang, Jeong Jin; Hong, Seok Kwan; Shin, Gwang Ho; Heo, Young Moo; Jung, Tae Sung

    2007-01-01

    Recently, GMP(Glass Molding Press) process is mainly used to produce aspheric glass lenses. Because glass lens is heated at high temperature above Tg (Transformation Temperature) for forming the glass, the quality of aspheric glass lens is deteriorated by residual stresses which are generated in a aspheric glass lens after forming. In this study, as a fundamental study to develop the mold for progressive GMP process, we conducted a aspheric glass lens forming simulation. Prior to a aspheric glass lens forming simulation, compression and thermal conductivity tests were carried out to obtain mechanical and thermal properties of K-PBK40 which is newly developed material for precision molding, and flow characteristics of K-PBK40 were obtained at high temperature. Then, using the flow characteristics obtained, compression simulation was carried out and compared with the experimental result for the purpose of verifying the obtained flow characteristics. Finally, a glass lens press simulation in progressive GMP process was carried out and we could forecast the shape of deformed glass lenses and residual stresses contribution in the structure of deformed glass lenses after forming

  19. Magnesium Lithospermate B, an Active Extract of Salvia miltiorrhiza, Mediates sGC/cGMP/PKG Translocation in Experimental Vasospasm

    Directory of Open Access Journals (Sweden)

    Chih-Zen Chang

    2014-01-01

    Full Text Available Background. Soluble guanylyl cyclases (sGCs and Ras homolog gene family, member A (rhoA/Ras homolog gene family kinase(rho-kinase plays a role in vascular smooth muscle relaxation in subarachnoid hemorrhage (SAH. It is of interest to examine the effect of MLB on rhoA/ROCK and sGC/cGMP/PKG expression. Methods. A rodent SAH model was employed. Tissue samples were for sGCα1, sGCβ1, PKG, rhoA, ROCK (Western blot, and cGMP (ELISA measurement. Results. MLB morphologically improved convolution of the internal elastic lamina, distortion of endothelial wall, and necrosis of the smooth muscle in the SAH rats. Expressed cGMP, sGCα1, sGCβ1, and PKG in the SAH groups were reduced (P<0.01, and MLB precondition significantly induced cGMP, sGCα1, sGCβ1, and PKG. L-NAME reversed the vasodilation effect of MLB, reduced the bioexpression of PKG and cGMP (P<0.01, and tends to reduce sGCα1 level and induce rhoA, ROCK level in MLB precondition + SAH groups. Conclusion. These results demonstrate that sGC/cGMP/PKG and NO/ET pathways play pivotal roles in SAH-induced vasospasm. Through activating sGC/cGMP/PKG pathway and partially by inactivating rho-kinase in a NO-dependent mechanism, MLB shows promise to be an effective strategy for the treatment of this disease entity.

  20. Ethical Issues for Direct-to-Consumer Digital Psychotherapy Apps: Addressing Accountability, Data Protection, and Consent.

    Science.gov (United States)

    Martinez-Martin, Nicole; Kreitmair, Karola

    2018-04-23

    This paper focuses on the ethical challenges presented by direct-to-consumer (DTC) digital psychotherapy services that do not involve oversight by a professional mental health provider. DTC digital psychotherapy services can potentially assist in improving access to mental health care for the many people who would otherwise not have the resources or ability to connect with a therapist. However, the lack of adequate regulation in this area exacerbates concerns over how safety, privacy, accountability, and other ethical obligations to protect an individual in therapy are addressed within these services. In the traditional therapeutic relationship, there are ethical obligations that serve to protect the interests of the client and provide warnings. In contrast, in a DTC therapy app, there are no clear lines of accountability or associated ethical obligations to protect the user seeking mental health services. The types of DTC services that present ethical challenges include apps that use a digital platform to connect users to minimally trained nonprofessional counselors, as well as services that provide counseling steered by artificial intelligence and conversational agents. There is a need for adequate oversight of DTC nonprofessional psychotherapy services and additional empirical research to inform policy that will provide protection to the consumer. ©Nicole Martinez-Martin, Karola Kreitmair. Originally published in JMIR Mental Health (http://mental.jmir.org), 23.04.2018.

  1. Competency in integrative psychotherapy: perspectives on training and supervision.

    Science.gov (United States)

    Boswell, James F; Nelson, Dana L; Nordberg, Samuel S; McAleavey, Andrew A; Castonguay, Louis G

    2010-03-01

    Increasingly, many psychotherapists identify with an integrative approach to psychotherapy. In recent years, more attention has been directed toward the operationalization and evaluation of competence in professional psychology and health care service delivery. Aspects of integrative psychotherapy competency may differ from competency in other psychotherapy orientations, although convergence is more often the case. Despite the potential differences, there exist very few formal training programs or guidelines to systematically guide clinicians in developing a competent integrative practice. This paper attempts to distill the essential elements of competent integrative psychotherapy practice and focuses on how these might be developed in training and supervision. We address most of these complex issues from a specific integrative perspective: principle-based assimilative integration. PsycINFO Database Record (c) 2010 APA, all rights reserved

  2. Cyclic GMP protects human macrophages against peroxynitrite-induced apoptosis.

    Science.gov (United States)

    Shaw, Catherine A; Webb, David J; Rossi, Adriano G; Megson, Ian L

    2009-05-07

    Nitric oxide (NO) can be both pro- and anti-apoptotic in various cell types, including macrophages. This apparent paradox may result from the actions of NO-related species generated in the microenvironment of the cell, for example the formation of peroxynitrite (ONOO-). In this study we have examined the ability of NO and ONOO- to evoke apoptosis in human monocyte-derived macrophages (MDMvarphi), and investigated whether preconditioning by cyclic guanosine monophosphate (cGMP) is able to limit apoptosis in this cell type. Characterisation of the NO-related species generated by (Z)-1- [2-(2-aminoethyl)-N-(2-ammonioethyl)amino]diazen-1-ium-1,2-diolate (DETA/NO) and 1,2,3,4-oxatriazolium, 5-amino-3-(3,4-dichlorophenyl)-, chloride (GEA-3162) was performed by electrochemistry using an isolated NO electrode and electron paramagnetic resonance (EPR) spectrometry. Mononuclear cells were isolated from peripheral blood of healthy volunteers and cultured to allow differentiation into MDMvarphi. Resultant MDMvarphi were treated for 24 h with DETA/NO (100 - 1000 muM) or GEA-3162 (10 - 300 muM) in the presence or absence of BAY 41-2272 (1 muM), isobutylmethylxanthine (IBMX; 1 muM), 1H- [1,2,4]oxadiazolo [4,3-a]quinoxalin-1-one (ODQ; 20 muM) or 8-bromo-cGMP (1 mM). Apoptosis in MDMvarphi was assessed by flow cytometric analysis of annexin V binding in combination with propidium iodide staining. Electrochemistry and EPR revealed that DETA/NO liberated free NO radical, whilst GEA-3162 concomitantly released NO and O2-, and is therefore a ONOO- generator. NO (DETA/NO) had no effect on cell viability, but ONOO- (GEA-3162) caused a concentration-dependent induction of apoptosis in MDMvarphi. Preconditioning of MDMvarphi with NO in combination with the phosphodiesterase inhibitor, 3-Isobutyl-1-methylxanthine (IBMX), or the NO-independent stimulator of soluble guanylate cyclase, BAY 41-2272, significantly attenuated ONOO--induced apoptosis in a cGMP-dependent manner. These results

  3. Cyclic GMP protects human macrophages against peroxynitrite-induced apoptosis

    Directory of Open Access Journals (Sweden)

    Rossi Adriano G

    2009-05-01

    Full Text Available Abstract Background Nitric oxide (NO can be both pro- and anti-apoptotic in various cell types, including macrophages. This apparent paradox may result from the actions of NO-related species generated in the microenvironment of the cell, for example the formation of peroxynitrite (ONOO-. In this study we have examined the ability of NO and ONOO- to evoke apoptosis in human monocyte-derived macrophages (MDMϕ, and investigated whether preconditioning by cyclic guanosine monophosphate (cGMP is able to limit apoptosis in this cell type. Methods Characterisation of the NO-related species generated by (Z-1- [2-(2-aminoethyl-N-(2-ammonioethylamino]diazen-1-ium-1,2-diolate (DETA/NO and 1,2,3,4-oxatriazolium, 5-amino-3-(3,4-dichlorophenyl-, chloride (GEA-3162 was performed by electrochemistry using an isolated NO electrode and electron paramagnetic resonance (EPR spectrometry. Mononuclear cells were isolated from peripheral blood of healthy volunteers and cultured to allow differentiation into MDMϕ. Resultant MDMϕ were treated for 24 h with DETA/NO (100 – 1000 μM or GEA-3162 (10 – 300 μM in the presence or absence of BAY 41–2272 (1 μM, isobutylmethylxanthine (IBMX; 1 μM, 1H- [1,2,4]oxadiazolo [4,3-a]quinoxalin-1-one (ODQ; 20 μM or 8-bromo-cGMP (1 mM. Apoptosis in MDMϕ was assessed by flow cytometric analysis of annexin V binding in combination with propidium iodide staining. Results Electrochemistry and EPR revealed that DETA/NO liberated free NO radical, whilst GEA-3162 concomitantly released NO and O2-, and is therefore a ONOO- generator. NO (DETA/NO had no effect on cell viability, but ONOO- (GEA-3162 caused a concentration-dependent induction of apoptosis in MDMϕ. Preconditioning of MDMϕ with NO in combination with the phosphodiesterase inhibitor, 3-Isobutyl-1-methylxanthine (IBMX, or the NO-independent stimulator of soluble guanylate cyclase, BAY 41–2272, significantly attenuated ONOO--induced apoptosis in a cGMP-dependent manner

  4. Using Animal-assisted Therapy to Enrich Psychotherapy.

    Science.gov (United States)

    Amerine, Jeanne Louise; Hubbard, Grace B

    2016-01-01

    Animal-assisted therapy (AAT) has been shown to be effective in the treatment of many psychological disorders, including autism spectrum disorders, depression, anxiety, and posttraumatic stress disorder (PTSD). AAT can be used as an adjunct to other forms of psychotherapy. With AAT, the animal becomes a part of the treatment plan. Outcomes for clients that are associated with the use of AAT include (1) increased sense of comfort and safety, (2) increased motivation, (3) enhanced self-esteem, (4) increased prosocial behaviors, and (5) decreased behavioral problems. AAT provides a bridge for the therapist to develop a therapeutic relationship with a client, and the animal can provide supportive reassurance for the therapist. The amount of data that supports the benefits of AAT for the treatment of those with mental illnesses is growing, but evidence-based research that supports its use is lacking. Further research is needed.

  5. Psychotherapy Utilization Among Rural and Urban Veterans From 2007 to 2010.

    Science.gov (United States)

    Mott, Juliette M; Grubbs, Kathleen M; Sansgiry, Shubhada; Fortney, John C; Cully, Jeffrey A

    2015-01-01

    This study evaluated change in rural and urban veterans' psychotherapy use during a period of widespread effort within the Veterans Health Administration (VHA) to engage rural veterans in mental health care. National VHA administrative databases were queried for patients receiving a new diagnosis of depression, anxiety, or posttraumatic stress disorder in fiscal years (FY) 2007 and 2010. Using the US Department of Agriculture Rural-Urban Continuum Codes, we identified urban (FY 2007: n = 192,347; FY 2010: n = 231,471) and rural (FY 2007: n = 72,923; FY 2010: n = 81,905) veterans. Veterans' psychotherapy use during the 12 months following diagnosis was assessed. From FY 2007 to 2010, the proportion of veterans receiving any psychotherapy increased from 17% to 22% for rural veterans and 24% to 28% for urban veterans. Rural veterans were less likely to receive psychotherapy across both fiscal years; however, the magnitude of this disparity decreased significantly from 2007 (odds ratio [OR] = 1.51) to 2010 (OR = 1.41). Similarly, although urban veterans received more psychotherapy sessions, urban-rural disparities in the receipt of 8 or more psychotherapy sessions decreased over the study period (2007: OR = 2.32; 2010: OR = 1.69). Rural and urban veterans are increasingly making use of psychotherapy, and rural-urban gaps in psychotherapy use are shrinking. These improvements suggest that recent VHA efforts to engage rural veterans in care have been successful at reducing differences between rural and urban veterans with respect to access and engagement in psychotherapy. © 2014 National Rural Health Association.

  6. NONVERBAL STORIES: THE BODY IN PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    Richard G. Erskine

    2014-11-01

    Full Text Available Emotional experience is stored within the amygdala and the limbic system of the brain as affect, visceral, and physiological sensation without symbolization and language. These significant memories are expressed in affect and through our bodily movements and gestures. Such body memories are unconscious non-symbolized patterns of self-in-relationship. Several methods of a body centered psychotherapy are described and clinical case examples illustrate the use of expressive methods within a relational psychotherapy.

  7. Design of GMP compliance radiopharmaceutical production facility in MINT

    International Nuclear Information System (INIS)

    Anwar Abd Rahman; Shaharum Ramli; M Rizal Mamat Ibrahim; Rosli Darmawan; Yusof Azuddin Ali; Jusnan Hashim

    2005-01-01

    In 1985, MINT built the only radiopharmaceutical production facility in Malaysia. The facility was designed based on IAEA (International Atomic Energy Agency) standard guidelines which provide radiation safety to the staff and the surrounding environment from radioactive contamination. Since 1999, BPFK (Biro Pengawalan Farmaseutikal Kebangsaan) has used the guidelines from Pharmaceutical Inspection Convention Scheme (PICS) to meet the requirements of the Good Manufacturing Practice (GMP) for Pharmaceutical Products. In the guidelines, the pharmaceutical production facility shall be designed based on clean room environment. In order to design a radiopharmaceutical production facility, it is important to combine the concept of radiation safety and clean room to ensure that both requirements from GMP and IAEA are met. The design requirement is necessary to set up a complete radiopharmaceutical production facility, which is safe, has high production quality and complies with the Malaysian and International standards. (Author)

  8. Reflections on Individual Psychotherapy with University Students: What Seems to Work

    Science.gov (United States)

    Pinkerton, Rolffs; Talley, Joseph E.; Cooper, Stacie L.

    2009-01-01

    The authors offer reflections on what seems to work in individual psychotherapy with university students. Discussion centers around the topics of triage and disposition, referral, crisis intervention, stress management, open-ended psychotherapy, extratherapeutic factors, and the psychotherapy relationship. These observations are not intended to be…

  9. Psychotherapy use in bipolar disorder: Association with functioning and illness severity.

    Science.gov (United States)

    Sylvia, Louisa G; Thase, Michael E; Reilly-Harrington, Noreen A; Salcedo, Stephanie; Brody, Benjamin; Kinrys, Gustavo; Kemp, David; Shelton, Richard C; McElroy, Susan L; Kocsis, James H; Bobo, William V; Kamali, Masoud; McInnis, Melvin; Friedman, Edward; Tohen, Mauricio; Bowden, Charles L; Ketter, Terence A; Singh, Vivek; Calabrese, Joseph; Nierenberg, Andrew A; Rabideau, Dustin J; Elson, Constance M; Deckersbach, Thilo

    2015-05-01

    This study examines characteristics of individuals with bipolar disorder who sought psychotherapy versus those who did not. Bipolar CHOICE was an 11-site comparative effectiveness study of lithium versus quetiapine in symptomatic outpatients (N = 482) with bipolar disorder. At baseline, participants' psychotherapy use within the past 3 months, mood, functioning, and overall health were assessed. Logistic regressions were used to test whether psychotherapy users and non-users differed on various demographic and clinical variables at baseline. Mixed-effects regression was used to determine whether psychotherapy groups differed on response to treatment over the 6-month study. Kaplan-Meier plots and log-rank tests were employed to test whether there were any differences in time to recovery (CGI-BP ≤ 2 for at least 8 weeks) between the groups. Thirty one percent of participants reported using psychotherapy services. Psychotherapy users reported greater medication side effect burden than non-users and were more likely to have moderate to high suicide risk and at least one anxiety disorder. Participants not utilizing medications or psychotherapy had greater mania symptom severity, were younger, and less educated than medication only users. Medication only users were more likely to be married than the other participants. These data suggest that a minority of individuals with bipolar disorder attend psychotherapy services, and those that do have greater illness burden. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  10. Inhibition of excitatory synaptic transmission in the trigeminal motor nucleus by the nitric oxide-cyclic GMP signaling pathway.

    Science.gov (United States)

    Pose, Inés; Silveira, Valentina; Morales, Francisco R

    2011-06-01

    Nitric oxide (NO) and cyclic GMP (cGMP) suppressed glutamatergic synaptic transmission to trigeminal motoneurons in brain stem slices of neonatal rats. Histological studies showed guanylate cyclase (GC) containing fibers in the trigeminal motor pool. Glutamatergic excitatory postsynaptic currents (EPSCs) were recorded from neonatal trigeminal motoneurons in response to stimulation of the supratrigeminal nucleus (SuV). The NO donors DETA/NONOate (DETA/NO), at a concentration which released 275.1 nM of NO, and Spermine/NONOate (Sper/NO) reduced the amplitude of the EPSC to 52.7±0.6% and 60.1±10.8% of control values, respectively. These actions were not blocked by the GC inhibitors, ODQ or NS-2028. However, in the presence of YC-1 or BAY41-2272, modulators of GC that act as NO sensitizers, lower and otherwise ineffective concentrations of DETA/NO induced a reduction of the EPSC to 60.6±5.2%. Moreover, NO effects were mimicked by 8BrcGMP and by Zaprinast, an inhibitor of Phosphodiesterase 5. Glutamatergic currents evoked by exogenous glutamate were not reduced by DETA/NO nor 8BrcGMP. Paired-pulse facilitation was increased by NO donors. Under "minimal stimulation" conditions NO donors and cGMP increased the failure rate of evoked EPSCs. Protein kinase inhibitors antagonized cGMP effects. The results suggest that NO, through the synthesis of cGMP, presynaptically inhibits glutamatergic synaptic transmission on trigeminal motoneurons. We propose that NO has complex actions on motor pools; specific studies are needed to elucidate their physiological significance in the behaving animal. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. cGMP-Phosphodiesterase Inhibition Prevents Hypoxia-Induced Cell Death Activation in Porcine Retinal Explants.

    Directory of Open Access Journals (Sweden)

    Lorena Olivares-González

    Full Text Available Retinal hypoxia and oxidative stress are involved in several retinal degenerations including diabetic retinopathy, glaucoma, central retinal artery occlusion, or retinopathy of prematurity. The second messenger cyclic guanosine monophosphate (cGMP has been reported to be protective for neuronal cells under several pathological conditions including ischemia/hypoxia. The purpose of this study was to evaluate whether the accumulation of cGMP through the pharmacological inhibition of phosphodiesterase (PDE with Zaprinast prevented retinal degeneration induced by mild hypoxia in cultures of porcine retina. Exposure to mild hypoxia (5% O2 for 24h reduced cGMP content and induced retinal degeneration by caspase dependent and independent (PARP activation mechanisms. Hypoxia also produced a redox imbalance reducing antioxidant response (superoxide dismutase and catalase activities and increasing superoxide free radical release. Zaprinast reduced mild hypoxia-induced cell death through inhibition of caspase-3 or PARP activation depending on the cell layer. PDE inhibition also ameliorated the effects of mild hypoxia on antioxidant response and the release of superoxide radical in the photoreceptor layer. The use of a PKG inhibitor, KT5823, suggested that cGMP-PKG pathway is involved in cell survival and antioxidant response. The inhibition of PDE, therefore, could be useful for reducing retinal degeneration under hypoxic/ischemic conditions.

  12. The influence of psychotherapy on marriage typology

    Directory of Open Access Journals (Sweden)

    Staniszewski Mirosław

    2016-07-01

    Full Text Available The article analyses the influence of psychotherapeutic group work on matrimonial relations. Such questions are put up in the research as if participating of one of the married couples in a group psychotherapy could indirectly influence the other partner, and also if the type of matrimony could change under the influence of psychotherapy, for example from hierarchical to the partner’s. The article generalizes the classification of marriage types and pays special attention on the types that can be subject to the positive changes as a result of psychotherapeutic influence. Actuality and value of this research lay in estimation of the ability of psychotherapy to influence the matrimony on the whole in case when only one of the partners takes part in the therapy.

  13. The Therapy Process Observational Coding System for Child Psychotherapy Strategies Scale

    Science.gov (United States)

    McLeod, Bryce D.; Weisz, John R.

    2010-01-01

    Most everyday child and adolescent psychotherapy does not follow manuals that document the procedures. Consequently, usual clinical care has remained poorly understood and rarely studied. The Therapy Process Observational Coding System for Child Psychotherapy-Strategies scale (TPOCS-S) is an observational measure of youth psychotherapy procedures…

  14. Ethics and aims in psychotherapy: a contribution from Kant.

    Science.gov (United States)

    Callender, J S

    1998-08-01

    Psychotherapy is an activity which takes many forms and which has many aims. The present paper argues that it can be viewed as a form of moral suasion. Kant's concepts of free will and ethics are described and these are then applied to the processes and outcome of psychotherapy. It is argued that his ideas, by linking rationality, free will and ethics into a single philosophical system, offer a valuable theoretical framework for thinking about aims and ethical issues in psychotherapy.

  15. Corrective relational experiences in psychodynamic-interpersonal psychotherapy: Antecedents, types, and consequences.

    Science.gov (United States)

    Huang, Teresa Chen-Chieh; Hill, Clara E; Strauss, Nicole; Heyman, Michelle; Hussain, Mahum

    2016-03-01

    In posttherapy interviews with 31 clients who had recently terminated from individual open-ended psychodynamic-interpersonal psychotherapy, 18 reported having had at least 1 corrective relational experience (CRE) during psychotherapy, whereas 13 did not report any CREs. CREs typically occurred in the context of therapeutic relationships that were primarily positive but also had minor difficulties. Therapists typically facilitated CREs by identifying or questioning client behavior patterns and conveying trustworthiness. Corrective shifts for clients typically involved a new understanding of the therapy experience and variantly involved gaining a new understanding of behavior patterns. Consequences generally included improvements in the therapy relationship and intrapersonal well-being. Qualitatively, the 13 non-CRE clients more frequently reported wishing the therapist's theoretical orientation was a better match than did the 18 CRE clients. Quantitatively, the CRE clients rated themselves as having more interpersonal problems at intake on the Inventory of Interpersonal Problems-32 (Barkham, Hardy, & Startup, 1996), had marginally significant improvements in interpersonal functioning over time, rated their therapy alliances higher on the Working Alliance Inventory-Short Revised (Hatcher & Gillaspy, 2006) midtherapy, and rated their therapy alliances higher over time compared with the non-CRE clients. Implications for practice and research are discussed. (c) 2016 APA, all rights reserved).

  16. [How timely are the methods taught in psychotherapy training and practice?].

