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Silva C, McGovern C, Gomez S, Beale E, Overholser J, Ridley J. Can I count on you? Social support, depression and suicide risk. Clin Psychol Psychother 2023; 30:1407-1415. [PMID: 37449798 DOI: 10.1002/cpp.2883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES Interpersonal factors play an important role in the etiology and treatment of depression. Social support derives from compassionate words and helpful actions provided by family, friends or a significant other. The present study was designed to examine various sources of social support as they relate to the severity of depressive symptoms, hopelessness and suicide risk in adult psychiatric outpatients. METHOD Participants were recruited through mental health clinics at a veteran's affairs medical centre. A total of 96 depressed patients were assessed using a diagnostic interview and self-report measures of depression severity, hopelessness and social support. Among these depressed adults, 45.8% had attempted suicide at least once. Social support variables were compared between suicide attempters and non-attempters to better understand the relationship between social support and suicidal behaviour. RESULTS Depression severity and hopelessness were both significantly associated with lower levels of social support in multiple areas. Individuals with a history of suicide attempt reported lower levels of available support as compared to those who have never attempted suicide. CONCLUSION Deficient social relationships increase the risk of suicide in depressed patients, exceeding the impact of depression alone on suicide risk. The lack of social support may play a vital role in feelings of hopelessness and isolation that contribute to a suicidal crisis. Psychosocial treatment should be considered to reduce the risk of suicide and severity of depression by strengthening social support and bolstering interpersonal relationships.
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Affiliation(s)
- Christiana Silva
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Christopher McGovern
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Stephanie Gomez
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Eleanor Beale
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - James Overholser
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Josephine Ridley
- Louis Stokes Cleveland Department of Veteran Affairs Medical Center, Cleveland, Ohio, USA
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2
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Praus P, Proctor T, Rohrmann T, Benedyk A, Tost H, Hennig O, Meyer-Lindenberg A, Wahl AS. Female sex and burden of depressive symptoms predict insufficient response to telemedical treatment in adult attention-deficit/hyperactivity disorder: results from a naturalistic patient cohort during the COVID-19 pandemic. Front Psychiatry 2023; 14:1193898. [PMID: 37867771 PMCID: PMC10585110 DOI: 10.3389/fpsyt.2023.1193898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is a chronic neuropsychiatric disorder, that typically manifests itself during childhood and persists in a majority of the affected individuals into adulthood, negatively affecting physical and mental health. Previous studies have shown detrimental effects of the COVID-19 pandemic on mental health in individuals with ADHD. Thus, telemedicine could be a useful tool for optimizing treatment-outcomes in adult ADHD by improving treatment adherence and persistence. However, data on telemedical treatment outcomes in adult patients with ADHD is scarce. Methods We report here the sub-cohort analysis of a naturalistic cohort of adult patients (N = 254) recruited between April 2020-April 2021, comparing the effects of telemedical treatment on participants either clinically diagnosed with depression (N = 54) or ADHD (N = 67). Participants were asked to fill out the WHO-5 repetitively during >12 weeks of telemedical treatment. Furthermore scores of WHO-5, SCL-90R and BDI-II, psychopathology, psychosocial functioning, sociodemographic data, medical records and a feedback survey were analyzed for both groups and compared. Participants with ADHD were further stratified according to the development of well-being during the study period in order to identify factors associated with a satisfactory treatment outcome. Results Participants with depression reported a significant improvement of well-being during the course of the study, while no such effect could be seen in participants with ADHD on a group level. Despite the good outcome, participants with depression were more severely affected at baseline, with significantly worse psychopathology and a more precarious labor and financial situation. A detailed analysis of ADHD participants without clinical improvement revealed significantly higher BDI-II scores than for ADHD participants with a satisfactory outcome (p = 0.03, Mann-Whitney-U-Test), suggesting successful treatment was hampered by the combination of ADHD and depressive symptoms. Furthermore, female sex among ADHD patients was correlated with an unfavorable treatment outcome during the course of the study (p = 0.001, Spearman correlation) as well as living with children (p = 0.02, Spearman correlation). Conclusion Besides screening for depressive symptoms before telemedical treatment, future research should address the specific needs of female ADHD patients as these patients may be at a particularly high risk of being overburdened with family work.
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Affiliation(s)
- Peter Praus
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Tanja Proctor
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Tobias Rohrmann
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Anastasia Benedyk
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Heike Tost
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Oliver Hennig
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | | | - Anna-Sophia Wahl
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
- Brain Research Institute, University of Zurich, Zurich, Switzerland
- Department of Neuroanatomy, Institute of Anatomy, Ludwigs-Maximilians-University, Munich, Germany
- Institute for Stroke and Dementia Research, University Hospital of Ludwigs-Maximilians-University, Munich, Germany
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3
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Jeon ME, Gomez MM, Stewart RA, Joiner TE. Acute suicidal affective disturbance and borderline personality disorder symptoms: Distinct yet correlated constructs. J Affect Disord 2023; 325:62-72. [PMID: 36586595 DOI: 10.1016/j.jad.2022.12.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 09/08/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Acute Suicidal Affective Disturbance (ASAD) has been proposed to address the need for a suicide-specific diagnostic entity that better accounts for the psychological symptoms that may emerge during an acute suicidal crisis and that may precede imminent suicidal behaviors. However, additional research is needed to establish ASAD's delimitation from preexisting psychological disorders, especially disorders that include suicidal thoughts and behaviors in their diagnostic criteria such as borderline personality disorder (BPD). METHODS We estimated two Gaussian graphical models (GGMs), exploratory factor analysis (EFA) models, and confirmatory factor analysis models in a sample of psychiatric outpatients (N = 460) to examine the structure of ASAD and BPD symptoms. RESULTS Our estimated models showed while most ASAD and BPD symptoms largely shared associations with other symptoms belonging to their respective disorder construct, strong associations connected some ASAD symptoms with BPD symptoms, which, in a network model, emerged in the form of nonzero edges among those symptoms, and in EFA models, as factors that featured both ASAD and BPD symptoms as indicators. CONCLUSIONS Our findings suggest the network structure of the proposed criteria of ASAD features symptoms that are largely distinct to ASAD but do include symptoms that share meaningful correlations with BPD symptoms that suggest ASAD and BPD are correlated constructs.
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Affiliation(s)
- Min Eun Jeon
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
| | - Marielle M Gomez
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Rochelle A Stewart
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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4
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Ekiz E, van Alphen SPJ, Ouwens MA, Van de Paar J, Videler AC. Systems Training for Emotional Predictability and Problem Solving for borderline personality disorder: A systematic review. Personal Ment Health 2023; 17:20-39. [PMID: 35729869 DOI: 10.1002/pmh.1558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/06/2022] [Accepted: 06/10/2022] [Indexed: 11/11/2022]
Abstract
Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment program for patients with borderline personality disorder (BPD). The program was intended to be highly accessible, both for patients and therapists. During STEPPS, patients are taught emotion regulation and behavior management skills. This systematic review synthesizes the current empirical status of STEPPS, focusing on research designs, quality of studies, target groups, protocols, and outcome. We selected 20 studies, with three randomized controlled trials. Patients with BPD, subthreshold BPD, and patients with BPD and comorbid antisocial personality disorder were investigated. One study was conducted in adolescents. There were no studies in older adults. Results demonstrated STEPPS to be associated with reduced BPD symptoms, improved quality of life, decreased depressive symptoms, and decreased negative affectivity. Mixed results were found for impulsivity and suicidal behaviors. STEPPS has both been studied as an add-on therapy to patients' ongoing treatment, and, with the addition of individual STEPPS sessions, as a stand-alone treatment. High attrition rates were found in patients attending STEPPS, complicating the generalizability of the results. Although the evidence for STEPPS is promising, further research is needed before firm conclusions can be drawn. Recommendations for future research are discussed.
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Affiliation(s)
- Erol Ekiz
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Sebastiaan P J van Alphen
- Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Clinical Center of Excellence for Personality Disorders in Older Adults, Mondriaan Mental Health Center, Heerlen-Maastricht, The Netherlands.,Personality and Psychopathology Research Group (PEPS), Department of Psychology (PE), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Machteld A Ouwens
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Jamie Van de Paar
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands
| | - Arjan C Videler
- PersonaCura, Clinical Center of Excellence for Personality Disorders and Autism in Older Adults, GGz Breburg, Tilburg, The Netherlands.,Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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5
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Robayo LE, Govind V, Salan T, Cherup NP, Sheriff S, Maudsley AA, Widerström-Noga E. Neurometabolite alterations in traumatic brain injury and associations with chronic pain. Front Neurosci 2023; 17:1125128. [PMID: 36908781 PMCID: PMC9997848 DOI: 10.3389/fnins.2023.1125128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Traumatic brain injury (TBI) can lead to a variety of comorbidities, including chronic pain. Although brain tissue metabolite alterations have been extensively examined in several chronic pain populations, it has received less attention in people with TBI. Thus, the primary aim of this study was to compare brain tissue metabolite levels in people with TBI and chronic pain (n = 16), TBI without chronic pain (n = 17), and pain-free healthy controls (n = 31). The metabolite data were obtained from participants using whole-brain proton magnetic resonance spectroscopic imaging (1H-MRSI) at 3 Tesla. The metabolite data included N-acetylaspartate, myo-inositol, total choline, glutamate plus glutamine, and total creatine. Associations between N-acetylaspartate levels and pain severity, neuropathic pain symptom severity, and psychological variables, including anxiety, depression, post-traumatic stress disorder (PTSD), and post-concussive symptoms, were also explored. Our results demonstrate N-acetylaspartate, myo-inositol, total choline, and total creatine alterations in pain-related brain regions such as the frontal region, cingulum, postcentral gyrus, and thalamus in individuals with TBI with and without chronic pain. Additionally, NAA levels in the left and right frontal lobe regions were positively correlated with post-concussive symptoms; and NAA levels within the left frontal region were also positively correlated with neuropathic pain symptom severity, depression, and PTSD symptoms in the TBI with chronic pain group. These results suggest that neuronal integrity or density in the prefrontal cortex, a critical region for nociception and pain modulation, is associated with the severity of neuropathic pain symptoms and psychological comorbidities following TBI. Our data suggest that a combination of neuronal loss or dysfunction and maladaptive neuroplasticity may contribute to the development of persistent pain following TBI, although no causal relationship can be determined based on these data.
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Affiliation(s)
- Linda E Robayo
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States.,Neuroscience Graduate Program, University of Miami, Miami, FL, United States
| | - Varan Govind
- Department of Radiology, University of Miami, Miami, FL, United States
| | - Teddy Salan
- Department of Radiology, University of Miami, Miami, FL, United States
| | - Nicholas P Cherup
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States
| | - Sulaiman Sheriff
- Department of Radiology, University of Miami, Miami, FL, United States
| | - Andrew A Maudsley
- Department of Radiology, University of Miami, Miami, FL, United States
| | - Eva Widerström-Noga
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL, United States.,Neuroscience Graduate Program, University of Miami, Miami, FL, United States.,Department of Neurological Surgery, University of Miami, Miami, FL, United States
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6
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Crossed functional specialization between the basal ganglia and cerebellum during vocal emotion decoding: Insights from stroke and Parkinson’s disease. COGNITIVE, AFFECTIVE, & BEHAVIORAL NEUROSCIENCE 2022; 22:1030-1043. [PMID: 35474566 PMCID: PMC9458588 DOI: 10.3758/s13415-022-01000-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/08/2022]
Abstract
There is growing evidence that both the basal ganglia and the cerebellum play functional roles in emotion processing, either directly or indirectly, through their connections with cortical and subcortical structures. However, the lateralization of this complex processing in emotion recognition remains unclear. To address this issue, we investigated emotional prosody recognition in individuals with Parkinson’s disease (model of basal ganglia dysfunction) or cerebellar stroke patients, as well as in matched healthy controls (n = 24 in each group). We analysed performances according to the lateralization of the predominant brain degeneration/lesion. Results showed that a right (basal ganglia and cerebellar) hemispheric dysfunction was likely to induce greater deficits than a left one. Moreover, deficits following left hemispheric dysfunction were only observed in cerebellar stroke patients, and these deficits resembled those observed after degeneration of the right basal ganglia. Additional analyses taking disease duration / time since stroke into consideration revealed a worsening of performances in patients with predominantly right-sided lesions over time. These results point to the differential, but complementary, involvement of the cerebellum and basal ganglia in emotional prosody decoding, with a probable hemispheric specialization according to the level of cognitive integration.