    Science.gov (United States)

    Beutel, Manfred E; Michal, Matthias; Wiltink, Jörg; Subic-Wrana, Claudia

    2015-01-01

    Even though many psychotherapists consider themselves to be eclectic or integrative, training and reimbursement in the modern healthcare system are clearly oriented toward the model of distinct psychotherapy approaches. Prompted by the proposition to favor general, disorder-oriented psychotherapy, we investigate how timely distinctive methods are that are taught in training and practice. We reviewed the pertinent literature regarding general and specific factors, the effectiveness of integrative and eclectic treatments, orientation toward specific disorders, manualization and psychotherapeutic training. There is a lack of systematic studies on the efficacy of combining therapy methods from different approaches. The first empirical findings reveal that a superiority of combined versus single treatmentmethods has yet to be demonstrated. The development of transnosological manuals shows the limits of disorder-specific treatment.General factors such as therapeutic alliance or education about the model of disease and treatment rationale require specific definitions. Taking reference to a specific treatment approach provides important consistency of theory, training therapy and supervision, though this does not preclude an openness toward other therapy concepts. Current manualized examples show that methods and techniques can indeed be integrated from other approaches. Integrating different methods can also be seen as a developmental task for practitioners and researchers which may be mastered increasingly better with more experience.

  17. Influential psychotherapy figures, authors, and books: An Internet survey of over 2,000 psychotherapists.

    Science.gov (United States)

    Cook, Joan M; Biyanova, Tatyana; Coyne, James C

    2009-03-01

    In a partial replication and extension of a survey conducted 25 years ago (Smith, 1982), over 2,400 North American psychotherapists completed a Web-based survey in which they identified prominent figures in the psychotherapy field who have most influenced their practice and the best psychotherapy books they had read in the past 3 years. There is a continued prominence to leaders of the field from 25 years ago but who are now deceased, notably the top-ranked Carl Rogers. Three books on the top-10 list represent empirically supported therapies (ESTs); two are treatment manuals for an EST, and one is a self-help book derived from an EST that has itself been shown to be efficacious bibliotherapy. Differences between psychologist and nonpsychologist therapists in the choice of influential figures, authors, and books are negligible. Implications are discussed in terms of the contemporary context into which therapeutic innovations are disseminated, as well as the conditions that may be necessary for successful dissemination. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  18. The experiences of the client, therapist and parents when using equine-assisted psychotherapy in a sexual abuse case

    OpenAIRE

    2013-01-01

    M. Psych. (Educational Psychology) The high child sexual abuse rate in South Africa and all over the world makes these cases a reality for educational psychologists practising today. Equineassisted psychotherapy is a relatively new field in psychology, and research shows that this therapeutic intervention can have a very significant impact on people. Sexual abuse leaves children with psychological effects (Beitchman, Zucker, Hood, DaCosta & Akman, 1991) ranging from intrapersonal problems ...

  19. DYNAMICS OF THE ANXIETY DISORDERS IN THE COURSE OF SHORT-TERM PSYCHOTHERAPY

    Directory of Open Access Journals (Sweden)

    T.N. Hmylova

    2008-06-01

    Full Text Available The tendency of psychotherapy modern concepts referring to the short-term forms having been taken into account, we carried out the research aimed at the study of short-term form personality-oriented psychotherapy effect on the anxiety disorder dynamics. 103 patients with neurotic disorders were examined in the neurosis and psychotherapy department of the Bekhterev Psychoneurological Research Institute. The findings revealed the situational and personal anxiety level to be objectively decreased in the short-term group psychotherapy course. The short-term group psychotherapy was proved to bean effective method in anxiety disorders treatment considering indications and limitations.

  20. Use of Psychotherapy by Rural and Urban Veterans

    Science.gov (United States)

    Cully, Jeffrey A.; Jameson, John P.; Phillips, Laura L.; Kunik, Mark E.; Fortney, John C.

    2010-01-01

    Purpose: To examine whether differences exist between rural and urban veterans in terms of initiation of psychotherapy, delay in time from diagnosis to treatment, and dose of psychotherapy sessions. Methods: Using a longitudinal cohort of veterans obtained from national Veterans Affairs databases (October 2003 through September 2004), we extracted…

  1. Momentary assessment of interpersonal process in psychotherapy.

    Science.gov (United States)

    Thomas, Katherine M; Hopwood, Christopher J; Woody, Erik; Ethier, Nicole; Sadler, Pamela

    2014-01-01

    To demonstrate how a novel computer joystick coding method can illuminate the study of interpersonal processes in psychotherapy sessions, we applied it to Shostrom's (1966) well-known films in which a client, Gloria, had sessions with 3 prominent psychotherapists. The joystick method, which records interpersonal behavior as nearly continuous flows on the plane defined by the interpersonal dimensions of control and affiliation, provides an excellent sampling of variability in each person's interpersonal behavior across the session. More important, it yields extensive information about the temporal dynamics that interrelate clients' and therapists' behaviors. Gloria's 3 psychotherapy sessions were characterized using time-series statistical indices and graphical representations. Results demonstrated that patterns of within-person variability tended to be markedly asymmetric, with a predominant, set-point-like interpersonal style from which deviations mostly occurred in just 1 direction (e.g., occasional submissive departures from a modal dominant style). In addition, across each session, the therapist and client showed strongly cyclical variations in both control and affiliation, and these oscillations were entrained to different extents depending on the therapist. We interpreted different patterns of moment-to-moment complementarity of interpersonal behavior in terms of different therapeutic goals, such as fostering a positive alliance versus disconfirming the client's interpersonal expectations. We also showed how this method can be used to provide a more detailed analysis of specific shorter segments from each of the sessions. Finally, we compared our approach to alternative techniques, such as act-to-act lagged relations and dynamic systems and pointed to a variety of possible research and training applications. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  2. Differential regulation of c-di-GMP metabolic enzymes by environmental signals modulates biofilm formation in Yersinia pestis

    Directory of Open Access Journals (Sweden)

    Gai-Xian eRen

    2016-06-01

    Full Text Available Cyclic diguanylate (c-di-GMP is essential for Yersinia pestis biofilm formation, which is important for flea-borne blockage-dependent plague transmission. Two diguanylate cyclases (DGCs, HmsT and HmsD and one phosphodiesterase (PDE, HmsP are responsible for the synthesis and degradation of c-di-GMP in Y. pestis. Here, we systematically analyzed the effect of various environmental signals on regulation of the biofilm phenotype, the c-di-GMP levels, and expression of HmsT, HmsD and HmsP in Y. pestis. Biofilm formation was higher in the presence of nonlethal high concentration of CaCl2, MgCl2, CuSO4, sucrose, sodium dodecyl sulfonate, or dithiothreitol, and was lower in the presence of FeCl2 or NaCl. In addition, we found that HmsD plays a major role in biofilm formation in acidic or redox environments. These environmental signals differentially regulated expression of HmsT, HmsP and HmsD, resulting in changes in the intracellular levels of c-di-GMP in Y. pestis. Our results suggest that bacteria can sense various environmental signals, and differentially regulates their DGCs and PDEs to coordinately regulate and adapt metabolism of c-di-GMP and biofilm formation to changing environments.

  3. [Online Counselling: The prospect of a therapeutic connection].

    Science.gov (United States)

    Giotakos, O; Papadomarkaki, E

    2016-01-01

    Over the last few years, Internet has become an integral part of daily life. An abundant source of information and a principal gateway of communication between individuals, Internet has been continuously gaining considerable ground as a tool of awareness and intervention in the area of public health. With regard to the field of mental health, Internet exhibits a credible potential in facilitating dialogue not only between experts and their beneficiaries but also between stakeholders. Moreover and with regard to various aspects of public concern, it can serve as a circulation portal of educational material between students and teachers. The advent of remote support services dates back in the decade of 1970-1980. In the present time, they consist of informative guides and self-help groups or online counselling. The latter is defined as the process in which both parties, namely the therapist and the client, are involved in an oral or written conciliation through means of an internet connection, videoconferencing, live chat or e-mail exchange. The benefits of this practice - accessibility, relocation, convenience, anonymity, facilitation of face-to-face psychotherapy and low cost - could make online counseling, in specific cases, the treatment of choice. While the usage of the World Wide Web seems promising for the rectification of mental health disorders, there is some debate among experts regarding the ethical aspect of practicing psychotherapy in an interactive digital environment. Issues such as technical expertise and the tackling of related problems, difficulties in the diagnostic process, interchange of verbal and nonverbal cues, crisis management, safeguarding the therapeutic alliance, protection of personal data, age restriction, keeping boundaries in relation to the setting, the time and the dynamics of the therapeutic relationship and, finally, training and supervisory process of online therapist, are some subjects of disagreement. Relevant research reveals

  4. Obstacles to early career psychiatrists practicing psychotherapy.

    Science.gov (United States)

    Clemens, Norman A; Plakun, Eric M; Lazar, Susan G; Mellman, Lisa

    2014-09-01

    Though psychiatric residents are expected to be competent psychotherapists on graduation, further growth in skill and versatility requires continued experience in their ongoing career. Maturity as a psychotherapist is essential because a psychiatrist is the only mental health provider who, as a physician, can assume full responsibility for biopsychosocial patient care and roles as supervisor, consultant, and team leader. Graduating residents face an environment in which surveys show a steady and alarming decline in practice of psychotherapy by psychiatrists, along with a decline in job satisfaction. High educational debts, practice structures, intrusive management, and reimbursement policies that devalue psychotherapy discourage early career psychiatrists from a practice style that enables providing it. For the early-career psychiatrist there is thus the serious risk of being unable to develop a critical mass of experience or a secure identity as a psychiatric psychotherapist. Implementation of parity laws and the Affordable Care Act (ACA) will affect the situation in unpredictable ways that call for vigilance and active response. Additional service and administrative demands may result from the ACA, creating ethical dilemmas about meeting urgent patient needs versus biopsychosocial standards of care. The authors recommend 1) vigorous advocacy for better payment levels for psychotherapy and freedom from disruptive management; 2) aggressive action against violations of the parity act, 3) active preparation of psychiatric residents for dealing with career choices and the environment for providing psychotherapy in their practice, and 4) post-graduate training in psychotherapy through supervision/consultation, continuing education courses, computer instruction, and distance learning.

  5. Review of Psychoanalytic Psychotherapy: A Practitioner's Guide.

    Science.gov (United States)

    Papouchis, Nicholas

    2006-01-01

    Reviews the book, Psychoanalytic Psychotherapy: A Practitioner's Guide by Nancy McWilliams (see record 2004-16060-000). Nancy McWilliams' book on analytic therapy is her latest contribution to the training needs of young clinicians. The book is organized into chapters that address fundamental issues clinical trainees typically face as they work with patients. To establish the context for describing psychoanalytic work, the first chapter defines what she means by psychoanalytic therapy. The three chapters that follow address what McWilliams means by a psychoanalytic sensibility: how the therapist may be prepared for doing therapy and how the client may be prepared for the experience of psychoanalytic psychotherapy. The next three chapters address the maintenance of boundaries and basic therapy processes. Two case examples follow in chapters eight and nine, and each example is a richly evocative description of the complexity of psychoanalytic psychotherapy. The last three chapters of the book deal with the ancillary lessons of psychoanalytic therapy, the occupational hazards and gratifications of the work, and a final chapter on self-care. This is an excellent book, but it should be read together with other texts on psychoanalytic psychotherapy that describe the treatment process systematically in more technical terms. This is a book written for clinicians in training or for experienced clinicians to use in working with clinical trainees. In this sense, Nancy McWilliams has more than achieved her goal of writing a book that will introduce clinical trainees to the psychoanalytic sensibility of doing psychoanalytic psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  6. Evaluation of Tissue Homogenization to Support the Generation of GMP-Compliant Mesenchymal Stromal Cells from the Umbilical Cord

    Directory of Open Access Journals (Sweden)

    Ryan J. Emnett

    2016-01-01

    Full Text Available Recent studies have demonstrated that the umbilical cord (UC is an excellent source of mesenchymal stromal cells (MSCs. However, current protocols for extracting and culturing UC-MSCs do not meet current good manufacturing practice (cGMP standards, in part due to the use of xenogeneic reagents. To support the development of a cGMP-compliant method, we have examined an enzyme-free isolation method utilizing tissue homogenization (t-H followed by culture in human platelet lysate (PL supplemented media. The yield and viability of cells after t-H were comparable to those obtained after collagenase digestion (Col-D. Importantly, kinetic analysis of cultured cells showed logarithmic growth over 10 tested passages, although the rate of cell division was lower for t-H as compared to Col-D. This slower growth of t-H-derived cells was also reflected in their longer population doubling time. Interestingly, there was no difference in the expression of mesenchymal markers and trilineage differentiation potential of cells generated using either method. Finally, t-H-derived cells had greater clonogenic potential compared to Col-D/FBS but not Col-D/PL and were able to maintain CFU-F capacity through P7. This bench scale study demonstrates the possibility of generating therapeutic doses of good quality UC-MSCs within a reasonable length of time using t-H and PL.

  7. Time-dependent inhibitory effects of cGMP-analogues on thrombin-induced platelet-derived microparticles formation, platelet aggregation, and P-selectin expression

    International Nuclear Information System (INIS)

    Nygaard, Gyrid; Herfindal, Lars; Kopperud, Reidun; Aragay, Anna M.; Holmsen, Holm; Døskeland, Stein Ove; Kleppe, Rune; Selheim, Frode

    2014-01-01

    Highlights: • We investigated the impact of cyclic nucleotide analogues on platelet activation. • Different time dependence were found for inhibition of platelet activation. • Additive effect was found using PKA- and PKG-activating analogues. • Our results may explain some of the discrepancies reported for cNMP signalling. - Abstract: In platelets, nitric oxide (NO) activates cGMP/PKG signalling, whereas prostaglandins and adenosine signal through cAMP/PKA. Cyclic nucleotide signalling has been considered to play an inhibitory role in platelets. However, an early stimulatory effect of NO and cGMP-PKG signalling in low dose agonist-induced platelet activation have recently been suggested. Here, we investigated whether different experimental conditions could explain some of the discrepancy reported for platelet cGMP-PKG-signalling. We treated gel-filtered human platelets with cGMP and cAMP analogues, and used flow cytometric assays to detect low dose thrombin-induced formation of small platelet aggregates, single platelet disappearance (SPD), platelet-derived microparticles (PMP) and thrombin receptor agonist peptide (TRAP)-induced P-selectin expression. All four agonist-induced platelet activation phases were blocked when platelets were costimulated with the PKG activators 8-Br-PET-cGMP or 8-pCPT-cGMP and low-doses of thrombin or TRAP. However, extended incubation with 8-Br-PET-cGMP decreased its inhibition of TRAP-induced P-selectin expression in a time-dependent manner. This effect did not involve desensitisation of PKG or PKA activity, measured as site-specific VASP phosphorylation. Moreover, PKG activators in combination with the PKA activator Sp-5,6-DCL-cBIMPS revealed additive inhibitory effect on TRAP-induced P-selectin expression. Taken together, we found no evidence for a stimulatory role of cGMP/PKG in platelets activation and conclude rather that cGMP/PKG signalling has an important inhibitory function in human platelet activation

  8. A New Language for Child Psychotherapy: A Response to Jerald Kay

    Science.gov (United States)

    Clark, James J.; Borden, William

    2009-01-01

    Jerald Kay's article in this issue reviews important research in the areas of adult psychotherapy and neuroscience, and their implications for child psychotherapy. We respond by exploring some of the strengths and limitations of these lines of research and their implications for child psychotherapy development and research. The paper closes with…

  9. Structural Basis for the Catalytic Mechanism of DncV, Bacterial Homolog of Cyclic GMP-AMP Synthase.

    Science.gov (United States)

    Kato, Kazuki; Ishii, Ryohei; Hirano, Seiichi; Ishitani, Ryuichiro; Nureki, Osamu

    2015-05-05

    Cyclic dinucleotides (CDNs) play key roles as second messengers and signaling molecules in bacteria and metazoans. The newly identified dinucleotide cyclase in Vibrio cholerae (DncV) produces three different CDNs containing two 3'-5' phosphodiester bonds, and its predominant product is cyclic GMP-AMP, whereas mammalian cyclic GMP-AMP synthase (cGAS) produces only cyclic GMP-AMP containing mixed 2'-5' phosphodiester bonds. We report the crystal structures of V. cholerae and Escherichia coli DncV in complex with various nucleotides in the pre-reaction states. The high-resolution structures revealed that DncV preferably recognizes ATP and GTP as acceptor and donor nucleotides, respectively, in the first nucleotidyl transfer reaction. Considering the recently reported intermediate structures, our pre-reaction state structures provide the precise mechanism of 3'-5' linked cyclic AMP-GMP production in bacteria. A comparison with cGAS in the pre-reaction states suggests that the orientation of the acceptor nucleotide primarily determines the distinct linkage specificities between DncV and cGAS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Medical psychotherapy of schizophrenia--a dynamic/supportive approach.

    Science.gov (United States)

    Corradi, Richard B

    2004-01-01

    Split psychiatric treatment-a psychiatrist prescribing medication while a nonphysician provides or coordinates psychosocial treatments-is common practice, especially in the managed care setting. This influence, along with a focus on the biology of mental illness, has shifted the emphasis in psychiatric education and practice away from psychotherapy. In particular, "psychotherapy" of schizophrenia has gotten short shrift. Since our drugs for schizophrenia do not cure, but only ameliorate, it would be unfortunate if psychiatrists were to become marginalized in a largely prescriptive role. This paper discusses medical psychotherapy of schizophrenia-an integrated treatment in which the psychiatrist provides the comprehensive care that such a chronic biopsychosocial illness requires.

  11. Attachment style and readiness for psychotherapy among psychiatric outpatients.

    Science.gov (United States)

    Kealy, David; Tsai, Michelle; Ogrodniczuk, John S

    2017-06-01

    Ninety-two adults attending outpatient mental health services completed measures of attachment style and readiness to engage in psychotherapy. Correlation and linear regression analyses found anxious attachment to be positively associated with treatment-seeking distress and found avoidant attachment to be negatively associated with openness to personal disclosure in the therapy relationship. Insecure attachment may influence prospective patients' readiness for psychotherapy. Patients with an avoidant attachment style may need assistance in preparing for the relational aspects of psychotherapy. © 2016 The British Psychological Society.

  12. Therapy 101: A Psychotherapy Curriculum for Medical Students

    Science.gov (United States)

    Aboul-Fotouh, Frieda; Asghar-Ali, Ali Abbas

    2010-01-01

    Objective: This pilot project, designed and taught by a resident, created a curriculum to introduce medical students to the practice of psychotherapy. Medical students who are knowledgeable about psychotherapy can become physicians who are able to refer patients to psychotherapeutic treatments. A search of the literature did not identify a…

  13. Internet-mediated psychotherapy: Are we ready for the ethical challenges?

    Science.gov (United States)

    Satalkar, Priya; Shrivastava, Shivanshu; Desousa, Avinash

    2015-01-01

    Advances in information and communication technology have facilitated the development of online psychotherapy. This form of psychotherapy would provide the developing world with better access to professional mental healthcare services. At the same time, it is prudent to carefully consider the various ethical, legal and regulatory issues involved in online psychotherapy. This paper highlights the major ethical issues involved in the use of online psychotherapy, whether conducted via e-mail, chat rooms or interactive video, and identifies practical solutions for the ethical dilemmas that exist. Many authors and organisations have expressed their opinions on the subject, but no consensus has evolved. The advice offered to psychologists is mostly skewed and the scarcity of literature available to those considering expanding their practice to include online psychotherapy is certainly a source of vexation. While reviewing the existing literature, this paper seeks to describe and discuss the major ethical issues in this area, particularly in India, but many of these issues will be equally applicable to any developing world settings.

  14. The role of cGMP signalling in regulating life cycle progression of Plasmodium.

    OpenAIRE

    Hopp, CS; Bowyer, PW; Baker, DA

    2012-01-01

    The 3′-5′-cyclic guanosine monophosphate (cGMP)-dependent protein kinase (PKG) is the main mediator of cGMP signalling in the malaria parasite. This article reviews the role of PKG in Plasmodium falciparum during gametogenesis and blood stage schizont rupture, as well as the role of the Plasmodium berghei orthologue in ookinete differentiation and motility, and liver stage schizont development. The current views on potential effector proteins downstream of PKG and the mechanisms that may regu...

  15. The role of cGMP signalling in regulating life cycle progression of Plasmodium.

    Science.gov (United States)

    Hopp, Christine S; Bowyer, Paul W; Baker, David A

    2012-08-01

    The 3'-5'-cyclic guanosine monophosphate (cGMP)-dependent protein kinase (PKG) is the main mediator of cGMP signalling in the malaria parasite. This article reviews the role of PKG in Plasmodium falciparum during gametogenesis and blood stage schizont rupture, as well as the role of the Plasmodium berghei orthologue in ookinete differentiation and motility, and liver stage schizont development. The current views on potential effector proteins downstream of PKG and the mechanisms that may regulate cyclic nucleotide levels are presented. Copyright © 2012 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

  16. PDE1A inhibition elicits cGMP-dependent relaxation of rat mesenteric arteries

    DEFF Research Database (Denmark)

    Khammy, Makhala Michell; Dalsgaard, Thomas; Larsen, Peter Hjorringgaard

    2017-01-01

    (EC50 = 32 nM). Inhibition of NOS with L-NAME, soluble GC with ODQ, or PKG with Rp-8-Br-PET-cGMP all attenuated PDE1 inhibition-induced relaxation, whereas PKA inhibition with H89 had no effect. CONCLUSION AND IMPLICATIONS: Pde1a was the dominant PDE1 isoform present in VSMC and relaxation mediated...... by PDE1A-inhibition was predominantly driven by enhanced cGMP signalling. These results imply that isoform-selective PDE1 inhibitors are powerful investigative tools allowing examination of physiological and pathological roles of PDE1 isoforms....

  17. Cyclic GMP-AMP displays mucosal adjuvant activity in mice.

    Directory of Open Access Journals (Sweden)

    Ivana Škrnjug

    Full Text Available The recently discovered mammalian enzyme cyclic GMP-AMP synthase produces cyclic GMP-AMP (cGAMP after being activated by pathogen-derived cytosolic double stranded DNA. The product can stimulate STING-dependent interferon type I signaling. Here, we explore the efficacy of cGAMP as a mucosal adjuvant in mice. We show that cGAMP can enhance the adaptive immune response to the model antigen ovalbumin. It promotes antigen specific IgG and a balanced Th1/Th2 lymphocyte response in immunized mice. A characteristic of the cGAMP-induced immune response is the slightly reduced induction of interleukin-17 as a hallmark of Th17 activity--a distinct feature that is not observed with other cyclic di-nucleotide adjuvants. We further characterize the innate immune stimulation activity in vitro on murine bone marrow-derived dendritic cells and human dendritic cells. The observed results suggest the consideration of cGAMP as a candidate mucosal adjuvant for human vaccines.

  18. Cyclic GMP-AMP displays mucosal adjuvant activity in mice.

    Science.gov (United States)

    Škrnjug, Ivana; Guzmán, Carlos Alberto; Rueckert, Christine; Ruecker, Christine

    2014-01-01

    The recently discovered mammalian enzyme cyclic GMP-AMP synthase produces cyclic GMP-AMP (cGAMP) after being activated by pathogen-derived cytosolic double stranded DNA. The product can stimulate STING-dependent interferon type I signaling. Here, we explore the efficacy of cGAMP as a mucosal adjuvant in mice. We show that cGAMP can enhance the adaptive immune response to the model antigen ovalbumin. It promotes antigen specific IgG and a balanced Th1/Th2 lymphocyte response in immunized mice. A characteristic of the cGAMP-induced immune response is the slightly reduced induction of interleukin-17 as a hallmark of Th17 activity--a distinct feature that is not observed with other cyclic di-nucleotide adjuvants. We further characterize the innate immune stimulation activity in vitro on murine bone marrow-derived dendritic cells and human dendritic cells. The observed results suggest the consideration of cGAMP as a candidate mucosal adjuvant for human vaccines.

  19. Psychotherapy, consciousness, and brain plasticity

    Directory of Open Access Journals (Sweden)

    Daniel eCollerton

    2013-09-01

    Full Text Available Purely psychological treatments for emotional distress produce lasting, measureable, and reproducible changes in cognitive and emotional consciousness and brain function. How these changes come about illustrates the interplay between brain and consciousness. Studies of the effects of psychotherapy highlight the holistic nature of consciousness. Pre and post treatment functional Magnetic Resonance Imaging localises the brain changes following psychotherapy to frontal, cingulate, and limbic circuits, but emphasise that these areas support a wide range of conscious experiences. Multivoxel Pattern Analysis of distributed changes in function across these brain areas may be able to provide the ability to distinguish between different states of consciousness.

  20. Antidepressant-like properties of sildenafil in a genetic rat model of depression: Role of cholinergic cGMP-interactions

    DEFF Research Database (Denmark)

    Liebenberg, Nico; Brink, Christiaan; Brand, Linda

    2008-01-01

    Background: The N-methyl-D-aspartate (NMDA)/nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway has been implicated in the neurobiology of depression. Recently we suggested a possible complex interaction between the cholinergic and NO-cGMP pathways in the antidepressant-like response....... Conclusions: Using a genetic animal model of depression, we have confirmed the antidepressant-like property of sildenafil following “unmasking” by concomitant block of muscarinic receptors. These findings hint at a novel interaction between the cGMP and cholinergic systems in depression, and suggest...

  1. Groups as a part of integrated treatment plans : Inpatient psychotherapy for outpatients?

    NARCIS (Netherlands)

    Staats, H

    2005-01-01

    Group psychotherapy in Germany is well established as part of an integrative treatment plan in inpatient treatment. Outpatient group psychotherapy, however, is conceptualized as a separate treatment option in competition with individual therapy. German guidelines for outpatient psychotherapy exclude

  2. A proposed impact assessment method for genetically modified plants (AS-GMP Method)

    International Nuclear Information System (INIS)

    Jesus-Hitzschky, Katia Regina Evaristo de; Silveira, Jose Maria F.J. da

    2009-01-01

    An essential step in the development of products based on biotechnology is an assessment of their potential economic impacts and safety, including an evaluation of the potential impact of transgenic crops and practices related to their cultivation on the environment and human or animal health. The purpose of this paper is to provide an assessment method to evaluate the impact of biotechnologies that uses quantifiable parameters and allows a comparative analysis between conventional technology and technologies using GMOs. This paper introduces a method to perform an impact analysis associated with the commercial release and use of genetically modified plants, the Assessment System GMP Method. The assessment is performed through indicators that are arranged according to their dimension criterion likewise: environmental, economic, social, capability and institutional approach. To perform an accurate evaluation of the GMP specific indicators related to genetic modification are grouped in common fields: genetic insert features, GM plant features, gene flow, food/feed field, introduction of the GMP, unexpected occurrences and specific indicators. The novelty is the possibility to include specific parameters to the biotechnology under assessment. In this case by case analysis the factors of moderation and the indexes are parameterized to perform an available assessment.

  3. The safety and efficacy of {+/-}3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study.

    Science.gov (United States)

    Mithoefer, Michael C; Wagner, Mark T; Mithoefer, Ann T; Jerome, Lisa; Doblin, Rick

    2011-04-01

    Case reports indicate that psychiatrists administered ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA as 'Ecstasy' resulted in its criminalization in 1985. Over two decades later, this study is the first completed clinical trial evaluating MDMA as a therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory to both psychotherapy and psychopharmacology, were randomly assigned to psychotherapy with concomitant active drug (n = 12) or inactive placebo (n = 8) administered during two 8-h experimental psychotherapy sessions. Both groups received preparatory and follow-up non-drug psychotherapy. The primary outcome measure was the Clinician-Administered PTSD Scale, administered at baseline, 4 days after each experimental session, and 2 months after the second session. Neurocognitive testing, blood pressure, and temperature monitoring were performed. After 2-month follow-up, placebo subjects were offered the option to re-enroll in the experimental procedure with open-label MDMA. Decrease in Clinician-Administered PTSD Scale scores from baseline was significantly greater for the group that received MDMA than for the placebo group at all three time points after baseline. The rate of clinical response was 10/12 (83%) in the active treatment group versus 2/8 (25%) in the placebo group. There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases. MDMA-assisted psychotherapy can be administered to posttraumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments.

  4. Aging has the opposite effect on cAMP and cGMP circadian variations in rat Leydig cells.

    Science.gov (United States)

    Baburski, Aleksandar Z; Sokanovic, Srdjan J; Andric, Silvana A; Kostic, Tatjana S

    2017-05-01

    The Leydig cell physiology displays a circadian rhythm driven by a complex interaction of the reproductive axis hormones and circadian system. The final output of this regulatory process is circadian pattern of steroidogenic genes expression and testosterone production. Aging gradually decreases robustness of rhythmic testosterone secretion without change in pattern of LH secretion. Here, we analyzed effect of aging on circadian variation of cAMP and cGMP signaling in Leydig cells. Results showed opposite effect of aging on cAMP and cGMP daily variation. Reduced amplitude of cAMP circadian oscillation was probably associated with changed expression of genes involved in cAMP production (increased circadian pattern of Adcy7, Adcy9, Adcy10 and decreased Adcy3); cAMP degradation (increased Pde4a, decreased Pde8b, canceled rhythm of Pde4d, completely reversed circadian pattern of Pde7b and Pde8a); and circadian expression of protein kinase A subunits (Prkac/PRKAC and Prkar2a). Aging stimulates expression of genes responsible for cGMP production (Nos2, Gucy1a3 and Gucy1b3/GUCYB3) and degradation (Pde5a, Pde6a and Pde6h) but the overall net effect is elevation of cGMP circadian oscillations in Leydig cells. In addition, the expression of cGMP-dependent kinase, Prkg1/PRKG1 is up-regulated. It seems that aging potentiate cGMP- and reduce cAMP-signaling in Leydig cells. Since both signaling pathways affect testosterone production and clockwork in the cells, further insights into these signaling pathways will help to unravel disorders linked to the circadian timing system, aging and reproduction.

  5. cGMP signalling : different ways to create a pathway

    NARCIS (Netherlands)

    Roelofs, Jeroen; Smith, Janet L.; Haastert, Peter J.M. van

    Recently, a novel cGMP signalling cascade was uncovered in Dictyostelium, a eukaryote that diverged from the lineage leading to metazoa after plants and before yeast. In both Dictyostelium and metazoa, the ancient cAMP-binding (cNB) motif of bacterial CAP has been modified and assembled with other

  6. The Overall Diagnosis: Psychodynamic Psychiatry, Six-Minute Psychotherapy, and Patient-Centered Care.

    Science.gov (United States)

    Weinberg, Elizabeth; Mintz, David

    2018-06-01

    Optimal patient care in psychiatry necessitates attention to the treatment relationship and to the patient's experience as an individual. The growth of patient-centered medicine has led to an increased appreciation of the importance of the biopsychosocial formulation, the personhood of both the patient and the physician, the autonomy and authority of the patient, and the therapeutic alliance. Patient-centered medicine, developed by the seminal psychoanalytic theorist Michael Balint, has its roots in psychodynamic concepts. A psychodynamic approach to psychopharmacology improves psychiatric prescribing, and guides the psychiatrist in providing brief, limited psychotherapy, similar to that which the Balints recommended in primary care practice. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Transforming psychotherapy in order to succeed with adolescent boys: male-friendly practices.

    Science.gov (United States)

    Kiselica, Mark S

    2003-11-01

    The purpose of this article is to describe a "male-friendly" therapeutic process with troubled adolescent boys. A male-friendly process is one in which the therapist employs a wide variety of strategies and activities that are likely to appeal to male youth and that facilitate the establishment and maintenance of rapport. The nuances of practicing a male-friendly approach are highlighted and then applied in a case study of psychotherapy with a depressed adolescent boy. The implications of this approach for redefining professional conceptions about boundaries in the client-therapist relationship and reexamining inaccurate stereotypes about the emotional lives of boys are discussed. Copyright 2003 Wiley Periodicals, Inc.

  8. Basurto-IGPP. A manual-directed approach of integrative group psychotherapy in psychosis.

    Science.gov (United States)

    Ruiz-Parra, Eduardo; González-Torres, M A; Eguiluz, I; de la Sierra, E; Trojaola, B; Catalán, A

    2010-01-01

    A manual on Integrative Group Psychotherapy for outpatients with schizophrenia and other psychoses (Basurto-PGIP) is presented. The model takes into account group specific therapeutic factors. It integrates influences from other integrative psychotherapeutic models, interpersonal group therapy, group analysis and recent developments in cognitive behavioural therapy for psychotic symptoms. The manual is structured in levels of different complexity that can be applied in a progressive manner. The intervention tries to adapt to patients features, therapists ability and training, and centres resources. It can be applied in two possible settings: a short term closed group and a long term open group. Advantages and disadvantages of the model are described.

  9. Baring the soul: Paul Bindrim, Abraham Maslow and 'nude psychotherapy'.

    Science.gov (United States)

    Nicholson, Ian

    2007-01-01

    Nude psychotherapy is one of the most flamboyant therapeutic techniques ever developed in American psychology. Largely forgotten today, the therapy was an academic and popular sensation upon its introduction in 1967. Developed by psychologist Paul Bindrim, the therapy promised to guide clients to their authentic selves through the systematic removal of clothing. This paper explores the intellectual, cultural and ethical context of nude therapy and its significance as a form of unchurched spirituality. Although nude therapy has an indisputable tabloid character, it is also rooted in a long-standing academic search for authenticity and ultimate meaning through science. Bindrim's career demonstrates the historically long-standing interweaving of spirituality and science within American psychology while simultaneously highlighting the field's extraordinary capacity for adaptive reinvention.

  10. [Psychotherapy of patients with personality disorders with predominance of hypochondria].

    Science.gov (United States)

    Burno, M E; Igovskaia, A S

    2008-01-01

    A standard of psychotherapeutic help to patients with hypochondriac disorder developed in paranoid, schizoid, anxiety and dependent personality disorders is worked out. In this case, hypochondria is inseparable from the personality structure. Patients of investigated group (61 people) received traditional medical treatment, individual differential symptomatic psychotherapy and a short group course with a variant of the therapy by means of creative sell-expression (TCSEB) worked out by M. Burno. This course aimed at preventing new hypochondriac symptoms and acquiring spiritual creative ways to overcome themselves. The control group (70 people) differed from the index-group by not receiving CSEB. A statistical analysis revealed a significant therapeutic efficacy of the mentioned new clinical psychotherapeutic standard compared to the psychotherapeutic tactics without TCSEB.

  11. In vitro and in vivo generation and characterization of Pseudomonas aeruginosa biofilm-dispersed cells via c-di-GMP manipulation

    DEFF Research Database (Denmark)

    Chua, Song Lin; Hultqvist, Louise D; Yuan, Mingjun

    2015-01-01

    Bis-(3'-5')-cyclic dimeric guanosine monophosphate (c-di-GMP) is a global secondary bacterial messenger that controls the formation of drug-resistant multicellular biofilms. Lowering the intracellular c-di-GMP content can disperse biofilms, and it is proposed as a biofilm eradication strategy...... biofilms by reducing the intracellular c-di-GMP content through modulation of phosphodiesterases (PDEs). Unlike conventional protocols that demonstrate biofilm dispersal by biomass quantification, our protocols enable physiological characterization of the dispersed cells. Biomarkers of dispersed cells...

  12. Clinical Considerations Regarding Regression in Psychotherapy with Patients with Conversion Disorder.

    Science.gov (United States)

    Kaplan, Marcia

    Regression is a ubiquitous phenomenon in psychodynamic psychotherapy and psychoanalysis, typically part of a reorganization that leads to progression, at least with respect to recruiting elements in the unconscious to consciousness. Regression in patients with conversion disorder (i.e., pseudo-neurological symptoms without an organic basis) is often itself somatic/physical rather than psychic in nature. Psychotherapists working with these patients must be prepared for confusing or frightening forms of regression that should be expected as part of the therapeutic process. In conversion disorder patients with adequate character structure, this regression, when handled effectively by the psychotherapist, ultimately leads to verbalized thoughts and feelings and a gradually strengthening alternative to physically experienced psychic conflict.

  13. Gametogenesis in malaria parasites is mediated by the cGMP-dependent protein kinase.

    Directory of Open Access Journals (Sweden)

    Louisa McRobert

    2008-06-01

    Full Text Available Malaria parasite transmission requires differentiation of male and female gametocytes into gametes within a mosquito following a blood meal. A mosquito-derived molecule, xanthurenic acid (XA, can trigger gametogenesis, but the signalling events controlling this process in the human malaria parasite Plasmodium falciparum remain unknown. A role for cGMP was revealed by our observation that zaprinast (an inhibitor of phosphodiesterases that hydrolyse cGMP stimulates gametogenesis in the absence of XA. Using cGMP-dependent protein kinase (PKG inhibitors in conjunction with transgenic parasites expressing an inhibitor-insensitive mutant PKG enzyme, we demonstrate that PKG is essential for XA- and zaprinast-induced gametogenesis. Furthermore, we show that intracellular calcium (Ca2+ is required for differentiation and acts downstream of or in parallel with PKG activation. This work defines a key role for PKG in gametogenesis, elucidates the hierarchy of signalling events governing this process in P. falciparum, and demonstrates the feasibility of selective inhibition of a crucial regulator of the malaria parasite life cycle.

  14. Effects of trauma-focused psychotherapy upon war refugees.

    Science.gov (United States)

    Kruse, Johannes; Joksimovic, Ljiljana; Cavka, Majda; Wöller, Wolfgang; Schmitz, Norbert

    2009-12-01

    The aim of this study is to evaluate the effects of a trauma-focused psychotherapy upon war refugees from Bosnia. Seventy refugees who met the criteria for posttraumatic stress disorder (PTSD) and somatoform disorders were included. The first 35 refugees were offered psychotherapy and the following 35 refugees received usual care. Outcome variables were changes in self-reported PTSD symptoms, psychological symptoms, and health status. At 12-month follow-up, participants in the intervention group reported significantly lower scores on the PTSD scale and the measure of psychological symptoms than the comparison group participants. Our results suggest that psychotherapy reduces symptoms of PTSD and somatoform disorders among war refugees even in the presence of insecure residence status.

  15. Specific GMP guidelines for radiopharmaceutical products

    International Nuclear Information System (INIS)

    2000-01-01

    These guidelines are intended to complement those provided in ''Good manufacturing practices for pharmaceutical products'', as well as the GMP for sterile pharmaceutical products. The regulatory procedures necessary to control radiopharmaceutical products are in large part determined by the sources of products and methods of manufacture. Manufacturing procedures within the scope of these guidelines include: preparation of radiopharmaceuticals in hospital radiopharmacies, preparation of radiopharmaceuticals in centralized radiopharmacies, production of radiopharmaceuticals in nuclear centres, institutes or industrial manufacturers, preparation and production of radiopharmaceuticals in Positron Emission Tomography (PET) centres

  16. Clearance of Pseudomonas aeruginosa Foreign-Body Biofilm Infections through Reduction of the Cyclic Di-GMP Level in the Bacteria

    DEFF Research Database (Denmark)

    Christensen, Louise D.; van Gennip, Maria; Rybtke, Morten Theil

    2013-01-01

    Opportunistic pathogenic bacteria can engage in biofilm-based infections that evade immune responses and develop into chronic conditions. Because conventional antimicrobials cannot efficiently eradicate biofilms, there is an urgent need to develop alternative measures to combat biofilm infections....... It has recently been established that the secondary messenger cyclic diguanosine monophosphate (c-di-GMP) functions as a positive regulator of biofilm formation in several different bacteria. In the present study we investigated whether manipulation of the c-di-GMP level in bacteria potentially can...... be used for biofilm control in vivo. We constructed a Pseudomonas aeruginosa strain in which a reduction in the c-di-GMP level can be achieved via induction of the Escherichia coli YhjH c-di-GMP phosphodiesterase. Initial experiments showed that induction of yhjH expression led to dispersal...

  17. Now that you want to take your HIV/AIDS vaccine/biological product research concept into the clinic: what are the "cGMP"?

    Science.gov (United States)

    Sheets, Rebecca L; Rangavajhula, Vijaya; Pullen, Jeffrey K; Butler, Chris; Mehra, Vijay; Shapiro, Stuart; Pensiero, Michael

    2015-04-08

    The Division of AIDS Vaccine Research Program funds the discovery and development of HIV/AIDS vaccine candidates. Basic researchers, having discovered a potential vaccine in the laboratory, next want to take that candidate into the clinic to test the concept in humans, to see if it translates. Many of them have heard of "cGMP" and know that they are supposed to make a "GMP product" to take into the clinic, but often they are not very familiar with what "cGMP" means and why these good practices are so important. As members of the Vaccine Translational Research Branch, we frequently get asked "can't we use the material we made in the lab in the clinic?" or "aren't Phase 1 studies exempt from cGMP?" Over the years, we have had many experiences where researchers or their selected contract manufacturing organizations have not applied an appropriate degree of compliance with cGMP suitable for the clinical phase of development. We share some of these experiences and the lessons learned, along with explaining the importance of cGMP, just what cGMP means, and what they can assure, in an effort to de-mystify this subject and facilitate the rapid and safe translational development of HIV vaccines. Published by Elsevier Ltd.

  18. Identification of the gamma subunit-interacting residues on photoreceptor cGMP phosphodiesterase, PDE6alpha '.

    Science.gov (United States)

    Granovsky, A E; Artemyev, N O

    2000-12-29

    Photoreceptor cGMP phosphodiesterase (PDE6) is the effector enzyme in the G protein-mediated visual transduction cascade. In the dark, the activity of PDE6 is shut off by the inhibitory gamma subunit (Pgamma). Chimeric proteins between cone PDE6alpha' and cGMP-binding and cGMP-specific PDE (PDE5) have been constructed and expressed in Sf9 cells to study the mechanism of inhibition of PDE6 catalytic activity by Pgamma. Substitution of the segment PDE5-(773-820) by the corresponding PDE6alpha'-(737-784) sequence in the wild-type PDE5 or in a PDE5/PDE6alpha' chimera containing the catalytic domain of PDE5 results in chimeric enzymes capable of inhibitory interaction with Pgamma. The catalytic properties of the chimeric PDEs remained similar to those of PDE5. Ala-scanning mutational analysis of the Pgamma-binding region, PDE6alpha'-(750-760), revealed PDE6alpha' residues essential for the interaction. The M758A mutation markedly impaired and the Q752A mutation moderately impaired the inhibition of chimeric PDE by Pgamma. The analysis of the catalytic properties of mutant PDEs and a model of the PDE6 catalytic domain suggest that residues Met(758) and Gln(752) directly bind Pgamma. A model of the PDE6 catalytic site shows that PDE6alpha'-(750-760) forms a loop at the entrance to the cGMP-binding pocket. Binding of Pgamma to Met(758) would effectively block access of cGMP to the catalytic cavity, providing a structural basis for the mechanism of PDE6 inhibition.

  19. Differential Contribution of the Guanylyl Cyclase-Cyclic GMP-Protein Kinase G Pathway to the Proliferation of Neural Stem Cells Stimulated by Nitric Oxide

    Directory of Open Access Journals (Sweden)

    Bruno P. Carreira

    2012-02-01

    Full Text Available Nitric oxide (NO is an important inflammatory mediator involved in the initial boost in the proliferation of neural stem cells following brain injury. However, the mechanisms underlying the proliferative effect of NO are still unclear. The aim of this work was to investigate whether cyclic GMP (cGMP and the cGMP-dependent kinase (PKG are involved in the proliferative effect triggered by NO in neural stem cells. For this purpose, cultures of neural stem cells isolated from the mouse subventricular zone (SVZ were used. We observed that long-term exposure to the NO donor (24 h, NOC-18, increased the proliferation of SVZ cells in a cGMP-dependent manner, since the guanylate cyclase inhibitor, ODQ, prevented cell proliferation. Similarly to NOC-18, the cGMP analogue, 8-Br-cGMP, also increased cell proliferation. Interestingly, shorter exposures to NO (6 h increased cell proliferation in a cGMP-independent manner via the ERK/MAP kinase pathway. The selective inhibitor of PKG, KT5823, prevented the proliferative effect induced by NO at 24 h but not at 6 h. In conclusion, the proliferative effect of NO is initially mediated by the ERK/MAPK pathway, and at later stages by the GC/cGMP/PKG pathway. Thus, our work shows that NO induces neural stem cell proliferation by targeting these two pathways in a biphasic manner.

  20. The role of cGMP as a mediator of lipolysis in bovine oocytes and its effects on embryo development and cryopreservation.

    Directory of Open Access Journals (Sweden)

    Kátia R L Schwarz

    Full Text Available This study aimed to determine the influence of cyclic guanosine 3'5'-monophosphate (cGMP and cGMP-dependent kinase (PKG during in vitro maturation (IVM on lipolysis-related parameters in bovine cumulus-oocyte complexes (COCs, and on embryo development and cryosurvival. COCs were matured with cGMP/PKG modulators and assessed for metaphase II rates (MII, cGMP levels, lipid content in oocytes (OO, transcript abundance for genes involved in lipolysis (ATGL and lipid droplets (PLIN2 in cumulus cells (CC and OO, and presence of phosphorylated (active hormone sensitive lipase (HSLser563 in OO. Embryo development, lipid contents and survival to vitrification were also assessed. Phosphodiesterase 5 inhibition (PDE5; cGMP-hydrolyzing enzyme with 10-5M sildenafil (SDF during 24 h IVM increased cGMP in COCs (56.9 vs 9.5 fMol/COC in untreated controls, p<0.05 and did not affect on maturation rate (84.3±6.4% MII. Fetal calf serum (FCS in IVM medium decreased cGMP in COCs compared to bovine serum albumin (BSA + SDF (19.6 vs 66.5 fMol/COC, respectively, p<0.05. FCS increased lipid content in OO (40.1 FI, p<0.05 compared to BSA (34.6 FI, while SDF decreased (29.8 and 29.6 FI, with BSA or FCS, respectively p<0.05. PKG inhibitor (KT5823 reversed this effect (38.9 FI, p<0.05. ATGL and PLIN2 transcripts were detected in CC and OO, but were affected by cGMP and PKG only in CC. HSLser563 was detected in OO matured with or without modulators. Reduced lipid content in embryos were observed only when SDF was added during IVM and IVC (27.6 FI compared to its use in either or none of the culture periods (34.2 FI, p<0.05. Survival to vitrification was unaffected by SDF. In conclusion, cGMP and PKG are involved in lipolysis in OO and possibly in CC and embryos; serum negatively affects this pathway, contributing to lipid accumulation, and cGMP modulation may reduce lipid contents in oocytes and embryos, but without improving embryo cryotolerance.