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7
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Robayo LE, Govind V, Vastano R, Felix ER, Fleming L, Cherup NP, Widerström-Noga E. Multidimensional pain phenotypes after Traumatic Brain Injury. FRONTIERS IN PAIN RESEARCH 2022; 3:947562. [PMID: 36061413 PMCID: PMC9437424 DOI: 10.3389/fpain.2022.947562] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/02/2022] [Indexed: 12/04/2022] Open
Abstract
More than 50% of individuals develop chronic pain following traumatic brain injury (TBI). Research suggests that a significant portion of post-TBI chronic pain conditions is neuropathic in nature, yet the relationship between neuropathic pain, psychological distress, and somatosensory function following TBI is not fully understood. This study evaluated neuropathic pain symptoms, psychological and somatosensory function, and psychosocial factors in individuals with TBI (TBI, N = 38). A two-step cluster analysis was used to identify phenotypes based on the Neuropathic Pain Symptom Inventory and Beck's Anxiety Inventory scores. Phenotypes were then compared on pain characteristics, psychological and somatosensory function, and psychosocial factors. Our analyses resulted in two different neuropathic pain phenotypes: (1) Moderate neuropathic pain severity and anxiety scores (MNP-AS, N = 11); and (2) mild or no neuropathic pain symptoms and anxiety scores (LNP-AS, N = 27). Furthermore, the MNP-AS group exhibited greater depression, PTSD, pain severity, and affective distress scores than the LNP-AS group. In addition, thermal somatosensory function (difference between thermal pain and perception thresholds) was significantly lower in the MNP-AS compared to the LNP-AS group. Our findings suggest that neuropathic pain symptoms are relatively common after TBI and are not only associated with greater psychosocial distress but also with abnormal function of central pain processing pathways.
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Affiliation(s)
- Linda E. Robayo
- Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL, United States
- Christine E. Lynn Rehabilitation Center, Miami Project to Cure Paralysis at UHealth/Jackson Memorial, Miami, FL, United States
| | - Varan Govind
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Roberta Vastano
- Christine E. Lynn Rehabilitation Center, Miami Project to Cure Paralysis at UHealth/Jackson Memorial, Miami, FL, United States
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Elizabeth R. Felix
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Loriann Fleming
- Christine E. Lynn Rehabilitation Center, Miami Project to Cure Paralysis at UHealth/Jackson Memorial, Miami, FL, United States
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Nicholas P. Cherup
- Christine E. Lynn Rehabilitation Center, Miami Project to Cure Paralysis at UHealth/Jackson Memorial, Miami, FL, United States
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Eva Widerström-Noga
- Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL, United States
- Christine E. Lynn Rehabilitation Center, Miami Project to Cure Paralysis at UHealth/Jackson Memorial, Miami, FL, United States
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
- *Correspondence: Eva Widerström-Noga
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8
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Hindradjat J, Livana PH. Effectiveness of Using a Mixed of CBT, CT-R, and Oral Treatment in Reducing Depression and Anxiety. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This qualitative research with case study method aims to determine the effectiveness of the combined use of CBT, CT-R and oral treatment to reduce depression and anxiety. The subject in this study was a 55 years old woman. Data were obtained through observation, interviews, and measurement of depression and anxiety levels using the DASS and MCMI-IV instruments. The results of this study showed that the combined use of CBT, CT-R and oral treatment reduced depression level and anxiety as indicated by a decrease in persistent depression scores 75 to 14, major depression scores 102 to 12 and generalized anxiety scores 115 to 30 on MCMI-IV scale. Measurements using the DASS show a decrease in depression scores 25 as major depression to 3 as normal depression, and a decrease in anxiety 16 as severe anxiety to 4 as normal anxiety. The measurement results supported by physical, psychological and behavioral changes. In addition, there are changes in personalities from borderline, melancholic and dependent to turbulent, histrionic and compulsiveon MCMI-IV scale..
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Shigemoto Y, Matsuda H, Kimura Y, Chiba E, Ohnishi M, Nakaya M, Maikusa N, Ogawa M, Mukai Y, Takahashi Y, Sako K, Toyama H, Inui Y, Taki Y, Nagayama H, Ono K, Kono A, Sekiguchi K, Hirano S, Sato N. Voxel-based analysis of age and gender effects on striatal [ 123I] FP-CIT binding in healthy Japanese adults. Ann Nucl Med 2022; 36:460-467. [PMID: 35174441 DOI: 10.1007/s12149-022-01725-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/01/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although previous studies have investigated age and gender effects on striatal subregional dopamine transporter (DaT) binding, these studies were mostly based on a conventional regions of interest-based analysis. Here, we investigated age and gender effects on striatal DaT binding at the voxel level, using a multicenter database of [(123)I] N-omega-fluoropropyl-2beta-carbomethoxy-3beta-{4-iodophenyl}nortropane ([(123)I] FP-CIT)-single photon emission computed tomography (SPECT) scans in 256 healthy Japanese adults. METHODS We used the Southampton method to calculate the specific binding ratios (SBRs) of each subject's striatum and then converted the [123I] FP-CIT SPECT images to quantitative SBRs images. To investigate the effects of age and gender effects on striatal DaT binding, we performed a voxel-based analysis using statistical parametric mapping. Gender differences were also compared between young to middle-aged subjects and elderly subjects (age threshold: 60 years). RESULTS When all subjects were explored as a group, DaT binding throughout the striatum decreased with advancing age. Among all subjects, the females showed higher DaT binding in the bilateral caudate compared to the males. In the young to middle-aged subjects, the females showed higher DaT binding throughout the striatum (with a slight caudate predominance) versus the males. In the elderly, there were no gender differences in striatal DaT binding. CONCLUSION Our findings of striatal subregional age- and gender-related differences may provide useful information to construct a more detailed DaT database in healthy Japanese subjects.
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Affiliation(s)
- Yoko Shigemoto
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.,Drug Discovery and Cyclotron Research Center, Southern TOHOKU Research Institute for Neuroscience, Koriyama, 963-8052, Japan
| | - Hiroshi Matsuda
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan. .,Drug Discovery and Cyclotron Research Center, Southern TOHOKU Research Institute for Neuroscience, Koriyama, 963-8052, Japan. .,Southern TOHOKU Research Institute for Neuroscience, Shin-Otemachi Building 6F (621), 2-2-1, Otemachi, Chiyoda-ku, Tokyo, 199-0004, Japan.
| | - Yukio Kimura
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Emiko Chiba
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Masahiro Ohnishi
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Moto Nakaya
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Norihide Maikusa
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Masayo Ogawa
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Yohei Mukai
- Department of Neurology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazuya Sako
- Department of Neurology, Nakamura Memorial Hospital, Sapporo, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University, Toyoake, Japan
| | - Yoshitaka Inui
- Department of Radiology, Fujita Health University, Toyoake, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Hiroshi Nagayama
- Department of Neurology, Graduate School of Medicine, Nippon Medical School Bunkyo-Ku, Tokyo, Japan
| | - Kenjiro Ono
- Division of Neurology, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan.,Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Atsushi Kono
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenji Sekiguchi
- Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
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10
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Feurer C, Granros M, Calentino AE, Suor JH, Patel K, Burkhouse KL. The interplay of stress and electrocortical reactivity to reward in the prospective prediction of depression symptoms during COVID-19. J Psychiatr Res 2021; 140:124-131. [PMID: 34111702 PMCID: PMC8319085 DOI: 10.1016/j.jpsychires.2021.05.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/29/2021] [Accepted: 05/20/2021] [Indexed: 11/28/2022]
Abstract
Rates of depression have increased during the novel coronavirus disease 2019 (COVID-19) pandemic, potentially due to associated stress exposure. However, it remains unclear which individuals are most susceptible. Electrocortical markers of reward processing, such as the reward positivity (RewP), are implicated in depression risk and may provide insights into who is most vulnerable to stress during the COVID-19 pandemic. The current study examined whether pre-pandemic neural correlates of reward reactivity (i.e., RewP) moderated the impact of social and financial stress on changes in youth and mother depression symptoms pre-to-post pandemic onset. Youth (n = 45) and mothers (n = 45) in the current sample were recruited prior to the COVID-19 pandemic as part of a larger study. RewP was assessed pre-pandemic, and depression symptoms were assessed pre- and post-pandemic onset for both youth and mothers. Additionally, social and financial chronic stress severity was assessed post-pandemic onset using a modified version of the UCLA Life Stress Interview. Financial stress was associated with prospective increases in depression for youth exhibiting blunted RewP at baseline. Similarly, family stress was associated with prospective increases in depression symptoms for mothers exhibiting blunted RewP at baseline. Findings suggest reduced reward responsiveness at the neural level may predispose both youth and mothers to future depression symptoms when exposed to higher levels of stress in the context of a pandemic.
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Affiliation(s)
- Cope Feurer
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA.
| | - Maria Granros
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Alison E. Calentino
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Jennifer H. Suor
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Khushboo Patel
- New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, Jonesboro, AR, USA
| | - Katie L. Burkhouse
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
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11
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Bronshteyn M, Yang FN, Shattuck KF, Dawson M, Kumar P, Moore DJ, Ellis RJ, Jiang X. Depression is associated with hippocampal volume loss in adults with HIV. Hum Brain Mapp 2021; 42:3750-3759. [PMID: 34089276 PMCID: PMC8288081 DOI: 10.1002/hbm.25451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/15/2021] [Accepted: 04/08/2021] [Indexed: 12/15/2022] Open
Abstract
Depressive symptoms are more prevalent in persons with HIV (PWH) than HIV‐uninfected individuals. In HIV‐uninfected individuals, depression has been associated with atrophy in the hippocampus and other brain regions. In the present study, we investigated the impact of depression on brain structure in PWH. One hundred PWH participated in a cross‐sectional study (56.6 ± 6.4 yrs, range 41–70 yrs, 24 females, 63 African Americans). The Beck's Depression Inventory‐II (BDI‐II) was used to assess depressive symptoms. Structural MRI images were collected. Both the voxel‐based morphometry (VBM) technique and a region of interest (ROI) based approach were used to examine the relationship between hippocampal gray matter volume (GMv) and depressive symptoms. The impact of HIV CD4 nadir and antidepressants was also investigated. Both VBM and ROI approaches revealed that higher BDI‐II scores (implicating more severe depressive symptoms) were associated with loss of hippocampal GMv, especially in the right hippocampus and the right entorhinal cortex. Low CD4 nadir predicted additional hippocampal volume loss independent of depressive symptoms. Taking antidepressants did not have a detectable effect on hippocampal volume. In summary, having more depressive symptoms is associated with smaller hippocampal volume in PWH, and a history of severe immunosuppression (i.e., low CD4 nadir) correlates with additional hippocampal volume reduction. However, the impact of depression on hippocampal volume may be independent of HIV‐disease severity such as low CD4 nadir.
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Affiliation(s)
- Margarita Bronshteyn
- Department of Neuroscience, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Fan Nils Yang
- Department of Neuroscience, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Kyle F Shattuck
- Department of Neuroscience, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Matthew Dawson
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Princy Kumar
- Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - David J Moore
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Ronald J Ellis
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA.,Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
| | - Xiong Jiang
- Department of Neuroscience, Georgetown University Medical Center, Washington, District of Columbia, USA
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12
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Henry LM, Steele EH, Watson KH, Bettis AH, Gruhn M, Dunbar J, Reising M, Compas BE. Stress Exposure and Maternal Depression as Risk Factors for Symptoms of Anxiety and Depression in Adolescents. Child Psychiatry Hum Dev 2020; 51:572-584. [PMID: 31729628 PMCID: PMC7225034 DOI: 10.1007/s10578-019-00940-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Little research has explored the implications of stress inside and outside of the family as a risk factor for psychological symptoms in adolescents of depressed mothers. In a sample of 115 adolescents and their mothers with and without depression histories, adolescents' family and peer stress exposure was measured through the Responses to Stress Questionnaire, and adolescents' anxious/depressed symptoms were measured with the Youth Self Report and Child Behavior Checklist. Mothers reported their current depression symptoms on the Beck Depression Inventory-II. Results suggest that adolescents of mothers with depression histories and current depression symptoms experience more family and peer stress than adolescents of nondepressed mothers. In multiple linear regression analyses, current maternal depression symptoms moderated the relation between adolescent peer stress and adolescent anxious/depressed symptoms, such that peer stress was associated with anxious/depressed symptoms when maternal depression symptoms were average or high, but not when maternal depression symptoms were low.