  1. Clinical application of combined detection of serum hs-CRP, GMP-140 and cTnI in patients with coronary heart diseases

    International Nuclear Information System (INIS)

    Qin Jibao; Wu Zhaozeng

    2010-01-01

    Objective: To explore the clinical significance of changes of serum hs-CRP, GMP-140 and cTnI levels in patients with coronary heart diseases. Methods: Serum GMP-140 (with RIA), cTnI (with ELISA) and hs-CRP (with immuno turbidity method) levels were determined in 91 patients with coronary heart diseases (42 SAP, 34UAP, 15AMI) and 35 controls. Results: Serum hs-CRP, GMP-140, cTnI levels in patients with coronary heart diseases were significantly higher than those in controls (P <0.01). Among the patients with of coronary heart diseases, the magnitude of changes of the levels of serum hs-CRP, GMP-140 and cTnI levels in AMI and UAP groups were significantly larger than those in SAP group (P < 0.05). Serum hs-CRP levels were positively correlated with serum GMP-140 and cTnI levels (r = 0.6214, 0.6023, P < 0.01). Conclusion: Serum hs-CRP, GMP140 and cTnI levels were closely related to the diseases process of coronary heart diseases and were of great clinical importance for assessment of the disease and outcome prediction. (authors)

  2. [Utilization of self-help groups and psychotherapy after psychosomatic-psychotherapeutic in-patient treatment].

    Science.gov (United States)

    Höflich, Anke; Matzat, Jürgen; Meyer, Friedhelm; Knickenberg, Rudolf J; Bleichner, Franz; Merkle, Wolfgang; Reimer, Christian; Franke, Wolfram; Beutel, Manfred E

    2007-05-01

    Until now little is known about the role of participation in self-help groups alone or combined with psychotherapy in post-in-patient care. In the present study 2933 patients were questioned about their experience of self-help groups and psychotherapy after discharge from a clinic for psychosomatic medicine and psychotherapy. Nearly 8 % of them utilized self-help groups (mostly combined with out-patient psychotherapy), and altogether 68 % out-patient psychotherapy following in-patient treatment. Patients without out-patient treatment were psychologically less burdened and had better resources than participants of self-help groups or psychotherapy. Self-help group members differed from patients in out-patient psychotherapy by expressing a more positive opinion of groupwork and higher openness to new experiences. Additionly, they had discussed the topic of self-help groups more frequently with their therapists. This may be a starting-point for promoting more self-help activities of patients in the future.

  3. Biophysical Techniques for Detection of cAMP and cGMP in Living Cells

    Directory of Open Access Journals (Sweden)

    Viacheslav O. Nikolaev

    2013-04-01

    Full Text Available Cyclic nucleotides cAMP and cGMP are ubiquitous second messengers which regulate myriads of functions in virtually all eukaryotic cells. Their intracellular effects are often mediated via discrete subcellular signaling microdomains. In this review, we will discuss state-of-the-art techniques to measure cAMP and cGMP in biological samples with a particular focus on live cell imaging approaches, which allow their detection with high temporal and spatial resolution in living cells and tissues. Finally, we will describe how these techniques can be applied to the analysis of second messenger dynamics in subcellular signaling microdomains.

  4. A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy.

    Science.gov (United States)

    Berghout, Caspar C; Zevalkink, Jolien; Hakkaart-van Roijen, Leona

    2010-01-01

    Despite the considerable and growing body of research about the clinical effectiveness of long-term psychoanalytic treatment, relatively little attention has been paid to economic evaluations, particularly with reference to the broader range of societal effects. In this cost-utility study, we examined the incremental cost-effectiveness ratio (ICER) of psychoanalysis versus psychoanalytic psychotherapy. Incremental costs and effects were estimated by means of cross-sectional measurements in a cohort design (psychoanalysis, n = 78; psychoanalytic psychotherapy, n = 104). Quality-adjusted life-years (QALYs) were estimated for each treatment strategy using the SF-6D. Total costs were calculated from a societal perspective (treatment costs plus other societal costs) and discounted at 4 percent. Psychoanalysis was more costly than psychoanalytic psychotherapy, but also more effective from a health-related quality of life perspective. The ICER--that is, the extra costs to gain one additional QALY by delivering psychoanalysis instead of psychoanalytic psychotherapy--was estimated at 52,384 euros per QALY gained. Our findings show that the cost-utility ratio of psychoanalysis relative to psychoanalytic psychotherapy is within an acceptable range. More research is needed to find out whether cost-utility ratios vary with different types of patients. We also encourage cost-utility analyses comparing psychoanalytic treatment to other forms of (long-term) treatment.

  5. Topoisomerase 1 Inhibition Promotes Cyclic GMP-AMP Synthase-Dependent Antiviral Responses.

    Science.gov (United States)

    Pépin, Geneviève; Nejad, Charlotte; Ferrand, Jonathan; Thomas, Belinda J; Stunden, H James; Sanij, Elaine; Foo, Chwan-Hong; Stewart, Cameron R; Cain, Jason E; Bardin, Philip G; Williams, Bryan R G; Gantier, Michael P

    2017-10-03

    Inflammatory responses, while essential for pathogen clearance, can also be deleterious to the host. Chemical inhibition of topoisomerase 1 (Top1) by low-dose camptothecin (CPT) can suppress transcriptional induction of antiviral and inflammatory genes and protect animals from excessive and damaging inflammatory responses. We describe the unexpected finding that minor DNA damage from topoisomerase 1 inhibition with low-dose CPT can trigger a strong antiviral immune response through cyclic GMP-AMP synthase (cGAS) detection of cytoplasmic DNA. This argues against CPT having only anti-inflammatory activity. Furthermore, expression of the simian virus 40 (SV40) large T antigen was paramount to the proinflammatory antiviral activity of CPT, as it potentiated cytoplasmic DNA leakage and subsequent cGAS recruitment in human and mouse cell lines. This work suggests that the capacity of Top1 inhibitors to blunt inflammatory responses can be counteracted by viral oncogenes and that this should be taken into account for their therapeutic development. IMPORTANCE Recent studies suggest that low-dose DNA-damaging compounds traditionally used in cancer therapy can have opposite effects on antiviral responses, either suppressing (with the example of CPT) or potentiating (with the example of doxorubicin) them. Our work demonstrates that the minor DNA damage promoted by low-dose CPT can also trigger strong antiviral responses, dependent on the presence of viral oncogenes. Taken together, these results call for caution in the therapeutic use of low-dose chemotherapy agents to modulate antiviral responses in humans. Copyright © 2017 Pépin et al.

  6. The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study

    Science.gov (United States)

    Mithoefer, Michael C; Wagner, Mark T; Mithoefer, Ann T; Jerome, Lisa; Doblin, Rick

    2011-01-01

    Case reports indicate that psychiatrists administered ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy before recreational use of MDMA as ‘Ecstasy’ resulted in its criminalization in 1985. Over two decades later, this study is the first completed clinical trial evaluating MDMA as a therapeutic adjunct. Twenty patients with chronic posttraumatic stress disorder, refractory to both psychotherapy and psychopharmacology, were randomly assigned to psychotherapy with concomitant active drug (n = 12) or inactive placebo (n = 8) administered during two 8-h experimental psychotherapy sessions. Both groups received preparatory and follow-up non-drug psychotherapy. The primary outcome measure was the Clinician-Administered PTSD Scale, administered at baseline, 4 days after each experimental session, and 2 months after the second session. Neurocognitive testing, blood pressure, and temperature monitoring were performed. After 2-month follow-up, placebo subjects were offered the option to re-enroll in the experimental procedure with open-label MDMA. Decrease in Clinician-Administered PTSD Scale scores from baseline was significantly greater for the group that received MDMA than for the placebo group at all three time points after baseline. The rate of clinical response was 10/12 (83%) in the active treatment group versus 2/8 (25%) in the placebo group. There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases. MDMA-assisted psychotherapy can be administered to posttraumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments. PMID:20643699

  7. Depressed patients’ preferences for type of psychotherapy: a preliminary study

    Directory of Open Access Journals (Sweden)

    Yrondi A

    2015-09-01

    Full Text Available Antoine Yrondi,1 Julie Rieu,1 Claire Massip,1 Vanina Bongard,2 Laurent Schmitt1 1Department of Psychiatry and Medical Psychology, 2Public Health Service, CHU Toulouse, Toulouse, France Background: The treatment recommendations for depressed patients by the American Psychiatric Association encourage a focus on the patient’s preferences. The focus of this study was the preference of depressed inpatients for the type of psychotherapy. Methods: Twenty-nine subjects of both sexes who were hospitalized with a major depressive episode were interviewed at 5-day intervals with the same questions after the depressive episode resolved, as indicated by a score less than 7 on the Hamilton Depression Rating Scale (HDRS. The selection of items was performed by expert consensus. Results: The supportive psychotherapy scores were the highest, followed by psychodynamic psychotherapy and cognitive behavioral therapy. The two sessions conducted at 5-day intervals showed no significant difference, which reflected the stability of choices and preferences of patients. Conclusion: In this study, the patients preferred supportive psychotherapy as first-line therapy compared to psychodynamic psychotherapy and cognitive behavioral therapy. Keywords: depression, depressive disorder, psychodynamic psychotherap, supportive psychotherapy, cognitive behavioral therapy

  8. Psychotherapy in psychiatry: the current situation and future directions in Germany.

    Science.gov (United States)

    Schnell, Knut; Herpertz, Sabine C

    2011-11-01

    The aim of this article is to review how psychotherapy is dispensed to patients in psychiatric treatment and to render the future perspectives of psychotherapy in psychiatric outpatient and inpatient care in Germany. We demonstrate that--according to the currently available data about healthcare providers, allocation of financial resources and curricular regulations--the presently used definition of the term "psychotherapy" is ambiguous. One major problem for the application of psychotherapy in psychiatry is obviously constituted by the dominance of the major guideline therapies ("Richtlinienverfahren") within psychiatric services. Here, guideline therapies do not meet the needs of a significant proportion of acutely, severely and/or chronically ill psychiatric patients and restrain the application of scientifically approved, disorder-oriented and context compliant interventions in psychiatric practice. As a future perspective, we suggest that the training of psychiatrists should impart profound interpersonal skills and provide the competence to offer psychotherapy within a multimodal, modular, and flexible treatment plan on the background of the self-conception of psychiatry as a medical discipline. Moreover, future concepts of psychiatric psychotherapy should promote an evidence-based selection and application of scientifically approved, disorder-oriented, and integrative treatment methods, which are available in growing number.

  9. Nitric oxide-soluble guanylyl cyclase-cyclic GMP signaling in the striatum: New targets for the treatment of Parkinson's disease?

    Directory of Open Access Journals (Sweden)

    Anthony R West

    2011-06-01

    Full Text Available Striatal nitric oxide (NO-producing interneurons play an important role in the regulation of corticostriatal synaptic transmission and motor behavior. Striatal NO synthesis is driven by concurrent activation of NMDA and dopamine (DA D1 receptors. NO diffuses into the dendrites of medium-sized spiny neurons (MSNs which contain high levels of NO receptors called soluble guanylyl cyclases (sGC. NO-mediated activation of sGC leads to the synthesis of the second messenger cGMP. In the intact striatum, transient elevations in intracellular cGMP primarily act to increase neuronal excitability and to facilitate glutamatergic corticostriatal transmission. NO-cGMP signaling also functionally opposes the inhibitory effects of DA D2 receptor activation on corticostriatal transmission. Not surprisingly, abnormal striatal NO-sGC-cGMP signaling becomes apparent following striatal DA depletion, an alteration thought to contribute to pathophysiological changes observed in basal ganglia circuits in Parkinson’s disease (PD. Here, we discuss recent developments in the field which have shed light on the role of NO-sGC-cGMP signaling pathways in basal ganglia dysfunction and motor symptoms associated with PD and L-DOPA-induced dyskinesias.

  10. Optogenetic manipulation of cGMP in cells and animals by the tightly light-regulated guanylyl-cyclase opsin CyclOp.

    Science.gov (United States)

    Gao, Shiqiang; Nagpal, Jatin; Schneider, Martin W; Kozjak-Pavlovic, Vera; Nagel, Georg; Gottschalk, Alexander

    2015-09-08

    Cyclic GMP (cGMP) signalling regulates multiple biological functions through activation of protein kinase G and cyclic nucleotide-gated (CNG) channels. In sensory neurons, cGMP permits signal modulation, amplification and encoding, before depolarization. Here we implement a guanylyl cyclase rhodopsin from Blastocladiella emersonii as a new optogenetic tool (BeCyclOp), enabling rapid light-triggered cGMP increase in heterologous cells (Xenopus oocytes, HEK293T cells) and in Caenorhabditis elegans. Among five different fungal CyclOps, exhibiting unusual eight transmembrane topologies and cytosolic N-termini, BeCyclOp is the superior optogenetic tool (light/dark activity ratio: 5,000; no cAMP production; turnover (20 °C) ∼17 cGMP s(-1)). Via co-expressed CNG channels (OLF in oocytes, TAX-2/4 in C. elegans muscle), BeCyclOp photoactivation induces a rapid conductance increase and depolarization at very low light intensities. In O2/CO2 sensory neurons of C. elegans, BeCyclOp activation evokes behavioural responses consistent with their normal sensory function. BeCyclOp therefore enables precise and rapid optogenetic manipulation of cGMP levels in cells and animals.

  11. Psychotherapy for Suicidal Clients.

    Science.gov (United States)

    Lester, David

    1994-01-01

    Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

  12. Using Media to Teach How Not to Do Psychotherapy

    Science.gov (United States)

    Gabbard, Glen; Horowitz, Mardi

    2010-01-01

    Objective: This article describes how using media depictions of psychotherapy may help in teaching psychiatric residents. Methods: Using the HBO series "In Treatment" as a model, the authors suggest how boundary transgressions and technical errors may inform residents about optimal psychotherapeutic approaches. Results: The psychotherapy vignettes…

  13. Advancing psychotherapy and evidence-based psychological interventions.

    Science.gov (United States)

    Emmelkamp, Paul M G; David, Daniel; Beckers, Tom; Muris, Peter; Cuijpers, Pim; Lutz, Wolfgang; Andersson, Gerhard; Araya, Ricardo; Banos Rivera, Rosa M; Barkham, Michael; Berking, Matthias; Berger, Thomas; Botella, Christina; Carlbring, Per; Colom, Francesc; Essau, Cecilia; Hermans, Dirk; Hofmann, Stefan G; Knappe, Susanne; Ollendick, Thomas H; Raes, Filip; Rief, Winfried; Riper, Heleen; Van Der Oord, Saskia; Vervliet, Bram

    2014-01-01

    Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom-based mental disorders as a result. (2) Psychotherapy research still lacks a comprehensive conceptual framework that brings together the wide variety of findings, models and perspectives. Analysing the state-of-the-art in psychotherapy treatment research, "component analyses" aiming at an optimal identification of core ingredients and the mechanisms of change is highlighted as the core need towards improved efficacy and effectiveness of psychotherapy, and improved translation to routine care. (3) In order to provide more effective psychological interventions to children and adolescents, there is a need to develop new and/or improved psychotherapeutic interventions on the basis of developmental psychopathology research taking into account knowledge of mediators and moderators. Developmental neuroscience research might be instrumental to uncover associated aberrant brain processes in children and adolescents with mental health problems and to better examine mechanisms of their correction by means of psychotherapy and psychological interventions. (4) Psychotherapy research needs to broaden in terms of adoption of large-scale public health strategies and treatments that can be applied to more patients in a simpler and cost-effective way. Increased research on efficacy and moderators of Internet-based treatments and e-mental health tools (e.g. to support

  14. Animal-assisted therapy with chronic psychiatric inpatients: equine-assisted psychotherapy and aggressive behavior.

    Science.gov (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Shaffer, Thomas M; Yellin, Mary; Desai, Prital J; Amin, Ruchi; Bouchard, Axel; Montalvo, Cristina

    2015-01-01

    Animal-assisted therapy (AAT), most frequently used with dogs, is being used increasingly as an adjunctive alternative treatment for psychiatric patients. AAT with larger animals, such as horses, may have unique benefits. In this randomized controlled study, equine and canine forms of AAT were compared with standard treatments for hospitalized psychiatric patients to determine AAT effects on violent behavior and related measures. The study included 90 patients with recent in-hospital violent behavior or highly regressed behavior. Hospitalization at the 500-bed state psychiatric hospital was two months or longer (mean 5.4 years). Participants were randomly selected to receive ten weekly group therapy sessions of standardized equine-assisted psychotherapy (EAP), canine-assisted psychotherapy (CAP), enhanced social skills psychotherapy, or regular hospital care. Participants' mean age was 44, 37% were female, 76% had diagnoses of schizophrenia or schizoaffective disorder, and 56% had been committed involuntarily for civil or forensic reasons. Violence-related incident reports filed by staff in the three months after study intake were compared with reports two months preintake. Interventions were well tolerated. Analyses revealed an intervention group effect (F=3.00, df=3 and 86, p=.035); post hoc tests showed specific benefits of EAP (p<.05). Similar AAT effects were found for the incidence of 1:1 clinical observation (F=2.70, df=3 and 86, p=.051); post hoc tests suggested benefits of CAP (p=.058) as well as EAP (p=.082). Covariance analyses indicated that staff can predict which patients are likely to benefit from EAP (p=.01). AAT, and perhaps EAP uniquely, may be an effective therapeutic modality for long-term psychiatric patients at risk of violence.

  15. Psychotherapy and Cognitive Behavioral Therapy Supervision in Danish Psychiatry: Training the Next Generation of Psychiatrists.

    Science.gov (United States)

    Schmidt, Lasse M; Foli-Andersen, Nina J

    2017-02-01

    Psychotherapy training is mandatory for physicians to qualify as psychiatrists in Denmark. Evidence for the effectiveness of psychotherapy has increased, and psychotherapy is increasingly included in international treatment guidelines. The authors investigated how psychiatrists in training in Denmark evaluate the opportunities to practice psychotherapy in their training and the quality of the supervision they receive in psychotherapy training, particularly for cognitive behavioral therapy (CBT). The authors conducted a survey regarding psychotherapy training and CBT supervision among psychiatrists in training at Danish psychiatric specialist training courses. They investigated respondents' interest and experience in psychotherapy and respondents' views on the relevance and feasibility of performing psychotherapy and receiving supervision in their psychiatry training. Eighty-eight percent of the psychiatrists in training found psychotherapy to be a relevant part of their training; however, 77 % found it difficult to find time to practice psychotherapy and 44 % felt that practicing psychotherapy was a strain on their employer. Thirty-six percent and 53 %, respectively, had difficulties securing psychodynamic and CBT supervision. In CBT supervision, more than 60 % reported supervision that appeared to be below the expected CBT supervision standard and often so much below it might not qualify as CBT supervision. There is a need to focus on how to better integrate psychotherapy and supervision in the Danish psychiatric training program. Good CBT supervision may be lacking, and a way to ensure high-quality supervision is required.

  16. The current status of psychotherapy | Gureje | West African Journal ...

    African Journals Online (AJOL)

    A fundamental understanding about the mechanisms of action of psychotherapy is a promising new development that is emanating from modern techniques of neurosciences and neuroimaging. Whether such understanding will lead to a renaissance in the clinical utility of psychotherapy is still early to say. However, there is ...

  17. Effects of Transference Work in the Context of Therapeutic Alliance and Quality of Object Relations

    Science.gov (United States)

    Hoglend, Per; Hersoug, Anne Grete; Bogwald, Kjell-Petter; Amlo, Svein; Marble, Alice; Sorbye, Oystein; Rossberg, Jan Ivar; Ulberg, Randi; Gabbard, Glen O.; Crits-Christoph, Paul

    2011-01-01

    Objective: Transference interpretation is considered as a core active ingredient in dynamic psychotherapy. In common clinical theory, it is maintained that more mature relationships, as well as a strong therapeutic alliance, may be prerequisites for successful transference work. In this study, the interaction between quality of object relations,…

  18. Psychotherapy and Women's Liberation

    Science.gov (United States)

    Holroyd, Jean

    1976-01-01

    Personality theories and scientific data on women frequently contribute negatively to the psychotherapy of female clients. This paper examines some of the background factors which have shaped our information about women, and then reviews some contemporaneous approaches to the therapy of women. (Author)

  19. Benefits of Combining Massage Therapy with Group Interpersonal Psychotherapy in Prenatally Depressed Women

    OpenAIRE

    Field, Tiffany; Deeds, Osvelia; Diego, Miguel; Hernandez-Reif, Maria; Gauler, Andy; Sullivan, Susan; Wilson, Donna; Nearing, Graciela

    2009-01-01

    One hundred twelve pregnant women who were diagnosed depressed were randomly assigned to a group who received group Interpersonal Psychotherapy or to a group who received both group Interpersonal Psychotherapy and massage therapy. The group Interpersonal Psychotherapy (one hour sessions) and massage therapy (30 minute sessions) were held once per week for six weeks. The data suggested that the group who received psychotherapy plus massage attended more sessions on average, and a greater perce...