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Affiliation(s)
- Lauren M. Henry
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Ellen H. Steele
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Kelly H. Watson
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Alexandra H. Bettis
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Meredith Gruhn
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Jennifer Dunbar
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Michelle Reising
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Bruce E. Compas
- Department of Psychology and Human Development, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
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13
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Lim JU, Park CK, Kim TH, Jang AS, Park YB, Rhee CK, Jung KS, Yoo KH, Lee WY, Yoon HK. The Difficulty Of Improving Quality Of Life In COPD Patients With Depression And Associated Factors. Int J Chron Obstruct Pulmon Dis 2019; 14:2331-2341. [PMID: 31632002 PMCID: PMC6790330 DOI: 10.2147/copd.s216746] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/16/2019] [Indexed: 11/23/2022] Open
Abstract
Objectives Depression is a major comorbidity that affects clinical outcomes in patients with chronic obstructive pulmonary disease (COPD). COPD patients with depression are hospitalized more frequently, and show more acute exacerbations, decreased physical and social activities, and higher mortality compared to their non-depressed counterparts. In the present study, we investigated the clinical impact of depressive symptoms and associated clinical factors in Korean patients with COPD by evaluating multicenter cohort data. Materials and methods Patients with COPD enrolled in the Korean COPD Subtype Study, a multicenter observational study, from December 2011 to October 2014 were selected for evaluation. The initial evaluation of all patients included pulmonary function tests, 6 min walk distance (6MWD), the COPD Assessment Test (CAT), and the COPD-specific version of the St. George’s Respiratory Questionnaire (SGRQ-C). Significant depression was defined as a Beck Depression Inventory-II (BDI-II) score ≥17. Results Among the 270 study patients, 19.6% had significant depression. The depressed group showed a higher proportion of females (41.4%), lower body mass index (BMI), and lower education level compared to the non-depressed group (p = 0.002, p = 0.008, and p = 0.019, respectively). The depressed group had significantly higher CAT and SGRQ-C scores, as well as a lower 6MWD, compared to the non-depressed group based on 6 month-interval serial measurements over 3 years. The total SGRQ-C score and the symptoms, activity, and impact domain scores were significant predictors of depression (area under curves [AUCs] of 0.699 [0.613–0.786], 0.670 [0.581–0.758], 0.680 [0.589–0.770], and 0.689 [0.603–0.776], respectively). From CAT score domains, sleep and energy scores were significant predictors of depression (AUCs of 0.619 [0.522–0.715] and 0.595 [0.504–0.685], respectively). SGRQ-C score, low BMI, and decreased 6MWD were significantly associated with depression in a multivariable analysis. Conclusion A considerable proportion of patients with COPD had depression, and a high SGRQ-C score, low BMI, and low 6MWD were significantly associated with depression. As improving quality of life in this subgroup is difficult, physicians should be more active in screening patients with significant depression.
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Affiliation(s)
- Jeong Uk Lim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kwon Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Tae-Hyung Kim
- Division of Pulmonary and Critical Care Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - An-Soo Jang
- Division of Respiratory and Allergy, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Yong Bum Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Chin Kook Rhee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki Suck Jung
- Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang, Republic of Korea
| | - Kwang Ha Yoo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Won-Yeon Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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14
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Coping and Stress Reactivity as Moderators of Maternal Depressive Symptoms and Youth's Internalizing and Externalizing Symptoms. J Youth Adolesc 2019; 48:1580-1591. [PMID: 31134560 DOI: 10.1007/s10964-019-01033-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
Abstract
Youth's responses to stress are a central feature of risk and resilience across development. The current study examined whether youth coping and stress reactivity moderate the association of current maternal depressive symptoms with youth's internalizing and externalizing symptoms. Mothers (Mage = 41.58, SD = 6.18) with a wide range of depressive symptoms and their children ages 9-15 (Mage = 12.25, SD = 1.89, 45.3% girls) completed measures of youth symptoms and coping and automatic responses to stress. Mothers also completed a self-report measure of depressive symptoms. Youth's primary and secondary control coping, stress reactivity, and involuntary disengagement moderated the association between current maternal depressive symptoms and youth symptoms. Maternal depressive symptoms were associated with youth's internalizing and externalizing symptoms when youth used low as opposed to high levels of primary and secondary control coping. Conversely, maternal depressive symptoms were associated with youth symptoms for youth with high levels of stress reactivity and involuntary disengagement. The findings suggest interventions focused on improving the use of primary and secondary control coping skills and reducing reactivity and involuntary disengagement to stress may benefit youth with mothers who are experiencing high levels of depressive symptoms.
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15
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Fernández-Navarro P, Ribeiro AP, Soylemez KK, Gonçalves MM. Innovative Moments as Developmental Change Levels: A Case Study on Meaning Integration in the Treatment of Depression. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2019. [DOI: 10.1080/10720537.2019.1592037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Pablo Fernández-Navarro
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - António P. Ribeiro
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Kerem K. Soylemez
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Miguel M. Gonçalves
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
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16
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Henry LM, Forehand R, Watson KH, Gruhn M, Bettis AH, McKee LG, Compas BE. Parental Depressive Symptoms and Parenting: Associations with Children's Coping in Families of Depressed Parents. PARENTING, SCIENCE AND PRACTICE 2018; 18:281-296. [PMID: 33343236 PMCID: PMC7747799 DOI: 10.1080/15295192.2018.1529453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This multi-method study examined parental depressive symptoms and levels of harsh/intrusive and warm/responsive parenting as correlates of secondary control coping (acceptance, cognitive reappraisal, distraction) in children of parents with a history of depression. DESIGN The sample included 165 parents with a history of major depressive disorder and their 9- to15-year-old children. Parents provided self-reports of their current depressive symptoms; videorecordings of parent-child interactions were coded to determine parenting behaviors; and children reported their use of secondary control coping strategies. RESULTS Harsh/intrusive parenting related to less, and warm/responsive parenting related to greater, use of secondary control coping strategies in children. Parents' current depressive symptoms were only conditionally related to children's use of secondary control coping strategies, such that depressive symptoms moderated the relation between warm/responsive parenting behaviors and child secondary control coping. When parental depressive symptoms were low or average, warm/responsive parenting was positively related to children's secondary control coping. When parental depressive symptoms were high, warm/responsive parenting was not associated with children's secondary control coping. CONCLUSIONS The association between positive parenting behaviors and children's coping is contingent on current levels of parents' depressive symptoms. Efforts to enhance children's coping skills should target both parental depressive symptoms and parenting skills.
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Affiliation(s)
- Lauren M Henry
- Lauren M. Henry, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203. . Rex Forehand, Kelly H. Watson, Meredith Gruhn, Alexandra H. Bettis, Laura G. McKee, and Bruce E. Compas are associated with Vanderbilt University and the University of Vermont
| | - Rex Forehand
- Lauren M. Henry, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203. . Rex Forehand, Kelly H. Watson, Meredith Gruhn, Alexandra H. Bettis, Laura G. McKee, and Bruce E. Compas are associated with Vanderbilt University and the University of Vermont
| | - Kelly H Watson
- Lauren M. Henry, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203. . Rex Forehand, Kelly H. Watson, Meredith Gruhn, Alexandra H. Bettis, Laura G. McKee, and Bruce E. Compas are associated with Vanderbilt University and the University of Vermont
| | - Meredith Gruhn
- Lauren M. Henry, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203. . Rex Forehand, Kelly H. Watson, Meredith Gruhn, Alexandra H. Bettis, Laura G. McKee, and Bruce E. Compas are associated with Vanderbilt University and the University of Vermont
| | - Alexandra H Bettis
- Lauren M. Henry, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203. . Rex Forehand, Kelly H. Watson, Meredith Gruhn, Alexandra H. Bettis, Laura G. McKee, and Bruce E. Compas are associated with Vanderbilt University and the University of Vermont
| | - Laura G McKee
- Lauren M. Henry, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203. . Rex Forehand, Kelly H. Watson, Meredith Gruhn, Alexandra H. Bettis, Laura G. McKee, and Bruce E. Compas are associated with Vanderbilt University and the University of Vermont
| | - Bruce E Compas
- Lauren M. Henry, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203. . Rex Forehand, Kelly H. Watson, Meredith Gruhn, Alexandra H. Bettis, Laura G. McKee, and Bruce E. Compas are associated with Vanderbilt University and the University of Vermont
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17
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Sullivan ADW, Parent J, Forehand R, Compas BE. Does interparental conflict decrease following changes in observed parenting from a preventive intervention program? Behav Res Ther 2018; 106:64-70. [PMID: 29772446 DOI: 10.1016/j.brat.2018.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 04/21/2018] [Accepted: 05/05/2018] [Indexed: 11/18/2022]
Abstract
Interparental conflict, which is common among families where a parent has a history of Major Depressive Disorder, is associated with deficits in parenting. Models of family functioning propose that interparental conflict and parenting behaviors are transactional in nature. Given the interdependent nature of family systems, increases in positive parenting practices may lead to subsequent decreases in interparental conflict. The current study was a secondary analysis of data from a preventive intervention to improve parenting, child coping skills, and child behavior in families with a history of parental depression. We hypothesized that increases in positive parenting strategies would be associated with decreases in interparental conflict 12 months later. Results supported the study hypothesis. Findings underscored the interdependent nature of parent-child and parent-parent subsystems.
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18
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Matsuda H, Murata M, Mukai Y, Sako K, Ono H, Toyama H, Inui Y, Taki Y, Shimomura H, Nagayama H, Tateno A, Ono K, Murakami H, Kono A, Hirano S, Kuwabara S, Maikusa N, Ogawa M, Imabayashi E, Sato N, Takano H, Hatazawa J, Takahashi R. Japanese multicenter database of healthy controls for [ 123I]FP-CIT SPECT. Eur J Nucl Med Mol Imaging 2018; 45:1405-1416. [PMID: 29478082 PMCID: PMC5993845 DOI: 10.1007/s00259-018-3976-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/12/2018] [Indexed: 10/30/2022]
Abstract
PURPOSE The aim of this multicenter trial was to generate a [123I]FP-CIT SPECT database of healthy controls from the common SPECT systems available in Japan. METHODS This study included 510 sets of SPECT data from 256 healthy controls (116 men and 140 women; age range, 30-83 years) acquired from eight different centers. Images were reconstructed without attenuation or scatter correction (NOACNOSC), with only attenuation correction using the Chang method (ChangACNOSC) or X-ray CT (CTACNOSC), and with both scatter and attenuation correction using the Chang method (ChangACSC) or X-ray CT (CTACSC). These SPECT images were analyzed using the Southampton method. The outcome measure was the specific binding ratio (SBR) in the striatum. These striatal SBRs were calibrated from prior experiments using a striatal phantom. RESULTS The original SBRs gradually decreased in the order of ChangACSC, CTACSC, ChangACNOSC, CTACNOSC, and NOACNOSC. The SBRs for NOACNOSC were 46% lower than those for ChangACSC. In contrast, the calibrated SBRs were almost equal under no scatter correction (NOSC) conditions. A significant effect of age was found, with an SBR decline rate of 6.3% per decade. In the 30-39 age group, SBRs were 12.2% higher in women than in men, but this increase declined with age and was absent in the 70-79 age group. CONCLUSIONS This study provided a large-scale quantitative database of [123I]FP-CIT SPECT scans from different scanners in healthy controls across a wide age range and with balanced sex representation. The phantom calibration effectively harmonizes SPECT data from different SPECT systems under NOSC conditions. The data collected in this study may serve as a reference database.
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Affiliation(s)
- Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan.
| | - Miho Murata
- Department of Neurology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Yohei Mukai
- Department of Neurology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazuya Sako
- Department of Neurology, Nakamura Memorial Hospital, Sapporo, Japan
| | - Hidetoshi Ono
- Department of Radiology, Nakamura Memorial Hospital, Sapporo, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University, Toyoake, Japan
| | - Yoshitaka Inui
- Department of Radiology, Fujita Health University, Toyoake, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Hideo Shimomura
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Hiroshi Nagayama
- Department of Neurology, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Amane Tateno
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Kenjiro Ono
- Department of Neurology, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Hidetomo Murakami
- Department of Neurology, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Atsushi Kono
- Department of Radiology, Kobe University, Kobe, Japan.,Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | | | - Norihide Maikusa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Masayo Ogawa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Etsuko Imabayashi
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Harumasa Takano
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Jun Hatazawa
- Department of Nuclear Medicine, Osaka University, Osaka, Japan
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19
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Li S, Yaseen ZS, Kim HJ, Briggs J, Duffy M, Frechette-Hagan A, Cohen LJ, Galynker II. Entrapment as a mediator of suicide crises. BMC Psychiatry 2018; 18:4. [PMID: 29310622 PMCID: PMC5759206 DOI: 10.1186/s12888-018-1587-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 01/01/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Prior research has validated the construct of a suicide crisis syndrome (SCS), a specific psychological state that precedes and may precipitate suicidal behavior. The feeling of entrapment is a central concept of the SCS as well as of several other recent models of suicide. However, its exact relationship with suicidality is not fully understood. In efforts to clarify the exact role of entrapment in the suicidal process, we have examined if entrapment mediates the relationship of other components of the SCS, including ruminative flooding, panic-dissociation, fear of dying and emotional pain, with suicidal ideation (SI) in recently hospitalized psychiatric inpatients. METHODS The Suicide Crisis Inventory (SCI) and Beck Scale for Suicidal Ideation (BSS) were administered to 200 high-risk adult psychiatric inpatients hospitalized following SI or suicide attempt, assessing SCS and SI levels at admission, respectively. The possible mediation effects of entrapment on the relationship between the other components of the SCS and SI at admission were evaluated. RESULTS Entrapment significantly and fully mediated the relationship of ruminative flooding, panic-dissociation, and fear of dying with SI, with no direct relationships between these variables and SI reaching statistical significance. Further, no reverse mediation relationships between these variables and SI were found, indicating that the mediation effects of entrapment were unidirectional. While entrapment did mediate the association between emotional pain and SI, the direct relationship between emotional pain and SI was also significant. Moreover, in reverse mediational analysis, emotional pain was a partial mediator of the relationship between entrapment and SI. CONCLUSION Entrapment and emotional pain may have a more direct association with SI than the other components of the SCS, including ruminative flooding, panic-dissociation, and fear of dying, the effects of which are mediated by the former. This suggests entrapment and emotional pain may represent key symptomatic targets for intervention in acutely suicidal individuals. Further research is needed to determine the relationship of these constructs to suicidal behavior.
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Affiliation(s)
- Shuang Li
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Zimri S. Yaseen
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Hae-Joon Kim
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Jessica Briggs
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Molly Duffy
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Anna Frechette-Hagan
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Lisa J. Cohen
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
| | - Igor I. Galynker
- Department of Psychiatry, Beth Israel Medical Center NY, 1st Avenue and 15th Street, New York, NY 10003 USA
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20
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Lopes RT, Gonçalves MM, Sinai D, Machado PP. Clinical outcomes of psychotherapy dropouts: does dropping out of psychotherapy necessarily mean failure? ACTA ACUST UNITED AC 2017; 40:123–127. [PMID: 28876379 PMCID: PMC6900777 DOI: 10.1590/1516-4446-2017-2267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/09/2017] [Indexed: 11/21/2022]
Abstract
Objective: A large proportion of psychotherapy patients remain untreated, mostly because they drop out. This study compares the short- and long-term outcomes of patients who dropped out of psychotherapy to those of therapy completers. Methods: The sample included 63 patients (23 dropouts and 40 completers) from a controlled clinical trial, which compared narrative therapy vs. cognitive-behavioral therapy for major depressive disorder. Patients were assessed at the eighth session, post-treatment, and at 31-month follow-up. Results: Dropouts improved less than completers by the last session attended, but continued to improve significantly more than completers during the follow-up period. Some dropout patients improved with a small dose of therapy (17% achieved a clinically significant change before abandoning treatment), while others only achieved clinically significant change after a longer period (62% at 31-month follow-up). Conclusion: These results emphasize the importance of dealing effectively with patients at risk of dropping out of therapy.Patients who dropped out also reported improvement of depressive symptoms without therapy, but took much longer to improve than did patients who completed therapy. This might be attributable to natural remission of depression. Further research should use a larger patient database, ideally gathered by meta-analysis.
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Affiliation(s)
- Rodrigo T Lopes
- Centro de Investigação em Psicologia (CIPsi), Escola de Psicologia, Universidade do Minho, Braga, Portugal.,Departamento de Psicologia, Universidade Católica de Petrópolis, Petrópolis, RJ, Brasil
| | - Miguel M Gonçalves
- Centro de Investigação em Psicologia (CIPsi), Escola de Psicologia, Universidade do Minho, Braga, Portugal
| | - Dana Sinai
- Laboratory for the Study of Interpersonal Relationships, Ben-Gurion University of the Negev (BGU), Beer-Sheva, Israel
| | - Paulo P Machado
- Centro de Investigação em Psicologia (CIPsi), Escola de Psicologia, Universidade do Minho, Braga, Portugal
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21
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Treating major depression with yoga: A prospective, randomized, controlled pilot trial. PLoS One 2017; 12:e0173869. [PMID: 28301561 PMCID: PMC5354384 DOI: 10.1371/journal.pone.0173869] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 02/27/2017] [Indexed: 12/16/2022] Open
Abstract
Background Conventional pharmacotherapies and psychotherapies for major depression are associated with limited adherence to care and relatively low remission rates. Yoga may offer an alternative treatment option, but rigorous studies are few. This randomized controlled trial with blinded outcome assessors examined an 8-week hatha yoga intervention as mono-therapy for mild-to-moderate major depression. Methods Investigators recruited 38 adults in San Francisco meeting criteria for major depression of mild-to-moderate severity, per structured psychiatric interview and scores of 14–28 on Beck Depression Inventory-II (BDI). At screening, individuals engaged in psychotherapy, antidepressant pharmacotherapy, herbal or nutraceutical mood therapies, or mind-body practices were excluded. Participants were 68% female, with mean age 43.4 years (SD = 14.8, range = 22–72), and mean BDI score 22.4 (SD = 4.5). Twenty participants were randomized to 90-minute hatha yoga practice groups twice weekly for 8 weeks. Eighteen participants were randomized to 90-minute attention control education groups twice weekly for 8 weeks. Certified yoga instructors delivered both interventions at a university clinic. Primary outcome was depression severity, measured by BDI scores every 2 weeks from baseline to 8 weeks. Secondary outcomes were self-efficacy and self-esteem, measured by scores on the General Self-Efficacy Scale (GSES) and Rosenberg Self-Esteem Scale (RSES) at baseline and at 8 weeks. Results In intent-to-treat analysis, yoga participants exhibited significantly greater 8-week decline in BDI scores than controls (p-value = 0.034). In sub-analyses of participants completing final 8-week measures, yoga participants were more likely to achieve remission, defined per final BDI score ≤ 9 (p-value = 0.018). Effect size of yoga in reducing BDI scores was large, per Cohen’s d = -0.96 [95%CI, -1.81 to -0.12]. Intervention groups did not differ significantly in 8-week change scores for either the GSES or RSES. Conclusion In adults with mild-to-moderate major depression, an 8-week hatha yoga intervention resulted in statistically and clinically significant reductions in depression severity. Trial registration ClinicalTrials.gov NCT01210651
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Patel V, Weobong B, Weiss HA, Anand A, Bhat B, Katti B, Dimidjian S, Araya R, Hollon SD, King M, Vijayakumar L, Park AL, McDaid D, Wilson T, Velleman R, Kirkwood BR, Fairburn CG. The Healthy Activity Program (HAP), a lay counsellor-delivered brief psychological treatment for severe depression, in primary care in India: a randomised controlled trial. Lancet 2017; 389:176-185. [PMID: 27988143 PMCID: PMC5236064 DOI: 10.1016/s0140-6736(16)31589-6] [Citation(s) in RCA: 239] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/15/2016] [Accepted: 08/25/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although structured psychological treatments are recommended as first-line interventions for depression, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of a brief psychological treatment (Healthy Activity Program [HAP]) for delivery by lay counsellors to patients with moderately severe to severe depression in primary health-care settings. METHODS In this randomised controlled trial, we recruited participants aged 18-65 years scoring more than 14 on the Patient Health Questionnaire 9 (PHQ-9) indicating moderately severe to severe depression from ten primary health centres in Goa, India. Pregnant women or patients who needed urgent medical attention or were unable to communicate clearly were not eligible. Participants were randomly allocated (1:1) to enhanced usual care (EUC) alone or EUC combined with HAP in randomly sized blocks (block size four to six [two to four for men]), stratified by primary health centre and sex, and allocation was concealed with use of sequential numbered opaque envelopes. Physicians providing EUC were masked. Primary outcomes were depression symptom severity on the Beck Depression Inventory version II and remission from depression (PHQ-9 score of <10) at 3 months in the intention-to-treat population, assessed by masked field researchers. Secondary outcomes were disability, days unable to work, behavioural activation, suicidal thoughts or attempts, intimate partner violence, and resource use and costs of illness. We assessed serious adverse events in the per-protocol population. This trial is registered with the ISRCTN registry, number ISRCTN95149997. FINDINGS Between Oct 28, 2013, and July 29, 2015, we enrolled and randomly allocated 495 participants (247 [50%] to the EUC plus HAP group [two of whom were subsequently excluded because of protocol violations] and 248 [50%] to the EUC alone group), of whom 466 (95%) completed the 3 month primary outcome assessment (230 [49%] in the EUC plus HAP group and 236 [51%] in the EUC alone group). Participants in the EUC plus HAP group had significantly lower symptom severity (Beck Depression Inventory version II in EUC plus HAP group 19·99 [SD 15·70] vs 27·52 [13·26] in EUC alone group; adjusted mean difference -7·57 [95% CI -10·27 to -4·86]; p<0·0001) and higher remission (147 [64%] of 230 had a PHQ-9 score of <10 in the HAP plus EUC group vs 91 [39%] of 236 in the EUC alone group; adjusted prevalence ratio 1·61 [1·34-1·93]) than did those in the EUC alone group. EUC plus HAP showed better results than did EUC alone for the secondary outcomes of disability (adjusted mean difference -2·73 [-4·39 to -1·06]; p=0·001), days out of work (-2·29 [-3·84 to -0·73]; p=0·004), intimate partner physical violence in women (0·53 [0·29-0·96]; p=0·04), behavioural activation (2·17 [1·34-3·00]; p<0·0001), and suicidal thoughts or attempts (0·61 [0·45-0·83]; p=0·001). The incremental cost per quality-adjusted life-year gained was $9333 (95% CI 3862-28 169; 2015 international dollars), with an 87% chance of being cost-effective in the study setting. Serious adverse events were infrequent and similar between groups (nine [4%] in the EUC plus HAP group vs ten [4%] in the EUC alone group; p=1·00). INTERPRETATION HAP delivered by lay counsellors plus EUC was better than EUC alone was for patients with moderately severe to severe depression in routine primary care in Goa, India. HAP was readily accepted by this previously untreated population and was cost-effective in this setting. HAP could be a key strategy to reduce the treatment gap for depressive disorders, the leading mental health disorder worldwide. FUNDING Wellcome Trust.