  20. Identification, activity and disulfide connectivity of C-di-GMP regulating proteins in Mycobacterium tuberculosis.

    Directory of Open Access Journals (Sweden)

    Kajal Gupta

    2010-11-01

    Full Text Available C-di-GMP, a bacterial second messenger plays a key role in survival and adaptation of bacteria under different environmental conditions. The level of c-di-GMP is regulated by two opposing activities, namely diguanylate cyclase (DGC and phosphodiesterase (PDE-A exhibited by GGDEF and EAL domain, respectively in the same protein. Previously, we reported a bifunctional GGDEF-EAL domain protein, MSDGC-1 from Mycobacterium smegmatis showing both these activities (Kumar and Chatterji, 2008. In this current report, we have identified and characterized the homologous protein from Mycobacterium tuberculosis (Rv 1354c named as MtbDGC. MtbDGC is also a bifunctional protein, which can synthesize and degrade c-di-GMP in vitro. Further we expressed Mtbdgc in M. smegmatis and it was able to complement the MSDGC-1 knock out strain by restoring the long term survival of M. smegmatis. Another protein Rv 1357c, named as MtbPDE, is an EAL domain protein and degrades c-di-GMP to pGpG in vitro. Rv1354c and 1357c have seven cysteine amino acids in their sequence, distributed along the full length of the protein. Disulfide bonds play an important role in stabilizing protein structure and regulating protein function. By proteolytic digestion and mass spectrometric analysis of MtbDGC, connectivity between cysteine pairs Cys94-Cys584, Cys2-Cys479 and Cys429-Cys614 was determined, whereas the third cysteine (Cys406 from N terminal was found to be free in MtbDGC protein, which was further confirmed by alkylation with iodoacetamide labeling. Bioinformatics modeling investigations also supported the pattern of disulfide connectivity obtained by Mass spectrometric analysis. Cys406 was mutated to serine by site directed mutagenesis and the mutant MtbC406S was not found to be active and was not able to synthesize or degrade c-di-GMP. The disulfide connectivity established here would help further in understanding the structure - function relationship in MtbDGC.

  1. Paranoia and psychotic process: some clinical applications of projective identification in psychoanalytic psychotherapy.

    Science.gov (United States)

    Sweet, Alistair D

    2010-01-01

    The concept of projective identification has, since its introduction by Melanie Klein over half a century ago, caused much controversy amongst psychoanalysts and psychotherapists. In this paper the author traces some of the key theoretical developments of the concept since its introduction in 1946, including: normal and pathological projective identification, aspects of symbolisation and projective identification as an intrapsychic mechanism. An extended case report of a patient in weekly psychoanalytic psychotherapy is offered in order to expand upon some of the theoretical ideas previously considered. Emphasis is placed on the patient's use of intrapsychic projective mechanisms and the emergence and mutation of such mechanisms in the therapeutic relationship.

  2. Research on psychotherapy integration: building on the past, looking to the future.

    Science.gov (United States)

    Castonguay, Louis G; Eubanks, Catherine F; Goldfried, Marvin R; Muran, J Christopher; Lutz, Wolfgang

    2015-01-01

    Integration has become an important and influential movement within psychotherapy practice, reflected by the fact that many treatment providers now identify as integrative. However, integration has not had as great an influence on psychotherapy research. The goal of this paper is to highlight the growing body of research on psychotherapy integration, and to identify future directions for research that may strengthen the integration movement as well as the field of psychotherapy as a whole. We first summarize the past 25 years of research on integration, with a focus on four approaches to integration: theoretical integration, technical eclectic, common factors, and assimilative integration. Next, we identify directions of research within these four areas that could strengthen and support integrative practice. We then propose ways in which the perspective of integrationists could contribute to psychotherapy research in the critical areas of harmful effects, therapist effects, practice-oriented research, and training. We end this paper by suggesting that a greater collaboration between integrationists and psychotherapy researchers will help to create a unified landscape of knowledge and action that will benefit all participants and advance the field.

  3. Meaning in life in psychotherapy: The perspective of experienced psychotherapists.

    Science.gov (United States)

    Hill, Clara E; Kanazawa, Yoshi; Knox, Sarah; Schauerman, Iris; Loureiro, Darren; James, Danielle; Carter, Imani; King, Shakeena; Razzak, Suad; Scarff, Melanie; Moore, Jasmine

    2017-07-01

    Our goal was to explore the meaning experienced psychotherapists derive from providing psychotherapy, their beliefs about the role of meaning in life (MIL) in psychotherapy, how they worked with MIL with a client who explicitly presented concerns about MIL, and how they worked with a different client for whom MIL was a secondary and more implicit concern. Thirteen experienced psychotherapists were interviewed and data were analyzed using consensual qualitative research. Therapists derived self-oriented meaning (e.g., feeling gratified, fulfilled, connected) and other-oriented meaning (helping others, making the world a better place) from providing psychotherapy. They believed that MIL is fundamental and underlies all human concerns, including those brought to therapy. In contrast to the clients who had implicit MIL concerns, clients who explicitly presented MIL concerns were reported to have more interpersonal problems and physical problems, but about the same amount of psychological distress and loss/grief. Therapists used insight-oriented interventions, support, action-oriented interventions, and exploratory interventions to work with MIL with both types of clients, but used more exploratory interventions with implicit than explicit MIL clients. MIL is a salient topic for experienced, existentially oriented psychotherapists; they work with MIL extensively with some clients in psychotherapy. We recommend that therapists receive training to work with MIL in therapy, and that they pay attention to MIL concerns when they conduct psychotherapy. We also recommend additional research on MIL in psychotherapy.

  4. Analysis of Pseudomonas aeruginosa diguanylate cyclases and phosphodiesterases reveals a role for bis-(3′-5′)-cyclic-GMP in virulence

    Science.gov (United States)

    Kulesekara, Hemantha; Lee, Vincent; Brencic, Anja; Liberati, Nicole; Urbach, Jonathan; Miyata, Sachiko; Lee, Daniel G.; Neely, Alice N.; Hyodo, Mamoru; Hayakawa, Yoshihiro; Ausubel, Frederick M.; Lory, Stephen

    2006-01-01

    The opportunistic pathogen Pseudomonas aeruginosa is responsible for systemic infections in immunocompromised individuals and chronic respiratory disease in patients with cystic fibrosis. Cyclic nucleotides are known to play a variety of roles in the regulation of virulence-related factors in pathogenic bacteria. A set of P. aeruginosa genes, encoding proteins that contain putative domains characteristic of diguanylate cyclases (DGCs) and phosphodiesterases (PDEs) that are responsible for the maintenance of cellular levels of the second messenger bis-(3′-5′)-cyclic dimeric GMP (c-di-GMP) was identified in the annotated genomes of P. aeruginosa strains PAO1 and PA14. Although the majority of these genes are components of the P. aeruginosa core genome, several are located on presumptive horizontally acquired genomic islands. A comprehensive analysis of P. aeruginosa genes encoding the enzymes of c-di-GMP metabolism (DGC- and PDE-encoding genes) was carried out to analyze the function of c-di-GMP in two disease-related phenomena, cytotoxicity and biofilm formation. Analysis of the phenotypes of DGC and PDE mutants and overexpressing clones revealed that certain virulence-associated traits are controlled by multiple DGCs and PDEs through alterations in c-di-GMP levels. A set of mutants in selected DGC- and PDE-encoding genes exhibited attenuated virulence in a mouse infection model. Given that insertions in different DGC and PDE genes result in distinct phenotypes, it seems likely that the formation or degradation of c-di-GMP by these enzymes is in highly localized and intimately linked to particular targets of c-di-GMP action. PMID:16477007

  5. Therapeutic affect reduction, emotion regulation, and emotional memory reconsolidation: A neuroscientific quandary.

    Science.gov (United States)

    LaBar, Kevin S

    2015-01-01

    Lane et al. emphasize the role of emotional arousal as a precipitating factor for successful psychotherapy. However, as therapy ensues, the arousal diminishes. How can the unfolding therapeutic process generate long-term memories for reconsolidated emotional material without the benefit of arousal? Studies investigating memory for emotionally regulated material provide some clues regarding the neural pathways that may underlie therapy-based memory reconsolidation.

  6. In Vivo Biochemistry: Single-Cell Dynamics of Cyclic Di-GMP in Escherichia coli in Response to Zinc Overload.

    Science.gov (United States)

    Yeo, Jongchan; Dippel, Andrew B; Wang, Xin C; Hammond, Ming C

    2018-01-09

    Intracellular signaling enzymes drive critical changes in cellular physiology and gene expression, but their endogenous activities in vivo remain highly challenging to study in real time and for individual cells. Here we show that flow cytometry can be performed in complex media to monitor single-cell population distributions and dynamics of cyclic di-GMP signaling, which controls the bacterial colonization program. These in vivo biochemistry experiments are enabled by our second-generation RNA-based fluorescent (RBF) biosensors, which exhibit high fluorescence turn-on in response to cyclic di-GMP. Specifically, we demonstrate that intracellular levels of cyclic di-GMP in Escherichia coli are repressed with excess zinc, but not with other divalent metals. Furthermore, in both flow cytometry and fluorescence microscopy setups, we monitor the dynamic increase in cellular cyclic di-GMP levels upon zinc depletion and show that this response is due to de-repression of the endogenous diguanylate cyclase DgcZ. In the presence of zinc, cells exhibit enhanced cell motility and increased sensitivity to antibiotics due to inhibited biofilm formation. Taken together, these results showcase the application of RBF biosensors in visualizing single-cell dynamic changes in cyclic di-GMP signaling in direct response to environmental cues such as zinc and highlight our ability to assess whether observed phenotypes are related to specific signaling enzymes and pathways.

  7. Investigating Psychometric Properties of the Persian Version of Positive Psychotherapy Inventory

    Directory of Open Access Journals (Sweden)

    Z Ghorbani

    2015-08-01

    Full Text Available The purpose of the study was to investigate psychometric properties of the Persian version of positive psychotherapy inventory in university students. Research method was descriptive, correlational type. The sample of the study consist of 432 MS and PhD students, 225 female and 207 male, aged between 23 to 45 of state universities of Tehran who were selected through multi-stage random sampling. To study reliability, convergent and structural validity of instrument the sample group completed, positive psychotherapy inventory (Rashid and Oxford Happiness Inventory (Argyle and Hills. To investigating the reliability Cronbach alpha and test- retest method, and for validity of instrument structural validity exploratory factor analysis method and convergent validity were used. Results showed the total internal consistency of positive psychotherapy inventory was 0.80 and subscales internal consistency was between 0.80 to 0.92 respectively. In addition test-retest reliability coefficient was 0.70 for total inventory and between 0.63 to 0.73 for the subscales. Also the correlation coefficients between positive psychotherapy inventory and oxford happiness inventory were 0.73, which indicated a satisfactory convergent validity for positive psychotherapy inventory. Confirmatory factor analysis results showed three factors model of positive psychotherapy inventory in the Iranian sample. These three factors explained 79.99 variance of total inventory.

  8. Design challenges in transdiagnostic psychotherapy research: Comparing Transdiagnostic Behavior Therapy (TBT) to existing evidence-based psychotherapy in veterans with affective disorders.

    Science.gov (United States)

    Gros, Daniel F

    2015-07-01

    To address the limitations of disorder-specific approaches, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. However, the recruitment of multiple diagnoses presents many challenges to the traditional design of psychotherapy randomized controlled trials (RCTs). The goal of the manuscript is to present the challenges and rationale for designing a RCT for transdiagnostic treatment to inform and aid in the development of future investigations. A recently funded and ongoing RCT for Transdiagnostic Behavior Therapy (TBT) is used as an example to discuss the related design challenges. The TBT study involves the recruitment of 96 veteran participants with any of the following eight principal diagnoses: posttraumatic stress disorder, panic disorder, social anxiety disorder, obsessive compulsive disorder, generalized anxiety disorder, specific phobia, major depressive disorder, or persistent depressive disorder. Within the TBT study, participants will complete a semi-structured diagnostic interview and a series of transdiagnostic self-report measures to determine eligibility and assess baseline symptomatology. Qualifying participants will be randomized to TBT or control psychotherapy. Additional assessments will be completed at post-treatment and 6-month follow-up. Due to the transdiagnostic nature of the sample, adjustments to the recruitment and randomization procedures, selection of measures, selection of control psychotherapy, and analysis plan were required. These adjustments have implications to future trials on transdiagnostic psychotherapy protocols as well as future research in line with the transdiagnostic focus of the National Institute of Mental Health's Research Domain Criteria (RDoC) funding strategy. Published by Elsevier Inc.

  9. Exercise training improves blood flow to contracting skeletal muscle of older men via enhanced cGMP signaling

    DEFF Research Database (Denmark)

    Piil, Peter Bergmann; Smith Jørgensen, Tue; Egelund, Jon

    2018-01-01

    Physical activity has the potential to offset age-related impairments in the regulation of blood flow and O2 delivery to the exercising muscles; however, the mechanisms underlying this effect of physical activity remain poorly understood. The present study examined the role of cGMP in training...... a period of aerobic high-intensity exercise training. To determine the role of cGMP signaling, pharmacological inhibition of phosphodiesterase 5 (PDE5) was performed. Before training, inhibition of PDE5 increased (P... group; however, these effects of PDE5 inhibition were not detected after training. These findings suggest a role for enhanced cGMP signaling in the training-induced improvement of regulation of blood flow in contracting skeletal muscle of older men....

  10. Physiological and Molecular Effects of the Cyclic Nucleotides cAMP and cGMP on Arabidopsis thaliana

    KAUST Repository

    Herrera, Natalia M.

    2012-12-01

    The cyclic nucleotide monophosphates (CNs), cAMP and cGMP, are second messengers that participate in the regulation of development, metabolism and adaptive responses. In plants, CNs are associated with the control of pathogen responses, pollen tube orientation, abiotic stress response, membrane transport regulation, stomatal movement and light perception. In this study, we hypothesize that cAMP and cGMP promote changes in the transcription level of genes related to photosynthesis, high light and membrane transport in Arabidopsis thaliana leaves and, that these changes at the molecular level can have functional biological consequences. For this reason we tested if CNs modulate the photosynthetic rate, responses to high light and root ion transport. Real time quantitative PCR was used to assess transcription levels of selected genes and infrared gas analyzers coupled to fluorescence sensors were used to measure the photosynthetic parameters. We present evidence that both cAMP and cGMP modulate foliar mRNA levels early after stimulation. The two CNs trigger different responses indicating that the signals have specificity. A comparison of proteomic and transcriptional changes suggest that both transcriptional and post-transcriptional mechanisms are modulated by CNs. cGMP up-regulates the mRNA levels of components of the photosynthesis and carbon metabolism. However, neither cAMP nor cGMP trigger differences in the rate of carbon assimilation, maximum efficiency of the photosystem II (PSII), or PSII operating efficiency. It was also demonstrated that CN regulate the expression of its own targets, the cyclic nucleotide gated channels - CNGC. Further studies are needed to identify the components of the signaling transduction pathway that mediate cellular changes and their respective regulatory and/or signaling roles.

  11. cGMP-phosphodiesterase inhibition enhances photic responses and synchronization of the biological circadian clock in rodents.

    Directory of Open Access Journals (Sweden)

    Santiago A Plano

    Full Text Available The master circadian clock in mammals is located in the hypothalamic suprachiasmatic nuclei (SCN and is synchronized by several environmental stimuli, mainly the light-dark (LD cycle. Light pulses in the late subjective night induce phase advances in locomotor circadian rhythms and the expression of clock genes (such as Per1-2. The mechanism responsible for light-induced phase advances involves the activation of guanylyl cyclase (GC, cGMP and its related protein kinase (PKG. Pharmacological manipulation of cGMP by phosphodiesterase (PDE inhibition (e.g., sildenafil increases low-intensity light-induced circadian responses, which could reflect the ability of the cGMP-dependent pathway to directly affect the photic sensitivity of the master circadian clock within the SCN. Indeed, sildenafil is also able to increase the phase-shifting effect of saturating (1200 lux light pulses leading to phase advances of about 9 hours, as well as in C57 a mouse strain that shows reduced phase advances. In addition, sildenafil was effective in both male and female hamsters, as well as after oral administration. Other PDE inhibitors (such as vardenafil and tadalafil also increased light-induced phase advances of locomotor activity rhythms and accelerated reentrainment after a phase advance in the LD cycle. Pharmacological inhibition of the main downstream target of cGMP, PKG, blocked light-induced expression of Per1. Our results indicate that the cGMP-dependent pathway can directly modulate the light-induced expression of clock-genes within the SCN and the magnitude of light-induced phase advances of overt rhythms, and provide promising tools to design treatments for human circadian disruptions.

  12. Social Problem Solving and Depressive Symptoms over Time: A Randomized Clinical Trial of Cognitive-Behavioral Analysis System of Psychotherapy, Brief Supportive Psychotherapy, and Pharmacotherapy

    Science.gov (United States)

    Klein, Daniel N.; Leon, Andrew C.; Li, Chunshan; D'Zurilla, Thomas J.; Black, Sarah R.; Vivian, Dina; Dowling, Frank; Arnow, Bruce A.; Manber, Rachel; Markowitz, John C.; Kocsis, James H.

    2011-01-01

    Objective: Depression is associated with poor social problem solving, and psychotherapies that focus on problem-solving skills are efficacious in treating depression. We examined the associations between treatment, social problem solving, and depression in a randomized clinical trial testing the efficacy of psychotherapy augmentation for…

  13. “Gold Standards,” Plurality and Monocultures: The Need for Diversity in Psychotherapy

    Directory of Open Access Journals (Sweden)

    Falk Leichsenring

    2018-04-01

    Full Text Available For psychotherapy of mental disorders, presently several approaches are available, such as interpersonal, humanistic, systemic, psychodynamic or cognitive behavior therapy (CBT. Pointing to the available evidence, proponents of CBT claim that CBT is the gold standard. Some authors even argue for an integrated CBT-based form of psychotherapy as the only form of psychotherapy. CBT undoubtedly has its strengths and CBT researchers have to be credited for developing and testing treatments for many mental disorders. A critical review, however, shows that the available evidence for the theoretical foundations of CBT, assumed mechanisms of change, quality of studies, and efficacy is not as robust as some researchers claim. Most important, there is no consistent evidence that CBT is more efficacious than other evidence-based approaches. These findings do not justify regarding CBT as the gold standard psychotherapy. They even provide less justification for the idea that the future of psychotherapy lies in one integrated CBT-based form of psychotherapy as the only type of psychotherapy. For the different psychotherapeutic approaches a growing body of evidence is available. These approaches have their strengths because of differences in their respective focus on interpersonal relationships, affects, cognitions, systemic perspectives, experiential, or unconscious processes. Different approaches may be suitable to different patients and therapists. As generally assumed, progress in research results from openness to new ideas and learning from diverse perspectives. Thus, different forms of evidence-based psychotherapy are required. Plurality is the future of psychotherapy, not a uniform “one fits all” approach.

  14. “Gold Standards,” Plurality and Monocultures: The Need for Diversity in Psychotherapy

    Science.gov (United States)

    Leichsenring, Falk; Abbass, Allan; Hilsenroth, Mark J.; Luyten, Patrick; Munder, Thomas; Rabung, Sven; Steinert, Christiane

    2018-01-01

    For psychotherapy of mental disorders, presently several approaches are available, such as interpersonal, humanistic, systemic, psychodynamic or cognitive behavior therapy (CBT). Pointing to the available evidence, proponents of CBT claim that CBT is the gold standard. Some authors even argue for an integrated CBT-based form of psychotherapy as the only form of psychotherapy. CBT undoubtedly has its strengths and CBT researchers have to be credited for developing and testing treatments for many mental disorders. A critical review, however, shows that the available evidence for the theoretical foundations of CBT, assumed mechanisms of change, quality of studies, and efficacy is not as robust as some researchers claim. Most important, there is no consistent evidence that CBT is more efficacious than other evidence-based approaches. These findings do not justify regarding CBT as the gold standard psychotherapy. They even provide less justification for the idea that the future of psychotherapy lies in one integrated CBT-based form of psychotherapy as the only type of psychotherapy. For the different psychotherapeutic approaches a growing body of evidence is available. These approaches have their strengths because of differences in their respective focus on interpersonal relationships, affects, cognitions, systemic perspectives, experiential, or unconscious processes. Different approaches may be suitable to different patients and therapists. As generally assumed, progress in research results from openness to new ideas and learning from diverse perspectives. Thus, different forms of evidence-based psychotherapy are required. Plurality is the future of psychotherapy, not a uniform “one fits all” approach. PMID:29740361

  15. Journeys through the valley of death: multimethod psychological assessment and personality transformation in long-term psychotherapy.

    Science.gov (United States)

    Finn, Stephen E

    2011-03-01

    The Psychodynamic Diagnostic Manual (PDM Task Force, 2006) is based on the assumption that an in-depth understanding of clients' underlying emotional, personality, and interpersonal patterns will facilitate their treatment. In this article I show how such an understanding can be achieved through multimethod psychological assessment, and how useful such information can be in long-term psychotherapy with high-achieving, successful clients who struggle with forming and maintaining intimate relationships. Such treatments are extremely difficult, because when these clients attach to their psychotherapists, many of them temporarily become more symptomatic. I illustrate these points with a detailed account of my long-term therapy with a resilient but highly traumatized young man. Repeated use of the Minnesota Multiphasic Personality Disorder-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and Rorschach with my client helped guide us in our work, and also helped create an important therapeutic "opening" into the underlying traumatic material. This and other experiences have convinced me that it is extremely useful for psychologists to have training in both assessment and psychotherapy.

  16. Good manufacturing practice (GMP) compliance in the biologics sector: plasma fractionation.

    Science.gov (United States)

    Ways, J P; Preston, M S; Baker, D; Huxsoll, J; Bablak, J

    1999-12-01

    The U.S. blood supply is the safest it has ever been. Due to blood safety and the introduction of viral inactivation/clearance technologies, protein therapies derived from human blood have also in recent years had a history of product safety. Nevertheless, since 1995, the plasma-fractionation industry has experienced increased compliance-related actions by the Food and Drug Administration (FDA), as shown by a substantive increase in the number of FDA 483 inspectional observations, FDA warning letters and other FDA regulatory action. An evaluation of these trends shows that they reflect the implementation by the FDA of increased inspectional interest in the plasma-fractionation industry and an evolution of inspectional practices and standards of current good manufacturing practice (cGMP). Plasma fractionators have responded to FDA actions by carefully evaluating and addressing each inspectional observation, assessing impact to product and taking appropriate actions, including corrective actions to prevent future occurrence. They have made major investments in facilities, quality systems, personnel and training to meet the evolving standards of cGMP and in an effort to implement these standards systemically. Through industry associations, manufacturers have further enhanced product safety by adopting additional voluntary standards for plasma to prevent the entry of potentially unsuitable plasma into the production process. The industry remains committed to application of cGMP and to working with the FDA in further evolution of these standards while striving to assure a continued supply of safe, pure and effective plasma-derived therapies.