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Affiliation(s)
- Vikram Patel
- Sangath Centre, Socorro Village, Bardez-Goa, Goa, India; Centre for Global Mental Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Benedict Weobong
- Centre for Global Mental Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Helen A Weiss
- Medical Research Council Tropical Epidemiology Group; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Arpita Anand
- Sangath Centre, Socorro Village, Bardez-Goa, Goa, India
| | - Bhargav Bhat
- Sangath Centre, Socorro Village, Bardez-Goa, Goa, India
| | | | - Sona Dimidjian
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
| | - Ricardo Araya
- Centre for Global Mental Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Steve D Hollon
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Michael King
- Department of Mental Health Sciences, University College London, London, UK
| | - Lakshmi Vijayakumar
- Sneha, Voluntary Health Services, University of Melbourne, Melbourne, VIC, Australia
| | - A-La Park
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - David McDaid
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
| | - Terry Wilson
- Department of Psychology, Rutgers School of Arts and Sciences, NJ, USA
| | - Richard Velleman
- Sangath Centre, Socorro Village, Bardez-Goa, Goa, India; Department of Psychology, University of Bath, Bath, UK
| | - Betty R Kirkwood
- Centre for Global Mental Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Gonçalves MM, Silva JR, Mendes I, Rosa C, Ribeiro AP, Batista J, Sousa I, Fernandes CF. Narrative Changes Predict a Decrease in Symptoms in CBT for Depression: An Exploratory Study. Clin Psychol Psychother 2016; 24:835-845. [PMID: 27766698 DOI: 10.1002/cpp.2048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 09/08/2016] [Accepted: 09/14/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Innovative moments (IMs) are new and more adjusted ways of thinking, acting, feeling and relating that emerge during psychotherapy. Previous research on IMs has provided sustainable evidence that IMs differentiate recovered from unchanged psychotherapy cases. However, studies with cognitive behavioural therapy (CBT) are so far absent. The present study tests whether IMs can be reliably identified in CBT and examines if IMs and symptoms' improvement are associated. METHODS The following variables were assessed in each session from a sample of six cases of CBT for depression (a total of 111 sessions): (a) symptomatology outcomes (Outcome Questionnaire-OQ-10) and (b) IMs. Two hierarchical linear models were used: one to test whether IMs predicted a symptom decrease in the next session and a second one to test whether symptoms in one session predicted the emergence of IMs in the next session. RESULTS Innovative moments were better predictors of symptom decrease than the reverse. A higher proportion of a specific type of IMs-reflection 2-in one session predicted a decrease in symptoms in the next session. Thus, when clients further elaborated this type of IM (in which clients describe positive contrasts or elaborate on changes processes), a reduction in symptoms was observed in the next session. DISCUSSION A higher expression and elaboration of reflection 2 IMs appear to have a facilitative function in the reduction of depressive symptoms in this sample of CBT. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE Elaborating innovative moments (IMs) that are new ways of thinking, feeling, behaving and relating, in the therapeutic dialogue, may facilitate change. IMs that are more predictive of amelioration of symptoms in CBT are the ones focused on contrasts between former problematic patterns and new adjusted ones; and the ones in which the clients elaborate on processes of change. Therapists may integrate these kinds of questions (centred on contrasts and centred on what allowed change from the client's perspective), in the usual CBT techniques. When elaborating these IMs successfully, therapists may expect an improvement in symptoms in the next session of psychotherapy.
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Affiliation(s)
| | | | - Inês Mendes
- University of Minho, School of Psychology, Braga, Portugal
| | - Catarina Rosa
- University of Minho, School of Psychology, Braga, Portugal
| | | | - João Batista
- University of Minho, School of Psychology, Braga, Portugal
| | - Inês Sousa
- University of Minho, Department of Mathematics, Braga, Portugal
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Yaseen ZS, Galynker II, Briggs J, Freed RD, Gabbay V. Functional domains as correlates of suicidality among psychiatric inpatients. J Affect Disord 2016; 203:77-83. [PMID: 27280966 PMCID: PMC4975988 DOI: 10.1016/j.jad.2016.05.066] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Suicide remains poorly understood and unpredictable. Addressing this challenge, this study examined the independent contributions of several research domain criteria (RDoC) constructs in relation to suicidality in patients hospitalized for acute suicide risk. Specifically, we examined anhedonia, anxiety/entrapment, and attachment disturbances, reflecting disturbances in reward processes, negative valence systems, and social processes, respectively. METHODS Anhedonia, anxiety, entrapment, and fearful attachment, were assessed quantitatively in 135 adults hospitalized for suicidality. Current suicidality and suicidal history were assessed with the Columbia Suicide Severity Rating Scale. Bivariate analyses (with significance threshold of p<.01 to account for multiple comparisons) and multivariate models examined relationships between symptom dimensions and severity of suicidal ideation (SI). We also assessed differences between patients with a history of suicide attempt and those who exhibited only suicidal ideations. RESULTS Using bivariate analyses all symptoms except for fearful attachment correlated robustly with SI (r =.37-0.50, p<.001). However, when using multivariate analyses, only anhedonia (β=.28, p=.01) and entrapment (β=.19, p=.03) were independently associated with SI across the entire sample. No functional domain measures differed between patients with history of suicide attempt versus ideation only. LIMITATIONS The reliance on self-report data and a cross-sectional design. CONCLUSIONS Disturbances in reward and threat processing may represent independent factors in the development of suicidal ideation in this high suicide risk cohort. Future studies should assess their role as risk factors.
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Affiliation(s)
- Zimri S Yaseen
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA; Mount Sinai Beth Israel, Department of Psychiatry, First Avenue at 16th Street, New York, NY 10003, USA.
| | - Igor I Galynker
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA; Mount Sinai Beth Israel, Department of Psychiatry, First Avenue at 16th Street, New York, NY 10003, USA
| | - Jessica Briggs
- Mount Sinai Beth Israel, Department of Psychiatry, First Avenue at 16th Street, New York, NY 10003, USA
| | - Rachel D Freed
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA
| | - Vilma Gabbay
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, One Gustave L. Levy Place, New York, NY 10029, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA
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Gonçalves MM, Batista J, Freitas S. Narrative and Clinical Change in Cognitive-Behavior Therapy: A Comparison of Two Recovered Cases. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2016. [DOI: 10.1080/10720537.2016.1183537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mendes I, Rosa C, Stiles WB, Caro Gabalda I, Gomes P, Basto I, Salgado J. Setbacks in the process of assimilation of problematic experiences in two cases of emotion-focused therapy for depression. Psychother Res 2016; 26:638-52. [PMID: 26838126 DOI: 10.1080/10503307.2015.1136443] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Research on the assimilation model has suggested that psychological change takes place in a sequence of stages punctuated by setbacks, that is, by transient reversals in the developmental course. This study analyzed such setbacks in one good outcome case and one poor outcome case of Emotion-focused therapy (EFT) for depression. METHOD Intensive analyses of five transcribed sessions from each case identified 26 setbacks in the good outcome case and 27 in the poor outcome case. The reason for each setback was classified into one of four categories: balance strategy, exceeding the therapeutic zone of proximal development either induced by the therapist (ZPD-T) or induced by the client (ZPD-C), or spontaneous switches. RESULTS In the good outcome case the most frequent reasons for setbacks were balance strategy and spontaneous switches, whereas in the poor outcome case the most frequent reason for setbacks was ZPD-T. CONCLUSIONS As in previously studied therapies, setbacks in EFT, usually represent productive work on relatively less advanced strands of the client's major problems. Results point to the importance of the therapist attending to the limits of the client's therapeutic ZPD.
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Affiliation(s)
- Inês Mendes
- a CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology , University of Minho , Braga , Portugal.,b Department of Behavior and Social Sciences , ISMAI - University Institute of Maia , Maia , Portugal
| | - Catarina Rosa
- c Department of Education , University of Aveiro , Averio , Portugal.,d Ibili - Institute for Biomedical Imaging and Life Sciences, University of Coimbra , Coimbra , Portugal
| | - William B Stiles
- e Department of Psychology , Miami University , Oxford , OH , USA.,f Department of Psychology , Appalachian State University , Boone , NC , USA
| | - Isabel Caro Gabalda
- g Department of Personality, Assessment and Psychological Treatments , University of Valencia , Valencia , Spain
| | - Pedro Gomes
- b Department of Behavior and Social Sciences , ISMAI - University Institute of Maia , Maia , Portugal.,h Center of Psychology , University of Porto , Porto , Portugal
| | - Isabel Basto
- i CINNEIC, Faculty of Psychology and Educational Sciences , University of Coimbra , Coimbra , Portugal
| | - João Salgado
- b Department of Behavior and Social Sciences , ISMAI - University Institute of Maia , Maia , Portugal.,h Center of Psychology , University of Porto , Porto , Portugal
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Widerström-Noga E, Govind V, Adcock JP, Levin BE, Maudsley AA. Subacute Pain after Traumatic Brain Injury Is Associated with Lower Insular N-Acetylaspartate Concentrations. J Neurotrauma 2016; 33:1380-9. [PMID: 26486760 DOI: 10.1089/neu.2015.4098] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Persistent pain is experienced by more than 50% of persons who sustain a traumatic brain injury (TBI), and more than 30% experience significant pain as early as 6 weeks after injury. Although neuropathic pain is a common consequence after CNS injuries, little attention has been given to neuropathic pain symptoms after TBI. Magnetic resonance spectroscopy (MRS) studies in subjects with TBI show decreased brain concentrations of N-acetylaspartate (NAA), a marker of neuronal density and viability. Although decreased brain NAA has been associated with neuropathic pain associated with spinal cord injury (SCI) and diabetes, this relationship has not been examined after TBI. The primary purpose of this study was to test the hypothesis that lower NAA concentrations in brain areas involved in pain perception and modulation would be associated with greater severity of neuropathic pain symptoms. Participants with TBI underwent volumetric MRS, pain and psychosocial interviews. Cluster analysis of the Neuropathic Pain Symptom Inventory subscores resulted in two TBI subgroups: The Moderate Neuropathic Pain (n = 17; 37.8%), with significantly (p = 0.038) lower insular NAA than the Low or no Neuropathic Pain group (n = 28; 62.2%), or age- and sex-matched controls (n = 45; p < 0.001). A hierarchical linear regression analysis controlling for age, sex, and time post-TBI showed that pain severity was significantly (F = 11.0; p < 0.001) predicted by a combination of lower insular NAA/Creatine (p < 0.001), lower right insular gray matter fractional volume (p < 0.001), female sex (p = 0.005), and older age (p = 0.039). These findings suggest that neuronal dysfunction in brain areas involved in pain processing is associated with pain after TBI.
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Affiliation(s)
- Eva Widerström-Noga
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida.,2 Department of Neurological Surgery, University of Miami Miller School of Medicine , Miami, Florida.,3 Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine , Miami, Florida
| | - Varan Govind
- 4 Department of Radiology, University of Miami Miller School of Medicine , Miami, Florida
| | - James P Adcock
- 1 The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, Florida
| | - Bonnie E Levin
- 5 Department of Neurology, University of Miami Miller School of Medicine , Miami, Florida
| | - Andrew A Maudsley
- 4 Department of Radiology, University of Miami Miller School of Medicine , Miami, Florida
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Peak NJ, Overholser JC, Ridley J, Braden A, Fisher L, Bixler J, Chandler M. Too Much to Bear: Psychometric Evidence Supporting the Perceived Burdensomeness Scale. CRISIS 2015; 37:59-67. [PMID: 26620916 DOI: 10.1027/0227-5910/a000355] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND People who feel they have become a burden on others may become susceptible to suicidal ideation. When people no longer feel capable or productive, they may assume that friends and family members would be better off without them. AIM The present study was designed to assess preliminary psychometric properties of a new measure, the Perceived Burdensomeness (PBS) Scale. METHOD Depressed psychiatric patients (N = 173) were recruited from a veterans affairs medical center. Patients were assessed with a structured diagnostic interview and self-report measures assessing perceived burdensomeness, depression severity, hopelessness, and suicidal ideation. RESULTS The present study supported preliminary evidence of reliability and concurrent validity of the PBS. Additionally, perceived burdensomeness was significantly associated with higher levels of hopelessness and suicidal ideation. CONCLUSION It is hoped that with the aid of the PBS clinicians may be able to intervene more specifically in the treatment of suicidality.
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Affiliation(s)
- Nicole J Peak
- 3 School of Professional Psychology, University of the Rockies, Colorado Springs, CO, USA
| | - James C Overholser
- 1 Department of Psychology, Case Western Reserve University, Cleveland, OH, USA
| | | | - Abby Braden
- 4 Center for Healthy Eating and Activity Research, University of California, San Diego, CA, USA
| | - Lauren Fisher
- 5 Depression Clinical and Research Program, Department of Psychiatry Massachusetts, General Hospital, Boston, MA, USA
| | - James Bixler
- 6 Counseling and Psychological Services, Frostburg State University, MD, USA
| | - Megan Chandler
- 7 The Sexual Responsibility and Treatment Program, Torrance State Hospital, Derry, PA, USA
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Prakash J, Srivastava K, Manandhar P, Saha A. Evaluation of nonmemory cognitive parameters in psychiatric patients' pre- and post-electroconvulsive therapy: An observational study. Ind Psychiatry J 2015; 24:206-9. [PMID: 27212831 PMCID: PMC4866354 DOI: 10.4103/0972-6748.181723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Possibility of cognitive side effects has made electroconvulsive therapy (ECT) questionable. Variable deficits have been debated in memory cognition. Pattern of changes in nonmemory cognition pre- and post-ECT is not clear. METHODOLOGY Forty patients undergoing ECT were studied on nonmemory cognitive parameters before ECT, after a course of ECT, and after 4 weeks of last. ECT. RESULTS Nonmemory cognition improved during the course of ECT and over 4 weeks of ECT. CONCLUSIONS ECT does not affect the nonmemory cognition adversely.
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Affiliation(s)
- Jyoti Prakash
- Department of Psychiatry, Command Hospital Eastern Command, Kolkata, West Bengal, India
| | - Kalpana Srivastava
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Pradeep Manandhar
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Amitabh Saha
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
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Carriere JS, Thibault P, Sullivan MJL. The Mediating Role of Recovery Expectancies on the Relation Between Depression and Return-to-Work. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:348-56. [PMID: 25252609 DOI: 10.1007/s10926-014-9543-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE Depressive symptoms have been identified as a significant risk factor for prolonged disability, however, little is known about the process by which depression impacts recovery following work-related musculoskeletal disorders (WRMDs). The primary objective of this study was to examine whether recovery expectancies mediate the relation between depression and return-to-work (RTW) status in individuals with WRMDs. METHODS A sample of 109 patients with WRMDs were recruited from 1 of 6 primary care physiotherapy clinics. Participants completed measures of pain severity, depression and recovery expectancies. RTW status was assessed by telephone interview 1 year after the initial assessment. RESULTS Consistent with previous research, more severe depressive symptoms and lower recovery expectancies were associated with a lower probability of RTW. Logistic regression analyses revealed that recovery expectancies completely mediated the relation between depression and RTW status at 1-year follow-up. CONCLUSION The results suggest that interventions specifically targeting recovery expectancies in individuals with WRMDs and depressive symptoms might improve RTW outcomes.
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Affiliation(s)
- Junie S Carriere
- Department of Psychology, McGill University, 1205 Dr. Penfield, Montreal, QC, H3A 1B1, Canada
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Compas BE, Forehand R, Thigpen J, Hardcastle E, Garai E, McKee L, Keller G, Dunbar JP, Watson KH, Rakow A, Bettis A, Reising M, Cole D, Sterba S. Efficacy and moderators of a family group cognitive-behavioral preventive intervention for children of parents with depression. J Consult Clin Psychol 2015; 83:541-53. [PMID: 26009786 PMCID: PMC4445475 DOI: 10.1037/a0039053] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Building on an earlier study (Compas, Forehand, Thigpen, et al., 2011), tests of main effects and potential moderators of a family group cognitive-behavioral (FGCB) preventive intervention for children of parents with a history of depression are reported. METHOD Assessed a sample of 180 families (242 children ages 9-15 years) in a randomized controlled trial assessed at 2, 6, 12, 18 and 24 months after baseline. RESULTS Significant effects favoring the FGCB intervention over a written information comparison condition were found on measures of children's symptoms of depression, mixed anxiety/depression, internalizing problems, and externalizing problems, with multiple effects maintained at 18 and 24 months, and on incidence of child episodes of major depressive disorder over the 24 months. Effects were stronger for child self-reports than for parent reports. Minimal evidence was found for child age, child gender, parental education, parental depressive symptoms, or presence of a current parental depressive episode at baseline as moderators of the FGCB intervention. CONCLUSIONS The findings provide support for sustained and robust effects of this preventive intervention.
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Affiliation(s)
| | | | | | | | - Emily Garai
- University of Vermont
- Atlanta Psychological Services
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Lopes RT, Gonçalves MM, Fassnacht DB, Machado PPP, Sousa I. Long-term effects of psychotherapy on moderate depression: a comparative study of narrative therapy and cognitive-behavioral therapy. J Affect Disord 2015; 167:64-73. [PMID: 25082116 DOI: 10.1016/j.jad.2014.05.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 05/23/2014] [Accepted: 05/24/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND In a previous clinical controlled trial (Lopes et al., 2014), narrative therapy (NT) showed promising results in ameliorating depressive symptoms with comparable outcomes to cognitive-behavioral therapy (CBT) when patients completed treatment. This paper aims to assess depressive symptoms and interpersonal problems in this clinical sample at follow-up. METHODS Using the Beck Depression Inventory-II and Outcome Questionnaire-45.2 Interpersonal Relations Scale, naturalistic prospective follow-up assessment was conducted at 21 and 31 months after the last treatment session. RESULTS At follow-up, patients kept improving in terms of depressive symptoms and interpersonal problems. The odds that a patient maintained recovery from depressive symptoms at follow-up were five times higher than the odds that a patient maintained recovery from interpersonal problems. In the same way, the odds of a patient never recovering from interpersonal problems were five times higher than the odds of never recovering from depressive symptoms. LIMITATIONS The study did not control for the natural course of depression or treatment continuation. CONCLUSIONS For depressed patients with greater interpersonal disabilities, longer treatment plans and alternative continuation treatments should be considered.
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Affiliation(s)
- Rodrigo T Lopes
- School of Psychology, University of Minho, 4710-057 Braga, Portugal
| | | | | | | | - Inês Sousa
- Department of Mathematics and Applications, University of Minho, Portugal
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Gonçalves MM, Ribeiro AP, Silva JR, Mendes I, Sousa I. Narrative innovations predict symptom improvement: Studying innovative moments in narrative therapy of depression. Psychother Res 2015; 26:425-35. [PMID: 25968420 DOI: 10.1080/10503307.2015.1035355] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Innovative moments (IMs) are moments in the therapeutic dialog that constitute exceptions toward the client's problems. These narrative markers of meaning transformation are associated with change in different models of therapy and diverse diagnoses. Our goal is to test if IMs precede symptoms change, or, on the contrary, are a mere consequence of symptomatic 15 change. METHOD For this purpose, IMs and symptomatology (Outcome Questionnaire-10.2) were assessed at every session in a sample of 10 cases of narrative therapy for depression. Hierarchical linear modeling was conducted to explore whether (i) IMs in a given session predict patients' symptoms in the following session and/or (ii) symptoms in a given session predict IMs in the next session. RESULTS Results suggested that IMs are better predictors of symptoms than the reverse. CONCLUSIONS These results are discussed considering the contribution of meanings and narrative processes' changes to symptomatic improvement.
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Affiliation(s)
- Miguel M Gonçalves
- a CIPsi - Psychology Research Center, Psychotherapy and Psychopathology, Research Unit, School of Psychology , University of Minho , Braga , Portugal
| | - AntÓnio P Ribeiro
- a CIPsi - Psychology Research Center, Psychotherapy and Psychopathology, Research Unit, School of Psychology , University of Minho , Braga , Portugal
| | - Joana R Silva
- a CIPsi - Psychology Research Center, Psychotherapy and Psychopathology, Research Unit, School of Psychology , University of Minho , Braga , Portugal
| | - InÊs Mendes
- a CIPsi - Psychology Research Center, Psychotherapy and Psychopathology, Research Unit, School of Psychology , University of Minho , Braga , Portugal.,b ISMAI , Avioso São Pedro , Portugal
| | - Inês Sousa
- c Department of Mathematics and Applications , University of Minho , Braga , Portugal
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Ribeiro AP, Gonçalves MM, Silva JR, Brás A, Sousa I. Ambivalence in Narrative Therapy: A Comparison Between Recovered and Unchanged Cases. Clin Psychol Psychother 2015; 23:166-75. [PMID: 25808359 DOI: 10.1002/cpp.1945] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/16/2015] [Accepted: 01/16/2015] [Indexed: 11/11/2022]
Abstract
UNLABELLED Research on the identification of poor outcome predictors is crucial for the prevention of therapeutic failure. Previous research suggests that clients' persistent ambivalence is one possible path to unsuccessful psychotherapy. The present study analyses ambivalence--here operationalized as return-to-the-problem markers (RPMs)--in five recovered and five unchanged cases of narrative psychotherapy for major depression. The results suggest that both recovered and unchanged cases presented a similar proportion of RPMs at baseline and a decreasing pattern of these ambivalence markers throughout therapy. However, the decreasing was more accentuated in recovered than in unchanged cases, and at the end of the treatment, the proportion of RPMs of the unchanged cases was significantly higher. The results are discussed in light of previous research on ambivalence in psychotherapy, focusing on the meaning of ambivalence and its clinical implications. KEY PRACTITIONER MESSAGE Ambivalence towards change, here operationalized as RPMs, seems to be a common process in both recovered and unchanged cases, perhaps signalling the uncertainty and anxiety that change may elicit. Although the number of RPMs decreased in both the recovered and unchanged cases, this reduction was significantly higher in the recovered group. Moreover, at the end of therapy, the recovered group revealed a significantly lower proportion of RPMs than the unchanged group, suggesting that ambivalence resolution (or lack thereof) may play a determining role in the therapy's evolution and outcome. RPMs in later stages of therapy may be operationalized as 'red flags' for the therapist to acknowledge the client's stuckness and adapt his or her intervention efforts, turning these instances into developmental opportunities.
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Affiliation(s)
- António P Ribeiro
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Miguel M Gonçalves
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Joana R Silva
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Andreia Brás
- CIPsi - Psychology Research Center, Psychotherapy and Psychopathology Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Ines Sousa
- Department of Mathematics and Applications, University of Minho, Braga, Portugal
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Wang GL, Wang L, Wang YL, Li ML. Risk factors for sexual dysfunction among Chinese women with type 2 diabetes. Int J Diabetes Dev Ctries 2014. [DOI: 10.1007/s13410-014-0241-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Satre DD, Leibowitz AS, Mertens JR, Weisner C. Advising depression patients to reduce alcohol and drug use: factors associated with provider intervention in outpatient psychiatry. Am J Addict 2014; 23:570-5. [PMID: 25164533 DOI: 10.1111/j.1521-0391.2014.12140.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 03/07/2014] [Accepted: 04/12/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Mental health clinicians have an important opportunity to help depression patients reduce co-occurring alcohol and drug use. This study examined demographic and clinical patient characteristics and service factors associated with receiving a recommendation to reduce alcohol and drug use from providers in a university-based outpatient psychiatry clinic. METHODS The sample consisted of 97 participants ages 18 and older who reported hazardous drinking (≥3 drinks/occasion), illegal drug use (primarily cannabis) or misuse of prescription drugs, and who scored ≥15 on the Beck Depression Inventory-II (BDI-II). Participants were interviewed at intake and 6 months. RESULTS At 6-month telephone interview, 30% of participants reported that a clinic provider had recommended that they reduce alcohol or drug use. In logistic regression, factors associated with receiving advice to reduce use included greater number of drinks consumed in the 30 days prior to intake (p = .035); and greater depression severity on the BDI-II (p = .096) and hazardous drinking at 6 months (p = .05). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE While participants with greater alcohol intake and depression symptom severity were more likely to receive advice to reduce use, the low overall rate of recommendation to reduce use highlights the need to improve alcohol and drug use intervention among depression patients, and potentially to address alcohol and drug training and treatment implementation issues among mental health providers.