  17. The effects of training in time-limited dynamic psychotherapy: changes in therapeutic outcome.

    Science.gov (United States)

    Bein, E; Anderson, T; Strupp, H; Henry, W; Schacht, T; Binder, J; Butler, S

    2000-02-01

    The present study explored the effects on therapeutic outcomes of training therapists in brief manualized therapy. As part of the Vanderbilt II project, each of 16 therapists (8 psychiatrists and 8 clinical psychologists) treated 2 moderately disturbed adult patients using his or her customary short-term treatment methods; they then received a year of training in a manualized form of brief dynamic therapy, Time-Limited Dynamic Psychotherapy (TLDP); finally, they administered TLDP to 2 additional patients. It was hypothesized that training would result in improved outcomes generally and that differentially greater improvement would be seen in patients commonly considered less suitable for brief dynamic therapy. Outcome data obtained at termination failed to support either hypothesis. Measurements of interpersonal dependency obtained at a one-year follow-up were consistent with the first hypothesis, but the follow-up data were inconsistent with the second. A systematic review of the 32 posttraining cases suggested that the majority of the therapists had not achieved basic competence at TLDP. Die hier beschriebene Studie untersucht die Wirkungen eines Trainings in manualisierter Kurzzeitherapie auf das Therapierergebnis. Als Teil des Vanderbilt II Projektes behandelten jeweils 16 Therapeuten (8 Psychiater und 8 klinische Psychologen) zwei mittelgradig beeinrächtigte erwachsene Patienten mit den ihnen vertrauten Kurzzeitbehandlungsmethoden. Danach wurden sie über ein Jahr in einer manualisierten Form psychodynamischer Kurzzeittherapie ausgebildet und wandten diese Therapie auf zwei weitere Patienten an. Es wurde angenommen, dass die Ausbildung in besseren Ergebnisdaten, die bei Ende der Therapie erhoben wurden, konnten diese Hypothese nicht bestätigen. Maße für die interpersonale Abhängigkeit zu einem Einjahreskatamnesezeitpunkt waren mit der ersten Hypothese konform, aber inkonsistent mit der zweiten. Eine systematische Untersuchung der 32 nach der Ausbildung

  18. Psychotherapists' spiritual, religious, atheist or agnostic identity and their practice of psychotherapy: a grounded theory study.

    Science.gov (United States)

    Magaldi-Dopman, Danielle; Park-Taylor, Jennie; Ponterotto, Joseph G

    2011-05-01

    In this present grounded theory study, 16 experienced psychologists, who practiced from varied theoretical orientations and came from diverse religious/spiritual/nonreligious backgrounds, explored their personal religious/spiritual/nonreligious identity development journeys, their experiences with clients' religious/spiritual content in psychotherapy sessions, and how their identity may have influenced the way they interacted with religious/spiritual material during sessions. Results revealed that psychologists' spiritual/religious/nonreligious identity is conflicted and complex and that their academic and clinical training did not provide sufficient opportunity to examine how this may affect their therapeutic work. A tentative grounded theory emerged suggesting that psychologists both identified with and were activated by clients' spiritual/religious conflicts and their internal experiences about the spiritual/religious content, both of which presented significant challenges to therapeutic work.

  19. Therapeutic Alliance and Treatment Adherence in Two Interventions for Bulimia Nervosa: A Study of Process and Outcome

    Science.gov (United States)

    Loeb, Katharine L.; Wilson, G. Terence; Labouvie, Erich; Pratt, Elizabeth M.; Hayaki, Jumi; Walsh, B. Timothy; Agras, W. Stewart; Fairburn, Christopher G.

    2005-01-01

    The relationship between therapeutic alliance, therapist adherence to treatment protocol, and outcome was analyzed in a randomized trial of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy for bulimia nervosa. Independent observers rated audiotapes of full-length therapy sessions. Purging frequency was the primary outcome…

  20. Cyclic GMP-AMP Containing Mixed Phosphodiester Linkages Is An Endogenous High Affinity Ligand for STING

    Science.gov (United States)

    Zhang, Xu; Shi, Heping; Wu, Jiaxi; Zhang, Xuewu; Sun, Lijun; Chen, Chuo; Chen, Zhijian J.

    2013-01-01

    The presence of microbial or self DNA in the cytoplasm of mammalian cells is a danger signal detected by the DNA sensor cyclic-GMP-AMP (cGAMP) synthase (cGAS), which catalyzes the production of cGAMP that in turn serves as a second messenger to activate innate immune responses. Here we show that endogenous cGAMP in mammalian cells contains two distinct phosphodiester linkages, one between 2′-OH of GMP and 5′-phosphate of AMP, and the other between 3′-OH of AMP and 5′-phosphate of GMP. This molecule, termed 2′3′-cGAMP, is unique in that it binds to the adaptor protein STING with a much greater affinity than cGAMP molecules containing other combinations of phosphodiester linkages. The crystal structure of STING bound to 2′3′-cGAMP revealed the structural basis of this high-affinity binding and a ligand-induced conformational change in STING that may underlie its activation. PMID:23747010

  1. Cyclic GMP-AMP containing mixed phosphodiester linkages is an endogenous high-affinity ligand for STING.

    Science.gov (United States)

    Zhang, Xu; Shi, Heping; Wu, Jiaxi; Zhang, Xuewu; Sun, Lijun; Chen, Chuo; Chen, Zhijian J

    2013-07-25

    The presence of microbial or self DNA in the cytoplasm of mammalian cells is a danger signal detected by the DNA sensor cyclic-GMP-AMP (cGAMP) synthase (cGAS), which catalyzes the production of cGAMP that in turn serves as a second messenger to activate innate immune responses. Here we show that endogenous cGAMP in mammalian cells contains two distinct phosphodiester linkages, one between 2'-OH of GMP and 5'-phosphate of AMP, and the other between 3'-OH of AMP and 5'-phosphate of GMP. This molecule, termed 2'3'-cGAMP, is unique in that it binds to the adaptor protein STING with a much greater affinity than cGAMP molecules containing other combinations of phosphodiester linkages. The crystal structure of STING bound to 2'3'-cGAMP revealed the structural basis of this high-affinity binding and a ligand-induced conformational change in STING that may underlie its activation. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. The CRP/FNR family protein Bcam1349 is a c-di-GMP effector that regulates biofilm formation in the respiratory pathogen Burkholderia cenocepacia

    DEFF Research Database (Denmark)

    Fazli, Mustafa; O'Connell, Aileen; Nilsson, Martin

    2011-01-01

    Burkholderia cenocepacia is an opportunistic respiratory pathogen that can cause severe infections in immune-compromised individuals and is associated with poor prognosis for patients suffering from cystic fibrosis. The second messenger cyclic diguanosine monophosphate (c-di-GMP) has been shown...... to control a wide range of functions in bacteria, but little is known about these regulatory mechanisms in B. cenocepacia. Here we investigated the role that c-di-GMP plays in the regulation of biofilm formation and virulence in B. cenocepacia. Elevated intracellular levels of c-di-GMP promoted wrinkly...... colony, pellicle and biofilm formation in B. cenocepacia. A screen for transposon mutants unable to respond to elevated levels of c-di-GMP led to the identification of the mutant bcam1349 that did not display increased biofilm and pellicle formation with excessive c-di-GMP levels, and displayed a biofilm...

  3. Clients' and therapists' stories about psychotherapy.

    Science.gov (United States)

    Adler, Jonathan M

    2013-12-01

    This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice. © 2012 Wiley Periodicals, Inc.

  4. The Theory and Art of Child Psychotherapy: A Corrective Developmental Approach.

    Science.gov (United States)

    Friedman, Robert

    2017-10-01

    The history of child psychotherapy is sketched from the psychoanalytic pioneers Anna Freud and Melanie Klein to the popular "nondirective" approach of Virginia Axline. The author's approach to child psychotherapy, based on contemporary psychoanalytic theories, allows the therapist to play any parental role that helps to repair developmental deficiencies and conflicts. These include nurturing, supporting, mirroring, role modeling, challenging, and limit setting. Following Winnicott, psychotherapy is conceived as a play space in which therapist and child are both spontaneous. The value of interpretation and insight in child therapy is discussed. There follows a more detailed discussion of three major problem areas in child psychotherapy: handling anger and hostile aggression; handling issues related to sexuality; and handling narcissistic issues of inferiority and shame.

  5. Angiotensin II increases phosphodiesterase 5A expression in vascular smooth muscle cells: A mechanism by which angiotensin II antagonizes cGMP signaling

    Science.gov (United States)

    Kim, Dongsoo; Aizawa, Toru; Wei, Heng; Pi, Xinchun; Rybalkin, Sergei D.; Berk, Bradford C.; Yan, Chen

    2014-01-01

    Angiotensin II (Ang II) and nitric oxide (NO)/natriuretic peptide (NP) signaling pathways mutually regulate each other. Imbalance of Ang II and NO/NP has been implicated in the pathophysiology of many vascular diseases. cGMP functions as a key mediator in the interaction between Ang II and NO/NP. Cyclic nucleotide phosphodiesterase 5A (PDE5A) is important in modulating cGMP signaling by hydrolyzing cGMP in vascular smooth muscle cells (VSMC). Therefore, we examined whether Ang II negatively modulates intracellular cGMP signaling in VSMC by regulating PDE5A. Ang II rapidly and transiently increased PDE5A mRNA levels in rat aortic VSMC. Upregulation of PDE5A mRNA was associated with a time-dependent increase of both PDE5 protein expression and activity. Increased PDE5A mRNA level was transcription-dependent and mediated by the Ang II type 1 receptor. Ang II-mediated activation of extracellular signal-regulated kinases 1/2 (ERK1/2) was essential for Ang II-induced PDE5A upregulation. Pretreatment of VSMC with Ang II inhibited C-type NP (CNP) stimulated cGMP signaling, such as cGMP dependent protein kinase (PKG)-mediated phosphorylation of vasodilator-stimulated-phosphoprotein (VASP). Ang II-mediated inhibition of PKG was blocked when PDE5 activity was decreased by selective PDE5 inhibitors, suggesting that upregulation of PDE5A expression is an important mechanism for Ang II to attenuate cGMP signaling. PDE5A may also play a critical role in the growth promoting effects of Ang II because inhibition of PDE5A activity significantly decreased Ang II-stimulated VSMC growth. These observations establish a new mechanism by which Ang II antagonizes cGMP signaling and stimulates VSMC growth. PMID:15623434

  6. Free and total GMP (glycomacropeptide contents of milk during bovine lactation Variação dos teores de GMP (glicomacropeptídeo livre e total no leite bovino durante a lactação

    Directory of Open Access Journals (Sweden)

    Andréa Maria Furlanetti

    2003-12-01

    Full Text Available Individual milk samples taken every two weeks from parturition to the end of lactation from 34 animals of three different herds and breeds were analyzed for free-GMP. A milk pool of each herd was analyzed for free and total GMP (released from k-casein by the action of rennin and the data were correlated with sanitary conditions of animal and udder, phase of lactation and milk production. Most udder problems were concentrated near parturition, with few and spaced occurrences of clinical mastitis. The Californian Mastitis Test (CMT results showed oscillations compatible with the phases of lactation period and environmental conditions. The widest variations in free-GMP occurred as a function of lactation period and as a consequence of clinical or subclinical mastitis. Higher levels were observed at the beginning of lactation (5.87mg L-1 of sialic acid, becoming normal with mean values of about 3.30mg L-1 at the end of the second month, and increasing again during the final third of lactation. On average, the same trends were observed for total GMP released by commercial rennet, beginning with slightly high values (35.59mg L-1, becoming normal by the sixth month with values close to 27.15mg L-1, and rising gradually up to the end of lactation, with 58.35mg L-1 of sialic acid. These results prove to be useful for the correct interpretation of tests applied to milk selection with respect to proteolytic status or even to restrain frauds by the addition of whey to milk.Amostras quinzenais, desde o parto até o final do período de lactação, obtidas de 34 vacas de três diferentes raças e propriedades, foram analisadas quanto à presença de GMP livre. Um "pool" das amostras quinzenais de cada rebanho foi analisada tanto para o conteúdo de GMP livre quanto para o GMP total (liberado da k-caseína pela ação da renina, correlacionando-os com as condições sanitárias do animal e do úbere, à fase da lactação e à produção de leite. A maioria

  7. Psychotherapy for chronic major depression and dysthymia: A meta analysis.

    NARCIS (Netherlands)

    Cuijpers, P.; Straten, van A.; Schuurmans, J.; Oppen, van P.C.; Hollon, S.D.; Andersson, G.

    2009-01-01

    Abstract Although several studies have examined the effects of psychotherapy on chronic depression and dysthymia, no meta-analysis has been conducted to integrate results of these studies. We conducted a meta-analysis of 16 randomized trials examining the effects of psychotherapy on chronic

  8. Similar expression patterns of bestrophin-4 and cGMP dependent Ca2+-activated chloride channel activity in the vasculature

    DEFF Research Database (Denmark)

    Bouzinova, Elena V.; Larsen, Per; Matchkov, Vladimir

    2008-01-01

    (abstract by Matchkov et. al) that siRNA mediated downregulation of bestrophin-4 is associated with the disappearance of a recently demonstrated2 cGMP-dependent Ca2+-activated Cl- current in vascular smooth muscle cells (SMCs). Here we study the distribution of bestrophin-4-and cGMP dependent Cl- channel...... expressed epitope) Western blot detected a ~65 kDa band in cell lysates from rat mesenteric small arteries and aorta, which was not seen in pulmonary arteries and when preincubated with the immunizing peptide. The distribution of bestrophin-4 mRNA and protein has a pattern similar to the cGMP-dependent Cl......- current in SMCs of different origins. Immunohistochemistry identified bestrophin-4 both in endothelial and SMCs of the vascular tree in the brain, heart, kidney and mesentery, but not in the lungs. We suggest that bestrophin-4 is important for the cGMP dependent, Ca2+ activated Cl- conductance in many...

  9. Winifred Rushforth and the Davidson Clinic for Medical Psychotherapy: a case study in the overlap of psychotherapy, Christianity and New Age spirituality.

    Science.gov (United States)

    Miller, Gavin

    2015-09-01

    The activities of both Winifred Rushforth (1885-1983), and the Edinburgh-based Davidson Clinic for Medical Psychotherapy (1941-73) which she directed, exemplify and elaborate the overlap in Scotland of religious discourses and practices with psychoanalytic psychotherapy. Even as post-war secularization began to affect Scottish culture and society, Rushforth and the Davidson Clinic attempted to renew the biographical discourses of Christianity using the idioms and practices of psychoanalytic psychotherapy. Furthermore, alongside these Christian-inflected activities, Rushforth promoted a psychoanalytically-informed New Age spirituality. This parallel mode of belief and practice drew on Christian life-narrative patterns, preserving them within psychoanalytic forms grafted onto a vitalist worldview informed by the work of Pierre Teilhard de Chardin. © The Author(s) 2015.

  10. The ethics of providing hope in psychotherapy.

    Science.gov (United States)

    Dembo, Justine Sarah; Clemens, Norman A

    2013-07-01

    The instillation of hope is a common factor in most psychotherapies. A considerable literature exists on the ethics of providing false or positively biased hope in non-psychiatric medical settings, and ethicists have generally concluded that this practice is unethical. However, the literature on the ethics of encouraging hope in psychotherapy, especially in the case of treatment-resistant mental illness, is sparse. The author explores two clinical cases with the intention of examining the nature of hope, false hope, positive illusions, and denial, as they relate to our definitions of mental health and psychotherapy. The cases highlight the ethics of balancing an acknowledgment of likely treatment futility with a desire to hope. Clinical psychological studies on depressive realism and optimistic bias indicate that some degree of positive bias, referred to by some authors as "the optimal margin of illusion," is in fact necessary to promote what we define as "good mental health;" conversely, stark realism is correlated with mild to moderate depression. An examination of the existential literature, including Ernest Becker's work, The Denial of Death, indicates that without the defense mechanism of denial, human beings tend to experience paralytic despair as a result of being fallible, mortal creatures in a frightening world. The combination of these diverse bodies of literature, along with the surprising outcomes of our case examples, leads to an unexpected conclusion: it may occasionally be ethical to encourage some degree of optimistic bias, and perhaps even positive illusion, when treating patients in psychotherapy.

  11. Nitric oxide increases cyclic GMP levels, AMP-activated protein kinase (AMPK)alpha1-specific activity and glucose transport in human skeletal muscle

    DEFF Research Database (Denmark)

    Deshmukh, A S; Long, Y C; de Castro Barbosa, T

    2010-01-01

    -nitrosohydrazino)-1,2-ethylenediamine (spermine NONOate) would increase intracellular cyclic GMP (cGMP) levels and promote glucose transport. METHODS: Skeletal muscle strips were prepared from vastus lateralis muscle biopsies obtained from seven healthy men. Muscle strips were incubated in the absence or presence...... of 5 mmol/l spermine NONOate or 120 nmol/l insulin. The L6 muscle cells were treated with spermine NONOate (20 micromol/l) and incubated in the absence or presence of insulin (120 nmol/l). The direct effect of spermine NONOate and insulin on glucose transport, cGMP levels and signal transduction...... was determined. RESULTS: In human skeletal muscle, spermine NONOate increased glucose transport 2.4-fold (p GMP levels (80-fold, p

  12. Psychotherapy for neurologists.

    Science.gov (United States)

    Hobday, Gabrielle S; Gabbard, Glen O

    2009-07-01

    Psychotherapy has traditionally been regarded as the purview of psychiatry rather than neurology. Yet, the doctor-patient relationship is fundamental to both specialties, and the principles that derive from psychotherapy theory and practice apply to that relationship regardless of the specialty. It is common knowledge that a large proportion of patients seen in the context of the practice of medicine have some kind of emotional disturbance. Moreover, patients with organic disease may also have significant emotional difficulties that complicate both the primary illness and its treatment. This experience inevitably has drawn attention to the need for the nonpsychiatric physician to have an understanding and proficiency in psychiatric diagnosis and psychotherapeutic principles. In this article, we consider basic psychotherapeutic principles that are useful in the everyday practice of neurologists and other nonpsychiatric physicians. These skills are important not only for practical reasons, but also because responsiveness to their emotional distress is essential to maintain empathy and caring as cornerstones of the art of medicine. With the use of clinical examples to illustrate these principles, we hope that readers can apply them to their own clinical experiences.

  13. Diguanylate cyclase null mutant reveals that C-Di-GMP pathway regulates the motility and adherence of the extremophile bacterium Acidithiobacillus caldus.

    Directory of Open Access Journals (Sweden)

    Matías Castro

    Full Text Available An understanding of biofilm formation is relevant to the design of biological strategies to improve the efficiency of the bioleaching process and to prevent environmental damages caused by acid mine/rock drainage. For this reason, our laboratory is focused on the characterization of the molecular mechanisms involved in biofilm formation in different biomining bacteria. In many bacteria, the intracellular levels of c-di-GMP molecules regulate the transition from the motile planktonic state to sessile community-based behaviors, such as biofilm development, through different kinds of effectors. Thus, we recently started a study of the c-di-GMP pathway in several biomining bacteria including Acidithiobacillus caldus. C-di-GMP molecules are synthesized by diguanylate cyclases (DGCs and degraded by phosphodiesterases (PDEs. We previously reported the existence of intermediates involved in c-di-GMP pathway from different Acidithiobacillus species. Here, we report our work related to At. caldus ATCC 51756. We identified several putative-ORFs encoding DGC and PDE and effector proteins. By using total RNA extracted from At. caldus cells and RT-PCR, we demonstrated that these genes are expressed. We also demonstrated the presence of c-di-GMP by mass spectrometry and showed that genes for several of the DGC enzymes were functional by heterologous genetic complementation in Salmonella enterica serovar Typhimurium mutants. Moreover, we developed a DGC defective mutant strain (Δc1319 that strongly indicated that the c-di-GMP pathway regulates the swarming motility and adherence to sulfur surfaces by At. caldus. Together, our results revealed that At. caldus possesses a functional c-di-GMP pathway which could be significant for ores colonization during the bioleaching process.

  14. Psychotherapy for chronic major depression and dysthymia: A meta analysis

    NARCIS (Netherlands)

    Cuijpers, P.; van Straten, A.; Schuurmans, J.; van Oppen, P.C.; Hollon, S.D.; Andersson, G.

    2010-01-01

    Although several studies have examined the effects of psychotherapy on chronic depression and dysthymia, no meta-analysis has been conducted to integrate results of these studies. We conducted a meta-analysis of 16 randomized trials examining the effects of psychotherapy on chronic depression and

  15. Psychotherapy for chronic major depression and dysthymia: A meta analysis.

    NARCIS (Netherlands)

    Cuijpers, P.; van Straten, A.; Schuurmans, J.; van Oppen, P.C.; Hollon, S.D.; Andersson, G.

    2009-01-01

    Although several studies have examined the effects of psychotherapy on chronic depression and dysthymia, no meta-analysis has been conducted to integrate results of these studies. We conducted a meta-analysis of 16 randomized trials examining the effects of psychotherapy on chronic depression and

  16. The self is an illusion: a conceptual framework for psychotherapy.

    Science.gov (United States)

    Stankevicius, Steve

    2017-06-01

    To explain the illusory nature of the self and explore its implications for psychotherapy. Our usual experience of the self is an illusion. Rather than a discrete entity, it is a network of processes that maintains apparent irreducible unity via alterations of perceptions, beliefs, intentions and memories. By providing an efficient summary of an individual and its surroundings, the self-illusion allows one to predict, experience and interact with the world efficiently. Targeting mechanisms that preserve the self-illusion could provide a focus for psychotherapy. Viewing the self as a complex network offers a valuable conceptual framework for psychotherapy.

  17. Psychotherapies for Children and Adolescents

    Science.gov (United States)

    ... in intentionally self-harmful behaviors, or have Borderline Personality Disorder. DBT emphasizes taking responsibility for one's problems and ... is a form of psychotherapy where there are multiple patients led by one or more therapists. It ...

  18. Hypnotic Psychotherapy with Sex Offenders

    Science.gov (United States)

    Moseley, Sullivan; Briggs, Wanda P.; Magnus, Virginia

    2005-01-01

    The authors review the literature on the prevalence of sex offenders; multiple treatment modalities; and implications of the use of hypnotic psychotherapy, coupled with cognitive behavioral treatment programs, for treating sex offenders. (Contains 2 tables.)

  19. cGMP inhibition of type 3 phosphodiesterase is the major mechanism by which C-type natriuretic peptide activates CFTR in the shark rectal gland

    Science.gov (United States)

    De Jonge, Hugo R.; Tilly, Ben C.; Hogema, Boris M.; Pfau, Daniel J.; Kelley, Catherine A.; Kelley, Megan H.; Melita, August M.; Morris, Montana T.; Viola, Ryan M.