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Affiliation(s)
- Derek D Satre
- Department of Psychiatry, University of California at San Francisco, San Francisco, California; Division of Research, Kaiser Permanente Northern California Region, Oakland, California
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Birnbaum-Weitzman O, Goldberg R, Hurwitz BE, Llabre MM, Gellman MD, Gutt M, McCalla JR, Mendez AJ, Schneiderman N. Depressive symptoms linked to 1-h plasma glucose concentrations during the oral glucose tolerance test in men and women with the metabolic syndrome. Diabet Med 2014; 31:630-6. [PMID: 24344735 PMCID: PMC3988212 DOI: 10.1111/dme.12356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 08/25/2013] [Accepted: 10/26/2013] [Indexed: 11/29/2022]
Abstract
AIMS The addition of the 1-h plasma glucose concentration measure from an oral glucose tolerance test to prediction models of future Type 2 diabetes has shown to significantly strengthen their predictive power. The present study examined the relationship between severity of depressive symptoms and hyperglycaemia, focusing on the 1-h glucose concentration vs. fasting and 2-h glucose measures from the oral glucose tolerance test. METHODS Participants included 140 adults with the metabolic syndrome and without diabetes who completed a baseline psychobiological assessment and a 2-h oral glucose tolerance test, with measurements taken every 30 min. Depressive symptoms were assessed using the Beck Depression Inventory. RESULTS Multivariate linear regression revealed that higher levels of depressive symptoms were associated with higher levels of 1-h plasma glucose concentrations after adjusting for age, gender, ethnicity, BMI, antidepressant use and high-sensitivity C-reactive protein. Results were maintained after controlling for fasting glucose as well as for indices of insulin resistance and secretion. Neither fasting nor 2-h plasma glucose concentrations were significantly associated with depressive symptoms. CONCLUSIONS Elevated depressive symptoms in persons with the metabolic syndrome were associated with greater glycaemic excursion 1-h following a glucose load that was not accounted for by differences in insulin secretory function or insulin sensitivity. Consistent with previous findings, this study highlights the value of the 1-h plasma glucose measurement from the oral glucose tolerance test in the relation between depressive symptoms and glucose metabolism as an indicator of metabolic abnormalities not visible when focusing on fasting and 2-h post-oral glucose tolerance test measurements alone.
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Affiliation(s)
- O Birnbaum-Weitzman
- Behavioral Medicine Research Center, University of Miami, Miami, FL, USA; Department of Psychology, University of Miami, Miami, FL, USA
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Hecimovic H, Santos J, Price JL, Sheline YI, Mintun MA, Snyder AZ, Christensen JJ, Carter J, Vahle V, Gilliam FG. Severe hippocampal atrophy is not associated with depression in temporal lobe epilepsy. Epilepsy Behav 2014; 34:9-14. [PMID: 24667480 PMCID: PMC4009341 DOI: 10.1016/j.yebeh.2014.02.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 02/19/2014] [Accepted: 02/27/2014] [Indexed: 11/19/2022]
Abstract
Depression in temporal lobe epilepsy (TLE) is common, is a strong predictor of subjective disability, and may have unique pathophysiological characteristics. Previous studies showed that reduced hippocampal volume is associated with significant depressive symptoms in patients with TLE. We utilized regions of interest analysis of high-resolution brain MRI and a reliable and valid measure of depressive symptoms to evaluate 28 consecutive adult subjects with video-EEG-confirmed TLE. Regions of interest were based on prior human and animal studies of mood and behavioral dysfunction. Forty-three percent of the entire group had significant symptoms of depression, defined by a Beck Depression Inventory (BDI) score of greater than 15. Total hippocampal volumes were significantly smaller in the group with BDI<15, (p<0.007). None of the subjects in the quartile with the smallest left hippocampal volume had a BDI score greater than 15 compared with 57% of the subjects in the upper three quartiles (p<0.008). No other limbic brain structures (amygdala, subcallosal gyrus, subgenual gyrus, gyrus rectus), or total cerebral volume were associated with depressive symptoms. Adequate hippocampal integrity may be necessary to maintain depression symptoms in mesial temporal lobe epilepsy. This finding also supports the possibility of a unique mechanism for depression in mesial temporal lobe epilepsy, such as hyperexcitable neuronal influence on the limbic network.
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Affiliation(s)
| | - Juan Santos
- Departamento de Psiquiatría, Universidad Maimónides, Buenos Aires, Argentina
| | - Joseph L Price
- Department of Anatomy and Neurobiology, Washington University, St. Louis, MO, USA
| | - Yvette I Sheline
- Department of Neurology, Washington University, St. Louis, MO, USA; Department of Psychiatry, Washington University, St. Louis, MO, USA; Department of Radiology, Washington University, St. Louis, MO, USA
| | - Mark A Mintun
- Department of Psychiatry, Washington University, St. Louis, MO, USA; Department of Radiology, Washington University, St. Louis, MO, USA
| | - Abraham Z Snyder
- Department of Radiology, Washington University, St. Louis, MO, USA
| | | | - Jewell Carter
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Victoria Vahle
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Frank G Gilliam
- Department of Neurology, Penn State University, Hershey, PA, USA
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Lopes RT, Gonçalves MM, Machado PPP, Sinai D, Bento T, Salgado J. Narrative therapy vs. cognitive-behavioral therapy for moderate depression: empirical evidence from a controlled clinical trial. Psychother Res 2014; 24:662-74. [PMID: 24479576 DOI: 10.1080/10503307.2013.874052] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Systematic studies of the efficacy of Narrative Therapy (NT) for depression are sparse. OBJECTIVE To evaluate the efficacy of individual NT for moderate depression in adults compared to Cognitive-Behavioral Therapy (CBT). METHOD Sixty-three depressed clients were assigned to either NT or CBT. The Beck Depression Inventory-II (BDI-II) and Outcome Questionnaire-45.2 (OQ-45.2) were used as outcome measures. RESULTS We found a significant symptomatic reduction in both treatments. Group differences favoring CBT were found on the BDI-II, but not on the OQ-45.2. CONCLUSIONS Pre- to post-treatment effect sizes for completers in both groups were superior to benchmarked waiting-list control groups.
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Affiliation(s)
- Rodrigo T Lopes
- a School of Psychology , University of Minho , Braga , Portugal
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Yaseen ZS, Kopeykina I, Gutkovich Z, Bassirnia A, Cohen LJ, Galynker II. Predictive validity of the Suicide Trigger Scale (STS-3) for post-discharge suicide attempt in high-risk psychiatric inpatients. PLoS One 2014; 9:e86768. [PMID: 24466229 PMCID: PMC3897755 DOI: 10.1371/journal.pone.0086768] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 12/17/2013] [Indexed: 11/19/2022] Open
Abstract
Background The greatly increased risk of suicide after psychiatric hospitalization is a critical problem, yet we are unable to identify individuals who would attempt suicide upon discharge. The Suicide Trigger Scale v.3 (STS-3), was designed to measure the construct of an affective ‘suicide trigger state’ hypothesized to precede a suicide attempt (SA). This study aims to test the predictive validity of the STS-3 for post-discharge SA on a high-risk psychiatric-inpatient sample. Methods The STS-3, and a psychological test battery measuring suicidality, mood, impulsivity, trauma history, and attachment style were administered to 161 adult psychiatric patients hospitalized following suicidal ideation (SI) or SA. Receiver Operator Characteristic and logistic regression analyses were used to assess prediction of SA in the 6-month period following discharge from hospitalization. Results STS-3 scores for the patients who made post-discharge SA followed a bimodal distribution skewed to high and low scores, thus a distance from median transform was applied to the scores. The transformed score was a significant predictor of post-discharge SA (AUC 0.731), and a subset of six STS-3 scale items was identified that produced improved prediction of post-discharge SA (AUC 0.814). Scores on C-SSRS and BSS were not predictive. Patients with ultra-high (90th percentile) STS-3 scores differed significantly from ultra-low (10th percentile) scorers on measures of affective intensity, depression, impulsiveness, abuse history, and attachment security. Conclusion STS-3 transformed scores at admission to the psychiatric hospital predict suicide attempts following discharge among the high-risk group of suicidal inpatients. Patients with high transformed scores appear to comprise two clinically distinct groups; an impulsive, affectively intense, fearfully attached group with high raw STS-3 scores and a low-impulsivity, low affect and low trauma-reporting group with low raw STS-3 scores. These groups may correspond to low-plan and planned suicide attempts, respectively, but this remains to be established by future research.
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Affiliation(s)
- Zimri S. Yaseen
- Beth Israel Medical Center, New York, New York, United States of America
- * E-mail:
| | - Irina Kopeykina
- Beth Israel Medical Center, New York, New York, United States of America
| | - Zinoviy Gutkovich
- St. Luke's Roosevelt Hospital, New York, New York, United States of America
| | - Anahita Bassirnia
- Beth Israel Medical Center, New York, New York, United States of America
| | - Lisa J. Cohen
- Beth Israel Medical Center, New York, New York, United States of America
| | - Igor I. Galynker
- Beth Israel Medical Center, New York, New York, United States of America
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Schoedel KA, Morrow SA, Sellers EM. Evaluating the safety and efficacy of dextromethorphan/quinidine in the treatment of pseudobulbar affect. Neuropsychiatr Dis Treat 2014; 10:1161-74. [PMID: 25061302 PMCID: PMC4079824 DOI: 10.2147/ndt.s30713] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Pseudobulbar affect (PBA) is a common manifestation of brain pathology associated with many neurological diseases, including amyotrophic lateral sclerosis, Alzheimer's disease, stroke, multiple sclerosis, Parkinson's disease, and traumatic brain injury. PBA is defined by involuntary and uncontrollable expressed emotion that is exaggerated and inappropriate, and also incongruent with the underlying emotional state. Dextromethorphan/quinidine (DM/Q) is a combination product indicated for the treatment of PBA. The quinidine component of DM/Q inhibits the cytochrome P450 2D6-mediated metabolic conversion of dextromethorphan to its active metabolite dextrorphan, thereby increasing dextromethorphan systemic bioavailability and driving the pharmacology toward that of the parent drug and away from adverse effects of the dextrorphan metabolite. Three published efficacy and safety studies support the use of DM/Q in the treatment of PBA; significant effects were seen on the primary end point, the Center for Neurologic Study-Lability Scale, as well as secondary efficacy end points and quality of life. While concentration-effect relationships appear relatively weak for efficacy parameters, concentrations of DM/Q may have an impact on safety. Some special safety concerns exist with DM/Q, primarily because of the drug interaction and QT prolongation potential of the quinidine component. However, because concentrations of dextrorphan (which is responsible for many of the parent drug's side effects) and quinidine are lower than those observed in clinical practice with these drugs administered alone, some of the perceived safety issues may not be as relevant with this low dose combination product. However, since patients with PBA have a variety of other medical problems and are on numerous other medications, they may not tolerate DM/Q adverse effects, or may be at risk for drug interactions. Some caution is warranted when initiating DM/Q treatment, particularly in patients with underlying risk factors for torsade de pointes and in those receiving medications that may interact with DM/Q.
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Affiliation(s)
| | | | - Edward M Sellers
- DL Global Partners, Inc., Toronto, Canada ; University of Toronto, Toronto, Ontario, Canada
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Shinohara K, Honyashiki M, Imai H, Hunot V, Caldwell DM, Davies P, Moore THM, Furukawa TA, Churchill R. Behavioural therapies versus other psychological therapies for depression. Cochrane Database Syst Rev 2013; 2013:CD008696. [PMID: 24129886 PMCID: PMC7433301 DOI: 10.1002/14651858.cd008696.pub2] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Behavioural therapies represent one of several categories of psychological therapies that are currently used in the treatment of depression. However, the effectiveness and acceptability of behavioural therapies for depression compared with other psychological therapies remain unclear. OBJECTIVES 1. To examine the effects of all BT approaches compared with all other psychological therapy approaches for acute depression.2. To examine the effects of different BT approaches (behavioural therapy, behavioural activation, social skills training and relaxation training) compared with all other psychological therapy approaches for acute depression.3. To examine the effects of all BT approaches compared with different psychological therapy approaches (CBT, third wave CBT, psychodynamic, humanistic and integrative psychological therapies) for acute depression. SEARCH METHODS We searched the Cochrane Depression Anxiety and Neurosis Group Trials Specialised Register (CCDANCTR, 31/07/2013), which includes relevant randomised controlled trials from The Cochrane Library (all years), EMBASE, (1974-), MEDLINE (1950-) and PsycINFO (1967-). We also searched CINAHL (May 2010) and PSYNDEX (June 2010) and reference lists of the included studies and relevant reviews for additional published and unpublished studies. SELECTION CRITERIA Randomised controlled trials that compared behavioural therapies with other psychological therapies for acute depression in adults. DATA COLLECTION AND ANALYSIS Two or more review authors independently identified studies, assessed trial quality and extracted data. We contacted study authors for additional information. MAIN RESULTS Twenty-five trials involving 955 participants compared behavioural therapies with one or more of five other major categories of psychological therapies (cognitive-behavioural, third wave cognitive-behavioural, psychodynamic, humanistic and integrative therapies). Most studies had a small sample size and were assessed as being at unclear or high risk of bias. Compared with all other psychological therapies together, behavioural therapies showed no significant difference in response rate (18 studies, 690 participants, risk ratio (RR) 0.97, 95% confidence interval (CI) 0.86 to 1.09) or in acceptability (15 studies, 495 participants, RR of total dropout rate 1.02, 95% CI 0.65 to 1.61). Similarly, in comparison with each of the other classes of psychological therapies, low-quality evidence showed better response to cognitive-behavioural therapies than to behavioural therapies (15 studies, 544 participants, RR 0.93, 95% CI 0.83 to 1.05) and low-quality evidence of better response to behavioural therapies over psychodynamic therapies (2 studies, 110 participants, RR 1.24, 95% CI 0.84 to 1.82).When compared with integrative therapies and humanistic therapies, only one study was included in each comparison, and the analysis showed no significant difference between behavioural therapies and integrative or humanistic therapies. AUTHORS' CONCLUSIONS We found low- to moderate-quality evidence that behavioural therapies and other psychological therapies are equally effective. The current evidence base that evaluates the relative benefits and harms of behavioural therapies is very weak. This limits our confidence in both the size of the effect and its precision for our key outcomes related to response and withdrawal. Studies recruiting larger samples with improved reporting of design and fidelity to treatment would improve the quality of evidence in this review.