    2013-01-01

    The in vitro perfused rectal gland of the dogfish shark (Squalus acanthias) and filter-grown monolayers of primary cultures of shark rectal gland (SRG) epithelial cells were used to analyze the signal transduction pathway by which C-type natriuretic peptide (CNP) stimulates chloride secretion. CNP binds to natriuretic receptors in the basolateral membrane, elevates cellular cGMP, and opens cystic fibrosis transmembrane conductance regulator (CFTR) chloride channels in the apical membrane. CNP-provoked chloride secretion was completely inhibitable by the nonspecific protein kinase inhibitor staurosporine and the PKA inhibitor H89 but insensitive to H8, an inhibitor of type I and II isoforms of cGMP-dependent protein kinase (cGKI and cGKII). CNP-induced secretion could not be mimicked by nonhydrolyzable cGMP analogs added alone or in combination with the protein kinase C activator phorbolester, arguing against a role for cGK or for cGMP-induced PKC signaling. We failed to detect a dogfish ortholog of cGKII by molecular cloning and affinity chromatography. However, inhibitors of the cGMP-inhibitable isoform of phosphodiesterase (PDE3) including milrinone, amrinone, and cilostamide but not inhibitors of other PDE isoenzymes mimicked the effect of CNP on chloride secretion in perfused glands and monolayers. CNP raised cGMP and cAMP levels in the SRG epithelial cells. This rise in cAMP as well as the CNP and amrinone-provoked chloride secretion, but not the rise in cGMP, was almost completely blocked by the Gαi-coupled adenylyl cyclase inhibitor somatostatin, arguing against a role for cGMP cross-activation of PKA in CNP action. These data provide molecular, functional, and pharmacological evidence for a CNP/cGMP/PDE3/cAMP/PKA signaling cascade coupled to CFTR in the SRG. PMID:24259420

  20. Mobile Phone-Based Mood Ratings Prospectively Predict Psychotherapy Attendance.

    Science.gov (United States)

    Bruehlman-Senecal, Emma; Aguilera, Adrian; Schueller, Stephen M

    2017-09-01

    Psychotherapy nonattendance is a costly and pervasive problem. While prior research has identified stable patient-level predictors of attendance, far less is known about dynamic (i.e., time-varying) factors. Identifying dynamic predictors can clarify how clinical states relate to psychotherapy attendance and inform effective "just-in-time" interventions to promote attendance. The present study examines whether daily mood, as measured by responses to automated mobile phone-based text messages, prospectively predicts attendance in group cognitive-behavioral therapy (CBT) for depression. Fifty-six Spanish-speaking Latino patients with elevated depressive symptoms (46 women, mean age=50.92years, SD=10.90years), enrolled in a manualized program of group CBT, received daily automated mood-monitoring text messages. Patients' daily mood ratings, message response rate, and delay in responding were recorded. Patients' self-reported mood the day prior to a scheduled psychotherapy session significantly predicted attendance, even after controlling for patients' prior attendance history and age (OR=1.33, 95% CI [1.04, 1.70], p=.02). Positive mood corresponded to a greater likelihood of attendance. Our results demonstrate the clinical utility of automated mood-monitoring text messages in predicting attendance. These results underscore the value of text messaging, and other mobile technologies, as adjuncts to psychotherapy. Future work should explore the use of such monitoring to guide interventions to increase attendance, and ultimately the efficacy of psychotherapy. Copyright © 2017. Published by Elsevier Ltd.

  1. A concise discussion of the regulatory role of cGMP kinase I in cardiac physiology and pathology.

    Science.gov (United States)

    Hofmann, Franz

    2018-06-22

    The underlying cause of cardiac hypertrophy, fibrosis, and heart failure has been investigated in great detail using different mouse models. These studies indicated that cGMP and cGMP-dependent protein kinase type I (cGKI) may ameliorate these negative phenotypes in the adult heart. Recently, evidence has been published that cardiac mitochondrial BKCa channels are a target for cGKI and that activation of mitoBKCa channels may cause some of the positive effects of conditioning in ischemia/reperfusion injury. It will be pointed out that most studies could not present convincing evidence that it is the cGMP level and the activity cGKI in specific cardiac cells that reduces hypertrophy or heart failure. However, anti-fibrotic compounds stimulating nitric oxide-sensitive guanylyl cyclase may be an upcoming therapy for abnormal cardiac remodeling.

  2. Involvement of NO-cGMP pathway in anti-hyperalgesic effect of PDE5 inhibitor tadalafil in experimental hyperalgesia.

    Science.gov (United States)

    Otari, K V; Upasani, C D

    2015-08-01

    The association of elevated level of cyclic guanosine monophosphate (cGMP) with inhibition of hyperalgesia and involvement of nitric oxide (NO)-cGMP pathway in the modulation of pain perception was previously reported. Phosphodiesterases 5 (PDE5) inhibitors, sildenafil and tadalafil (TAD) used in erectile dysfunction, are known to act via the NO-cGMP pathway. TAD exerts its action by increasing the levels of intracellular cGMP. Hence, the present study investigated the effect of TAD 5, 10, or 20 mg/kg, per os (p.o.) or L-NAME 20 mg/kg, intraperitoneally (i.p.) and TAD (20 mg/kg, p.o.) in carrageenan- and diabetes-induced hyperalgesia in rats using hot plate test at 55 ± 2 °C. In carrageenan- and diabetes-induced hyperalgesia, TAD (10 and 20 mg/kg, p.o.) significantly increased paw withdrawal latencies (PWLs) as compared to the control group. L-NAME significantly decreased PWLs as compared to the normal group and aggravated the hyperalgesia. Moreover, significant difference in PWLs of L-NAME and TAD 20 was evident. Co-administration of L-NAME (20 mg/kg) with TAD (20 mg/kg) showed significant difference in PWLs as compared to the TAD (20 mg/kg), indicating L-NAME reversed and antagonized TAD-induced anti-hyperalgesia. This suggested an important role of NO-cGMP pathway in TAD-induced anti-hyperalgesic effect.

  3. Clinical Significance: a Therapeutic Approach Topsychological Assessment in Treatment Planning

    Directory of Open Access Journals (Sweden)

    Afolabi Olusegun Emmanuel

    2015-06-01

    Full Text Available Psychological assessment has long been reported as a key component of clinical psychology. This paper examines the complexities surrounding the clinical significance of therapeutic approach to treatment planning. To achieve this objective, the paper searched and used the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to analysed, 1 a strong basis for the usage of therapeutic approach to psychological assessment in treatment plans, 2 explained the conceptual meaning of clinical significant change in therapeutic assessment, 3 answered some of the questions regarding practicability and the clinical significance of therapeutic approach to treatment plans, particularly during or before treatment, 4 linked therapeutic assessment to change in clients’ clinical impression, functioning and therapeutic needs 5 analysed the empirically documenting clinically significant change in therapeutic assessment. Finally, the study suggested that though therapeutic assessment is not sufficient for the systematic study of psychotherapy outcome and process, it is still consistent with both the layman and professional expectations regarding treatment outcome and also provides a precise method for classifying clients as ‘changed’ or ‘unchanged’ on the basis of clinical significance criteria.

  4. Individual psychotherapy for schizophrenia: trends and developments in the wake of the recovery movement

    Directory of Open Access Journals (Sweden)

    Hamm JA

    2013-08-01

    Full Text Available Jay A Hamm,1 Ilanit Hasson-Ohayon,2 Marina Kukla,3 Paul H Lysaker11Richard L Roudebush VA Medical Center, Department of Psychiatry, Indianapolis, IN, USA; 2Bar-Ilan University, Department of Psychology, Ramat Gan, Israel; 3Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice, Richard L Roudebush VA Medical Center, Indianapolis, IN, USAAbstract: Although the role and relative prominence of psychotherapy in the treatment of schizophrenia has fluctuated over time, an analysis of the history of psychotherapy for schizophrenia, focusing on findings from the recovery movement, reveals recent trends including the emergence of the development of integrative psychotherapy approaches. The authors suggest that the recovery movement has revealed limitations in traditional approaches to psychotherapy, and has provided opportunities for integrative approaches to emerge as a mechanism for promoting recovery in persons with schizophrenia. Five approaches to integrative psychotherapy for persons with schizophrenia are presented, and a shared conceptual framework that allows these five approaches to be compatible with one another is proposed. The conceptual framework is consistent with theories of recovery and emphasizes interpersonal attachment, personal narrative, and metacognitive processes. Implications for future research on integrative psychotherapy are considered.Keywords: schizophrenia, psychotherapy, recovery, metacognition, psychosis, integrative psychotherapy

  5. Individual psychotherapy for schizophrenia: trends and developments in the wake of the recovery movement.

    Science.gov (United States)

    Hamm, Jay A; Hasson-Ohayon, Ilanit; Kukla, Marina; Lysaker, Paul H

    2013-01-01

    Although the role and relative prominence of psychotherapy in the treatment of schizophrenia has fluctuated over time, an analysis of the history of psychotherapy for schizophrenia, focusing on findings from the recovery movement, reveals recent trends including the emergence of the development of integrative psychotherapy approaches. The authors suggest that the recovery movement has revealed limitations in traditional approaches to psychotherapy, and has provided opportunities for integrative approaches to emerge as a mechanism for promoting recovery in persons with schizophrenia. Five approaches to integrative psychotherapy for persons with schizophrenia are presented, and a shared conceptual framework that allows these five approaches to be compatible with one another is proposed. The conceptual framework is consistent with theories of recovery and emphasizes interpersonal attachment, personal narrative, and metacognitive processes. Implications for future research on integrative psychotherapy are considered.

  6. Individual psychotherapy for schizophrenia: trends and developments in the wake of the recovery movement

    Science.gov (United States)

    Hamm, Jay A; Hasson-Ohayon, Ilanit; Kukla, Marina; Lysaker, Paul H

    2013-01-01

    Although the role and relative prominence of psychotherapy in the treatment of schizophrenia has fluctuated over time, an analysis of the history of psychotherapy for schizophrenia, focusing on findings from the recovery movement, reveals recent trends including the emergence of the development of integrative psychotherapy approaches. The authors suggest that the recovery movement has revealed limitations in traditional approaches to psychotherapy, and has provided opportunities for integrative approaches to emerge as a mechanism for promoting recovery in persons with schizophrenia. Five approaches to integrative psychotherapy for persons with schizophrenia are presented, and a shared conceptual framework that allows these five approaches to be compatible with one another is proposed. The conceptual framework is consistent with theories of recovery and emphasizes interpersonal attachment, personal narrative, and metacognitive processes. Implications for future research on integrative psychotherapy are considered. PMID:23950665

  7. [Ethical foundations of institutional psychotherapy].

    Science.gov (United States)

    Cano, N

    2006-01-01

    The idea behind this work is to have an ethical examination of the institutional psychotherapy movement which has long influenced French public psychiatry and which has progressively, since the 80s, been subject to growing doubts. In the first part, institutional psychotherapy is presented. It is a model for theoretical development and practice in psychiatric care. It came into being just following the end of the Second World War at the same time as modern medical ethics. Its principles come on the one hand, from recognition of asylums' pathogenic effects--which led to the crushing of the patient's being--and on the other, through recognition of the uniqueness of each person and the subjectivity of mental suffering. These elements gave rise to creativity within the world of medicine and, in the sector, generated the science of psychiatry which advocated for continuity in care (both inpatient and outpatient) and preventive work directed at the population. This movement called for the use of the institution in its dynamic aspect which promotes exchanges and allows patients to situate or resituate themselves in historic and symbolic dimensions. It privileges a high level of transversality, maximum communication, favouring speaking out loud and responsibility. It requires a permanent analysis of the institutional counter transference (emotional reactions of the caregivers involved, their interrelations and the social and material organization of the institution) which determines the therapeutic action itself. THEORICAL BASIS: In a second part, its theoretical foundations and its practice shall be investigated in light of the guiding concepts of medical ethics (justice, autonomy, beneficence, non-malfeasance). Institutional psychotherapy responds to the need for justice by considering the patient as a whole and by conceiving each patient as being like oneself despite the differences (associated with the mode of hospitalization, the social or diagnostic category). The

  8. Is There Room for Criticism of Studies of Psychodynamic Psychotherapy?

    Science.gov (United States)

    Thombs, Brett D.; Jewett, Lisa R.; Bassel, Marielle

    2011-01-01

    Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler. Shedler declared unequivocally that "empirical evidence supports the efficacy of psychodynamic therapy" (p. 98). He did not mention any specific criticisms that have been made of evidence on psychodynamic psychotherapies or address possible distinctions…

  9. [The relationship of therapeutic alliance with a symptom reduction and treatment satisfaction in the therapeutic treatment of children and adolescents with ADHD and/or conduct disorder].

    Science.gov (United States)

    Kinnen, Claudia; Döpfner, Manfred

    2013-03-01

    The relationship of therapeutic alliance and outcome is investigated in outpatient behavior therapies of children and adolescents with externalizing problem behavior. Therapist-patient and therapist-parent relationships were evaluated twice during the therapies of N = 53 patients using German relationship questionnaires adapted for use in child and adolescent psychotherapy (BeKi). Pre-post symptom reduction in parent and patient rating, treatment satisfaction as rated by therapist, parent and patient as well as child's global functioning by therapist rating are examined as outcome parameters. The correlations between therapeutic alliance and symptom reduction vary depending on the rater between absence of correlation and high correlation (maximum: r = .53). Most correlations are low to moderate. These results are comparable to those reported in recently published meta-analyses and studies of adult psychotherapy. There are moderate correlations between therapist-patient and therapist-parent alliance and treatment satisfaction and low to moderate correlations with improvements in the children's global functioning. Only few studies have focused on treatment satisfaction and improvements in children's global functioning as outcome variables. Besides symptom reduction, these two variables also correlate significantly with the therapist-patient and therapist-parent alliance. Because correlations highly depend on the rater, future studies should consider the various perspectives.

  10. [SOPHO-NET - a research network on psychotherapy for social phobia].

    Science.gov (United States)

    Leichsenring, Falk; Salzer, Simone; Beutel, Manfred E; von Consbruch, Katrin; Herpertz, Stephan; Hiller, Wolfgang; Hoyer, Jürgen; Hüsing, Johannes; Irle, Eva; Joraschky, Peter; Konnopka, Alexander; König, Hans-Helmut; de Liz, Therese; Nolting, Björn; Pöhlmann, Karin; Ruhleder, Mirjana; Schauenburg, Henning; Stangier, Ulrich; Strauss, Bernhard; Subic-Wrana, Claudia; Vormfelde, Stefan V; Weniger, Godehard; Willutzki, Ulrike; Wiltink, Jörg; Leibing, Eric

    2009-01-01

    This paper presents the Social Phobia Psychotherapy Research Network (SOPHO-NET). SOPHO-NET is among the five research networks on psychotherapy funded by "Bundesministerium für Bildung und Forschung". The research program encompasses a coordinated group of studies of social phobia. In the central project (Study A), a multi-center randomized controlled trial, refined models of manualized cognitive-behavioral therapy (CBT) and manualized short-term psychodynamic psychotherapy (STPP) are compared in the treatment of social phobia. A sample of n=512 outpatients will be randomized to either CBT, STPP or wait list. For quality assurance and treatment integrity, a specific project has been established (Project Q). Study A is complemented by four interrelated projects focusing on attachment style (Study B1), cost-effectiveness (Study B2), polymorphisms in the serotonin transporter gene (Study C1) and on structural and functional deviations of hippocampus and amygdala (Study C2). Thus, the SOPHO-NET program allows for a highly interdisciplinary research of psychotherapy in social phobia.

  11. Training Psychiatry Residents in Psychotherapy: The Role of Manualized Treatments.

    Science.gov (United States)

    Pagano, Joshua; Kyle, Brandon N; Johnson, Toni L; Saeed, Sy Atezaz

    2017-06-01

    Evidence-based treatment and manualized psychotherapy have a recent but rich history. As interest and research have progressed, defining the role of treatment manuals in resident training and clinical practice has become more important. Although there is not a universal definition of treatment manual, most clinicians and researchers agree that treatment manuals are an essential piece of evidence-based therapy, and that despite several limitations, they offer advantages in training residents in psychotherapy. Requirements for resident training in psychotherapy have changed over the years, and treatment manuals offer a simple and straightforward way to meet training requirements. In a search limited to only depression, two treatment manuals emerged with the support of research regarding both clinical practice and resident training. In looking toward the future, it will be important for clinicians to remain updated on further advances in evidence based manualized treatment as a tool for training residents in psychotherapy, including recent developments in online and smartphone based treatments.

  12. Qualitative psychotherapy research: the journey so far and future directions.

    Science.gov (United States)

    Levitt, Heidi M

    2015-03-01

    This article documents the evolution of qualitative psychotherapy research over the past 3 decades. Clients' and therapists' accounts of their experiences in psychotherapy provide a window into the psychotherapy relationship and its mechanisms of change. A sizable body of literature has been generated that uses qualitative methods to collect and analyze these accounts and to shed light on the psychotherapy process. It notes changes in the field such as growing numbers of dissertations and publications using qualitative methods as well as a strengthening emphasis on qualitative research within graduate education and research funding bodies. Future recommendations include developing principles for practice from qualitative methods and conducting qualitative meta-analyses. Other recommendations include forming journal review policies that support the publication of qualitative research and that focus on coherence in adapting methods to meet research goals, in light of a study's characteristics and epistemological framework, rather than focusing on sets of procedures. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  13. The cost-effectiveness of psychotherapy for the major psychiatric diagnoses.

    Science.gov (United States)

    Lazar, Susan G

    2014-09-01

    Psychotherapy is an effective and often highly cost-effective medical intervention for many serious psychiatric conditions. Psychotherapy can also lead to savings in other medical and societal costs. It is at times the firstline and most important treatment and at other times augments the efficacy of psychotropic medication. Many patients are in need of more prolonged and intensive psychotherapy, including those with personality disorders and those with chronic complex psychiatric conditions often with severe anxiety and depression. Many patients with serious and complex psychiatric illness have experienced severe early life trauma in an atmosphere in which family members or caretakers themselves have serious psychiatric disorders. Children and adolescents with learning disabilities and those with severe psychiatric disorders can also require more than brief treatment. Other diagnostic groups for whom psychotherapy is effective and cost-effective include patients with schizophrenia, anxiety disorders (including posttraumatic stress disorder), depression, and substance abuse. In addition, psychotherapy for the medically ill with concomitant psychiatric illness often lowers medical costs, improves recovery from medical illness, and at times even prolongs life compared to similar patients not given psychotherapy. While "cost-effective" treatments can yield savings in healthcare costs, disability claims, and other societal costs, "cost-effective" by no means translates to "cheap" but instead describes treatments that are clinically effective and provided at a cost that is considered reasonable given the benefit they provide, even if the treatments increase direct expenses. In the current insurance climate in which Mental Health Parity is the law, insurers nonetheless often use their own non-research and non-clinically based medical necessity guidelines to subvert it and limit access to appropriate psychotherapeutic treatments. Many patients, especially those who need

  14. Assessing the marks of change: how psychotherapy alters the brain structure in women with borderline personality disorder.

    Science.gov (United States)

    Mancke, Falk; Schmitt, Ruth; Winter, Dorina; Niedtfeld, Inga; Herpertz, Sabine C; Schmahl, Christian

    2017-12-13

    There is increasing evidence that psychotherapy can alter the function of the brain of patients with borderline personality disorder (BPD). However, it is not known whether psychotherapy can also modify the brain structure of patients with BPD. We used structural MRI data of female patients with BPD before and after participation in 12 weeks of residential dialectical behavioural therapy (DBT) and compared them to data from female patients with BPD who received treatment as usual (TAU). We applied voxel-based morphometry to study voxel-wise changes in grey matter volume over time. We included 31 patients in the DBT group and 17 in the TAU group. Patients receiving DBT showed an increase of grey matter volume in the anterior cingulate cortex, inferior frontal gyrus and superior temporal gyrus together with an alteration of grey matter volume in the angular gyrus and supramarginal gyrus compared with patients receiving TAU. Furthermore, therapy response correlated with increase of grey matter volume in the angular gyrus. Only women were investigated, and groups differed in size, medication (controlled for) and intensity of the treatment condition. We found that DBT increased grey matter volume of brain regions that are critically implicated in emotion regulation and higher-order functions, such as mentalizing. The role of the angular gyrus for treatment response may reside in its cross-modal integrative function. These findings enhance our understanding of psychotherapy mechanisms of change and may foster the development of neurobiologically informed therapeutic interventions.

  15. Personality Theory and Psychotherapy

    Science.gov (United States)

    Fagan, Joen; And Others

    1974-01-01

    This group of articles discusses various aspects of Gestalt Therapy including its major contributions, role in psychotherapy, and contributions of Gestalt psychology in general. There is some discussion of the philosophical background of Gestalt therapy along with Gestalt theory of emotion. A case study and an annotated bibliography are included…

  16. Emergence of psychotic content in psychotherapy: An exploratory qualitative analysis of content, process, and therapist variables in a single case study.

    Science.gov (United States)

    Leonhardt, Bethany L; Kukla, Marina; Belanger, Elizabeth; Chaudoin-Patzoldt, Kelly A; Buck, Kelly D; Minor, Kyle S; Vohs, Jenifer L; Hamm, Jay A; Lysaker, Paul H

    2018-03-01

    Emerging integrative metacognitive therapies for schizophrenia seek to promote subjective aspects of recovery. Beyond symptom remission, they are concerned with shared meaning-making and intersubjective processes. It is unclear, however, how such therapies should understand and respond to psychotic content that threatens meaning-making in therapeutic contexts. Accordingly, we sought to understand what factors precede and potentially trigger psychotic content within psychotherapy and what aids in resolution and return to meaning-making. Forty-eight transcripts from a single psychotherapy case were analyzed with thematic analysis. Passages of delusional or disorganized content were identified and themes present prior to the emergence and resolution of such material were identified and coded. Themes that preceded the emergence of psychotic content varied across early, middle, and late phases of therapy. Material related to the patient's experience of inadequacy and potential vulnerability, therapist setting boundaries within the therapeutic relationship and making challenges appeared to trigger psychotic content, especially early in treatment. Psychotic content may emerge in session following identifiable antecedents which change over phases of therapy. Attending to psychotic content by assuming a non-hierarchical stance and not dismissing psychotic content may aid in maintaining intersubjectivity and support patient's movements toward recovery in integrative metacognitive therapies.

  17. The Oxidative Stress Agent Hypochlorite Stimulates c-di-GMP Synthesis and Biofilm Formation in Pseudomonas aeruginosa

    Directory of Open Access Journals (Sweden)

    Nikola Strempel

    2017-11-01

    Full Text Available The opportunistic human pathogen Pseudomonas aeruginosa is able to survive under a variety of often harmful environmental conditions due to a multitude of intrinsic and adaptive resistance mechanisms, including biofilm formation as one important survival strategy. Here, we investigated the adaptation of P. aeruginosa PAO1 to hypochlorite (HClO, a phagocyte-derived host defense compound and frequently used disinfectant. In static biofilm assays, we observed a significant enhancement in initial cell attachment in the presence of sublethal HClO concentrations. Subsequent LC-MS analyses revealed a strong increase in cyclic-di-GMP (c-di-GMP levels suggesting a key role of this second messenger in HClO-induced biofilm development. Using DNA microarrays, we identified a 26-fold upregulation of ORF PA3177 coding for a putative diguanylate cyclase (DGC, which catalyzes the synthesis of the second messenger c-di-GMP – an important regulator of bacterial motility, sessility and persistence. This DGC PA3177 was further characterized in more detail demonstrating its impact on P. aeruginosa motility and biofilm formation. In addition, cell culture assays attested a role for PA3177 in the response of P. aeruginosa to human phagocytes. Using a subset of different mutants, we were able to show that both Pel and Psl exopolysaccharides are effectors in the PA3177-dependent c-di-GMP network.

  18. Interpersonal Psychotherapy for Depressed Adolescents (IPT-A): A Case Illustration

    Science.gov (United States)

    Hall, Elisabeth Baerg; Mufson, Laura

    2009-01-01

    This article describes the treatment of a depressed adolescent (15 years of age) boy using Interpersonal Psychotherapy for depressed adolescents (IPT-A). IPT-A is an empirically supported psychosocial intervention for adolescents suffering from a depressive episode. It is delivered as an individual psychotherapy with a minimum of parental…

  19. [Psychotherapy research in the German-speaking community--a bibliometric analysis of three journals].

    Science.gov (United States)

    Petermann, Franz; Schüssler, Gerhard

    2010-01-01

    Psychotherapy research has often been considered a neglected topic in clinical psychology, psychosomatic medicine, and psychiatry because of its massive organizational and financial demands. However, it is unclear whether this assumption actually reflects the research activities in the field. We conducted a bibliometric analysis of the annual volumes for 2008 and 2009 of three clinical journals published in German. All publications referring to facets of psychotherapy research were analysed. About 30% of the publications dealt with issues of psychotherapy research. Outcome and process studies were about equally distributed. Process research frequently focused on patient variables as outcome predictors. Outcome studies most often presented effectiveness studies with rather small sample sizes. Psychotherapy research is a well-represented and multifaceted field in the German speaking research community. However, the traditional distinction between efficacy and process research among the various schools of psychotherapy research may be hampering further developments in this branch. The government-funded research networks may turn out to be promising approaches to overcoming some of the obstacles of classic psychotherapy research.

  20. [Attitudes towards psychotherapy in South Korea and Germany : A cross-cultural comparative study].

    Science.gov (United States)

    Schulz, W; Shin, M A; Schmid-Ott, G

    2018-01-01

    Due to the relatively recent introduction of psychotherapy in South Korea and against the background of collectivist and Confucian values, it has been suggested that South Koreans harbor more negative attitudes towards psychotherapy compared to Germans and that the social acceptance of psychotherapy is lower. We compared the attitudes of 99 women from South Korea with 98 German women using the questionnaire on attitudes towards psychotherapeutic treatment (FEP). For the study of the South Korean women we translated the questionnaire into the Korean language. The results of the psychometric analysis suggest that the Korean version of the FEP is of acceptable quality. South Korean women reported a significantly more negative attitude towards psychotherapy compared to German women. Furthermore, South Korean women anticipated a more skeptical social attitude towards psychotherapy compared to Germans. The presented results suggest the relevance of cultural imprinting in psychotherapy. They are discussed with respect to culture-specific self-concepts, concepts of disease and healing expectations and the increase of individualistic values in the Korean society.

  1. Counselling/psychotherapy and older people in medical settings.

    OpenAIRE

    Trethewey-Spurgeon, Celia.

    2004-01-01

    This study explores the nature of the need for counselling/psychotherapy for older people who suffer a debilitating physical injury or illness. This topic is investigated within a medical setting where the emphasis is on physical rehabilitation. The relevance of this inquiry is highlighted by the paucity of literature about the individual impact of such an event and the need for counselling/psychotherapy in these situations. Theories, on the ageing process, the body, and the self, are used to...

  2. Acceptance of Serious Games in Psychotherapy: An Inquiry into the Stance of Therapists and Patients.

    Science.gov (United States)

    Eichenberg, Christiane; Grabmayer, Gloria; Green, Nikos

    2016-11-01

    Serious games are computer or video games that contain elements that are specifically designed for the purpose of education or training. Serious games are increasingly being used within healthcare, but their introduction into and application in psychotherapeutic settings as an e-mental health treatment modality raises questions for both patients and therapists. Current research demonstrates the potential role and effectiveness of serious games within a psychotherapeutic context. However, a limited understanding of patients' and therapists' existing knowledge and experience of serious games, as well as of their readiness to utilize and apply them for the treatment of psychological conditions, requires further investigation. Acceptance, experience, and requirements for the utilization of serious games in therapeutic contexts were assessed through online surveys with German-speaking patients (n = 260) and psychotherapists (n = 234). Respondents' answers were analyzed by a combination of descriptive and inferential statistics by using SPSS. Current knowledge regarding serious games was very limited, with only 10.4% of patients and 11.5% of therapists reporting existing knowledge. However, a general openness toward the concept was observed: 88% of patients and 90% of therapists could envisage a therapeutic use. Patients (rs = 0.169, p = 0.006) who self-rated their level of computer and video game expertise as high were more likely to consider use within psychotherapy, compared with patients who self-rated their expertise as low. Therapists who currently play computer and video games perceive fewer disadvantages of serious game application in a psychotherapeutic context (p = 0.097). Consideration of serious game use was differentiated by the therapeutic approach (p = 0.003), specific mental disorders (highest rated relevant cases: anxiety disorders, affective disorders, disorders regarding impulse control, and adjustment disorders), and patient

  3. Psychotherapy, psychopathology, research and practice: pathways of connections and integration.

    Science.gov (United States)

    Castonguay, Louis G

    2011-03-01

    This paper describes three pathways of connections between different communities of knowledge seekers: integration of psychotherapeutic approaches, integration of psychotherapy and psychopathology, and integration of science and practice. Some of the issues discussed involve the delineation and investigation of common factors (e.g., principles of change), improvement of major forms of psychotherapy, clinical implications of psychopathology research, as well as current and future directions related to practice-research networks. The aim of this paper is to suggest that building bridges across theoretical orientations, scientific fields, professional experiences, and epistemological views may be a fruitful strategy to improve our understanding and the impact of psychotherapy.

  4. Exploring Psychotherapy Clients' Independent Strategies for Change While in Therapy

    Science.gov (United States)

    Mackrill, Thomas

    2008-01-01

    Psychotherapy research usually describes how client change is caused by therapist interventions. This article describes how clients change by continuing to use and revising the strategies for change that they bring with them when they first enter therapy. This article presents data from a qualitative diary study of psychotherapy. Three cases…

  5. Humor and creativity in psychotherapy

    Directory of Open Access Journals (Sweden)

    Javier Martín Camacho

    2015-09-01

    Full Text Available In the current article principal theories on humor are analyzed, relating them to different conceptions of creativity. Finally, some indications for the use of humor in psychotherapy are introduced, highlighting their positive and negative aspects. 

  6. Personal Investigator: A Therapeutic 3D Game for Adolescent Psychotherapy

    OpenAIRE

    Coyle, David; Matthews, Mark; Sharry, John; Nisbet, Andy; Doherty, Gavin

    2005-01-01

    Although mental health problems increase markedly during adolescent years, therapists often find it difficult to engage withadolescents. The majority of disturbed adolescents do not receive professional mental health care and of those who do fewerstill will fully engage with the therapeutic process (Offer et al. 1991; US Surgeon General 1999). Personal Investigator (PI) is a3D computer game specifically designed to help adolescents overcome mental health problems such as depression and helpth...

  7. Psychiatric Residents' Views of Quality of Psychotherapy Training and Psychotherapy Competencies: A Multisite Survey

    Science.gov (United States)

    Calabrese, Christina; Sciolla, Andres; Zisook, Sidney; Bitner, Robin; Tuttle, Jeffrey; Dunn, Laura B.

    2010-01-01

    Objective: Few studies of residents' attitudes toward psychotherapy training exist. The authors examined residents' perceptions of the quality of their training, support for training, their own competence levels, and associations between self-perceived competence and perceptions of the training environment. Methods: An anonymous, web-based…

  8. The effect of medical comorbidities on male and female Veterans' use of psychotherapy for PTSD.

    Science.gov (United States)

    Breland, Jessica Y; Greenbaum, Mark A; Zulman, Donna M; Rosen, Craig S

    2015-04-01

    Posttraumatic stress disorder (PTSD) is associated with an increased risk for medical comorbidities that may prevent participation in psychotherapy. The present study investigated whether medical comorbidities were associated with lower initiation rates and fewer psychotherapy visits for PTSD. Because women are more likely to initiate psychotherapy after traumatic events, we also assessed whether relationships were weaker among women. Veterans (N=482, 47% women) recently diagnosed with PTSD completed a survey assessing demographics, mood, functional status, and interest in treatment. Data on medical comorbidities, psychotherapy visits, antidepressant prescriptions, and service connection were assessed longitudinally through administrative files. Logistic and negative binomial regressions assessed associations between number of medical comorbidities in the 2 years before the survey and the initiation and number of psychotherapy visits for PTSD in the year after the survey. All analyses were stratified by sex and controlled for survey and administrative variables. The relationship between medical comorbidities and number of psychotherapy visits was stronger among women than among men. A greater number of medical comorbidities was associated with significantly fewer psychotherapy visits in the total sample [incidence rate ratio: 0.91; 95% confidence interval (CI): 0.83, 1.00] and among women (incidence rate ratio: 0.87; 95% CI: 0.77, 0.99), but not among men (95% CI: 0.75, 1.01). Medical comorbidities were not associated with the initiation of psychotherapy among men or women. Addressing medical comorbidities may help individuals remain in psychotherapy for PTSD. Medical comorbidities may play a larger role in the number of psychotherapy visits among women than men.

  9. Beneficial effects of combined benazepril-amlodipine on cardiac nitric oxide, cGMP, and TNF-alpha production after cardiac ischemia.

    Science.gov (United States)

    Siragy, Helmy M; Xue, Chun; Webb, Randy L

    2006-05-01

    The aim of this study was to determine if myocardial inflammation is increased after myocardial ischemia and whether angiotensin-converting enzyme inhibitors, calcium channel blockers, or diuretics decrease mediators of inflammation in rats with induced myocardial ischemia. Changes in cardiac interstitial fluid (CIF) levels of nitric oxide metabolites (NOX), cyclic guanosine 3',5'-monophosphate (cGMP), angiotensin II (Ang II), and tumor necrosis factor-alpha (TNF-alpha) were monitored with/without oral administration of benazepril, amlodipine, combined benazepril-amlodipine, or hydrochlorothiazide. Using a microdialysis technique, levels of several mediators of inflammation were measured after sham operation or 30-minute occlusion of the left anterior descending coronary artery. Compared with sham animals, levels of CIF NOX and cGMP were decreased in animals with ischemia (P Benazepril or amlodipine significantly increased NOX levels (P benazepril significantly increased cGMP (P benazepril-amlodipine further increased CIF NOX and cGMP (P benazepril alone, or combined benazepril-amlodipine significantly reduced TNF-alpha (P benazepril-amlodipine may be beneficial for managing cardiac ischemia.

  10. Internet and video technology in psychotherapy supervision and training.

    Science.gov (United States)

    Wolf, Abraham W

    2011-06-01

    The seven articles in this special section on the use of Internet and video technology represent the latest growth on one branch of the increasingly prolific and differentiated work in the technology of psychotherapy. In addition to the work presented here on video and the Internet applications to supervision and training, information technology is changing the field of psychotherapy through computer assisted therapies and virtual reality interventions.

  11. CSF concentrations of cAMP and cGMP are lower in patients with Creutzfeldt-Jakob disease but not Parkinson's disease and amyotrophic lateral sclerosis.

    Directory of Open Access Journals (Sweden)

    Patrick Oeckl

    Full Text Available BACKGROUND: The cyclic nucleotides cyclic adenosine-3',5'-monophosphate (cAMP and cyclic guanosine-3',5'-monophosphate (cGMP are important second messengers and are potential biomarkers for Parkinson's disease (PD, amyotrophic lateral sclerosis (ALS and Creutzfeldt-Jakob disease (CJD. METHODOLOGY/PRINCIPAL FINDINGS: Here, we investigated by liquid chromatography/tandem mass spectrometry (LC-MS/MS the cerebrospinal fluid (CSF concentrations of cAMP and cGMP of 82 patients and evaluated their diagnostic potency as biomarkers. For comparison with a well-accepted biomarker, we measured tau concentrations in CSF of CJD and control patients. CJD patients (n = 15 had lower cAMP (-70% and cGMP (-55% concentrations in CSF compared with controls (n = 11. There was no difference in PD, PD dementia (PDD and ALS cases. Receiver operating characteristic (ROC curve analyses confirmed cAMP and cGMP as valuable diagnostic markers for CJD indicated by the area under the curve (AUC of 0.86 (cAMP and 0.85 (cGMP. We calculated a sensitivity of 100% and specificity of 64% for cAMP and a sensitivity of 67% and specificity of 100% for cGMP. The combination of both nucleotides increased the sensitivity to 80% and specificity to 91% for the term cAMPxcGMP (AUC 0.92 and to 93% and 100% for the ratio tau/cAMP (AUC 0.99. CONCLUSIONS/SIGNIFICANCE: We conclude that the CSF determination of cAMP and cGMP may easily be included in the diagnosis of CJD and could be helpful in monitoring disease progression as well as in therapy control.

  12. Solicited Diary Studies of Psychotherapy in Qualitative Research - Pros and Cons

    DEFF Research Database (Denmark)

    Mackrill, Thomas

    2008-01-01

    Diary studies are scarce within the field of qualitative psychotherapy research. In this article arguments for and against the employment of solicited diaries studies in qualitative psychotherapy research are investigated. The strengths of diary studies are presented along with arguments concerning...

  13. [Meaning in life and mental health: personal meaning systems of psychotherapists and psychotherapy patients].

    Science.gov (United States)

    Löffler, Sabine; Knappe, Rainer; Joraschky, Peter; Pöhlmann, Karin

    2010-01-01

    This study investigated differences in the personal meaning systems of psychotherapists and psychotherapy patients as well as correlations between meaning in life and mental health. We qualitatively assessed the content and structure of the personal meaning systems of 41 psychotherapists and 77 psychotherapy patients. In addition, the participants completed questionnaires measuring meaning in life (LRI-r-d), sense of coherence (SOC-9L), self-esteem (RSES), satisfaction with life (SWLS), self-efficacy (SWK), and depression (BDI). The personal meaning systems of psychotherapists were more complex and coherent compared to psychotherapy patients. In the group of psychotherapy patients, a more elaborate structure of the personal meaning system correlated with the subjective sense of meaning. We were able to confirm correlations between meaning in life and mental health for most of the instances. Psychotherapists had more elaborate and coherent meaning systems than psychotherapy patients. Especially for psychotherapy patients elaborate and coherent meaning systems turned out to be important for mental health.

  14. Critical Role of Nitric Oxide-cGMP Cascade in the Formation of cAMP-Dependent Long-Term Memory

    Science.gov (United States)

    Aonuma, Hitoshi; Mizunami, Makoto; Matsumoto, Yukihisa; Unoki, Sae

    2006-01-01

    Cyclic AMP pathway plays an essential role in formation of long-term memory (LTM). In some species, the nitric oxide (NO)-cyclic GMP pathway has been found to act in parallel and complementary to the cAMP pathway for LTM formation. Here we describe a new role of the NO-cGMP pathway, namely, stimulation of the cAMP pathway to induce LTM. We have…

  15. Cost benefit of investment on quality in pharmaceutical manufacturing: WHO GMP pre- and post-certification of a Nigerian pharmaceutical manufacturer.

    Science.gov (United States)

    Anyakora, Chimezie; Ekwunife, Obinna; Alozie, Faith; Esuga, Mopa; Ukwuru, Jonathan; Onya, Steve; Nwokike, Jude

    2017-09-18

    Pharmaceutical companies in Africa need to invest in both facilities and quality management systems to achieve good manufacturing practice (GMP) compliance. Compliance to international GMP standards is important to the attainment of World Health Organization (WHO) prequalification. However, most of the local pharmaceutical manufacturing companies may be deterred from investing in quality because of many reasons, ranging from financial constraints to technical capacity. This paper primarily evaluates benefits against the cost of investing in GMP, using a Nigerian pharmaceutical company, Chi Pharmaceuticals Limited, as a case study. This paper also discusses how to drive more local manufacturers to invest in quality to attain GMP compliance; and proffers practical recommendations for local manufacturers who would want to invest in quality to meet ethical and regulatory obligations. The cost benefit of improving the quality of Chi Pharmaceuticals Limited's facilities and system to attain WHO GMP certification for the production of zinc sulfate 20-mg dispersible tablets was calculated by dividing the annual benefits derived from quality improvement interventions by the annual costs of implementing quality improvement interventions, referred to as a benefit-cost ratio (BCR). Cost benefit of obtaining WHO GMP certification for the production of zinc sulfate 20-mg dispersible tablets was 5.3 (95% confidence interval of 5.0-5.5). Investment in quality improvement intervention is cost-beneficial for local manufacturing companies. Governments and regulators in African countries should support pharmaceutical companies striving to invest in quality. Collaboration of local manufacturing companies with global companies will further improve quality. Local pharmaceutical companies should be encouraged to key into development opportunities available for pharmaceutical companies in Africa.

  16. Improvements in the automated radioimmunoassay for cAMP or cGMP

    International Nuclear Information System (INIS)

    Brooker, G.

    1988-01-01

    The work others in developing antibodies and the original radioimmunoassay for cyclic nucleotides provides the basis for these sensitive assays. The acetylation radioimmunoassay for cyclic nucleotides has enabled the measurement of cyclic AMP and cyclic GMP in very small biological samples. This is because accurate determinations can be made in samples containing less than 1 fmol of cyclic AMP or cyclic GMP. The Gamma-Flo automated radioimmunoassay system has been adapted to these assays such that cyclic nucleotides can be automatically measured at a rate of about 60 samples/hr. The Gamma-Flo instrument provides high-precision assays and eliminates human intervention in all steps of the radioimmunoassay. The automated assay has been in continuous operation in our laboratory over the last 10 years and this chapter summarizes the methodology and delineates improvements which have occurred over that time frame. Details for the preparation of the radioligands apply also to the manual acetylated radioimmunoassay for cyclic nucleotides

  17. IL-4 induces cAMP and cGMP in human monocytic cells

    Directory of Open Access Journals (Sweden)

    B. Dugas

    1995-01-01

    Full Text Available Human monocytes, preincubated with IFN-γ respond to IL-4 by a cGMP increase through activation of an inducible NO synthase. Here, IL-4 was found to induce an accumulation of cGMP (1 – 3 min and cAMP (20 – 25 min in unstimulated monocytes. This was impaired with NOS inhibitors, but also with EGTA and calcium/calmodulin inhibitors. These results suggest that: (1 IL-4 may stimulate different NOS isoforms in resting and IFN-γ activated monocytes, and (2 cAMP accumulation may be partially dependent on the NO pathway. By RT-PCR, a type III constitutive NOS mRNA was detected in U937 monocytic cells. IL-4 also increased the [Ca2+]i in these cells. Different NOS may thus be expressed in monocytic cells depending on their differentiation and the signals they receive.

  18. A comparison of pre-dropout and temporary rupture sessions in psychotherapy.

    Science.gov (United States)

    Gülüm, I Volkan; Soygüt, Gonca; Safran, Jeremy D

    2016-11-15

    Although numerous studies have investigated the relationship between the therapeutic alliance and dropout, most have focused on the relationship between alliance quality and psychotherapy outcomes. To compare sessions with therapeutic alliance ruptures and two sessions prior to treatment dropout (pre-dropout) in terms of rupture subtypes, psychotherapists' behavior, attitudes, and session content. We implemented quantitative methods to select the sessions and qualitative methods to analyze them. We analyzed 16 temporary rupture sessions from 12 therapist-patient dyads and 16 pre-dropout sessions from 8 different therapist-patient dyads. The sessions originate from clinical psychology Master's or Doctoral students under supervision in either cognitive behavioral or schema therapy. Pre-dropout sessions were considered unrepaired rupture sessions while rupture sessions were subsequently repaired. Results revealed apparent differences and similarities between the session types in positive and negative psychotherapist behaviors, content intensity, and the type and frequency of ruptures. We explored three new rupture subtypes: attributing positive developments to other sources, indirect speech, and sarcastic hostility. A striking implication is that the frequency of positive and negative psychotherapist behaviors, ruptures, and session content is more likely to decrease in the pre-dropout sessions than in the temporary rupture sessions.

  19. Brief Psychotherapy for Maternal Depression: Impact on Mothers and Children.

    Science.gov (United States)

    Swartz, Holly A; Cyranowski, Jill M; Cheng, Yu; Zuckoff, Allan; Brent, David A; Markowitz, John C; Martin, Stacy; Amole, Marlissa C; Ritchey, Fiona; Frank, Ellen

    2016-06-01

    Two-generation studies demonstrate that treating maternal depression benefits school-age children. Although mothers prefer psychotherapy to medication, little is known about how psychotherapy for maternal depression affects offspring, especially in very high-risk families in which both mothers and children concurrently meet syndromal criteria for psychiatric disorders. This trial evaluated the effects of 2 brief psychotherapies for maternal depression on very high-risk families. Mothers with major depressive disorder were randomly assigned to 9 sessions of either brief interpersonal psychotherapy for mothers (IPT-MOMS; n = 85) or brief supportive psychotherapy (BSP; n = 83). Independent assessors evaluated mothers and their children, ages 7 to 18 years, diagnosed with at least 1 internalizing disorder, every 3 months over the course of 1 year. Symptoms and functioning of mothers and children improved significantly over time, with no between-group differences. However, children of mothers assigned to BSP had more outpatient mental health visits and were more likely to receive antidepressant medication. Mothers reported greater satisfaction with IPT-MOMS than BSP. Improvement in mothers' depressive symptoms was associated with improvement in child functioning in time-lagged fashion, with children improving 3 to 6 months after mothers improved. Antidepressant medication use and number of mental health visits received by children did not affect outcomes. IPT-MOMS and BSP demonstrated comparable beneficial effects on maternal depression. Children's functioning improved following maternal improvement, independent of youths' treatment. Children of mothers randomized to IPT-MOMS, compared with BSP, achieved comparable outcomes despite less follow-up treatment. Observation of lagged association between maternal improvement and change in child functioning should influence treatment planning for families. Clinical trial registration information-Psychotherapy for Depressed

  20. Malaria parasite cGMP-dependent protein kinase regulates blood stage merozoite secretory organelle discharge and egress.

    Directory of Open Access Journals (Sweden)

    Christine R Collins

    2013-05-01

    Full Text Available The malaria parasite replicates within an intraerythrocytic parasitophorous vacuole (PV. Eventually, in a tightly regulated process called egress, proteins of the PV and intracellular merozoite surface are modified by an essential parasite serine protease called PfSUB1, whilst the enclosing PV and erythrocyte membranes rupture, releasing merozoites to invade fresh erythrocytes. Inhibition of the Plasmodium falciparum cGMP-dependent protein kinase (PfPKG prevents egress, but the underlying mechanism is unknown. Here we show that PfPKG activity is required for PfSUB1 discharge into the PV, as well as for release of distinct merozoite organelles called micronemes. Stimulation of PfPKG by inhibiting parasite phosphodiesterase activity induces premature PfSUB1 discharge and egress of developmentally immature, non-invasive parasites. Our findings identify the signalling pathway that regulates PfSUB1 function and egress, and raise the possibility of targeting PfPKG or parasite phosphodiesterases in therapeutic approaches to dysregulate critical protease-mediated steps in the parasite life cycle.