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Affiliation(s)
- Kiyomi Shinohara
- Kyoto University Graduate School of Medicine / School of Public HealthDepartment of Health Promotion and Human BehaviorYoshida Konoe‐cho, Sakyo‐kuKyotoJapan601‐8501
| | - Mina Honyashiki
- Kyoto University Graduate School of Medicine / School of Public HealthDepartment of Health Promotion and Human BehaviorYoshida Konoe‐cho, Sakyo‐kuKyotoJapan601‐8501
| | - Hissei Imai
- Kyoto University Graduate School of Medicine / School of Public HealthDepartment of Field MedicineKyotoJapan
| | - Vivien Hunot
- University of BristolCentre for Academic Mental Health, School of Social and Community MedicineOakfield HouseOakfield GroveBristolAvonUKBS8 2BN
| | - Deborah M Caldwell
- University of BristolSchool of Social and Community MedicineCanynge Hall, 39 Whatley RoadBristolAvonUKBS8 2PS
| | - Philippa Davies
- University of BristolSchool of Social and Community MedicineCanynge Hall, 39 Whatley RoadBristolAvonUKBS8 2PS
| | - Theresa HM Moore
- University of BristolSchool of Social and Community MedicineCanynge Hall, 39 Whatley RoadBristolAvonUKBS8 2PS
| | - Toshi A Furukawa
- Kyoto University Graduate School of Medicine / School of Public HealthDepartments of Health Promotion and Behavior Change and of Clinical EpidemiologyYoshida Konoe‐cho, Sakyo‐ku,KyotoJapan601‐8501
| | - Rachel Churchill
- University of BristolCentre for Academic Mental Health, School of Social and Community MedicineOakfield HouseOakfield GroveBristolAvonUKBS8 2BN
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Thorndike FP, Ritterband LM, Gonder-Frederick LA, Lord HR, Ingersoll KS, Morin CM. A randomized controlled trial of an internet intervention for adults with insomnia: effects on comorbid psychological and fatigue symptoms. J Clin Psychol 2013; 69:1078-93. [PMID: 24014057 DOI: 10.1002/jclp.22032] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Insomnia is frequently comorbid with other medical and psychological disorders. This secondary data analysis investigated whether an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) intervention could also reduce comorbid psychological and fatigue symptoms. METHOD Data from a pilot randomized controlled trial (RCT) testing the efficacy of Internet-delivered CBT-I relative to a waitlist control was used to examine changes in symptoms of depression, anxiety, mental health quality of life (QOL), and fatigue. RESULTS Group by time interactions from repeated measures analyses revealed significant post intervention improvements in Internet participants (n = 22) relative to control participants (n = 22) on all psychological symptoms, mental health QOL, and fatigue. A small post hoc subsample of Internet participants with mild or moderate depression also showed large effect size changes in these constructs (depression, anxiety, mental health QOL, and fatigue). CONCLUSION Internet-delivered CBT-I appears to not only improve sleep but also reduce comorbid psychological and fatigue symptoms.
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Alves D, Fernández-Navarro P, Baptista J, Ribeiro E, Sousa I, Gonçalves MM. Innovative moments in grief therapy: The meaning reconstruction approach and the processes of self-narrative transformation. Psychother Res 2013; 24:25-41. [PMID: 23885786 DOI: 10.1080/10503307.2013.814927] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Fond G, Bayard S, Capdevielle D, Del-Monte J, Mimoun N, Macgregor A, Boulenger JP, Gely-Nargeot MC, Raffard S. A further evaluation of decision-making under risk and under ambiguity in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2013; 263:249-57. [PMID: 22639243 DOI: 10.1007/s00406-012-0330-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 05/12/2012] [Indexed: 12/01/2022]
Abstract
Abnormal decision-making has been described as a key-concept to understand some behavioral disturbances in schizophrenia. However, whether schizophrenia patients display impairments in profitable decision-making on experimental designs is still controversial (1) to assess performance on decision-making paradigms under ambiguity and under risk conditions in a large sample of schizophrenia patients and (2) to study the impact of clinical variables on decision-making performance in schizophrenia. The Iowa gambling task (IGT) and the game of dice task (GDT) were administered to assess, respectively, decision-making under ambiguity and under risk in 63 schizophrenia patients and 67 healthy controls. In addition, clinical variables (e.g., schizophrenic symptoms, self-reported depression, and impulsivity) were evaluated using appropriate questionnaires the same day. Pharmacological treatments were reported. Schizophrenia patients had impaired performances on both IGT and GDT tasks. No correlation between the decision-making tasks performance and clinical variables was found. Lower gains on the GDT were associated with executive dysfunctioning in schizophrenia. These findings give evidence that schizophrenia patients display impairments in both decision-making under ambiguity and under risk.
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Satre DD, Delucchi K, Lichtmacher J, Sterling SA, Weisner C. Motivational interviewing to reduce hazardous drinking and drug use among depression patients. J Subst Abuse Treat 2013; 44:323-9. [PMID: 22999815 PMCID: PMC3659173 DOI: 10.1016/j.jsat.2012.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 07/12/2012] [Accepted: 08/08/2012] [Indexed: 11/20/2022]
Abstract
This randomized study examined the efficacy of motivational interviewing (MI) to reduce substance use among adults with depression in outpatient psychiatry. The sample consisted of 104 participants ages 18 and over who reported hazardous drinking (three drinks or more per occasion), illegal drug use or misuse of prescription drugs in the prior 30 days, and who scored ≥ 15 on the Beck Depression Inventory-II (BDI-II). Participants were randomized to receive either three sessions of MI or printed literature about alcohol and drug use risks, as an adjunct to usual outpatient depression care, and completed telephone follow-up interviews at 3 and 6 months (93 and 99% of the baseline sample, respectively). Among participants reporting any hazardous drinking at baseline (n=73), MI-treated participants were less likely than controls to report hazardous drinking at 3 months (60.0 vs. 81.8%, p=.043). MI is a promising intervention to reduce hazardous drinking among depression patients.
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Affiliation(s)
- Derek D Satre
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, Box 0984, San Francisco, CA 94143, USA.
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Fathers with PTSD and depression in pregnancies complicated by preterm preeclampsia or PPROM. Arch Gynecol Obstet 2012. [DOI: 10.1007/s00404-012-2611-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Recovery from depressive symptoms over the course of physical therapy: a prospective cohort study of individuals with work-related orthopaedic injuries and symptoms of depression. J Orthop Sports Phys Ther 2012; 42:957-67. [PMID: 22711267 DOI: 10.2519/jospt.2012.4182] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Prospective cohort. OBJECTIVES (1) To determine the trajectory of depressive symptoms over the course of physical therapy, (2) to identify variables that best predict the resolution of depressive symptoms, and (3) to explore the relationship between recovery from depressive symptoms and long-term outcomes. BACKGROUND Twenty-five percent to 50% of patients referred to physical therapy for orthopaedic injuries suffer from symptoms of depression. Depressive symptoms have been identified as an influential risk factor for problematic response to physical therapy. Despite these findings, there is a dearth of research specifically exploring the trajectory and determinants of patients' depressive symptoms over the course of physical therapy, which has impeded the evidence-based management of patients with depressive symptoms. METHODS One hundred six patients with work-related musculoskeletal injuries and symptoms of depression received 7 weeks of physical therapy and were followed 1 year after treatment onset. Pain intensity, depressive symptoms, and other psychosocial factors were evaluated throughout treatment, and data were collected at 1-year follow-up. RESULTS Depressive symptoms resolved in 40% of patients, and resolution was linked to pain and disability at 1-year follow-up. Persistence of depressive symptoms at treatment completion was predicted by elevated levels of depressive symptoms and pain catastrophizing at pretreatment, and by lack of improvement in levels of depressive symptoms and pain self-efficacy at midtreatment. CONCLUSION For many patients, depressive symptoms resolve over the course of physical therapy, and resolution is associated with long-term improvements in pain and disability. These findings will help identify patients whose depressive symptoms are least likely to respond to physical therapy and may therefore warrant additional treatment.
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Ammerman RT, Shenk CE, Teeters AR, Noll JG, Putnam FW, Van Ginkel JB. Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation. JOURNAL OF CHILD AND FAMILY STUDIES 2012; 21:612-625. [PMID: 23710123 PMCID: PMC3660728 DOI: 10.1007/s10826-011-9513-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the impacts of maternal depression and childhood trauma on parenting in the context of home visitation. This study contrasted depressed and non-depressed mothers enrolled in the first year of a home visitation program on parenting stress, quality of home environment, social network, and psychiatric symptoms. Mothers were young, low income, and predominantly unmarried. Results indicated that depressed mothers displayed impairments in parenting, smaller and less robust social networks, and increased psychiatric symptoms relative to their non-depressed counterparts. Path analyses for the full sample revealed a path linking childhood trauma, depression, and parenting stress. Path analyses by group revealed several differential relationships between dimensions of social network and parenting. Number of embedded networks, namely the number of different domains in which the mother is actively interacting with others, was associated with lowered parenting stress among non-depressed mothers and increased parenting stress in their depressed counterparts with childhood trauma histories. In depressed mothers, social network size was associated with lower levels of parenting stress but decreased quality of the home environment, whereas number of embedded networks was positively related to quality of the home environment. Implications of findings for home visitation programs are discussed.
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Affiliation(s)
- Robert T Ammerman
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH 45229
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Buckner JD, Joiner TE, Schmidt NB, Zvolensky MJ. Daily marijuana use and suicidality: the unique impact of social anxiety. Addict Behav 2012; 37:387-92. [PMID: 22154236 PMCID: PMC3288149 DOI: 10.1016/j.addbeh.2011.11.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 09/21/2011] [Accepted: 11/16/2011] [Indexed: 10/15/2022]
Abstract
Despite a clear relationship between marijuana use and suicidality, little is known about psychological vulnerability factors that may interact with marijuana use to increase suicidality among this high-risk group. The present study examined the moderational impact of social anxiety on the relationship between marijuana use status (current users vs abstainers) and suicidality among 343 community adults. We also examined whether social anxiety moderated the relation between more frequent use (daily vs less frequent) among the 134 current marijuana users. Although social anxiety did not moderate the relation between use status and suicidality, it did moderate the relation between daily use status and suicidality after controlling for a wide range of relevant variables (e.g., demographics, depression, negative affect, and other types of anxiety). The overall model accounted for 59% of the variance in suicidality such that daily marijuana users with elevated social anxiety reported the highest suicidality. Findings highlight the importance of considering social anxiety in efforts to understand and prevent suicidality among this high-risk population.
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Affiliation(s)
- Julia D. Buckner
- Department of Psychology, Louisiana State University, Audubon Hall, Baton Rouge, LA 70803. Telephone: 1-225-578-4096; Fax: 1-225-578-4125
| | - Thomas E. Joiner
- Department of Psychology, Florida State University, 1107 W. Call Street Tallahassee, FL 32306-4301, Phone: 1-850-644-2040, Fax:1-850-644-7739
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, 1107 W. Call Street Tallahassee, FL 32306-4301, Phone: 1-850-644-2040, Fax:1-850-644-7739
| | - Michael J. Zvolensky
- Department of Psychology, University of Vermont. John Dewey Hall, Burlington, VT 05405-0134, Telephone: 1-802-656-3831; Fax: 1-802-656-8783
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